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Results

Verbal Autopsy with Participatory Action Research (VA-PAR): Developing a people-centred health systems research methodology. 25 Mar 2015

People-centred health systems (PCHS) is a recent progressive shift that has moved thinking beyond building-blocks models of health systems towards ones that centralise a human and relational nature. Despite the conceptual advance, empirical methods are lacking. The project seeks to develop methods for conducing and using Verbal Autopsy (VA) consistent with a PCHS approach by combining VA with Participatory Action Research (PAR) in a process connected to the health system at different levels. VA is a health surveillance technique that provides information on levels and causes of mortality in populations where deaths occur outside facilities and/or without registration. PAR is a process that aims to transform the roles of those participating from objects of research to active researchers and agents of change. It systematises local experience through collective analysis to generate valid forms of evidence on the relationships between health problems and their causes. Three phases of research are proposed. In Phase 1, we will conduct a secondary analysis of data gained through the application of the 2012 WHO VA standard in a Health and Demographic Surveillance Site (HDSS) in rural South Africa. Combing data on medical causes with new data on background characteristics of deaths, we will develop improved ways to classify causes in a method suitable for use at sub-district/district level. In Phase 2, local service users and providers will engage in a PAR process to review the results of Phase 1, set priorities for local services, and explore the potential for co-benefits related to empowerment and social inclusion. The final Phase 3 aims to consult at higher levels of the health system to consider how the method could be further applied and evaluated. The overall output is a practical and integrated methodology based on core standards that is contextually relevant and capable of affecting health gains by translating local priorities into actionable public health agendas.

Amount: £33,202
Funder: The Wellcome Trust
Recipient: University of Aberdeen

Open access award 2015/16. 21 Sep 2015

Not available

Amount: £36,560
Funder: The Wellcome Trust
Recipient: University of Exeter

Open access award 2015/16. 21 Sep 2015

Not available

Amount: £29,154
Funder: The Wellcome Trust
Recipient: University of Aberdeen

Do Beards Matter? Facial Hair, Health, Medicine and Masculinity in Britain, c. 1700-2014. 12 Jan 2015

The project explores the history of facial hair through time, and across different social and geographical spaces, Exploring individual British regions, as well as questions of beardedness at different social levels, it questions assumptions of elite hegemony and emulation that currently underpin existing historiography. It will recover the complex health/medical, cultural, scientific and intellectual changes that have affected views and styles of facial hair, as well as the extent to which bear ds have symbolised changing concepts of masculinity. Over the past three centuries facial hair has been closely bound with health. This study will chart various aspects from humoural views of facial hair to the beard as a visible index of health, and also its broader place within the shifting medical contexts of hair. This will include studies of medical remedies as well as the changing relationship between barbers and beards, including the eighteenth-century decline of the barber-surgeon and th e changing health and medical functions barbers undertook. It also explores the relationship between shaving technologies and the management of facial hair. Everything from cast steel to electric and disposable razors have made shaving easier, but this study interrogates the extent to which technologies directly influenced mens facial hair choices.

Amount: £163,785
Funder: The Wellcome Trust
Recipient: University of Exeter

Santorio Santorio and the Emergence of Quantifying Procedures in Medicine at the End of the Renaissance: Problems, Context, Ideas. 12 Jan 2015

While mechanics and astronomy have always been placed at the heart of the major narrative of the scientific revolution, historians are currently reconsidering disciplines or ways of thinking once regarded as peripheral, in particular medical disciplines such as anatomy and physiology. In this context, a study on the Italian physician Santorio Santorio (1561-1636) could be particularly noteworthy. Santorio is reputed to be the first to conceive and apply the quantification of the so called 'persp iratio insensibilis' in his major work 'Ars de statica medicina' (Venice 1614). Although developed in the context of traditional medicine, concepts such as 'weight', 'measurement' and 'certainty' became essential pillars of his thought and for this reason, Santorio invented many scientific devices, among which were the first graded thermometers. Despite his relevance, however, there are no recent studies on Santorio. The goal of my research would be to illustrate the medical impetus towards cont rolled experimentation and quantitative measurement in the cultural context of the end of the Renaissance. Considering Santorio's wide legacy across the Europe, the research would also show how the development of instruments has driven medicine in the late seventeenth and early eighteenth centuries.

Amount: £127,884
Funder: The Wellcome Trust
Recipient: University of Exeter

Putative gene regulatory functions of Csy1, a component of the CRISPR-Cas adaptive immune system, in the opportunistic pathogen Pseudomonas aeruginosa. 15 Sep 2015

It is becoming increasingly clear that CRISPR-Cas (Clustered Regularly Interspaced Short Palindromic Repeats; CRISPR associated) systems function beyond adaptive immunity. Preliminary data show that CRISPR-Cas deletion from Pseudomonas aeruginosa reduces both in vitro fitness and in vivo virulence. These phenotypes are caused by Csy1, a Cas protein thought to be involved in sequence-specific binding of the 5'-handle of crRNA. We hypothesise that Csy1 regulates expression of genes carrying sequen ce motifs similar to the 5'-handle. We will test this hypothesis by (1) transcriptome analysis of WT and Csy1 deletion mutants, (2) RIP-seq analysis of RNA co-purifying with Csy1 and (3) EMSA to measure sequence specificity of Csy1-RNA interactions. This project will reveal whether Csy1 of the P. aeruginosa CRISPR-Cas system is involved in a gene regulation function and will identify specific RNA motifs targeted by Csy1. If successful, the data from this seed project will serve as a basis for a full grant proposal aimed at (1) validating the Csy1-motif interactions in vivo (2) generalising Csy1-mediated gene regulation across P. aeruginosa strains and (3) testing the impact of Csy1 on P. aeruginosa virulence in other, more relevant, infection models, such as cell culture and thermally injured mouse infection models.

Amount: £99,981
Funder: The Wellcome Trust
Recipient: University of Exeter

Typhoid Fever: Novel Cellular Mechanisms driving Host Defense. 15 Sep 2015

Typhoid fever is caused by Salmonella enterica serovar Typhi (S. Typhi), a unique intracellular pathogen that can infect only humans. The molecular mechanisms underlying this host-specificity are still poorly understood. My research takes advantage of a powerful combination of cutting-edge experimental approaches to explore the host-pathogen molecular interface. Using these approaches I identified a novel trafficking pathway that blocks S. Typhi survival in macrophages from non-susceptible hosts , e.g. mice. This pathway, which depends on the Rab32 GTPase, is emerging as a general antimicrobial pathway critical for killing intracellular pathogens. The differences in this pathway between mice and humans likely underpin the successful infection of humans by S. Typhi. My preliminary data, backed by genome-wide association studies, suggest that this pathway is active in humans but there must be substantial differences to account for the different host susceptibilities. The objectives of thi s project are to: 1) determine the role of the Rab32 antimicrobial pathway in controlling pathogen growth in humans; and 2) elucidate the mechanisms that promote killing of S. Typhi in human macrophages. These studies will empower a larger study to identify novel S. Typhi virulence factors and to suggest ways to boost innate immunity pathways to control bacterial diseases.

Amount: £99,995
Funder: The Wellcome Trust
Recipient: University of Aberdeen

Monogenic diabetes in Iran. 01 May 2015

The aim of this seed project is to establish a collaboration with hospital-based researchers in Iran to understand monogenic diabetes in this Middle Eastern country. This study is important: (i) The prevalence of diabetes and obesity is high in Iran; family history and clinical criteria used in Europe may not be useful in diagnosis. Correct diagnosis is important because monogenic forms can often be treated with oral agents rather than insulin. (ii) The rate of consanguinity is high; identificat ion of new recessive mutations/genes is easier in consanguineous families, which will inform us about the underlying mechanism and diagnostic tests for monogenic diabetes. (iii) This will be the first study of the genetics of monogenic diabetes in Iran using next generation sequencing and whole-exome sequencing. I work with one of the leading groups in monogenic diabetes (led by Professors Hattersley and Ellard). I aim to (i) Establish a collaboration with Iranian clinicians and set up cohorts of monogenic diabetes. (ii) Use advances in DNA sequencing to assess the role of known and novel genes in the pathogenesis of monogenic diabetes. (iii) Use known genetic variants and non-genetic biomarkers to help classify young patients into type 1 diabetes or likely monogenic diabetes.

Amount: £93,819
Funder: The Wellcome Trust
Recipient: University of Exeter

Applying the power of genetics to increase knowledge of underlying mechanisms of recessively inherited congenital hyperinsulinism. 29 Oct 2014

This project will search for novel genetic causes of recessively inherited congenital hyperinsulinism in patients born to consanguineous parents in whom all the known genetic causes of HI have been excluded 1. Using genetic approaches to localise the genetic location of the aetiological gene I will use genome-wide SNP analysis to identify large (>3cM) homozygous segments, which are identical by descent in all 187 subjects. To refine gene localisation I will: a. Genotype additional affecte d and unaffected family members b. Search for shared haplotypes across families in ethnically matched apparently unrelated individuals c. Combine analysis of unrelated individuals with shared extra- pancreatic features d. Combine analysis of multiple families with isolated hyperinsulinism to identify shared regions of homozygosity. 2. Next generation sequencing to identify potential variants Potential aetiological variants in coding and non-coding regions will be detected within the refin ed regions of linkage by genome sequencing in key family members. 3. Confirming aetiological role of variants To define a novel aetiological gene needs replication in multiple families and finding different variants in the same gene. Therefore potential aetiological genes will be sequenced in the larger cohort. When there is clear genetic evidence we will go on perform appropriate functional studies to investigate disease mechanism(s).

Amount: £773,545
Funder: The Wellcome Trust
Recipient: University of Exeter

Greek diet, health and medicine in the Roman world conference 30 Sep 2015

The conference, entitled Greek diet, health and medicine in the Roman world, will be held at the University of Exeter from September 9-11, 2015. The study of diet, health and medicine in the Roman world, from an archaeological perspective, has grown exponentially in the last few decades with the increased study of archaeobotanical and zooarchaeological remains as well as advances in isotopic analysis. Nevertheless, the impact of Greek concepts on Roman beliefs and practices has never been fully explored, and at present, there has been no amalgamation of the literary and archaeological evidence. Speakers from the UK, Italy, Germany, Greece, Israel and the United States will be presenting papers that examine the impact of Greek thought on Roman notions of diet, health and medicine from both the literary and archaeological perspectives with the key goal of forming a more holistic understanding of the activities taking place to maintain good health amongst both the elite and non-elite members of Roman society. After a strict selection process, the proceedings of the conference will be published by the conference organizing committee in an edited volume.

Amount: £5,000
Funder: The Wellcome Trust
Recipient: University of Exeter

Postgraduate Medical Humanities Conference 2015. 29 May 2015

Now in its third consecutive year, the Postgraduate Medical Humanities Conference at the University of Exeter provides a welcoming and collegial atmosphere for students at all stages of their postgraduate career. The deadline for abstracts has now closed, and we are delighted to be welcoming over fifty delegates from a wide range of disciplines and institutions, including speakers from Hungary, Austria, Switzerland, the Netherlands, Norway, South Africa, Australia, the USA, and India. In additio n to postgraduates working in the areas of Film, Literature, History, Classics, and Archaeology, the conference will also include papers by medical students. Specific sessions will include a workshop on public engagement run by the organisers, a panel bringing together archivists and curators of interest to medical humanities scholars, and workshops from the Brighton Health and Wellbeing Centre and the University of Falmouth. We hope that the conference will promote interdisciplinary approaches and collaboration. We also hope to provoke lively debate about the intersection of medical practice and the medical humanities.

Amount: £1,600
Funder: The Wellcome Trust
Recipient: University of Exeter

A Pseudo-Aristotelian Medical/Magical Arabic Manuscript. 20 Apr 2015

This project will produce a preliminary transcription and an article describing the contents of a manuscript containing an influential, previously unedited work of Arabic Hermetic magic, The Book of Venus. It will elucidate its reliance on the concept of man-as-microcosm, and other ideas central to medieval medical, philosophical, and scientific literature. By describing the relation of this manuscript to other similar manuscripts, this article will help scholars navigate an important but poorly -understood body of texts that survive mainly in manuscript form. It will also explore the decisions of the manuscripts compiler in presenting these medical-magical texts and their intriguing illustrations.

Amount: £3,189
Funder: The Wellcome Trust
Recipient: University of Exeter

Gender stereotypes in ADHD diagnosis. 31 Mar 2015

This small-scale social epidemiology project seeks to establish evidence for a gender bias in the diagnosis of childhood Attention Deficit Hyperactivity Disorder (ADHD). It will question whether boys are more likely to receive a diagnosis than girls, given equally severe symptoms. Social epidemiologists in child psychiatry have suggested there is likely to be both real differences in ADHD symptomology between genders and additional referral / identification bias towards boys. The latter m ay be because ADHD is stereotyped as a 'male disorder', therefore boys are more likely to be assigned the label, whereas girls with comparable difficulties are overlooked. The methodology will be a secondary analysis of data from a birth cohort which comprises 14,000 children. Two groups, one with, and one without ADHD diagnosis will be matched on symptom severity. Gender ratios will be compared between these two groups. It is important to establish whether there is referral/ labelling bia s to help clinicians recognise girls who might benefit from ADHD diagnosis. The findings will also inform on-going debates about over-diagnosis of ADHD in boys. Outputs include one journal article, a press release, and workshops with ADHD charities.

Amount: £4,985
Funder: The Wellcome Trust
Recipient: University of Exeter

Detinova on Safari: Forgotten Histories of Global Health. 27 Oct 2014

This pilot project explores the influences of Soviet tropical medicine in Sub-Saharan Africa. It takes as its focus a method of mosquito dissection pioneered in the 1940s by a team of vector biologists based at the Moscow Martsinovsky Institute. The Detinova Technique offered a way to determine the exact physiological age of the female mosquito and provided insight into the dynamics of disease transmission. Heralded as a game-changer for global malaria eradication efforts, the technique prompted new collaborations and rivalries between East and West. The global health trajectory of this method reveals alternative histories of malaria control through a rather different set of techno-scientific circulations than those commonly associated with the WHO. Extending previous ethnographic and archival research conducted in Africa with archival and memory work in Russia and the UK, this project explores the significance of this scientific exchange for our current understandings of malaria contr ol and the Cold War, advancing a rapprochement in Anglo-Russian histories of global health.

Amount: £4,977
Funder: The Wellcome Trust
Recipient: University of Exeter

Biomedical Vacation Scholarship 22 Jun 2015

Not available

Amount: £7,500
Funder: The Wellcome Trust
Recipient: University of Aberdeen

Institutional Strategic Support Fund FY2013/14 14 Oct 2013

The aim of this fund is to support outstanding research within the remit of the Wellcome Trust - biomedical sciences and medical humanities - that will enable the University to strategically advance research in these areas and to leverage further funding from the Wellcome Trust and other funding sources. The scope of this funding is open to all university research staff, across all of the discipline areas, but in particular to: to support outstanding postdoctoral researchers allowing them to generate preliminary data to support independent Fellowship applications; to support early career academics by enabling them to generate preliminary data in support of research grant applications; to support mid-career and senior academics working in Wellcome Trust remit areas wishing to make a transition towards research in the remit of the Wellcome Trust and/or seeking to apply to the Trust for the first time; and to support newly recruited research staff seeking pump priming support for a new activity that will lead to a Wellcome Trust application, with first time applicants to the Trust particularly encouraged. If awarded, there is a commitment from the award holder to carry out the following: To provide the ISSF project team/project manager with regular updates on progress To provide a final report to the ISSF Project Board within two months of completion of the award which will cover the following: how the funds were used; the outcomes of the activity and the extent to which the proposed aims and objectives were achieved; how the funding has led, or will lead, to an application/award to an external funder; a list of publications either in press or out to print To include ISSF Biomedical Hub members involved in the award as authors on any resulting publications unless stated otherwise in the application To acknowledge the ISSF funding in all publications arising as a result of the award by including the following statement - "This work was generously supported by a Wellcome Trust Institutional Strategic Support Award (WT097835MF)" To cost in ISSF Biomedical Hub members involved in the award into related future funding applications

Amount: £500,000
Funder: The Wellcome Trust
Recipient: University of Exeter

C-type lectins in antifungal immunity 03 Dec 2013

Over the last decade, in research funded primarily by the Wellcome Trust, my group hasestablished that C-type lectin receptors (CLRs) are critical for protective antifungal immunity [1].Yet our understanding of the roles of these receptors remains in its infancy, despite thetherapeutic potential that this knowledge could offer. Over the next five years, I will build on ourexciting recent observations to answer three fundamentally important questions:I. Which systems driven by Dectin-1 and other myeloid-expressed CLRs are required forprotective antifungal immunity?II. How does costimulation of CLRs with other pattern recognition receptors (PRRs)mediate protective immunity and pathology?III. Does MelLec and other epithelial cell CLRs contribute to antifungal immunity?

Amount: £2,219,410
Funder: The Wellcome Trust
Recipient: University of Aberdeen
Amount: £21,439
Funder: The Wellcome Trust
Recipient: University of Exeter

Quantitative Proteomics Equipment for the Aberdeen Proteomics Facility. 25 Jun 2014

High throughput quantitative proteomics is an essential component of the contemporary experimental toolbox, and is critical for world-leading research programmes in the College of Life Sciences and Medicine at Aberdeen University. The Aberdeen Proteomics Facility was established 16 years ago and is manned by staff with vast experience of high quality proteomics service provision and training in quantitative proteomics, including SILAC and label-free approaches. The Facility provides a rang e of proteomics services to local and external users, including protein identifications, whole protein analyses, MALDI imaging and biotyping. To satisfy local research demand, the Facility needs more advanced equipment to extend our capabilities to high throughput, in-depth, quantitative analyses of specific proteomes, which is not currently possible in the Facility. Therefore, we are requesting a Q Exactive mass spectrometer and high throughput proteomic sample preparation robots. Our key objectives are: 1. To purchase a Q Exactive mass spectrometer and proteomics sample preparation robotics for the Aberdeen Proteomics Facility. 2. Exploit this equipment to provide cutting-edge proteomics services and bespoke proteomics training that empower a wide range of biomedical research programmes at Aberdeen University and other institutions. 3. To ensure the long term sustainability of this equipment by implementing appropriate cost-recovery mechanisms.

Amount: £414,964
Funder: The Wellcome Trust
Recipient: University of Aberdeen

Open access publishing costs 2014/15. 15 Sep 2014

Not available

Amount: £36,560
Funder: The Wellcome Trust
Recipient: University of Exeter