NIHRDataInsights/HRCSData huggingface dataset:
Title: “But why is that better?”: An investigation of what applied philosophy and ethics can bring to quality improvement work in health care
Funder: Wellcome Trust

Abstract: This project uses and builds the potential of applied philosophy to help deliver on the promise, and avoid the pitfalls, of healthcare quality improvement (QI). QI is promoted internationally to tackle the shortcomings of health services including the harms they can cause. But QI initiatives often fail to fulfil their aspirations, and can generate practical and ethical problems of their own. In part these challenges arise from the complex and contested concept of 'quality'. We suggest that applied philosophy can help elucidate and address the conceptual, ethical and practical challenges of QI, with potentially transformative implications. The project’s key goals are to: • Work with QI partners to tackle the challenges of addressing the complexity and contestedness of quality, and to elucidate and explore ways of navigating some of the potential harms and ethical challenges that arise in QI; and • Pioneer a partnership approach to integrating applied philosophy with QI work and contribute to the methodology of embedded empirical bioethics. These substantive and methodological goals will be addressed by interweaving applied philosophical scholarship with (a) literature based work; (b) interviews with QI leaders; (c) partnership working with 3 QI sites; (d) knowledge exchange events; and (e) methodological innovation and reflection.

Lay abstract: This project seeks to strengthen healthcare quality improvement (QI). QI aims to tackle the shortcomings of health services, but QI initiatives do not always work and sometimes create new problems. We suggest that one of the reasons for these failures is that people do not agree about what counts as good quality, and quality is often interpreted in ways that fail to capture what matters to people about healthcare. We are applied philosophers, and our project’s goals are: (1) to work with QI partners from diverse healthcare settings to address debates about quality and to understand how the potential harms and ethical challenges produced by QI can be better managed; and (2) to pioneer a partnership approach to building applied philosophy into QI. We will address these goals by integrating our applied philosophical scholarship with literature based work, fieldwork and workshops with QI partners, and methodological reflection.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Using neuroscience, physiology and behavioural science to measure and improve workplace stress
Funder: Innovate UK

Abstract: The project vision is to improve the management of work-related stress. The project will measure the long-term physiological response of employees in order to objectively assess stress and recovery levels. This will be linked to a software platform to enable organisations to accurately identify improvement areas for wellbeing and business performance that the organisation can implement across the entire workforce, and to help employees to make positive changes to their own lifestyle. This will allow organisations to adopt, for the first time, evidence-based practices to improve workplace stress.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Social Science Designed Meaningful Friendships Service
Funder: Innovate UK

Abstract: BuddyHub's 'Friendship Wheel' service is tackling the loneliness epidemic amongst older people. We surround a lonely older person with an intergenerational, supportive social group of 4, to help them rebuild their social circle. This project will design and pilot a parallel service to form groups or 'Clubs' of 10-15 people around diverse interests. This will help older people further increase their personal network with members of all ages benefiting from local intergenerational friendships. The challenge the project solves is groups of 4 require a significant commitment from supporters and larger groups may have more longer-term resilience. The number of friends you have is a key predictor of your mental and physical health. Having friends to socialise with and for support, protects against disease and cognitive decline. The flipside is loneliness: 2.6m UK adults always or often feel lonely and 1.5m chronically lonely people are 65+. The cost to the NHS alone of today's chronically lonely 65+ people is £1bn per year. Evidence suggests a maximum personal network size of 150 people arranged in layers of 5, 15, 50, 150\. Emotional closeness lessens with each layer. Adults mostly socialise with the first 15, our 'sympathy group', with 5 forming a supportive, inner circle. Our sympathy group declines into old age and it is difficult to build new friendships. The innovation is a personalised, matching, introduction, and ongoing support service so lonely older people can rebuild their 'sympathy group' with meaningful friends. Our novel approach leads to several meaningful, enduring friendships as close friends help in ways acquaintances do not and it is meaningful conversations not small talk which boosts well-being. By comparison, third sector loneliness solutions - traditional befriending and group social activities aimed at older people - encourage short-term interactions that do not rebuild the 'sympathy group. Commercial solutions can suffer from barriers due to the price point, and a lack of digital literacy, connectivity or hardware. Our service supports the creation of new friendships enabling people to sustain and broaden their social connections into later life. We also speak to the theme of sustaining physical activity as people with fewer social connections are less likely to be active. We also speak to living well with cognitive impairment as we accept members living with early-stage dementia and provide dementia training to vetted members We support people to form meaningful friendships who are often excluded by traditional services for older people.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Feasibility study for a minimum viable proposition of an augmented reality app for Great Ormond Street Hospital to prevent distress and anxiety for paediatric patients needing MRI scans
Funder: Innovate UK

Abstract: With nearly 40 million MRI scans performed annually in the United States alone, diagnostic imaging costs are substantial. In the UK, between October 2018 and September 2019, there were 45.2 million imaging tests of which 3.46 million were Magnetic Resonance Imaging (MRI). Children account for approximately 10% of adult MRI statistics and may need to undergo MRI scans for a variety of reasons (eg head injuries, neuro-inflammatory conditions). The experience can be distressing and upsetting especially for young children. The quality of the scan relies on the child lying still for 30 minutes to over an hour. If they become distressed, the scan will need to be done again or the child will need sedation or general anaesthetic. This feasibility study is to develop a MVP for an augmented reality app for Great Ormond Street Hospital patients that need MRI scans to prepare from home in order to reduce the numbers of children needing sedation and general anaesthetic. Prevention of psychological issues relating to hospital procedures, also ensures a happier patient experience and better physical and mental outcomes which reduces the longer-term burden on the social care system.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;4.3 INFLUENCES AND IMPACT
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: RBAN - Roadside Breath Analysis of Narcotics
Funder: Innovate UK

Abstract: Drug-driving is a growing global problem, particularly in countries where enforcement is weak, or recreational use is legalised (30% of US, 32% of EU). In the UK there were 11,614 successful prosecutions for drug-driving in 2019, a 20% increase on the previous year. The most common narcotic is Tetrahydrocannabinol (THC), the psychoactive component of cannabis. Roadside use of the ubiquitous alcohol 'breathalyser' has played a significant part in changing attitudes and behaviours around drink driving.There is a need and a significant business opportunity to develop a product that can do the same for THC and a range of other narcotics for roadside, and industrial, insurance, prison and border force use. Current solutions rely on taking a significant sample of saliva from the suspect's mouth and carrying out spectroscopic analysis in a portable machine, or lateral flow analysis with colour changing strips. Collection of saliva is invasive, and testing typically takes between 5 and 20 minutes to complete, with results hard to interpret in the case of indicator strips. The University of Manchester (UoM) has developed a highly selective and sensitive sensor using 'odorant binding proteins' (OBPs) similar to those found in animal smell sensory channels. In these sensors a significant change in the electronic characteristics is detectable on the binding of very small amounts of the 'target' molecule. Deposition of a range of OBPs on parallel devices can produce a unique 'fingerprint' for discrimination in a noisy environment. Epinal Ltd is a recent startup and has been working with UoM in the past 18 months to demonstrate a route from the academic lab to a commercial device. This project aims to build on the current work and de-risk the route to market by demonstrating a narcotic breath detection system which can give results in a short (<2mins) time, with a realistic supply chain and manufacturing plan in the UK.


Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: FS:Insight
Funder: Innovate UK

Abstract: Helping children with special educational needs reach their potential requires significant reforms in policy and support processes. With waiting lists for special needs assessment and appeals to Tribunals at a record high, SEND is at breaking point and something needs to change \[Barnes,2020\]. The administrative burden for Local Authorities (LAs), schools and multi-academy trusts (MATs) in assessing special educational needs and developing sufficient support programs is unduly intensified by the current policy-driven and process-focused system \[Barnes,2020\]. Lacking efficient, user-friendly and purpose-built support software, care providers simply do not have the time and resources to focus on the children's outcomes \[HoC,2019\]. To improve the process of supporting pupils with common SEN conditions, FullSpektrum developed FS:Insight, a business intelligence and management information system for LAs and schools. The software comprehensively ingests inputs from all interventions and presents them in a collaborative multi-dashboard platform, simplifying quantitative and qualitative analysis. FS:Insight reduces administrative burden and simplifies reporting and accurate student insights. It will equip staff to meet the needs of SEN pupils and improve outcomes of their school performance. Giving children centralised access for all SEND support, empowers them to take more responsibility for their own health.


Research activity codes: 3.5 RESOURCES AND INFRASTRUCTURE (PREVENTION);8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Manchester Metropolitan University and LovedBy Services Limited KTP 21_22 R3
Funder: Innovate UK

Abstract: To expand services for adolescents and young adults with chronic health conditions via development of an in-house research and development capability, leading to production of new tailored, robust, evidence-based, behavioural frameworks that inform engagement with target groups.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.5 RESOURCES AND INFRASTRUCTURE (PREVENTION)
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Handling Barbie: The Effects of Haptic Experience of Bodies on Body Perception
Funder: The British Academy

Abstract: Negative attitudes towards one’s own body are pervasive, and central to several negative outcomes. Body dissatisfaction is known to be related to the unrealistic depiction of bodies in media, and dolls like Barbie. Such influences have traditionally been attributed to the visual depiction of bodies. However, touch is a major way that children experience and play with dolls. We argue that haptic experiences with dolls plays an important role in the emergence of problematic body representations. Recent studies have used visual adaptation aftereffects as an experimental model for the effects of seeing extreme body types. We recently showed that analogous aftereffects occur following haptic body experience. This project will explore the effects of such haptic body-size aftereffects on body perception. Further, it will determine whether haptic and visual influences reflect modality-specific representations or a supramodal bodily representation. Finally, we will directly test the effects of haptics with commercially-available Barbie dolls.


Research activity codes: 1.2 PSYCHOLOGICAL AND SOCIOECONOMIC PROCESSES;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: VariAbilities: Distinctions of the Body
Funder: The British Academy

Abstract: For those of us who have atypical bodies, the word “Disability” does us few favours. Defined as negatively able, the word suggests we can never match up to the able-bodied, we are expected to have our hands out asking for help from “allies” or if we manage by ourselves to do something ordinary, we are regarded as super-crips. But life for us atypical has never been, and is not now a negative experience. This project, encompassing two meetings at archives, brings together scientists, historians of science, politicians and activists under the new term VariAbility, which defines all people as having bodies that are “the same only different” from one another. From this inclusive standpoint, we will try to explain and explore how society might re-define its individuals so that we can better understand one another: so we can each feel what it might be like to be inside another body.


Research activity codes: 1.2 PSYCHOLOGICAL AND SOCIOECONOMIC PROCESSES
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH
Title: Public health data science to investigate and improve migrant health.
Funder: Wellcome Trust

Abstract: Migration is a defining political challenge of our time and a global health priority. Internationally there is a lack of epidemiological data on new migrants including the prevalence of high morbidity conditions and estimates of risk factors for disease. The overarching aim of this research is to generate evidence that will improve the health of migrants moving from low and middle-income to high-income countries. Key goals: 1. Million migrant study: Create an electronic cohort that will establish the first national rates of age-specific morbidity and risk factors for disease in migrants. 2. Migrant eCohort: Investigate the migrant exposome and how this changes over time since migration, using digital technologies (smart phones and apps) for data collection. 3. Personalised public health intervention: Develop and test the feasibility of a tailored health advice website to improve migrant health. Outcomes: These studies will transform how we conduct digital cohorts in mobile populations and have wide application for efficient study design. The detailed epidemiological and health service data produced will provide the first national evidence of the health effects of rapid epidemiological transition as a result of UK migration, and a platform from which to carry out digitally enabled personalised public health interventions.

Lay abstract: There are currently eight million migrants living in the UK and approximately 600,000 new arrivals annually. However, we know very little about the health problems new migrants face. Migrants experience large changes in terms of the people they live and work with, the type of housing they live in, the food they eat and the amount of exercise they take. These factors, compounded by inequalities in wealth, mean that despite being young and healthy when migrating, they are particularly vulnerable to subsequently becoming ill. This study aims to understand what the health needs of migrants are, how their personal and environmental risk factors for becoming unhealthy change, and to test whether these risks can be improved. Study 1 will use data on over one million migrants who came to the UK before 2017 to see what diseases they had when they saw a GP or hospital doctor. Migrants arriving after 2017 will be approached to take part in study 2 which uses mobile phones to follow them up and see how their risks for ill health change. Finally, study 3 will develop and pilot a web-based personalised health quiz to see whether it can be used to improve migrant health.

Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH;CARDIOVASCULAR
Title: Developmental origins of child neurodevelopment: Novel approaches to clinical risk prediction using an international metadataset.
Funder: Medical Research Council

Abstract: Approximately 250 million children under 5 years, worldwide, are at risk of delayed development. Early neurodevelopmental delays (ENDs) are associated with poorer educational, economic, and health outcomes across the lifecourse. As developmental interventions during this period have enduring positive impacts, identifying children at risk early is key to targeting interventions within this window of sensitivity. While it technically challenging to assess neurocognitive skills during early infancy, the use of risk profiles presents an alternative, low-cost strategy for the identification of children at risk. However, as yet, there is no such tool to identify, at scale and across international populations, children at high risk of ENDs. Multiple prenatal, perinatal and postnatal risk factors (including prematurity, growth, and health) have been associated with ENDs. However, patterns of associations vary between populations limiting the generalisability of findings. Understanding risk factors associated with developmental delay, is key to identifying, as early as possible, children at high risk of delay. To study this, I will bring together already collected data from 9 studies, representing 8,015 children from 13 high-, middle- and low-income countries. For all children, neurodevelopment at 2 years was measured on the INTER-NDA test. I will examine associations between early risk factors and ENDs using hierarchical association analyses; identify risk clusters and construct models to predict risk of developmental delay during early childhood. I will validate these models in an independent study from Mysore, India (n=500). My hypothesis is that these risk models will satisfactorily predict ENDs, and if proven, I will translate these findings into a tool for early identification of developmental delay. This project leverages on established collaborations with data contributors and the epidemiological expertise of Southampton's MRC Lifecourse Epidemiology Unit.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH;NEUROLOGICAL
Title: Identifying suppressor mutations of ATR-X and ADNP syndromes using a novel CRISPR-based screening method in mice
Funder: Wellcome Trust

Abstract: The recent Deciphering Developmental Disorders Study found that mutations in genes encoding epigenetics proteins are a primary cause of intellectual disability. These disorders are incurable and their underlying mechanisms remain elusive. Intriguingly, varying symptom severity has been described in patients with the same causative mutations for a number of these disorders and phenotypes displayed in some mouse models are strain-dependent. To search for secondary mutations that suppress phenotypes in mouse models of the neurological disorder, Rett syndrome, Monica Justice’s lab performed a genome-wide screen by inducing random mutations with the chemical mutagen ENU. I aim to take advantage of recent advances in CRISPR/Cas9 technology to develop a CRISPR-based screening method. This method will simplify isolation of modifying mutations, greatly reduce the number of animals required and can be adapted for recessive screening. I will use this method to screen for suppressors of two neurological disorders that are predicted to be modifiable: ATR-X and ADNP syndromes. Both causative genes encode epigenetic proteins: ATRX is a chromatin remodelling ATPase and ADNP is a putative transcription factor. I hope that the ‘hits’ obtained in these screens will help us to better understand ATRX/ADNP protein function and open up therapeutic avenues for patients.

Lay abstract: Every cell in our bodies contains the same set of instructions, our DNA. Yet, in different cell types, different genes must be expressed at different levels: controlled by a large number of ‘epigenetic’ proteins. Mutations in genes encoding epigenetic proteins were recently found to be a frequent cause of intellectual disability. However, establishing a genetic diagnosis is only the first step towards a cure. Intriguingly, the severity of the effect of the same disease-causing mutations is variable, potentially due to other mutations. Inspired by the idea that in genetics "two wrongs could make a right", I designed a screening method to find genes that reduce the severity of genetic diseases. I will test this method using mouse models of two disorders: ATR-X and ADNP syndrome. I hope that these screens will help understand why patients develop neurological abnormalities and identify pathways that could be targeted with drugs to ameliorate symptoms.

Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: GENERIC HEALTH RELEVANCE;MENTAL HEALTH;NEUROLOGICAL