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gen_392ace8434d7971d6a8910e5e0d44b59 | Promoting science for all | Arcadia Fundation | British Science Association | 360G-ArcadiaFund-2737 | To help the association reposition itself as a public body dedicated to promoting science for all. | Discretionary / Discretionary | 3networking_collaborative
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gen_ef2e4e9bfcf6b19523df287dc2bf1742 | Conservation of East Asian-Australasian Flyway | Arcadia Fundation | Wetlands International | 360G-ArcadiaFund-4095 | To address threats and restore degraded habitats in the Yellow Sea region in the East Asian-Australasian Flyway. | On-site conservation / Strategic | 5out_of_scope
|
gen_153e3816552b9503f3401d69b35fc4e7 | Secondary school bursaries | Arcadia Fundation | Mvule Trust | 360G-ArcadiaFund-1296 | To provide bursaries to young women in Uganda. | Discretionary / Discretionary | 5out_of_scope
|
gen_9037569aabc408670819602dc5fb921a | Endangered Archaeology of the Middle East and North Africa | Arcadia Fundation | University of Oxford (School of Archaeology) | 360G-ArcadiaFund-4178 | To document archaeological heritage in the Middle East and North Africa using satellite imagery. | Heritage sites / Strategic | 6project_grants_public
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gen_3fd416c21bf6c8f5f7a50dc9dec68c82 | To support the Wildlife Justice Commission’s (WJC’s) core operations. | Arcadia Fundation | The Wildlife Justice Commission | 360G-ArcadiaFund-4505 | To conduct intelligence-led, undercover investigations to gather evidence, working closely with law enforcement agencies to support the investigation and prosecution of high-level wildlife crime cases. | Governance / Strategic | 5out_of_scope
|
gen_e311c3a23fbc417f0bcd6c791166e749 | Digital library for the study of Africa | Arcadia Fundation | Aluka | 360G-ArcadiaFund-2523 | To build an online library of scholarly resources and make it available for free online to users from African institutions | Archives and manuscripts / Strategic | 7research_infrastructure
|
gen_2b51b626aa7cb50e65836734355da87f | Palestinian Museum Digital Archive | Arcadia Fundation | Palestinian Museum | 360G-ArcadiaFund-3865 | To digitize endangered, dispersed and inaccessible collections of documents, photographs, videos and ephemeral materials representing the culture and history of Palestine from 1800 to the present and to make them available in an open-access online archive. | Archives and manuscripts / Strategic | 7research_infrastructure
|
gen_c42a748d6837c517a51d73d27adcf367 | Advancing open access | Arcadia Fundation | New York Public Library | 360G-ArcadiaFund-4273 | Advancing open access | Other / Strategic | 4other_research_funding
|
gen_f95115a3665db6d3279414367bb5d78c | Henry Koerner Hall | Arcadia Fundation | Bard College Berlin | 360G-ArcadiaFund-3956 | Towards a new building for student accommodations | Discretionary / Discretionary | 5out_of_scope
|
gen_0f0d5fa626a93c94b7ffbf5e6a657b0d | Wende endowment | Arcadia Fundation | Wende Museum | 360G-ArcadiaFund-5090 | Towards an endowment for the Wende Museum for collections care and acquisitions and general operations. | Other / Discretionary | 5out_of_scope
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gen_c0d0af42b6e5eab6c791277c00c1737d | Endangered Wooden Architecture Programme | Arcadia Fundation | Oxford Brookes University | 360G-ArcadiaFund-4382 | To establish a grant-giving programme for the documentation of endangered wooden architecture. By providing funding to researchers and maintaining an open-access digital repository, its objectives are to document endangered wooden building traditions and preserve the record long term. | Heritage sites / Grant programme | 7research_infrastructure
|
gen_b68cbd04a4c9def3d49fa5b7ba7ac994 | Towards the Wikimedia Endowment | Arcadia Fundation | Wikimedia Foundation (Tides) | 360G-ArcadiaFund-4159 | Trustee-led grant offered in December 2018 | Other / Strategic | 4other_research_funding
|
gen_6f64a91544aaf727ae1109457062f385 | Cambridge Conservation Initiative: Collaborative Conservation Research Fund | Arcadia Fundation | University of Cambridge | 360G-ArcadiaFund-3873 | To support collaborative research among the initiative's partners to address high priority biodiversity conservation issues. | Leadership / Strategic | 3networking_collaborative
|
gen_41e4737276e0169b2157ef84c6a11d8d | Sinai Palimpsest Project open access online publication | Arcadia Fundation | University of California Los Angeles | 360G-ArcadiaFund-3618 | To provide open access online publication of multispectral images produced by the Sinai Palimpsest Project, which documents the manuscripts in St. Catherine’s Monastery in Sinai | Archives and manuscripts / Strategic | 7research_infrastructure
|
gen_56961da9cea6e8da1e853b876ea7b829 | Digitizing Israeli Ephemera | Arcadia Fundation | National Library of Israel | 360G-ArcadiaFund-3193 | To collect, digitize and preserve printed ephemera from the early history of modern Israel and make them available for free online. | Archives and manuscripts / Strategic | 7research_infrastructure
|
gen_28cd5e03a4bb3cae7f982846aca64cca | Developing non-destructive methods to read texts in mummy cartonnages | Arcadia Fundation | University College London | 360G-ArcadiaFund-3733 | To assess the feasibility of nondestructive digital imaging technology to read texts on papyri in mummy cartonnages. All data, findings and methodologies will be freely available online for further research. | Other / Strategic | 6project_grants_public
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gen_77f37e41200bf5e5411c4676db0ee066 | Visiting fellowship | Arcadia Fundation | Reuters Institute for the Study of Journalism | 360G-ArcadiaFund-2582 | To support visiting fellow Dominic Lawson. | Discretionary / Discretionary | 1fellowships_scholarships
|
gen_3c161e5cba2abf7f1d88319b190e484d | Advancing Open Access | Arcadia Fundation | UCLA Library | 360G-ArcadiaFund-4872 | Advancing open access | Other / Strategic | 4other_research_funding
|
gen_cdc463339857edfc4ee667c4895324ef | Institute for Archival Research | Arcadia Fundation | Wende Museum | 360G-ArcadiaFund-4981 | Towards construction costs for the Wende Museum's international centre for digitization and conservation of at-risk post-war archives | Other / Strategic | 7research_infrastructure
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gen_3c978a519f567fd36a0bdf52a65e67ca | Advancing open access | Arcadia Fundation | Harvard University | 360G-ArcadiaFund-4498 | Advancing open access | Other / Strategic | 4other_research_funding
|
gen_d254647a09e082ad3fff64a958dced42 | Mosfell Archaeological Project | Arcadia Fundation | Vikingaminjar ehf | 360G-ArcadiaFund-3119 | To excavate and research a Viking-age archaeological site in western Iceland, in partnership with UCLA and the Institute for Viking and North Atlantic Studies. | Heritage sites / Strategic | 6project_grants_public
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gen_bb04e71b5be323d8a90465924cc9b2dc | To establish the Scott Waugh Fund for Medieval History, and endowment for the History Department. | Arcadia Fundation | University of California Los Angeles | 360G-ArcadiaFund-4177 | To support graduate students, to bring distinguished visiting scholars to UCLA to give lectures and teach courses, to underwrite conferences and workshops, and for other purposes that the chair of the UCLA History Department determines to be beneficial to the vitality of the field of medieval history at UCLA. | Discretionary / Discretionary | 1fellowships_scholarships
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gen_082ef0fd9a470733fe60a80a33fec255 | Modern Endangered Archives Program | Arcadia Fundation | The Regents of the University of California, on behalf of its Los Angeles campus, for the UCLA Library | 360G-ArcadiaFund-4765 | To continue a grants programme that funds projects to digitize and make accessible at-risk archival materials from the 20th and 21st centuries. The digitized materials are available for free online. | Archives and manuscripts / Grant programme | 7research_infrastructure
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gen_7780c27f5aef9474d62b04dd516c0414 | Towards the costs of running the museum | Arcadia Fundation | Wende Museum | 360G-ArcadiaFund-4924 | Towards the costs of running the museum | Other / Strategic | 5out_of_scope
|
gen_5ab69d89b6e1383b58a7ba983d36a5be | Dead Sea Scrolls online database | Arcadia Fundation | Israel Antiquities Authority | 360G-ArcadiaFund-2990 | To develop resources related to the Dead Sea Scrolls including bibliography, transcriptions of the text, translations and commentaries from experts and make them available for free online. | Archives and manuscripts / Strategic | 7research_infrastructure
|
gen_df6d1a7677f2058588a091f110ef2cef | OpenAlex: a free index for the world's research | Arcadia Fundation | Our Research | 360G-ArcadiaFund-5147 | To support the growth, development, and institutional usage of OpenAlex - an open and comprehensive index of scholarly works, authors, and institutions. | Discoverability / Strategic | 7research_infrastructure
|
gen_53e21b810783c0eb743822e95038d55c | HIV/AIDS programme | Arcadia Fundation | Absolute Return for Kids | 360G-ArcadiaFund-2357 | To treat mothers and carers with HIV/AIDS in South Africa. | Discretionary / Discretionary | 5out_of_scope
|
gen_6e6a07e3dad08cbcc323fdbc9c9d148b | Millennium Seed Bank Partnership | Arcadia Fundation | Royal Botanic Gardens Kew | 360G-ArcadiaFund-2837 | To expand the partnership's work in biodiversity rich low- and middle-income countries. | On-site conservation / Strategic | 3networking_collaborative
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gen_422dedc20449c3b23ba64eb51ee67057 | Patagonia National Park | Arcadia Fundation | Tompkins Conservation | 360G-ArcadiaFund-3847 | To create a continuous area of protected natural landscape by purchasing land adjacent to the Patagonia Park, which contains key access points and valuable habitat for threatened wildlife. | On-site conservation / Strategic | 5out_of_scope
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gen_922a7452847bf117be3f9e275cdaaf01 | Advancing Open Access | Arcadia Fundation | Wikimedia Foundation Inc | 360G-ArcadiaFund-4874 | Advancing open access | Other / Strategic | 4other_research_funding
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gen_976526c08af2ceeb646f1e6ba225c2de | Advancing open access | Arcadia Fundation | Yale University | 360G-ArcadiaFund-4014 | To further open access to scholarly and cultural materials | Other / Strategic | 4other_research_funding
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gen_c04fe5ad85f80fa4cc536239a3b2653c | Noves estratègies per la identificació i caracterització funcional de marcadors genètics pronòstics en les síndromes mielodispàsiques/leucèmies agudes mieloblàstiques hereditàries de la infància | La Marató de TV3 | Fundació per a la Recerca i la Docència Hospital Sant Joan de Déu - FSJD | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_ed09a2d7b889b6b7ebb6d216f95ffa5c | Transcripció espurial neuronal i desregulació d'estimuladors en l'etiologia de la discapacitat intel·lectual | La Marató de TV3 | Institut de Neurociències - Universitat Miguel Hernández, Alacant | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_bc7dd453c1f52688d7f8a6caef6c825f | iGenCO: anàlisi genòmica exhaustiva i anàlisi cross-òmica per a malalties minoritàries no diagnosticades en una plataforma col·laborativa amigable | La Marató de TV3 | Fundació Privada Centre de Regulació Genòmica - Centre Nacional d'Anàlisi Genòmica CRG | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_24697349f8b239bac8779c79164823ab | Anàlisi preclínica de nous tractaments combinats per a l'atròfia muscular espinal: efectes sobre la supervivència de la moroneurona, la integritat sinàptica i la preservació del múscul esquelètic | La Marató de TV3 | Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré - IRBLL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_d50aab7938c04a00721ad68ec39b48e0 | Genòmica avançada i lipidòmica per a la identificació de noves causes genètiques de trastorns de moviment hereditaris | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica Hospital Universitari de Bellvitge - IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_3ff7115203df53d8fa39b9a8d0fc7cf8 | Recerca centrada en el pacient: estudi de les necessitats dels pacients, fenotipació clínica i patogènesi molecular en la Neurofibromatosi tipus 2 | La Marató de TV3 | Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol - IIGTP | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_78cb1cf2c7d6dc925f7a0fef7b780a63 | Predisposició germinal a la síndrome de poliposi serrada: caracterització funcional de gens candidats mitjançant CRISPR/CAS i organoides | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_88d28d5312822a31f280d8ae38065215 | Registre PSP: estudi de cohort clínics, recerca de biomarcadors i programa d'educació sanitària | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clìnic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_ca3954694330d0a3e7ee6306fb525012 | Avaluació de la teràpia cel·lular mitjançant cèl·lules RPE corregides genèticament en mamífers inferiors i superiors per al tractament de les distròfies hereditàries de la retina | La Marató de TV3 | Fundació Centre d'Investigació Príncep Felip, València - CIPF | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_273b3526c051fc57cb7499a85e9939b0 | Desenvolupament de tractaments personalitzats en malalties genètiques rares causants de parkinsonisme pediàtric | La Marató de TV3 | Fundació per a la Recerca i la Docència Hospital Sant Joan de Déu - FSJD | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_23a1ebbe1a5b48198d16a092724ca799 | Gliotransmissors i receptors de cannabinoides en l'origen dels dèficits cognitius i de plasticitat sinàptica en la malaltia de Huntington | La Marató de TV3 | Universitat de Barcelona - Facultat de Medicina i Ciències de la Salut UB | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_e970d2f4a3853f9ade61576486c865b2 | Fenilcetonuria: de la infantesa als adults a través del connectoma cerebral, canvis cardiovasculars, característiques metabòliques i de la microbiota intestinal | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_2332d23bbb8ef63941008a54d126aa11 | Eliminar cèl·lules senescents per controlar les comorbiditats de la síndrome de Cushing | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_57ed88e3460d8d17e2f7ecc951ce51c6 | CoALeS: Optimitzant els resultats a llarg termini de nens amb coartació de l'aorta mitjançant l'aprenentatge automàtic integrant dades des del fetus fins a la infància | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_cd13f4c0f76706b5327dfba1447f9651 | Rol de l'Apolipoproteïna A-Ib en la síndrome nefròtica idiopàtica | La Marató de TV3 | Fundació Hospital Universitari Vall d'Hebron Institut de Recerca - VHIR | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_88b047ed434aa48cb3e051c75545320c | Alteracions bioquímiques i del neurodesenvolupament en la malaltia de Lesch-Nyhan | La Marató de TV3 | Universitat Autònoma de Barcelona - Institut de Neurociències UAB | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_2ae490f3e0d8d008c2ef8a8b197568fb | Vinculació de defectes cel·lulars amb manifestacions clíniques a la síndrome de Cohe | La Marató de TV3 | Fundació Institut de Recerca Biomèdica de Barcelona - IRBB | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_c5ad294e3c9e525a198175fc5d1a33de | Desoxiribonucleòsids com a teràpia per als trastorns de la replicació de l'ADN mitocondrial: investigació dels mecanismes terapèutics i ampliació del tractament a les mutacions en POLG i altres gens | La Marató de TV3 | Fundació Hospital Universitari Vall d'Hebron Institut de Recerca - VHIR | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_dd181764041697c1847a204c99f87dbb | La senescència cel·lular, un nou objectiu per combatre i millorar la distròfia muscular de Duchenne | La Marató de TV3 | Universitat Pompeu Fabra - Facultat de Ciències de la Salut i de la Vida UPF | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_56da632247102543f6db1c792fc6cf64 | ArmTracker: Un sistema portable per avaluar la funció motora de les extremitats superiors durant la vida diària per a pacients amb distròfia muscular de Duchenne i atròfia muscular espinal | La Marató de TV3 | Fundació per a la Recerca i la Docència Hospital Sant Joan de Déu - FSJD | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_2a1351d508232816089aa626b6a0f35e | Noves aplicacions terapèutiques a l'acondroplàsia | La Marató de TV3 | Institut de Neurociències d'Alacant - CSIC | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_0fe9a1b96faaea357edaf6e0020fdfbc | Estratègies terapèutiques per a la cistinúria | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica Hospital Universitari de Bellvitge - IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_fe4629edda25bf14463826678909efbe | Anàlisi del sistema de complement en la preeclàmpsia greu i la síndrome de Hellp com a diana terapèutica | La Marató de TV3 | Fundació Recerca Clínic BCN – Institut d’Investigacions Biomèdiques August Pi i Sunyer | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_1b9c9efd175958b432c7076bca4ea7f2 | Impulsa la integració de cèl·lules trasplantades per regenerar retines amb Retinitis Pigmentària | La Marató de TV3 | Fundació Privada Centre de Regulació Genòmica - CRG | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_c390f6babf37d6cbd2839d9f36e62632 | Caracterització dels esdeveniments moleculars inicials de la carcinogènesi associada a la síndrome de Deficiència Reparadora Constitucional (CMMRD) per millorar el seguiment i la prevenció del càncer | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica de Bellvitge - Institut Català d'Oncologia ICO IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_c8717fcadd4774609732c2701a365967 | Cap a la millora de l'assistència clínica i la cura de la linfangioleiomiomatosi: estudi integrat de biomarcadors i teràpies | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica de Bellvitge - Institut Català d'Oncologia ICO IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_5925e086069db4d1407a102e737a9015 | Modulació de la senyalització retrògrada mitocondrial com a tractament de la síndrome de Leigh | La Marató de TV3 | Universitat Autònoma de Barcelona - Facultat de Medicina UAB | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_86fd243d84483acbd886ef13ddb3e97a | Alteracions de la tiroide en pacients amb un defecte heretat de la maquinària de biogènesi del miRNA | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica Hospital Universitari de Bellvitge - IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_663206c605c9db460705e820a865a814 | La malaltia de Lafora: paper de la glia en la producció de glicogen aberrant i neuroinflamació | La Marató de TV3 | Institut de Biomedicina de València, CSIC | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_a055bbdcc9661c7288e98d0eb9766128 | Lipodistròfia i sarcopènia en la síndrome de progèria Hutchinson-Gilford: mecanismes i paper en la progressió de la malaltia | La Marató de TV3 | Universitat Pompeu Fabra - Facultat de Ciències de la Salut i de la Vida UPF | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_dc9d90492ebd8cda59894e15c5db91a4 | Noves teràpies dirigides contra subpoblacions de cèl·lules fibroadipogèniques implicades en la degeneració muscular | La Marató de TV3 | Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau - IRHSCSP | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_e4fed8952425105f1be70b7827e9879b | Disfunció de la barrera hematoencefàlica i modulació de l'estrès oxidatiu en malformacions arteriovenoses cerebrals: Un estudi translacional del dany secundari posterior a la resecció quirúrgica | La Marató de TV3 | Consorci Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic - IDIBAPS | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_6dadb4457b4fb6a8864c1306d8b03a75 | Ús de la intel·ligència artificial i la biologia de sistemes per a la diagnosi i l'avaluació de risc personalitzat per a les malalties renals hereditàries, centrat en la síndrome d'Alport | La Marató de TV3 | Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau - IRHSCSP | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_9db9700fca5fafb456ed4746b26b550f | Desxifrant els mecanismes de l'autoimmunitat de cèl·lules B específiques de PLA2R a la nefropatia membranosa primària (PMN) (BCELL-MEM) | La Marató de TV3 | Fundació Institut d'Investigació Biomèdica Hospital Universitari de Bellvitge - IDIBELL | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_eb0fbb3b81d574762d922aff73a767f4 | Inhibició d'ACVR1-PI3K a Fibrodisplàsia ossificant progressiva: noves teràpies per a l'ossificació heterotòpica | La Marató de TV3 | Universitat de Barcelona - Facultat de Medicina i Ciències de la Salut UB | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_76512b0e2edf95a19d3f841af6311e00 | Relació de la infertilitat genètica masculina amb les regions d'unió entre toroides de l'espermatozoide | La Marató de TV3 | Universitat de Girona - Departament de Ciències Mèdiques UDG | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_72417b4ba9fdd32683688094fc261aae | Mecanismes aritmogènics específics del genotip en la síndrome d'Andersen-Tawil | La Marató de TV3 | Fundación para la Investigación del Hospital Universitario La Fe - FIHFE | Not available | La Marató 2019 Malalties minoritàries | 6project_grants_public
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gen_2bf029061f90f61fd5109956a0489cb1 | A randomised, observer-blind, non-inferiority trial to evaluate alternative human papillomavirus vaccination schedules in young females in West Africa | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00757 | The trial will investigate the potential future utility of alternative HPV vaccination schedules in West Africa. The schedules aim to reduce the financial and logistical burden of HPV vaccine rollout and to provide new opportunities to optimise coverage. The following questions will be addressed: 1. Does the administration of 1 or 2 doses of a quadrivalent HPV vaccine (qHPV) result in lower type-specific seroconversion rates in 9 to 12 year old females in West Africa compared to a 3 dose schedule? 2. Does the administration of 2 doses of qHPV result in lower type-specific seroconversion rates in 4 to 8 year old females in West Africa compared to 3 doses in 9 to 12 year old females? 3. What are the long term health and economic implication of a reduced dose schedule and/or a younger age of routine vaccination in a low income West African setting? A randomised, observer-blind, non-inferiority trial will be undertaken. 9 to 12 year old females will be randomised to receive 1, 2 or 3 doses of a qHPV over up to six months. An additional group of 4 to 8 eight year old females will be recruited and will receive two doses of qHPV. The following outcome measures will be examined: Primary: - HPV types 16 and 18 neutralising antibody seroconversion rates at 7 months Secondary: - HPV types 16 and 18 neutralising antibody seropositivity rates at 12, 24 and 48 months - HPV types 16 and 18 neutralizing antibody GMT at 7, 12, 24 and 48 months - HPV types 16 and 18 antibody avidity at 7, 12, and 48 months Exploratory: HPV specific B-cell and T-cell responses will also be examined in a sub-set of subjects A sample size of 256 participants per group is based on a reference 3 dose seroconversion rate of 99% and a noninferiority margin of 5%. The figure provides over 90% power to determine the non-inferiority of the primary outcome measure using a 1-sided alpha of 1.25% allowing for multiplicity two HPV types and an attrition rate of up to 10%. | 6.1 Pharmaceuticals / Research Grant | 6project_grants_public
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gen_8d97ad5ca923cbdf97e6e728e3a19b5d | A non-inferiority trial to assess the safety and immunogenicity of yellow fever vaccine dose sparing strategies for campaign and programmatic use | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00759 | A phase 3, randomized, observer-blind non-inferiority trial will be undertaken to assess the safety and immunogenicity of fractional doses of the yellow fever vaccine when administered to 9-12 month olds in The Gambia. In 2016, the worst epidemic of yellow fever in 30 years occurred in Central Africa on a background of year on year increases in disease despite the availability of a safe and highly effective vaccine. A revised global strategy for epidemic elimination published by the WHO highlighted the critical role played by vaccine supply shortages in the current disease resurgence. These shortages became acute during the recent epidemic when, faced with the impending exhaustion of vaccine stockpiles, fractional (one fifth, 0.1mL) doses of the vaccine were recommended for ongoing emergency campaigns. This trial aims to generate a comprehensive data set on which to base future policy decisions regarding the use of fractional dose of the yellow fever vaccine in infants and children in sub-Saharan Africa. The following research questions will be addressed: 1. Does the administration of a fractional subcutaneous or intradermal dose of a yellow fever vaccine result in seroconversion rates which are non-inferior to those induced by a full subcutaneous dose of the same vaccine? 2. Is there a difference in the geometric mean antibody titres induced by fractional yellow fever vaccine doses according to whether administered by the subcutaneous or intradermal route? 3. Is there a difference in the safety profile of fractional yellow fever vaccine doses according to whether administered by the subcutaneous or intradermal route? Immunogenicity will be compared based on neutralizing antibodies. Local and systemic reactogenicity will be collected according to standard criteria. Other adverse events following immunization will also be recorded. The data are expected to influence future global vaccine policy decisions regarding fractional dose yellow fever vaccine use. | 3.4 Vaccines / Research Grant | 6project_grants_public
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gen_85f17067dd28f985da8ab86f1ed276b4 | SUPPLEMENTARY FUNDING OFFER FOR THE MRC UNIT, THE GAMBIA AT LSHTM (resource to support a clinical trial of Hydroxychloroquine and Azithromycin, studies on the transmission and antibody dynamics to SARS-CoV-2 infection, and to further support | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00851 | This £4.4m award provides resource to support a clinical trial of Hydroxychloroquine and Azithromycin, studies on the transmission and antibody dynamics to SARS-CoV-2 infection, and to further support surveillance activities funded by BMGF. Including PaTS-COVID CLINICAL TRIAL – led by Professor Beate Kampmann with an end date 31/12/2023 The TransVir project – led by Dr Anna Roca with an end date 30/06/2023 | 2.2 Factors relating to physical environment / P&Cs | 6project_grants_public
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gen_ec150e5ae6f02f91d95e69dbf3004761 | Enhancing the Unit Support of Uganda’s Efforts to Contain COVID-19 - part 2 | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_00854 | Following the initial rapid successes in supporting the national diagnostic capacity and to characterise the viruses, the Unit now recognizes its ability and responsibility to continue working as a close partner and reliable ally of the Government in ramping up the response to prevent the further spread of this deadly disease. The Unit could have a significant impact in curbing the COVID-19 outbreak in Uganda and the region and to further develop the global understanding of the disease as below: to prioritise research capacity and resources towards COVID-19 research - to support the Ugandan national response to the COVID-19 outbreak, which includes diagnostics, sequencing and clinical support - to lead and contribute to COVID-19 research activities with local and international partnerships - to remain operational as much as possible during the outbreak, this includes the delivery of non-COVID-19 related projects - to continue delivering the Unit restructuring that addresses the Unit’s financial and structural crisis - to deliver capital projects as expected | 2.6 Resources and infrastructure (aetiology) / P&Cs | 6project_grants_public
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gen_a193486af86348a1286693130ae7f4fb | Community surveillance for SARS-CoV-2 and COVID-19 in the general and in high risk populations in Uganda and assessment of the wider impact of infection and of pandemic mitigation. | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_00855 | In collaboration with MoH, we will undertake rigorous community SARS-CoV2/COVID-19 surveillance in high-risk and general populations, to identify infected individuals with and without symptoms. This would provide a robust foundation for answering critical scientific questions relating to the pandemic, including on transmission dynamics, burden and distribution of infection (including identifying vulnerable groups, such as older people or those with HIV/TB). In addition, with extensive background data and linkage to health facilities, we will determine clinical outcomes as well as understand the wider impacts of pandemic spread and associated mitigation strategies. This provides a resource in which to embed further work, including mechanistic research. The proposed study will last 18 months, covering the early and later stages of the pandemic, allowing for detection of secondary epidemic waves and to begin to examine the longer-term effects. | 2.1 Biological and endogenous factors / P&Cs | 6project_grants_public
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gen_5c848934184f9fe38c34ba0042d3855a | Excess mortality during the COVID-19 pandemic in The Gambia: a denominator based analysis within the HDSSs | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00861 | The COVID-19 pandemic is causing an unprecedented global burden of mortality. Mathematical models predicted that most West African countries, one of the poorest regions in the world, would exceed 100,000 COVID-19 cases by June 2020. As a result, most countries reacted pragmatically closing borders after the first few cases were confirmed. Official number of COVID-19 cases in Africa show that the expectation has been unmet leading to the idea that COVID-19 severity is disproportionally lower in the continent. The effect of the COVID-19 pandemic, however, goes beyond the official number of cases and deaths. On the one hand, COVID-19 testing is insufficient and, therefore, cases underestimated. Also, limited health resources available are being allocated to the CVODI-19 response which compromises further other health services. Behaviour of people towards health systems may have also changed due to fear of the pandemic. The Gambia, a small West Africa country (2.2 million inhabitants), has 3,626 cases confirmed (September 21st) and 108 deaths. Approximately two thirds of these deaths have occurred in the community and the testing was conducted post-mortem. The MRCG @ LSHTM has 20% of the population under surveillance as part of the Health & Demographic Surveillance Systems (HDSSs). We propose to utilize our HDSSs to assess the excess mortality during COVID-19. To differentiate between the direct and the indirect excess deaths and explain the observed results, we are planning to: (i) conduct analysis of mortality stratified by age group, (ii) perform verbal autopsies to identify causes of death; (iii) carry out COVID-19 serological surveys and correlate hot spots with increased mortality. Rationale: In many high income countries, COVID-19 excess mortality is being quantified showing that the global harm of the epidemic expands beyond the official number of COVID deaths. The overall effect of the COVID-19 in West Africa is unknown. COVID-19 mortality, direct and indirect, is difficult to quantify in this region as there are no official death’s register. We rely on official numbers of COVID-19 deaths but, with the limited testing, cases and associated deaths may be largely un-diagnosed. Deaths mostly occur outside of health facilities a situation that may worsen should health systems become overwhelmed. Un-resourced health systems are less resilient to increased burden and therefore, the risk of collateral damage becomes exacerbated. As highlighted by the WHO, community-based surveillance is critical to have a holistic picture of the COVID-19 deaths in economically constraint regions. The HDSS is a unique resource to quantify excess mortality in African countries. Because The Gambia is a small country, we can have as much as 20% of its population under demographic surveillance which will give a robust picture of the overall effect of COVID-19 in the country. We have the opportunity to quantify direct and indirect effects, and identify their drivers. The strength of this study, in addition, is the combination of historical and prospective data and the serology component. https://www.worldometers.info/coronavirus/country/gambia/ https://ourworldindata.org/excess-mortality-covid | 2.4 Surveillance and distribution / P&Cs | 6project_grants_public
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gen_627b7f0839b8fa1e3d89099c280a44e6 | Population differences in vaccine response (POPVAC)-2: the impact of environmental exposures and selected interventions on waning of vaccine-induced immune responses | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_00901 | We propose that parasite infections contribute substantially to population differences in vaccine response; and that their effects are mediate We will test this hypothesis through four linked objectives among Ugandan adolescents. An immunisation programme comprising relevant live and inert vaccines will be given over one school year, with primary endpoints one month postimmunisation. A secondary endpoint at one year will assess response waning. 1. We will compare vaccine response profiles in urban adolescents (low parasite burden) with two rural cohorts, chosen for high schistosomiasis and high malaria prevalence. 2. We will establish whether current parasite infections have causal effects using individually-randomised, placebocontrolled interventions targeting the dominant infection in each rural cohort. Sample sizes will be robust, powered to detect vaccine response differences of 0.14log10 between study arms (modest effects compared to preliminary data). 3. We will assess herpesvirus-specific antibodies (Luminex), viral loads (droplet digital PCR) and cellular responses (ELISpot); and microbial translocation (MT; PCR for bacterial 16s ribosomal DNA, ELISA for lipopolysaccharide and other biomarkers). Markers of viral activation and MT will be related to parasite exposures and vaccine outcomes. 4. We will investigate pre-immunisation immunological characteristics using simple biomarkers and cell phenotyping, and with in-depth studies (including by mass cytometry) in smaller, representative groups; and link findings to both parasite exposures and vaccine outcomes. Our data will be integrated using causal mediation analyses to determine how urban-rural environment, parasites, "transkingdom" effects and immune responses relate to determine vaccine responses partly by "transkingdom" pathways (activation of herpesviruses; intestinal translocation of microbial products), and ultimately by pre-immunisation immune characteristics of the host. | 3.4 Vaccines / P&Cs | 6project_grants_public
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gen_b614a0b9e47755a15c752f3d8bef3ecb | Evaluating the implementation of the Peer Educator Intervention for improving adolescent health in India's National Adolescent Health Programme | Medical Research Council | Public Health Foundation of India (PHFI) | HRCS22_00921 | India is home to 243 million adolescents, yet they remain an understudied population in India with lack of data on the health indicators for this age group and current levels of knowledge on adolescent health issues and effective approaches on reaching marginalized adolescents. In 2014, the Ministry of Health and Family Welfare (MOHFW), Government of India launched a comprehensive National Adolescent Health Programme (Rashtriya Kishor Swasthya Karyakram-RKSK), to emphasize on community-based health promotion and strengthening preventive, diagnostic and curative service across health system related to 6 strategic health priorities. RKSK includes a peer educator (PE) programme, which seeks to ensure that adolescents benefit from sustained peer education and is expected to improve knowledge, attitudes and life skills of adolescents. The PE programme is also expected to change parental and community norms towards the need for adolescent friendly health services, leading to increased attendance to Adolescent Friendly Health Clinics (AFHCs) and subsequently positive adolescent health outcomes. This study will evaluate the impact and process of PE intervention as an integrated component of the RKSK and also explore its interaction with other RKSK components. It will further undertake economic analysis of costs related to implementing PE intervention for guiding scale up. This implementation research will be conducted in 4 high priority districts of 2 Indian states (2 each in Madhya Pradesh & Andhra Pradesh). Mixed methods approach will evaluate the process of the PE programme and its effects on primary outcomes at the adolescent (knowledge, attitudes, life skills, practices) and parental (attitudes, communication) levels as well as impact on PE skills and attendance at AFHCs. The research project also aims to provide guidance to MoHFW on modifying, scaling up and sustaining the PE programme and share findings with countries adapting RKSK. | 8.4 Research design and methodologies (health services) / Research Grant | 6project_grants_public
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gen_7bcd0ff5f84840c02583f9d7b525f059 | A randomised controlled trial (RCT) to evaluate a scalable active case finding primary care-based intervention for tuberculosis using a point-of-care | Medical Research Council | University of Cape Town | HRCS22_00923 | A startling statistic is that more than 40% of TB cases in endemic countries are "missing" (~4.2 million cases globally remain undiagnosed or unreported)! Most of these undiagnosed cases, which continue to transmit disease, are concentrated in the peri-urban 'slums' and 'shanty towns' of large African cities. Without addressing the 'missing cases' the TB epidemic will never be controlled. However, the lack of suitable diagnostic tools has been a major hurdle in finding the 'missing cases'. However, we have recently shown that community-based screening with molecular diagnostic tools (Gene Xpert) is highly effective in detecting these missing cases (Calligaro & Dheda, Lancet Infect Dis, 2017; XACT I study). This has now been superseded by a new simple to use portable, battery operated, point-of care (POC) version of Xpert (OMNI). For the first time we have a highly sensitive tool that is ideally suited for community-based active case finding (ACF). We have now validated this tool in a NIH-funded RCT in Cape Town (XACT II study; n= 5500 participants). The results show that Xpert is feasible at community-based POC and works much better than POC smear microscopy. However, we now need to validate the methodology and results in different settings to enable uptake and policy recommendations for primary care. Moreover, we now need to optimise the ACF model and determine where Xpert should optimally be located. Thus, we propose conducting a RCT to evaluate the feasibility and impact of primary care-based Xpert performed at POC compared Xpert performed in a centralized laboratory (XACT III). This study will set a new standard of care for ACF and likely revolutionize TB detection, moving it out of clinics and into the community. Furthermore, this project will enable, for the first time, the bio-phenotyping of TB patients in the community who have minimal or no TB symptoms using novel technologies including cough aerosol sampling and whole genome sequencing. | 2.5 Research design and methodologies (aetiology) / P&Cs | 6project_grants_public
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gen_18ae9effe140ccabece4c4174c5756cf | Two decades of primary health care expansion in Latin America: evaluation and forecasting study for health-related SDGs | Medical Research Council | Federal University of Bahia (UFBA) | HRCS22_00924 | A strong Primary Health Care(PHC) is essential for achieving Universal Health Coverage(UHC) and should be an integral part of and coordinate multi-sectoral actions addressing economic and social determinants of health, acting synergistically with social interventions such as cash transfer programmes(CCT) and social pensions(SP). The evidence of PHC effectiveness in LMICs is sparse, with most studies conducted in North America and Europe, moreover PHC's long-term effects and synergistic interactions with social assistance interventions have rarely been evaluated. We will perform a multi-country study in Brazil, Colombia, Ecuador and Mexico (BCEM) with the aim to: 1)Evaluate of the effects of PHC coverage on all the range of notifiable diseases, hospitalizations and mortality (overall, for specific causes and age-groups) over the last two decades using ecologic longitudinal data at municipal level in each BCEM from 2000 to 2018. We will also measure the effects of duration of PHC coverage (expressed as the average coverage of the previous years) and the presence of long-term effects (with lag and age-cohorts analyses). 2)We will evaluate the synergistic effects of PHC with the other healthcare system components (secondary and tertiary levels of care),CCT and SP on the full range of health outcomes at the municipal level. We will also measure as local factors, such as human development index(HDI) or local administration capacity, affected the effectiveness of PHC, paying attention to the heterogeneity of effects within and between countries.3)Using individual-level data from national health cohorts, surveys and censuses and multilevel modelling we will evaluate the granularity of PHC effectiveness on health outcomes in all BCEM.4)Using an integrated microsimulation approach we will forecast the effects of PHC coverage changes, calibrating the best implementation scenarios for achievement of health-related SDGs and reduction of health inequalities in BCEM up to 2030. | 8.1 Organisation and delivery of services / Research Grant | 6project_grants_public
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gen_91b732bf910d7647ee8ecdb4f7c445d1 | The risk of a chronic clinical condition following a previous hospitalisation by a psychiatric disorder: a linkage nationwide study in Brazil | Medical Research Council | Fiocruz (Oswaldo Cruz Foundation) | HRCS22_00928 | This project will analyse electronic data routinely collected within the Brazilian Public Health System (SUS). It involves enriching this type of data by linking them to other Brazilian governmental databases destined to national social protection programmes, which have important socio-economic variables of the individuals. A very large dataset with over 114 million people (The 100 Million Brazilian Cohort), which more than half of the Brazilian population, will be consolidated to the study of multimorbidity and its socio-economic determinants nationwide. Therefore, establishing foundations on the magnitude of the problem, in particular on the most impoverished population and for further studies on this subject in Brazil and other similar middle-income countries. We aim to study the risk of hospitalisation or death by diabetes mellitus, cardiovascular disease, stroke, or tuberculosis associated with previous hospitalisation by the following psychiatric disorders: depression, alcohol and substance use-related, and schizophrenia. We also intend to identify disease clusters and their related patterns, and how these patterns interact over time to influence the formation of such clusters. "Big data" is seen as having great potential to answer numerous questions and CIDACS collection of Brazilian data is unique in low-middle income countries. Our access to this collection of data allows for unprecedented study of morbidity and mortality in a nationwide scope. | 2.1 Biological and endogenous factors / P&Cs | 6project_grants_public
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gen_7b55d04f512318b25e23a3c8846f52b1 | The Khayelitsha Comorbidity Cohort: Establishing a multimorbidity cohort with integrated clinical, genomic and epidemiological data in South Africa. | Medical Research Council | University of Cape Town | HRCS22_00931 | There is high multimorbidity in South Africa, consisting both infectious and non-communicable diseases. Elucidating diagnostic, therapeutic and prognostic genetic drivers of morbidities can help tailor preventative and therapeutic patient care at both population and individual levels, and requires research into associations between genetic factors, complex patient phenotypes, and how these factors work in concert to impact complex clinical phenotypes in African individuals. The Provincial Health Data Centre (PHDC) is a health information exchange collating routine health data on a daily basis from 6.6million health care clients in the Western Cape Province (South Africa), compiling a patient-centric longitudinal health profile for every individual, with daily updates available on an ongoing basis. This presents an opportunity to research complete, complex clinical phenotypes with prospective automated health data updates for consenting individuals. The H3Africa Bioinformatics Network has developed an African-specific 2.5million SNP genotyping chip including novel African variants, known disease markers and pharmacogenomic variants. With the appropriate informed consent from participants, individuals' genotypes generated with the H3Africa chip can be linked to complex, longitudinal clinical phenotypes from the PHDC to develop an infinitely-scalable comorbidity cohort. At the seed-stage of the project, nested case-control analyses and genetic epidemiology methods will be used to explore complex genotype-phenotype associations focusing on high prevalence morbidities - diabetes, hypertension and kidney disease - in conjunction with HIV and TB. As the cohort grows, going forward, other morbidities can be analysed. Clinical data will be updated from the PHDC biannually, growing the extent of the clinical profiles over time. Additionally, a framework will be developed for returning clinically actionable findings to the Western Cape government health service. | 4.1 Discovery and preclinical testing of markers and technologies / P&Cs | 6project_grants_public
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gen_eb9b1ecaad9361f9c491f612bf1bc0bb | Exploring treatment burden and capacity for self care among patients with HIV/NCD multimorbidity in South Africa to inform interventions (EXTRA) | Medical Research Council | University of Cape Town | HRCS22_00932 | In Sub-Saharan Africa the rising burden of non-communicable diseases (NCDs) against a background of chronic infectious disease epidemics, most notably HIV, is giving rise to patterns of multimorbidy that are occurring in people of working age, with implications for productivity and social stability. Chronic care for patients with multimorbidity in South Africa (SA) is fragmented, uncoordinated and does not account for increased complexity of the demands on patients. We aim to systematically identify, characterize and understand the workload experienced by patients with HIV/NCD multimorbidity, and their caregivers in SA. This is to ensure that the patient perspective is fully considered in current healthcare reform initiatives to improve primary level chronic care and outcomes. We further aim to explore the relevance and applicability of existing theoretical models of NCD treatment workload-capacity from high income countries and adapt them to inform future research and interventions in the LMIC context of SA. We will use qualitative research methods to: conduct semi-structured interviews with purposively selected samples of patient and carer dyads in urban and rural settings; convene task groups with healthcare decision makers, doctors, nurses and community health workers from the same settings to discuss the findings and consider their implications for local service redesign and interventions to reduce burden and increase capacity; engage policy and decision makers provincially and nationally in stakeholder meetings to influence health reforms. This project will help us better understand treatment and capacity issues in a LMIC context. Our theory-informed qualitative analyses will develop a culturally and contextually appropriate theoretical model of HIV/NCD workload and capacity. This work will contribute to development of individual, peer group and service level interventions that can be validated in a large scale, complex intervention trial. | 7.1 Individual care needs / P&Cs | 6project_grants_public
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gen_810a22d5b07954b690f943dbd1a85ae0 | Developing a Digital Health-enabled Intervention to tackle Multimorbidity in Primary care in India | Medical Research Council | Centre for Chronic Disease Control | HRCS22_00936 | More than a quarter of adult patients attending primary care facilities in India have multimorbidity. However, national health programmes are disease-centric, including the ongoing National Programme for Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), which caters to large population groups in primary care for a range of chronic conditions. The specific objectives of the proposed research work in the Indian state of Tripura are: a) To discover major multimorbidity patterns relevant for NPCDCS in primary care; and b) To develop a digital health-enabled intervention, targeting major multimorbidity patterns, relevant for NPCDCS, to improve targeting and delivery of clinical services in primary care. A digital tool- comprising clinical decision support and electronic health record- is deployed in 40 primary care facilities in Tripura to aid the healthcare team in managing six chronic conditions - hypertension, diabetes, dyslipidaemia, chronic obstructive pulmonary diseases, alcoholism and tobacco use- for the past 29 months. In such patient's record, information on the presence of eight additional chronic conditions is also routinely recorded. This dataset will be used for discovering multimorbidity patterns. Using these inputs, and expert consultations, we will develop a digital health-enabled intervention for the management of multimorbidity following the MRC framework for developing complex interventions. To guide intervention development, a theory of change will be constructed, covering the building blocks of the health system and other contextual factors. Using mixed methods, we will develop a prototype intervention and pilot it in two health facilities for assessing feasibility, developing mitigation strategies for barriers, identifying potential indicators for the process of care and patient-level outcomes, sample size and recruitment feasibility for planning an application for controlled evaluation of the intervention developed in a future trial. | 8.2 Health and welfare economics / P&Cs | 6project_grants_public
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gen_6784b3f85bb352fcededea9a93f951fc | Self-management approaches for individuals with multiple chronic health conditions in rural South Africa | Medical Research Council | University of the Witwatersrand | HRCS22_00938 | South Africans are experiencing a complex, protracted health transition characterised by ongoing burdens from epidemic infectious diseases, particularly HIV/AIDS, rapidly increasing morbidity and mortality from chronic diseases such as heart diseases, stroke, cancer and metabolic disorders and ill-prepared healthcare systems. Levels of multimorbidity, commonly defined as having two or more medical conditions are very high among older South Africans in rural areas with combinations of cardiometabolic conditions, cardiometabolic conditions and depression, HIV and anaemia and combinations of mental disorders as the most common condition groups and multimorbid profiles. As self-management is a critical aspect of the management of chronic diseases, it is important to understand the extent to which individuals with multiple chronic health conditions in South Africa, particularly in rural settings are involved in the self-management of their conditions. Evidence from high income settings shows that self-monitoring of personal health, which is a key aspect of patients' self-management of chronic illnesses, could improve self-management, symptom management and disease regulation, and could lead to reductions in complications, improved patients' coping and attitudes toward their disease, realistic goal setting and an enhanced quality of life. Using a combination of quantitative and qualitative research approaches this project will assess the extent to which individuals with multiple chronic health conditions living in rural South Africa self-monitor their health, what methods they use, and the effect of different self-monitoring approaches on behaviours and health outcomes. The research will be conducted in the Agincourt health and socio-demographic surveillance system study area in Agincourt sub-district in Mpumalanga province, in northeast South Africa. | 3.1 Primary prevention interventions to modify behaviours or promote well-being / P&Cs | 6project_grants_public
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gen_6642aefe55f49c3528d31fbbceaa4e91 | MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine - Training and Development | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00947 | MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine - Training and Development | HRCS Research Uncodeable / Studentship | 1fellowships_scholarships
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gen_30e43274afcc68fe23ceee643ce198e2 | LSH&TM - Gambia (at LSH&TM) DTA - 2019-2029 | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_00954 | No abstract available for this analysis | HRCS Research Uncodeable / Studentship | 1fellowships_scholarships
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gen_726cc11abd906416e49217599e2820ac | 8 - DTA - URVI Uganda (at LSH&TM) | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01014 | The Unit has established management and training structures that are used to ensure there is transparency and equity. These include the Unit Management Committee (UMC) whose membership includes the heads of programmes and sections (the UMC has approved TOR). The Unit has a Training Coordinator who coordinates training activities. At UMC meetings, training needs and the allocation of available resources are discussed and agreed upon. The process of presenting training applications to the UMC is as follows: any staff member, in discussion with their supervisor, can make a case for consideration for training. The Training Coordinator reviews applications and compiles cases for training to be put to the UMC. At the UMC decisions are by consensus. Approval is given on the basis of factors such as relevance to the Unit’s research portfolio, strength of the applicant and application, any previous support to the candidate and available funds. The courses considered include both PhD and Masters Courses. The PhD courses are fully funded and most of those taken on are enrolled at the London School of Hygiene and Tropical Medicine. The Masters courses are funded on a 50% MRC funded and 50% individual student sponsored basis. Consideration for these courses is based on many factors among which is relevance to Unit research and projects with the potential to ultimately result into innovative science. | HRCS Research Uncodeable / Studentship | 1fellowships_scholarships
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gen_26dae5ea3087e2c13354a6d978362f86 | 2018 - DTA - Gambia (at LSH&TM) | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01015 | In developing societies characterised by complete absence of vital registration systems, the continuous demographic surveillance (DSS) approach to data collection provides the best opportunity to generate the quantitative and qualitative evidence of disease burden needed for the formulation and/or adjustment of health policies. Against this background and with the aim of providing robust research platforms for the design and evaluation of interventions to reduce mortality and morbidity, the Medical Research Council, The Gambia runs two such demographic surveillance sites, namely the Farafenni and Basse DSS sites. The Farafenni site, established in October 1981 with the aim of monitoring the impact of village-based Primary Health Care on mortality, is located on the north bank of the river Gambia, about 120 km from the capital city of Banjul, and currently has a total population of over 45,000 under surveillance. The Basse DSS site was established in 2007 and covers all residents of the two eastern-most districts of the country south of the river − over 175,000 people. With the long term goal of serving as a platform for multi-disciplinary population-based investigations on tropical infectious diseases, this site currently facilitates the estimation of the burden of diarrhoea and pneumonia. The available data from both Farafenni and Basse surveillance areas reveal dramatic recent declines in under-5 mortality. In fact, the trends suggest that the Farafenni area reached its Millennium Developing Goal 4 target in 2008, well before the planned date in 2015. Mortality has mainly decreased in older children, while neonatal mortality is stubbornly resistant to change, with the consequence that the proportion of neonatal deaths among children under 5 years has steadily increased. Similar trends were also reported from Niakhar DSS site in Senegal and Navrongo DSS site in northern Ghana. Considering that reliably detecting newborn deaths is a major challenge, the problem may be even worse than we realize. Therefore, improving our techniques of measuring neonatal and infant mortality is an urgent priority. Indeed, this is important to determine the most common causes of death and formulate adequate interventions to decrease the burden. The Child Survival Theme in conjunction with the Disease Control and Elimination Theme plans to build on and go beyond the sound track record of mortality data that exists in The Gambia to achieve the highly robust information on levels and causes of neonatal mortality data that we need. Goal and Scope of Work The goal of the proposed PhD project is to: 1. Adopt a methodological strategy to improve the measurement of neonatal and infant mortality at national and regional levels to accurately reflect the magnitude of the burden. One such approach is the intensive follow-up of identified women up to the completion of their pregnancies and beyond; and of their offspring up to 12 months of age. 2. Investigate the extent to which a childhood mortality transition is evident in the West African sub-region and identify the key health and socio-cultural practices or changes in practices that are driving the phenomenon; as well as the factors sustaining the level of neonatal mortality. The approach will be mainly through quantitative analysis of DSS data from sites in The Gambia, with the possibility of broadening the scope to include DSS data from other West African countries, especially the Sahel region. Demographic and Health Survey (DHS) data from countries in the region with at least one such dataset, and other nationally representative local surveys may also be used to complement the analysis. Where possible and deemed necessary, reasonably scaled qualitative approaches can be adopted to answer questions or establish linkages that quantitative methods may not readily provide. | HRCS Research Uncodeable / Studentship | 6project_grants_public
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gen_bff8d9705e6861bcc4dcbe6e4d3502a7 | LSH&TM - MRC/UVRI Uganda Research Unit on AIDSUVRI Uganda (at LSH&TM) - DTA 2019-2029 | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01023 | No abstract available for this analysis | HRCS Research Uncodeable / Studentship | 2institutional_funding
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gen_5221aaeb96a8e0631bf1eb98dab77d07 | Pathogen Genomics, Phenotype and Immunity (PGPI) & Basic Sciences Programme | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01304 | We propose to monitor the HIV epidemic by characterising the circulating HIV-1 subtypes especially in recent infections and use full length genome sequencing to understand better the increasing recombinant viruses using better bioinformatics tools. We will use molecular in combination with social-epidemiological and modelling approaches to provide novel avenues to monitor epidemic trends and transmission dynamics, and to contribute to targeted interventions through the identification of transmission clusters and hotspots. We will expand our drug resistance (DR) studies to contribute to improved interventions. We are well positioned to provide such data being a National and Regional Reference laboratory for HIV DR and active participants in related national activities. We propose to undertake a comprehensive and systematic analysis of HIV-1 viruses representing the subtypes and recombinant forms circulating in Uganda to elucidate if transmitted/early HIV-1 viruses have recurrent patterns (signatures) that distinguish them from chronic viruses. We will contribute to the studies aimed at understanding whether Zika virus exists among humans, primates and mosquitos in Uganda and conduct studies to molecularly characterize the Zika genome. There is renewed global interest in understanding events surrounding HIV superinfection (SI). However, due to the introduction of test and treat, opportunities to study this phenomenon are very limited. We are uniquely positioned to address this subject, we have a large collection of specimens from high risk populations and hence propose to investigate the host and viral factors associated with SI. This information will contribute to knowledge on protective immune responses. We recently won an NIH RO1 to address this topic and have set up an international collaborative network to address specific questions. The best vaccine induced protection achieved to date against SIV in macaques has been a live attenuated SIV. We propose to study the potential protective immune responses against HIV through PrEP in highly exposed populations. This is in order to explore whether exposure to HIV under PrEP cover could induce immunity equivalent to that afforded by a live attenuated vaccine. This is a proof of the concept that immunity to HIV might be achieved if the initial infections are hampered by chemoprophylaxis, simulating vaccination with a live attenuated virus strain. Gilead has provided the drugs for this study. We will participate in other studies to contribute to HIV Vaccine research and development | 1.1 Normal biological development and functioning / Unit | 6project_grants_public
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gen_a346b078bc8447e355fc08f394c7f98b | Cancer Epidemiology | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01305 | We will build on our work showing that the malignant and non-malignant consequences of oncogenic infections (including HIV) are a major cause of morbidity and mortality in Uganda and that lifestyle risk-factors such as tobacco are currently relatively less important in this setting. We will i) examine the transmission dynamics of oncogenic infections, ii) initiate preventive interventions and, iii) conduct aetiological research on specific cancers. For example, the determinants and immune correlates of suppression and transmission of Kaposi’s sarcoma associated herpesvirus (which exists at higher prevalence in our rural cohort than has been reported anywhere else in the world) will be studied. Working within our population platforms, we will: i) examine the impact of a national HPV vaccination scheme on circulating subtypes of HPV; ii) assess the feasibility of H. pylori eradication in a population in which infection is ubiquitous; iii), conduct a feasibility study of Hepatitis C Virus cure and iv) develop further work on understanding liver disease and progression of chronic infection with Hepatitis B virus. We will also seek external funding to conduct a randomised-controlled trial of low-technology methods (a package of post-harvest measures) in combination with a bio-control approach to reduce aflatoxin levels, which we have previously shown to be an important exposure. Comparative research on the epidemiology and aetiology of haematological malignancies in Uganda and in the UK will be further developed, in conjunction with studies of the HIV-related cancers Kaposi’s sarcoma and conjunctival carcinoma. | 2.1 Biological and endogenous factors / Unit | 6project_grants_public
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gen_5258662cd625c5edeaef01b3b601f0a9 | HIV Epidemiology and Prevention Programme | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01306 | This Programme has two broad areas within which there are specific projects. a) Prevent acquisition of new infections in general and in key populations: i) assess knowledge and preferences for biomedical HIV prevention interventions and adherence to oral PrEP and determine best recruitment and retention strategies for research among adolescents and young women ii) assessing the long term safety profile and adherence of dapivirine vaginal ring in an open-label trial while continuing to assess HIV incidence; iii) work on assessing the impact and adherence of Test-and-Treat as prevention; iv) HIV combination prevention including PrEP among fishing communities, as well as modelling of HIV combination prevention and estimation of the cost-effectiveness, and the impact on HIV incidence; v) continuation of research on evaluating HIV vaccines in early phase I and II trials and phase IIb/III efficacy trials, and new microbicides. b) Improve survival and quality of life among those infected i) mental health care interventions; ii) research on health systems for chronic disease; iii) investigate the effect of hormonal contraceptives on recurrent bacterial vaginosis (BV), vaginal microbiota and inflammatory markers among women at high risk for HIV in Kampala; iv) collaborate with The AIDS Support Organisation (TASO) to identify research questions on topics such as ART toxicities. | 3.1 Primary prevention interventions to modify behaviours or promote well-being / Unit | 6project_grants_public
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gen_0a054175559d216008aed7a04fb9a7d5 | Social Aspects of Health across the Life Course Programme | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01307 | The aim of the programme is to further our understanding of the social aspects of health and wellbeing for specified individuals and populations to inform the design, implementation and evaluation of interventions, as well as contribute to policy development. We will work primarily across the HIV and Non-Communicable Disease themes in close collaboration with the associated programmes. The main geographical focus is Uganda but the programme will contribute to cross-Africa studies and intervention development as appropriate. Our methodological and theoretical work will be of international relevance. The proposed programme builds on core elements of our past work by investigating health across the lifecourse. We anticipate that the programme, which embraces health economics, will continue to grow and will provide training and mentoring to Ugandan and international staff and students. Translational research is an important aspect of all our work and we aim to contribute to the development and testing of interventions. This programme will focus on different stages of the life course and specific populations: 1) Children and adolescents; 2) Key (at-risk) populations; 3) People 50 years and older. | 2.3 Psychological, social and economic factors / Unit | 6project_grants_public
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gen_751d569f08353ba050a0647369486076 | Immunomodulation and Vaccines | Medical Research Council | MRC/UVRI and LSHTM Research Unit Uganda | HRCS22_01308 | Our goal is to understand the impact of infection exposure on human immunological programming and health. Our overarching hypothesis is that chronic and cumulative infection exposure influences immunological mechanisms through active processes (during current infection), lasting epigenetic modifications, and genetic selection; that (therefore) some effects do not immediately respond to treatment; and that effects critically impact upon major health outcomes including vaccine responses and susceptibility to pathogens, allergy-related disease and metabolic conditions (Figure 8.8). The main focus of our work is on vaccine responses, addressing the role of infectious exposures in striking population differences in vaccine immunogenicity. We also support studies on the role of chronic infection in allergy-related and metabolic disease susceptibility. Building on recent findings, exploiting unique platforms that we have established, we aim to determine the effects of infectious exposures (prenatal, cumulative life-time and current, active exposures) on health outcomes comprising: 1. Vaccine immunogenicity 2. Infectious disease susceptibility – focussing on oncogenic viruses 3. Asthma phenotypes and allergy-related effector mechanisms 4. Infection, inflammation and cardio-metabolic risk To obtain deeper insights into mechanisms by which infections have their effects, we plan complementary studies (for which funding is available, or being sought elsewhere) on the mediating role of the microbiome and on the mediating role of epigenetic modifications In addition, the programme supports related studies on tuberculosis and schistosomiasis, and genetic studies. | 2.1 Biological and endogenous factors / Unit | 6project_grants_public
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gen_52a5b102a24708a9cddba7e2411d41b9 | Thematic Support - Disease Control and Elimination | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01342 | The theme answers scientific questions related to the control and elimination of infectious diseases by designing large epidemiological studies and clinical trials (i.e., individually and cluster randomized). These projects target, beyond clinical cases, asymptomatic infections as these are key for maintaining transmission at community level. To control and eliminate diseases of public health importance in the region, DCE needs access to large population and geographical areas. The knowledge of population structure provided in part by the three HDSS run in The Gambia, gives DCE a unique knowhow for implementing cluster randomized trials, mainly in rural areas, to evaluate interventions aimed at system-wide changes or to avoid contamination between arms. Access to community for other studies and trials is through governmental health facilities. The DCE scientific strategy focuses on unravelling the interactions between hosts, pathogens, and vectors and at evaluating interventions aimed at interrupting transmission and/or reducing the disease burden. Both components can inform each other and provide new elements for understanding the dynamics of transmission and identifying new targets for interventions. DCE has a multidisciplinary approach combining epidemiological research with strong laboratory support (formerly for diagnosis but increasingly for more sophisticated molecular analysis). The core component of epidemiology and laboratory sciences is complemented, whenever possible, by social sciences investigating the human factors influencing the epidemiology of the diseases, the uptake and coverage of interventions as well as health economic research to ensure that successful interventions are promptly translated into practice. Research areas: - Malaria. The malaria research activities contribute to a better understanding of malaria epidemiological trends and transmission dynamics needed for better targeting interventions for both control and elimination of malaria. - Invasive bacterial infections (IBI) remain major causes of morbidity and mortality in childhood with an even higher burden among neonates. The research activities on this area have contributed to a better understanding of etiologies responsible for IBI in The Gambia, community transmission and risk factors. In addition, we have designed context specific trials to decrease neonatal sepsis and associated mortality and have evaluated the impact of new country-wise implementations for children. All the studies and trials have a component to assess trends of antimicrobial resistance (AMR) on bacterial isolates. On this area, the Unit has also pioneered research on S. pneumoniae before and after the implementation of Pneumococcal Conjugate Vaccines (PCVs). - Diarrhoeas are a leading cause of morbidity and mortality in children. During the last years, we have quantified burden of disease and main aetiologies responsible for diarrhoeas in The Gambia. Our work led to the introduction of Rotavirus vaccine. Trials to evaluate new interventions are also part of our remit. The Theme conducts research on the links between infections and chronic diseases (such as group A Streptococcus infection and rheumatic heart disease or hepatitis B and liver cancer). Lately, the theme has built a large portfolio on epidemiological research of SARS-CoV-2 and COVID-19 disease. | 2.2 Factors relating to physical environment / Unit | 6project_grants_public
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gen_1c1f10369e15ef6c883222fc86d56fee | Thematic Support - Vaccines and Immunity | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01344 | The Vaccines & Immunity (V&I) Theme aims to contribute to the evidence‐based development and delivery of vaccines through integration of laboratory science with clinical trials and longitudinal cohort studies, including for tuberculosis. Using cutting‐edge immunological methods and bioinformatic approaches, we investigate host responses in individuals of different ages and dissect the interactions between host and pathogen under vaccine or disease pressures. We have worked towards a better understanding of the ontogeny of immunity to inform the next generation of vaccines, and we have a large portfolio of clinical trials to assess safety, immunogenicity and efficacy of novel vaccines and to nurture trust in these interventions. There are several specific workstreams: 1. New interventions to protect pregnant women and their infants against vaccine‐preventable morbidity and mortality Amongst the interventions to improve the unacceptably high morbidity and mortality in women and young children, vaccination of pregnant women could be a valuable approach; this concept is already established for neonatal tetanus in Africa and for influenza and pertussis in high‐income settings. New vaccines aimed at licensure for use specifically in pregnancy are on the horizon (RSV, Group B streptococcus) and our theme is playing an active role in their assessment and implementation through clinical trials and embedded laboratory science to learn more about the immune responses the vaccines induce. 2. Optimising vaccines, schedules and delivery against key pathogens affecting the health of women and children Our research supports the WHO’s Immunization agenda to make sure that ultimately, everyone, everywhere, at every age, can fully benefit from vaccines. We run clinical trials that lead to licensure of highly protective and more cost‐effective vaccines, e.g against causes of bacterial meningitis and pneumonia, viral diseases e.g. cervical cancer, polio, and we work towards optimisation of vaccine delivery and -schedules. We use geospatial mapping methods and social science approaches to understand why not all children in the region receive timely vaccinations. 3. Understanding immune ontogeny through systems biology Systems biology provides new tools to unravel the complex interactions between the different immune compartments; vaccination represents a controlled intervention which allows probing in unprecedented depth the pathways for immune development. We conduct in depth multi-omic analyses of different immune compartments, incl mucosal immunity using optimised laboratory protocols that require minimal blood volumes. 4. Tuberculosis (TB) in adults and children The Gambia remains endemic for TB, with a prevalence rate of 128/100 000 and an average of 3,800 new cases per year. We are ideally placed for in‐depth immunological and microbiological analyses, using a well characterised household contact cohort (the TBCC) approach which facilitates long‐term follow up and has resulted in longstanding track record in TB transmission dynamics research. We work towards identification of novel biomarkers of TB susceptibility and risk of progression to inform correlates of protection which in turn will serve vaccine development, and to develop novel diagnostics, prevent childhood TB and understand long‐term TB sequelae. | 3.4 Vaccines / Unit | 6project_grants_public
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gen_3e61604abee26d4995a2066e84b82471 | Thematic Support - Nutrition Planetary Health | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01345 | Emerging nations such as The Gambia suffer a double burden of malnutrition: rates of undernutrition in mothers and young children are gradually diminishing but remain a major threat to health and well-being; meanwhile rates of overweight and obesity are escalating rapidly with the attendant risks of diabetes and hypertension. The Nutrition & Planetary Health (N&PH) Theme focuses on discovery science in 5 focus areas to better identify diet-disease pathways in order to devise and test more effective next-generation interventions. Early Growth & Development: Having identified pre- and very early post-natal effects on cognitive outcomes this sub-theme is trialling novel supplementary feeding approaches to optimise brain development. Iron, Infection & Anaemia: Having recently identified novel pathways by which hepcidin-mediated blockade of iron uptake contributes to iron deficiency our research is trialling novel interventions focussed particularly on very early iron supplementation of breast-fed babies. The effects of early life iron deficiency on immune function and vaccine responses are key topics. Nutritional Genetics & Epigenetics: We have demonstrated that a mother’s nutritional status at the time of conception influences the methylation of certain genomic regions. We hypothesise that this constitutes a system to sense the external environment, record the information and adapt the developing fetal phenotype accordingly. We have evidence that these loci are under genetic control and can alter life-long risk of disease. Reaching a fuller understanding of the mechanisms and sequelae of these changes may help inform future nutritional guidance and/or interventions for mothers-to-be. Nutrition-Related Chronic Diseases: Burgeoning levels of overweight and obesity, and an ageing population in Africa are leading to multiple chronic diseases. Our research aims to characterise the nature and causes of diabetes, hypertension, sarcopenia and fractures in both rural and urban populations with a view to guide the development of Africa-specific therapeutics. Planetary Health: In response to the growing threats posed by climate change and planetary degradation we are rapidly growing a portfolio of research aimed at designing local and pan-African adaptive strategies built upon a clearer understanding of the complex interactions between agriculture and food systems, alterations in land use, and human-animal interactions. | 2.1 Biological and endogenous factors / Unit | 6project_grants_public
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gen_65df78710c99d2f9a8e4d045cef7fac6 | Genomics Strategic Core Platform | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01346 | Genomics Strategic Core Platform - The move towards high throughput genomics technologies will increase the unit genomics sequencing and data output. The genomics core platform will link the genomics facility with the data science platform (Bioinformatics, HPC, AI) and strengthen current capabilities and work towards becoming a hub for genomics service provider, centre of excellence for establishing SOP and protocols, training in the sub-region. This vision will be pursued vigorously with the aim of establishing a formal sub-regional sequencing service provider that will have visibility for collaboration, joint grant application and revenue earning potential. There is a niche in the sub-region for a provider of this vital service and the ongoing unit-wide programme of accreditation standards will provide relevant experience for the platform to be genomics clinical testing centre and for all its sequencing platforms to achieving the standard required internationally to be certified/accredited service provider. Funding will be sought to support a system for periodic assessment of sample integrity by whole genome amplification (WGA) that allow wider use of stored samples in the unit Biobank, expanding on the system been developed and established for a current project. One key area is developing a platform operated by proactive group continually evolving, seeking out new challenges to solve and new technologies to exploit. And active involvement in knowledge and technology transfer through extension, networks and partnerships experience in training MSc and Post Doc fellows, visitors, and interns. The platform will contribute to the overall Institutional capacity development and will involve improving staff and stakeholder skills, knowledge and experience as well as developing infrastructure, financial resourcefulness, organizational culture, and learning. And thus, strengthening the capacity for influencing policy effectively by working with National Public Health Laboratories, Ministry of Health. We will put in place strategies to attract and retain a new generation of technically qualified staffs and at the same time increase the impact and scale of capacity development for genomics interventions and investment. Secure core-funding for post graduate qualifications and for establishing a R and D and training activities on research areas in the facility. Our status as a World Health Organization Collaborating Centre for New Vaccines Surveillance, Pandemic Preparedness, will open improved opportunities for exchange of information and technical cooperation with other institutions in West Africa, in particular at the international level, and to mobilize additional and important resources from funding partners. | 2.6 Resources and infrastructure (aetiology) / Unit | 7research_infrastructure
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gen_5d6cc9261b9cda9d26f4a30e61c0c880 | Surveillance & Epidemics Preparedness | Medical Research Council | London School of Hygiene and Tropical Medicine | HRCS22_01347 | Surveillance & Epidemics Preparedness | HRCS Research Uncodeable / Unit | 6project_grants_public
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gen_169e22356dc4b88fd40cec2691d1c7be | A randomized controlled trial of influenza vaccine to prevent adverse vascular events. | Medical Research Council | McMaster University | HRCS22_01393 | The goal of this study is to assess whether inactivated influenza vaccine can reduce adverse vascular events in high risk participants. We will address the question by randomizing patients at high risk for adverse vascular events to either annual inactivated influenza vaccine or to placebo over three influenza seasons. Participants will aged 18 years and over and have New York Heart Association functional class II, III and IV heart failure. Patients will be randomized to either influenza vaccine or placebo. We will enroll 3,500 participants from centres in seven countries: Philippines (the lead centre), Mozambique, Sudan, Uganda, Saudi Arabia, Malaysia, China. The primary outcome is a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI), non- fatal stroke, and hospitalization for CHF. We hypothesize that the intervention will lead to a 25% risk reduction in the primary outcome. This proposed randomized trial has important implications for the management of patients at high risk for major adverse vascular events. Although the influenza vaccine is recommended annually for groups with diabetes and cardiovascular disease in many counties, uptake of these recommendations is relatively low. Cardiologists in most jurisdictions do not routinely recommend annual influenza vaccine for their patients as a strategy to reduce future adverse vascular events such as acute coronary syndrome or stroke. Uptake of influenza vaccine in patients with heart disease varies by country but in study sites is 11% on average. Rigorous demonstration of influenza vaccine leading to a reduction in major adverse vascular events would represent a landmark study. | 6.1 Pharmaceuticals / Research Grant | 6project_grants_public
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gen_5ab0b550e0335ea1d235ab2fdfad6605 | Designing and evaluating provider results-based financing for tuberculosis care in Georgia: understanding costs, mechanisms of effect and impact | Medical Research Council | Curatio International Foundation | HRCS22_01486 | The study will first inform how the problem is conceptualised and the intervention is designed in collaboration with the policy makers at national level. Once piloting is started, the research will seek to answer the following research questions: (1) What is the impact of provider-focused Results Based Financing (RBF) on patients' adherence to tuberculosis treatment and treatment outcomes of both Drug-Susceptible (DS) and MDR patients in Georgia? The impact of RBF will be evaluated using a quasi-experimental trial design. Eligible facilities will be randomly selected in 20 districts, then randomly allocated to intervention and control groups. The study population will include nurses and physicians involved in TB primary care and TB patients (DS & MDR-TB cases), who provide TB treatment to approximately 500 patients, which represents 12% of the expected total newly registered TB patients. The intervention will be RBF with provider incentives, complementing the existing patients' incentives. The comparison will be of intervention (RBF) and control groups (existing funding model), considering the variety of the contexts (e.g. semi-urban/urban, and public/private facilities). The outcome measures will be adherence to TB treatment and treatment success rate. (2) Is the RBF intervention cost-effective? Cost-effectiveness analysis will generate evidence on the costs of the intervention by comparing the existing model with the added supply side RBF intervention. (3) How does it work, for whom and in which conditions? and (4) How should RBF be modified to optimise national roll-out for this and possibly other health services? To identify the mechanisms of change and the context factors that enhance or undermine the effectiveness of the RBF intervention, we will carry out realist case studies in a sub-set of sites. This theory-informed trial design will allow us to assess how and why the RBF scheme leads to the observed results, for whom and in which conditions. | 8.1 Organisation and delivery of services / Research Grant | 6project_grants_public
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