Secondary schools are important settings for health improvement, providing access to young people during a critical period when health risk behaviours markedly increase. Yet despite sustained effort to promote health through schools, the evidence for school-based interventions that effectively address issues such as obesity, smoking, alcohol use and mental health is limited. Health improvement research in school settings is challenging, with trials currently implemented in an ad hoc and inefficient manner. This is in stark contrast to research in primary care, which was greatly enhanced by the advent of primary care research networks (PCRNs) which facilitated an increase in the quantity and quality of randomised trials, improved research capacity and provided support for practitioner-led research. Such a step change is urgently needed to advance school-based research in the UK. The project aims to improve the quantity, quality and efficiency of public health research in schools by developing and evaluating a School Health Action Research Partnership and Network (SHARPEN). The research to evaluate and refine SHARPEN has 3 strands. In the first, researchers from Cardiff, Bristol, Oxford and Swansea universities will work in partnership with the Welsh Government, Cancer Research UK, Public Health Wales and Cardiff and Vale University Health Board to establish a network of up to 90 secondary schools that are 'trial ready', by developing more efficient recruitment, consent and data linkage procedures. We will identify the infrastructure and processes necessary to make the network efficient, effective, acceptable and rewarding for both schools and researchers. We will explore the barriers and facilitators to making the network sustainable. Students in network schools will complete the Health Behaviour in School-Aged Children (HBSC) survey, a school environment schedule will be completed for each school, and we will pilot a system that uses these data as a basis for providing regular, tailored feedback to schools on pupil health behaviours and the school environment. In the second strand we will test the feasibility of establishing school-based action research partnerships to see whether they add significant value to the network model. Five schools will each form an action group of pupils, teachers, parents, health professionals and academics and over the course of a year each group will review their HBSC survey and school environemnt data, identify health priority areas, discuss the links between health and educational outcomes and develop and implement a school health action plan. Action plans will draw on the project partners and local resources and adopt a whole-school approach to health improvement. We will evaluate the action research partnerships to capture how they worked, the factors that hindered and helped them, and whether schools and other stakeholders found them feasible and useful. During this strand, student and parent views on data linkage will also be sought. Issues around informed consent and anonymity will be discussed with students and parents and if possible, data linkage will be piloted. The aim of the third strand is to scope the potential for sustaining the network and expanding it in Wales and for transferring the network model to secondary schools in England. Lessons from the first two strands will be fed back to key stakeholders in England and Wales and their views will be sought on network sustainability and its potential for expansion. The development of new school health research networks in England and Wales has significant potential to coordinate, increase and strengthen school-based research and inform evidence-based school health activity, thereby contributing to young people's health in the UK.

The Bionics+ NetworkPlus will represent the spectrum of research, clinical and industrial communities across bionic technologies within the EPSRC Grand Challenge theme of Frontiers of Physical Intervention. It will invigorate and support a cohesive, open and active network with the mission of creating a mutually supportive environment. It will lead to the co-creation of user-centred bionic solutions that are fit for purpose. These advances will have a global impact, consolidating the world-leading position of the UK. The founding tranche will focus on ambitious and transformative research, new collaborative and translational activities, and the formulation of a longer-term strategy. Within this context, as a community, we will explore and identify areas of opportunity and value, driven by Bionics users' needs, complementary to existing activity and strengths. The network will instigate and support early-stage research in these priority areas, alongside providing an outward-facing representation and engagement of the UK Bionics community. Further, we aim to contribute in an advisory capacity to public bodies, UK industry and government policy. At the time of the application, we have obtained a positive commitment from circa 70 groups including bionic users, academic partners from universities in England, Scotland, Wales and Northern Ireland and a few international partners; partners in medical devices, orthotics and prosthetics industry, both large corporates and small-medium size companies; and many clinicians, surgeons and aligned health experts from relevant NHS clinics and the private sector.

The ability to predict weather offers the potential to provide valuable information that can be used in planning health services. For example, imagine a hospital planning system that was able to predict fluctuations in demand for different services as a consequence of predictions of meteorological events such as the early February cold spell in 2009. Such a tool would result in a substantial benefit to both the NHS and health outcomes. Specifically, appropriate use of meteorological intelligence would help to:1. Improve health by reducing morbidity and mortality rates, and generally improving health outcomes.2. Improve access to services by better predicting hospital pressures due to weather events, thus allowing for hospital mangers to anticipate and better prepare for such fluctuations. This research will explore and quantify the relationship between weather patterns and extreme weather events, and their impact on various health conditions, such a heart attacks, stroke, asthma, and fractures. For example, it is thought that a sudden surge in cold temperature can cause blood to thicken slightly and blood pressure to increase, which can trigger a heart attack or stroke in vulnerable patients. There are many other reported (observed) trends such as thunderstorm-related asthma. A thunderstorm in South East England, for example, saw 640 patients presenting with severe asthma to hospital, ten times the usual number. By linking weather and health in this way, we can help save lives or minimise the risk of morbidity by creating an early warning system that can ensure at-risk patients are well informed and have sufficient medication and advice. Furthermore, this research will utilise computer simulation techniques and statistical models and apply their use to create a novel hospital operational capacity support tool (MetSim) that will utilise meteorological forecasts alongside NHS hospital data to provide information to hospitals on expected levels of emergency admissions and to alert them of sudden surges in demand and daily fluctuations. By forecasting demand in this manner, MetSim will allow hospital managers to understand more closely resulting resource needs over the short-term planning horizon and assist in planning decisions such as cancellation of elective admissions. Given that the provision of hospital resources is a matter of considerable public and political concern and has been the subject of widespread debate, this research will help the NHS more effectively and efficiently plan and manage their health services.A further benefit of MetSim is that it can act as a public health warning system. Health-weather correlations could be used by regional Strategic Health Authorities or Primary Care Trusts to alert at-risk populations. This could have significant public health benefits by ensuring such people are better informed about the forthcoming risks and have sufficient medication and appropriate medical advice. Treating patients for the health conditions evaluated in this research (to include heart disease, stroke, acute bronchitis, fractures and pneumonia) accounts for a significant proportion of the NHS budget. For example, stroke and heart disease incidence in the UK is amongst the highest in the world and these two conditions alone cost the NHS an estimated 18.3 billion annually. Using MetSim to prevent hospital admissions or improving health outcomes for even a small percentage of these patients could result in significant costs savings to NHS Trusts.This novel and valuable research involves a collaborative team of specialists in Operational Research and Statistics, with co-operation and support of the Met Office, Southampton University Hospital NHS Trust, and the Cardiff and Vale NHS Trust. The level of support, commitment and excitement about this research from these three organisations is such that between them they have pledged 60,000 towards the costs of the overall project.

Brain diseases such as tumours, head injury, epilepsy, multiple sclerosis and dementias have considerable personal, social and economic costs for the sufferers and their carers. While magnetic resonance imaging (MRI) has revolutionised the management of many brain conditions in the last 40 years, there is a need for better tools for quantifying the brain's supply of energy in terms of blood flow and vascular function and it use of energy in terms of metabolic function. For example, in the case of the most common forms of brain tumour, glioma, we lack detailed information about the heterogeneity of tissue function that could help guide better treatments such as more targeted and individualised combined radiotherapy and drug programmes. Understanding more about the tumour microenvironment will also promote the development of more effective treatments. For high-grade gliomas, particularly glioblastoma, the prognosis remains poor, highlighting an urgent clinical need. Recently, we at Cardiff University Brain Research Imaging Centre (CUBRIC), and others, have developed MRI-based tools (termed dual calibrated fMRI) to map across the human brain, with a spatial resolution of a few millimetres, the amount of oxygen that the brain is consuming (known as CMRO2) along with measures of the efficiency of blood supply. CMRO2 reflects neural activity and can be altered with disease such as tumour where there is cell proliferation and energy metabolism is changed. Knowing also the functional properties of brain blood vessels and the oxygen status of brain tissue is important for understanding whether blood supply is sufficient or the vasculature is abnormal as is often seen in tumours where vessels proliferate. Our newly developed methods have shown promise in revealing abnormalities of brain tissue energy consumption in multiple sclerosis and epilepsy. In epilepsy they may offer an alternative to the use of radiation-based PET scans in the evaluation of patients for brain surgery by identifying areas in the brain with abnormally low metabolism. However, to produce a wider clinical impact it is necessary to advance the MRI and data analysis further, such that they could then be taken forward for commercial development and routine clinical use, initially within clinical trials. Two-thirds of the proposed project will address engineering and physical science challenges to (i) speed up data acquisition to about 10 mins, a clinically feasible time, by optimising the MRI data acquisition and analysis, (ii) widen the range of tissue pathology that we can reliably measure through collection of additional MRI information and detailed biophysical modelling of tissue properties and (iii) implement efficient artificial intelligence (neural network) based data analysis that can rapidly feed the images to the clinician at the MRI scanner. The remaining one-third of the project will demonstrate the feasibility of the method and its value in application to brain tumour (glioma). We aim to show that we can map the heterogeneity of tumour tissue that can reveal the type of tumour, where it is actively growing, where it is and is not responding to treatment and where radiotherapy may be damaging healthy tissue, all helping to guide treatment decisions for maximum efficacy. Central to the success of our proposal are our partnerships with industry and the NHS. Siemens will contribute the expertise of its onsite scientist at CUBRIC for the development of the MRI technology. The Velindre Cancer Centre, South Wales' principal centre for oncology, will partner on the clinical pilot studies and help to evaluate imaging for future patient benefit. Our partners will help us to bring the methods to the point within this project, if successful, of commercial development for healthcare benefit and larger scale clinical trials to demonstrate how the methods may be used in clinical practice for diagnosis, treatment planning and monitoring.

Neurological diseases cause a substantial and increasing personal, social and economic burden. Although there have been exceptions, there is increasing frustration at the limitations of learning from animal models, emphasising the importance of studying human tissue. Neuropathologists work in NHS hospitals examining samples from the brain and related tissues derived from operations (biopsies) or post mortem examinations. Their job is to identify abnormalities, make a diagnosis and try to understand how the abnormalities arise. Neuropathology has existed as a specialty in the UK for 40-50 years and, as a consequence of this work, substantial archives of diagnostically verified tissue have been established nationwide. These archives contain a wealth of tissue from a great variety of neurological conditions, including common conditions such as stroke, head injury, tumours, infections, psychiatric disorders, developmental disorders and many rare conditions, and represent an underutilised resource for research. BRAIN UK (the UK BRain Archive Information Network) networks the tissue archives of neuropathology departments based in 26 regional NHS Clinical Neuroscience Centres to form a virtual brain bank, acting as a "matchmaker" linking researchers needing tissue to the appropriate samples. Through BRAIN UK researchers can gain access to >400,000 samples from a wide range of diseases affecting the brain, spinal cord, nerve, muscle and eye. BRAIN UK has ethical approval which covers the majority of projects, saving the researchers considerable time as they would otherwise have to obtain this approval independently. Over the past 4 years BRAIN UK has supported 48 research projects in many centres around the UK and overseas. In the coming 4 years we want to continue to provide tissue to researchers from existing resources and add newly obtained samples of which >16,000 are becoming available each year. We also aim to gather the results of researchers' studies performed on tissue obtained through BRAIN UK to form a central register of findings which will benefit new researchers wanting to perform new studies on these tissue samples. Finally, we will link BRAIN UK with UK Biobank, which has 500,000 intensively studied participants from the general population, in order to learn more about the origins of neurological disease. As far as we are aware, the BRAIN UK network is unique in the world and is very economical as it makes use of tissue samples already being stored in NHS archives which would otherwise be unused and unavailable to researchers.