UK ENABLE Consortium vision, aims and objectives: Local government is uniquely placed to shape the environmental and social factors which fundamentally influence non-communicable diseases (NCDs) and thus our health and wellbeing. Our vision is for local government to consider the health of local populations in all policy and practice decisions and to have the best possible scientific evidence to support those decisions. We will test our vision by working with five different local authority (LA) based public health systems across the UK, learning what works best, and what can be useful for all LAs across the UK. Our consortium brings together academics, practitioners, policy makers and other stakeholders from across the UK in five centres in NE and SW England, Scotland, Northern Ireland and Wales; each with different models of public health delivery. We will develop and test a process that embeds research capacity and expertise in LAs. Working closely with our partners in each LA, we will identify a current priority for improving the health and wellbeing and reducing inequalities of people living in that area. By building relationships between academics, practitioners and policy makers we will enable the LA to access and create new evidence that is relevant for decision making about the priority issue. Scientific rationale for the proposed research: Evidence-informed policy-making aims to improve decision making by using the best available research. Organisational and cultural barriers within the current system have made this approach difficult to achieve. New methods and approaches are needed which bring together researchers, practitioners and policy makers in local government, where evidence is only one contributing factor to decision-making. Embedded researchers and knowledge brokers can help to ensure evidence is used by building understanding of the context, accessing existing, and co-producing new evidence. Intervention(s) of interest and the potential applications and anticipated benefits of the work: By the end of the project we will: 1. Increase research capacity and 'no how' in each LA, focusing on a local NCD priority issue, enabling access to evidence to inform local decision-making. We will develop and share learning which is generalisable across the UK 2. Build and support new partnerships for active and effective research use with practitioners, policy makers, and academia 3. Build knowledge and skills in local government and universities to maximise use of different kinds of evidence for policy, practice and public decision-making 4. Co-create evidence that addresses local government priorities, with a focus on prevention, by working across sectors and disciplines, utilising novel methodological approaches, including complex systems models 5. Develop a range of health and system interventions that have been co-produced and tested across LA areas 6. Create sustained change in research culture in LAs and academia so that evidence use is embedded across local government 7. Evaluate this new approach and methods to see if we made a difference to the health of people living in each area, related to their priority topic, and whether/how this approach could be rolled out across the UK We anticipate that this work will improve population health and wellbeing and increase the use of scientific research. It aims to improve quality, efficiency and effectiveness of public health interventions and services, reduce waste, and improve staff morale and retention. Consortium management: Our across-UK academic leadership brings together experience of applied translational research in prevention from four of the UKCRC funded Centres of Excellence in Public Health. Senior leaders in local government public health, bring practical experience of putting evidence into action. Other members have expertise in systems thinking, embedded research, knowledge brokerage and other skills essential to our success.

Speech Sound Disorders (SSDs) are the most common communication impairment in childhood; 16.5% of eight year olds have SSDs ranging from problems with only one of two speech sounds to speech that even family members struggle to understand. SSDs can occur in isolation or be part of disability such as Down syndrome, autism or cleft palate. In 2015, the James Lind Alliance identified improving communication skills and investigating the direction of interventions as the top two research priorities for children with disabilities. Our programme of research aims to fulfil this need by developing technology which will aid the assessment, diagnosis and treatment of SSDs. Currently in Speech and Language Therapy, technological support is sparse. Through our previous work in the Ultrax project we showed that by using ultrasound to image the tongue in real-time, children can rapidly learn to produce speech sounds which have previously seemed impossible for them. Through this project, we developed technology that enhances the ultrasound image of the tongue, making it clearer and easier to interpret. Ultrax2020 aims to take this work forward, by further developing the ultrasound tongue tracker into a tool for diagnosing specific types of SSDs and evaluating how easy it is to use ultrasound in NHS clinics. The ultimate goal of our research is that Ultrax2020 will be used by Speech and Language Therapists (SLTs) to assess and diagnose SSDs automatically, leading to quicker, more targeted intervention. Normally speech assessment involves listening to the child and writing down what they say. This approach can miss important subtleties in the way children speak. For example, a child may try to say "key" and it may be heard as "tea". This leads the SLT to believe the child cannot tell the difference between t and k and select a therapy designed to tackle this. However, ultrasound allows us to view and measure the tongue, revealing that in many cases children are producing imperceptible errors. In the above example, an ultrasound scanner placed under the chin shows that the child produces both t and k simultaneously. Identification of these errors means that the SLT must choose a different therapy approach. However, ultrasound analysis is a time consuming task which can only be carried out by a speech scientist with specialist training. It is a key output of Ultrax2020 to develop a method for analysing ultrasound automatically, therefore creating a speech assessment tool which is both more objective and quicker to use. Building on the work of the Ultrax project, where we developed a method of tracking ultrasound images of the tongue, Ultrax2020 aims to develop a method of classifying tongue shapes to form the basis of an automatic assessment and a way of measuring progress objectively. We are fortunate to already have a large database of ultrasound images of tongue movements from adults and primary school children, including those with speech disorders, on which to base the model of tongue shape classification and to test its performance. At the same time, we will evaluate the technology we develop as part of Ultrax2020 by partnering with NHS SLTs to collect a very large database of ultrasound from children with a wide variety of SSDs. In three different NHS clinics, SLTs will record ultrasound from over 100 children before and after ultrasound-based speech therapy. This data will be sent to a university speech scientist for analysis and feedback to clinicians recommending intervention approaches. Towards the end of the project, we will be able to compare this gold-standard hand-labelled analysis with the automatic classification developed during the project. At the conclusion of our research project we will have developed and validated a new ultrasound assessment and therapy tool (Ultrax2020) for Speech and Language Therapists to use in the diagnosis and treatment of SSDs.

The EPSRC IRC Proteus is made up of a group of world-leading scientists, engineers and clinicians. Interdisciplinarity is at our heart - we work across traditional boundaries linking together disciplines such as optical physics, chemical biology, biology and engineering to name but a few. The ambition and desire is to translate technologies to help patients - empowering clinicians to "see disease" in front of their eyes at the bedside and help them to make the right decisions and give the right treatments at the right time. This highly interdisciplinary collaboration driven by clinical need and pull, has led to the design, fabrication and testing in patients of a number of world-leading bedside-based technology platforms. Our technology platform combines advanced fibre optic technology (that can be readily be passed into the lung of patients) and highly sensitive detectors in association with highly sensitive fluorescent chemical reagents to diagnose disease. This allows clinicians to "view" inside the lung to detect bacteria or aberrant disease signatures of disease. Clinical pull: Intensive care unit (ICU) patients suffer high death and disability rates and are responsible for a disproportionate financial burden on the health service (the equivalent of 1% of USA GDP is spent on patients in intensive care). Potentially fatal lung complications are a common problem in ventilated ICU patients and doctors caring for these patients in the ICU face many challenges, often needing to make snap decisions without the information necessary to properly inform those decisions. The new technology platforms being developed by Proteus are helping doctors in the intensive care unit to make rapid and accurate diagnoses of patients, allowing them to direct and inform therapy and ensure patients get the right treatment, at the right time and quickly. Although our technology platforms have a focus at this time on being used in the intensive care unit, it is widely applicable to a wide range of lung conditions and other healthcare situations, such as bowel or pancreatic cancer. The next steps for the IRC are to take our technology into a new area in which different flavours of light can be used to diagnose disease - using the teams' highly advanced light sensors (that are able to count a single photon). In addition the proposal moves the IRC towards sustainability, creating a legacy from the EPSRC investment - accelerating the pathways to take new technology into patients, while developing commercial opportunities. In summary the EPSRC IRC Proteus has generated a new cohort of young interdisciplinary scientists trained in physical and biological sciences and engineering that have a full appreciation and practical experience of clinical translational and commercialisation pathways. They will be able to meet the challenges of converting advances in science and engineering into healthcare benefits with the development of a number of cutting-edge bedside technology platforms which will help doctors make rapid and accurate diagnoses. The team, in association with the partner Universities, have also begun to make major strides towards full sustainability of the IRC - making major impacts in the areas of clinical and commercial translation, with significant academic outputs and public engagement activities.

Parents whose baby is in a neonatal intensive care unit (NICU) usually are under a lot of stress. Much of this stress is unavoidable, but in some cases parents are under more stress than necessary because they do not understand what is happening to their baby. Although NICU medical staff of course do their best to keep parents informed, some parents may not fully understand the terminology used by doctors and nurses (and may be reluctant to admit this), and also some parents may not be able to physically visit the NICU and talk to medical staf because of other commitments such as caring for other children.In a PhD project associated with the EPSRC-funded BabyTalk project, we have developed a software system, BT-Family, which produces summaries of a baby's status for parents. BT-Family builds on the award-winning BabyLink parent-information system used in the Edinburgh NICU, primarily by using artificial intelligence and natural language generation technology to automatically analyse and summarise the information in the baby's electronic patient record.BT-Family has been developed in consultation with parents, but it has not actually been deployed and evaluated by parents; this was not possible in the time frame of the PhD project. The goal of this project is to enhance BT-Family and deploy it in the wild where parents of NICU babies can use it, and evaluate how useful it is and also find out how parents believe the system can be improved.Although our focus in this project is specifically on parents of NICU babies, if this project is successful we believe that our ideas can be generalised to other situations where a parent or carer is responsible for someone in hospital. We believe that providing better information to parents and carers can reduce stress in many contexts (not just NICU), and that this is a major opportunity to use advanced IT to enhance the quality of life of people in the unfortunate position of having a child or dependent in hospital.

Those living in low-income areas have a much higher risk of long-term conditions such as diabetes, heart disease, depression, and frailty. Our lifestyle, such as how active we are, what we eat and if we smoke or drink alcohol in excess can greatly increase our chance of having one of these diseases. The environment that we live in, such as if we live close to or visit parks, canals, and forests, can help us live a healthier life. However, communities living in low-income areas can have poorer access to such spaces or use them less. They also have less voice in decisions affecting their local spaces, at either local or national level. We propose a new partnership: researchers, clinicians, practitioners (such as urban designers) and policymakers all working with local citizens who have the most to benefit from better access to and use of quality spaces. We will work collaboratively to identify poor quality and underused spaces through citizen-led approaches. We will then work with them to develop and/or modify outdoor spaces so that they are high quality and fit for purpose. These actions can be as small as window boxes in schools, or as large as the development of new greenways or reshaping policies regarding land use to protect our green spaces. We will also work to identify ways in which we can promote such spaces for everyone, ensuring that no community is excluded form benefit. The important aspect is that local communities are fully involved in decisions about what they want, and what they will use, thus becoming central to the decision-making process. They will also be involved in the evaluation of these actions, enabling them to directly see how the process has benefited their communities. An important part of putting actions and solutions in place is understanding if they work (or not). Data plays an important part in measuring success, particularly if the same data can be collected consistently across the different actions. Another part of the partnership will be establishing a way of bringing multiple sources of data together so we can effectively determine what works across multiple projects and settings. So, whilst citizens can be involved in collecting data about whether the space has improved their health and wellbeing (through a bespoke app), we can also use other data on health, wellbeing and the environment that is routinely collected by local councils and governments. The main research will take place in three different cities - Edinburgh, Belfast and Liverpool - all with some similar features (such as large urban areas with lower income communities) and distinct features (such as geography and culture). Each city already has policies and programmes in place to improve green and blue space, but there is much room for improvement. Working with the local citizens we will test a range of different methods and approaches, and be able to collect a large amount of data. This data can then be used to understand what works for whom and why across the cities. We can then use this knowledge to predict what could be effective over a much wider area, and also what does not work. We can also make some decisions around what is good value for money, and what is not. We also understand that individual small actions within local communities (or even within cities) are not going to solve the problem, which is why we are also going to focus on how our research can help inform future policies and programmes. Our programme of work will take a whole life course approach which will ensure inclusive environments for all; working with our youngest citizens in particular will ensure early cultural change levers are activated, empowering a new generation with lifelong health and wellbeing.