Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

In developed countries such as the UK, we spend 90% of our time indoors with approximately two thirds of this in our homes. Despite this fact, most air pollutant regulation focuses on the outdoor environment. There is increasing evidence that exposure to air pollution causes a range of health effects, but uncertainties on the causal effects of individual pollutants on specific health outcomes still exist partly due to crude exposure metrics. Nearly all studies of health effects to date have used measurements from fixed outdoor air pollution monitoring networks, a procedure that ignores the modification effects of indoor microenvironments where people spend most of their time. There are consequently large uncertainties surrounding human exposure to indoor air pollution, which means we are currently unable to identify the most effective solutions to design, operate and use our homes to minimise our exposure to air pollution within them. In the UK, there are virtually no data to quantify indoor air pollutant emissions, building-to-building variability of these, chemical speciation of indoor pollutants, ingress of outdoor pollution indoors or of indoor generated pollutants outdoors, or the social, economic or lifestyle factors that can lead to elevated pollutant exposures. Without a fundamental understanding of how indoor air pollution is caused, transformed and distributed in UK homes, research aiming to develop behavioural, technical or policy interventions may have little impact, or at worst be counterproductive. For example, energy efficiency measures are broadly designed to make buildings more airtight. However, given that the concentrations of many air pollutants are often higher indoors than outdoors, reducing ventilation rates may increase our exposure to air pollution indoors and to any potentially harmful effects of the resulting pollutant mixture. Further, if interventions are introduced without sufficient consideration of how occupants actually use and behave in a building, they may fail to achieve the desired effect. To understand and improve indoor air quality (IAQ), we must adopt a systems approach that considers both the home and the human. There is a particular paucity of data for the most deprived households in the UK. There is a facile assumption that poorer homes are likely to experience worse IAQ than better off households, although the reality may be considerably more nuanced. Lower quality housing may be leakier than more expensive homes allowing indoor emissions to escape more easily, whilst large, expensive town-houses converted to flats can be badly ventilated following poor retrofitting practices. Differences in cooking practices, smoking rates, internal building materials and the usage of solvent containing products indoors will also be subject to wide variations across populations and hence have differential effects on IAQ and pollutant exposure. In fact, differences in individual behaviour lead to large variations in indoor concentrations of air pollutants even for identical houses, typically driven by the frequency and diversity of personal care product use. The INGENIOUS project will provide a comprehensive understanding of indoor pollution in UK homes, including i) the key sources relevant to the UK ii) the variability between homes in an ethnically diverse urban city, with a focus on deprived areas (using the ongoing Born in Bradford cohort study) iii) the effects of pollutant transformation indoors to generate by-products that may adversely affect health iv) the drivers of behaviours that impact on indoor air pollution (v) recommendations for interventions to improve IAQ that we have co-designed and tested with community members.

The COVID19 pandemic has dramatically changed how health care is delivered. Pregnant women have been identified as a vulnerable group to COVID19 and as a consequence, women have received much of their essential health care over the phone, and partners have not been able to attend maternity appointments including baby scans. After birth the usual social support offered by friends and family has been restricted due to social distancing. For women and their partners who are having a baby during this time there is concern that this could have an impact on their physical and mental wellbeing and the health and development of their babies. The recovery from the COVID19 pandemic needs research information on the health, social and economic impacts on vulnerable populations to be made available quickly to key policy and decision makers so that they can develop and implement policies and interventions to reduce potential longer term impacts of the COVID19 pandemic. The Born in Bradford (BiB) research programme (www.borninbradford.nhs.uk) is in a unique position to be able to provide such information on a key vulnerable population: pregnant women living in a highly deprived and ethnically diverse city. BiB have two ongoing birth cohort studies: Born in Bradford's Better Start (BiBBS) focussed on women living in ethnically diverse and deprived communities and BiB4All - a routine data linkage birth cohort study aiming to recruit all pregnant women booked to give birth at Bradford Teaching Hospitals NHS Foundation Trust. Participants give permission for follow-up via routine data from multiple agencies (e.g. GPs, maternity, health visiting, social care) and agree to be contacted for additional research projects with bespoke data collection. The aim of our study is to understand the experiences of being pregnant, giving birth and caring for a baby during the COVID19 pandemic. We will adapt the data collection within our birth cohorts to collect additional quantitative survey data and qualitative interview data at 4 time points during pregnancy and during the first year after birth. This will allow us to: a) understand how COVID19 has affected pregnant women (e.g., being identified as high risk by government, having changes to care or birth plans), and the short- and long-term impact these changes have had, for example on their expectations and experiences of care, their mental wellbeing, worries and concerns, birth outcomes; (b) understand how the crisis is affecting wider aspects of pregnancy and the transition to parenthood, for example peer-to-peer social support, support for breastfeeding and parenting, family relationships and livelihoods; (c) explore how these changes affect the partners of pregnant women during pregnancy and in the postnatal period; (d) inform practitioners, service providers and policy makers where intervention is needed to reduce the adverse effects of the health and well being of women and their babies in the short term and as part of recovery. We will combine the findings of our surveys and qualitative work and use expert groups of key stakeholders and local parents to co-produce recommendations for practice. This research will significantly contribute to understanding the impact of COVID19 on pregnant women and their partner's current and future health and the health and development of their children. It will also inform interventions to reduce the impacts of the pandemic. Bradford, like many other large UK cities, has high levels of deprivation and ethnic diversity, the findings from our study will therefore be scientifically valid and relevant to services and policy makers nationally. Our research team have connections to many other COVID19 research teams nationally and internationally as well as direct links into key national health organisations and policy makers. We will use these connections to ensure wide dissemination of our findings and ensure they are integrated in policy.

Naso-gastric tubes (called NG-tubes) are passed through the nasal cavity down the back of the throat and through the oesophagus (food pipe) to the stomach and are used to give medication, fluids or liquid feeds to patients. Each year one million NG-tubes are used in the NHS in hospital, community (care home and home settings), to give fluids, feeds and medicines into a patient's stomach, if they cannot swallow or drink, or need surgery or intensive care. There is a small chance that NG-tubes can accidentally be put into the lungs (1 to 3 times out of 100) or move from the stomach into the food pipe (19 times out of 100). If liquid is then given down the misplaced tube, serious harm or death can result, this is known in the NHS as a Never Event. Since 2011 there have been 132 such 'never events' reported and, despite the publication of national patient safety alerts in 2011, 2012 and 2016 warning of the dangers of misplaced NG-tubes, the number of reported events has not decreased, with 26 cases of serious harm and death occurring in 2016/17 alone. Until now, the recommended way to check that an NG-tube is placed in the stomach is to get some fluid up the tube known as aspirate, and test how acidic it is using pH paper. A reading below 5.5 indicates the aspirate is acidic and that the tube is in the stomach. However, getting stomach fluid is difficult with a 50-85% chance of success of getting some, so X-rays are often used instead. X-rays can be interpreted incorrectly (as seen in 57% of never events). Moreover, X-rays cost more, cause delays and inconvenience for patients and staff, as well as exposure of radiation to patients. A different approach is needed. Our project aims to develop and test a new portable, sensor-based device (called NG-Sure) to give an accurate check of NG-tube position. NG-Sure works using sensor technology, measuring gases or chemicals, known as volatile organic compounds or VOCs, at the end of the NG-tube to create 'smell fingerprints' in addition to a pH reading. These fingerprints are different depending upon where the tube is situated (stomach, food pipe or lungs). We have carried out a study to test whether it is possible to accurately distinguish smell fingerpints for stomach aspirate and breath from a patient's lungs. Our results were 100% accurate, all breath samples were correctly identified as breath and all gastric samples were identified as stomach aspirate. We have discussed our idea with different clinical groups, in hospital and community settings, and they have told us that a solution to the problem of NG-tube placement is required. In the work proposed here we now want to develop, produce and test a prototype NG-Sure model. To do this we will: - Generate additional smell fingerprints and pH readings for breath, food pipe and stomach samples from patients to add to our existing database of smell fingerprints - Work out a way of getting the gas and chemical samples needed to measure the smell fingerprints and pH readings up the patient's NG-tube when it is in place - Work closely with healthcare staff and patients and their carers throughout the project to understand their needs and requirements as we design and build our prototype device - Test the safety and function of our prototype device once built in a clinical study with 200 patients by comparing our device against X-rays taken in patients who need the position of their NG-tube confirming before it is used - Study the financial benefits of our new device compared to current practice and identify ways to manufacture our device on a large scale.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.