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"id":"4fb8117c-3e16-459e-83e1-f435ea44c9b9", "related_activity_context":"ID: GB-GOV-10-RP_06\nTitle: National Institute for Health and Care Research (NIHR)’s sixth Global Research Professorship call\nDescription: National Institute for Health and Care Research (NIHR)’s sixth Global Research Professorship call. The Global Research Professorships programme funds research leaders, with a track-record of applied health research in low- and middle-income countries (LMICs), to promote effective translation of research and to strengthen research leadership at the highest academic levels. Funding of up to £2m over up to 5 years is awarded to Professors working in close partnership with a research institution in an LMIC.. By the end of the award, NIHR Global Research Professors will be expected to: \n\n1) Have demonstrated research leadership at a national and/or international level.\n2) Have been developed and protected by their institutions, including being relieved of administrative tasks.\n3) Enhance existing and establish new research collaborations in low- and middle-income countries (LMICs).\n4) Have supported training and capacity strengthening/mentorship within LMIC and UK (if applicable) institutions that enhances research capacity for future global health and care research.\n \n ID: GB-GOV-10-RP_06_303125\nTitle: NIHR GRP: Mitigating Chronic Respiratory Disease through the lens of Multi-Morbidity\nDescription: AIM: The scientific challenge I will address is how to better identify people living with chronic respiratory diseases (CRDs) in low- and middle-income countries (LMICs). Specifically, I will demonstrate the ability to reliably identify previously un-diagnosed CRDs in people attending clinics for other conditions such as high-blood pressure and diabetes in San Carlos, Brazil. I will also demonstrate that identifying chronic obstructive pulmonary disease (COPD) and asthma in this way benefits those affected and society.. This project has 5 aims:\n\nAIM-1: Determine the patterns and time-sequence of acquiring other medical conditions in people with chronic respiratory diseases (CRDs). This will be achieved by applying a novel mathematical approach to our existing, large random population dataset of 10,664 people.\n\nAIM-2: Assess the accuracy of simple chronic obstructive pulmonary disease (COPD) case-finding questionnaires to find people with un-diagnosed CRDs in community-based high-blood pressure and/or diabetes clinics in Brazil. We will enrol 859 people from such clinics, use casefinding questionnaires to measure CRD risk, and compare this against a gold-standard diagnosis using spirometry.\n\nAIM-3: Assess if CRD case-finding questionnaires can be successfully used by clinicians in community high-blood pressure and/or diabetes clinics in Brazil. We will ask four clinicians at each of five clinics to use the questionnaire in 50 patients each (1,000 people in total). We will test how well they use the questionnaire and ask about ease of use.\n\nAIM-4: Investigate whether people identified using case-finding questionnaires as being at high-risk for CRDs in high-blood pressure and/or diabetes clinics are able to access health-care. We will re-contact people identified in AIMS 2 and 3 as being at high-risk for CRDs to see if they were able to access a confirmatory diagnosis and treatment six months later.\n\nAIM-5: Determine whether optimisation of care in people found to have COPD and asthma through case-finding is associated with improvement in their health and benefit to society. For people confirmed as having COPD and asthma in AIMS 3 and 4, we will recommend optimal care and measure health-status before and after six months. We will collect information on costs to tell us whether such an approach could be cost effective at scale.\n \n ID: GB-GOV-10-RP_06_303140\nTitle: NIHR GRP: Refining interventions to reduce AIDS mortality from bacterial and fungal infections in Africa\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-countries (LMICs), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nThis Global Research Professorship aims to reduce deaths caused by serious bacterial and fungal infections amongst adults living with Advanced HIV Disease (AHD) in Africa. The work is being done predominantly in South Africa, taking place between March 2024 and February 2029. In 2021, approximately 650,000 people died of AIDS-related causes, two-thirds in African countries. Serious bacterial and fungal infections cause a third of AIDS-related deaths at least on par with tuberculosis. The World Health Organization (WHO) recommends ways to reduce infection-related deaths in people with advanced HIV disease, their preferred term for AIDS. This includes taking a daily tablet antibiotic (cotrimoxazole) to prevent bacterial/ fungal infections, and a blood test plus a course of antifungal medicines for a fungal infection called cryptococcosis. \n\nThe main work packages in this professorship are firstly to collect information using laboratory records on the number and causes of bacterial blood infections and meningitis among South African adults with advanced HIV disease, and at some hospitals, collect detailed information from patients and run additional tests directly on their blood samples plus any bacteria cultured from these samples. Secondly to test fluconazole and flucytosine treatment for cryptococcosis in a clinical trial, while meaningfully involving patients and the public in a study design to answer questions about acceptability and feasibility. And finally to evaluate new laboratory tests, which measure the amount of fungal genetic material in blood, to work out if such tests can: (a) identify patients with cryptococcosis at higher risk of meningitis, and (b) diagnose histoplasmosis/ emergomycosis.. This project has three specific objectives: \n1. Determine the burden, aetiological causes of, and risk factors for bacterial bloodstream infections/ meningitis, relative to cryptococcosis and tuberculosis, in a South African inpatient cohort with Advanced HIV Disease (AHD).\n2. Evaluate fluconazole and flucytosine treatment for cryptococcal antigenaemia in a randomised-controlled trial (EFFECT), with added-value qualitative-methods research studies guided by patient and public involvement and engagement.\n3. Evaluate novel quantitative molecular assays for risk stratification of subclinical cryptococcosis and early diagnosis of histoplasmosis/ emergomycosis.\n \n ID: GB-GOV-10-RP_06_303157\nTitle: NIHR GRP: Improving sexual Health in pregnancy in Africa: A people-centred Approach\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nSexually transmitted infections (STIs), including HIV, cause a high morbidity and mortality burden in Southern and Eastern Africa. During pregnancy and post-partum, STIs have additional serious consequences. This is also a period when women are engaging with health services, presenting a window of opportunity for intervention, both to prevent immediate adverse consequences and to educate and empower for the future. Generating evidence-based guidance on sexual healthcare in pregnancy is a priority for the World Health Organization (WHO). To generate the evidence needed to inform sexual healthcare in pregnancy and post-partum, this Professorship will build on my well-established programme of research at the Botswana Sexual and Reproductive Health Initiative and a newer collaboration with the Malawi-Liverpool-Wellcome Trust Programme. We will conduct many different types of research to learn how to improve these services using better STI diagnostic tests. We will also design and evaluate an intervention for STI testing and treatment in pregnancy to improve care for women, their babies and their partners.\n\nPregnancy and breastfeeding are a time of high risk for women getting HIV infection and passing HIV onto their babies. Treatments to prevent HIV in people at high HIV risk, called HIV PrEP, are already available and many more are being developed. We need to learn more about how to best deliver these treatments to pregnant and breastfeeding women. We will conduct research to understand women’s knowledge, needs, and preferences for HIV prevention in pregnancy. Using that information, we will design and test an intervention for HIV prevention in pregnancy to improve care for women, their babies and their partners. This work is being done between March 2024 and February 2030.\n\nAt the end of this project, together with women, their partners, young people and healthcare providers, we will develop a ‘Better Sexual Health in Pregnancy’ intervention that is people-centred and based on scientific evidence. We will also set up a research site within public health services in Botswana to test the intervention, and to study the impact of other interventions in the future.. This project has five specific objectives:\n1. Public-patient involvement and engagement. A Community Engagement and Involvement Group and Community and Youth Advisory Boards will be appointed to map out the overall project priorities, goals, processes, review progress, and co-produce/co-design specific project activities and interventions.\n2. Diagnostic-driven sexually transmitted infections (STI) management. STI services are often unavailable, inaccessible or inappropriate to populations in Africa; rely on ‘syndromic management’ which has been shown to be ineffective in controlling STIs; are not routinely informed by surveillance data; and often do not include care for sexual partners. We will conduct a series of mixed-method studies to address these challenges, developing and evaluating a patient-centred, diagnostic STI intervention, with cost-effectiveness assessments and antimicrobial resistance surveillance.\n3. Preventing HIV-infection. HIV incidence is high during pregnancy and post-partum. Pre-exposure prophylaxis for HIV (PrEP) is critical, yet implementation models remain undefined. We will assess preferences for PrEP and HIV self-testing among HIV-uninfected pregnant and post-partum women and their partners using discrete choice experiments and qualitative methodologies. We will then co-design and test an intervention to improve PrEP and HIV self-testing using integrated delivery models.\n4. Intervention and cohort. From Aim 1-3 outputs, we will co-create a people-centred, evidence-based ‘Better Sexual Health in Pregnancy’ intervention and a cohort infrastructure embedded within routine services in Botswana to test it, and ultimately to determine programmatic outcomes when delivered at scale.\n5. Policy and practice. To maximise sustainable impact, we will engage key stakeholders and develop relationships and resources to influence regional and international policy and build a well-equipped advocacy network to drive progress beyond this Professorship.\n \n ID: GB-GOV-10-RP_06_303161\nTitle: NIHR GRP: Improving outcomes of infants, children, and adolescents with HIV (REFINE)\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-country (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nDespite advances in HIV treatment, HIV-related ill-health and death remains a huge problem in South Africa. The goal of HIV treatment is to keep the virus count/load (VL) in the blood very low or suppressed to ensure that HIV does not result in sickness, death or impact the growth and development of children during this critical stage in their lives. Despite advances in HIV treatment, children lag behind adults, with only 40% of children virally suppressed compared to 70% of adults. There is an urgent need to develop scalable models of delivering HIV treatment to optimise the number of virally suppressed children retained in care.\n\nThe study will be conducted amongst people living with HIV in a poor, rural area (uMkhadyakude district) and an urban area (eThekwini district) of KwaZulu-Natal. The work is being done between March 2024 and February 2029. The aim of this work is to improve the outcomes of children and adolescents living with HIV in South Africa. I will do this through improved HIV treatments (biomedical) and develop a peer-led intervention with psychosocial support (biosocial intervention) tailored to this population. First, we will evaluate a peer-support intervention conducted either in-person or via mobile phone (mHealth) to support adolescents (15-19years) living with HIV transition to adult care where they need to be responsible for their own health. \n\nSecond, we will develop and conduct a study to evaluate a peer-support intervention to support families of children (0-15years) living with HIV. During the first 12 months, we will use participatory research with patients and public involvement (PPI) to optimise a peer-navigator-delivered intervention for families. \n\nThirdly, we will use a mixture of interviews with children, families and caregivers, service providers and peer navigators, and programme data to evaluate the implementation of the peer-support intervention at the clinic to understand the barriers and enabling factors.\n\nAnd finally, we will explore the perspectives of children, adolescents, caregivers, healthcare workers and policymakers on potential new long-acting HIV treatments to be developed in the future and establish a platform to evaluate them in primary healthcare settings. These will be used to inform the development of new generations of simplified treatment options.. The study will consist of four work packages linked to the four main study aims:\nAim 1: Using a stepped-wedge cluster randomised controlled trial, determine the effectiveness of in-person or mHealth-based adolescent-friendly transition interventions compared to standard care on retention in care and viral suppression among adolescents (aged 15-19) living with HIV who have low transition readiness. The study is funded by the National Institutes of Health (NIH) (InTSHA VIP Grant: R01MH131434).\nAim 2: Using a stepped-wedge cluster randomised controlled trial to determine the effectiveness of the peer-led interventions with or without financial incentives with families and carers compared to standard care on retention in care and viral suppression among children (1month-14 years) living with HIV. The study will be conducted in the same sites as an NIH-funded adolescent study (InTSHA-VIP). It will leverage the clinic staff and study set-up but will adapt the intervention to be family-based with a younger cohort of participants.\nAim 3: Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, determine the implementation factors involved in the provision of the interventions (aims 1 and 2).\nAim 4: Conduct a nested acceptability and feasibility study to evaluate children, adolescents, caregivers, health care workers (HCWs), and policymakers' perceptions of novel antiretroviral treatment (ART) formulations in urban and rural settings in South Africa, including long-acting injectables and micro-array patches (MAP).\n \n ID: GB-GOV-10-RP_06_303164\nTitle: NIHR GRP: Translating evidence for Early Intervention in Psychosis (TRANSLATE) in Low- and Middle-Income Countries: Implementation and Evaluation\nDescription: Aims: We aim to develop and establish early intervention for psychosis services in Pakistan and Sri Lanka and assess whether the service can help improve the health outcomes among people with first episodes of psychosis. We also aim to understand the factors that are associated with treatment resistant schizophrenia (TRS) and whether based on these factors we can develop a tool that can predict the likelihood of a patient developing treatment resistant schizophrenia.. This project has 6 objectives:\n\n1. To implement a culturally sensitive early intervention psychosis (EIP) service in Pakistan and Sri Lanka based on recent guidelines for managing first episode psychosis (FEP) adopted for low-and-middle-income (LMIC) settings.\n\n2. Evaluate the implementation of EIP in maintaining engagement with the services, achieving remission in FEP, and other relevant implementation outcomes.\n\n3. To assemble a cohort of FEP within the EIP service and identify potential predicting factors of treatment resistant schizophrenia at one-year follow-up.\n\n4. To develop a prognostic model for estimating an individual's risk of treatment resistance at one year and to undertake the validation of the model's predictive performance.\n\n5. To identify barriers and facilitators for the scale-up of the EIP at regional and international level.\n\n6. To build capacity for implementation research and service development for youth mental health in LMICs.\n \n ID: GB-GOV-10-RP_06_303165\nTitle: NIHR GRP: Mobile health (mHealth) supported self-care among tertiary education students in Zimbabwe (MASCOT)\nDescription: To work together with students to develop a self-care strategy that combines mHealth and decision aids and enables students to optimally use HIV and contraception services. The study is divided into five stages and builds on another study where a self-care strategy supported by an mHealth tool (without decision aids) was developed. In the first stage, we will conduct research to find out what students prefer a self-care strategy that is combined with decision aids to look like. In the second stage, we will use findings from the first stage to develop blueprints for two decision aids: one for contraception and the other for HIV prevention. In the next stage we will integrate the decision aids with the existing mHealth tool through a group activity that includes students and experts in health and mHealth. In the fourth stage we will test whether the whole self-care strategy, supported by the mHealth tool with decision aids, works well. Finally, in the fifth stage we will compare colleges/universities that use the self-care strategy with those that do not, to see whether promoting self-care results in more students taking up HIV and contraception services. We will also make recommendations on how the strategy can be provided outside colleges/universities.. This project has 6 specific objectives:\n\n1. Explore preferences for decision aids and how they can be incorporated into the existing self-care intervention. \n\n2. Develop/adapt blueprints for human immunodeficiency virus (HIV) prevention and contraception decision aids according to student values/preferences. \n\n3. Integrate the existing mHealth tool with decision aids for HIV prevention and contraception.\n\n4. Determine feasibility and acceptability of MASCOT (mobile health (mHealth) supported self-care among tertiary education students in Zimbabwe) in two colleges/universities. \n\n5. Determine the effectiveness of MASCOT in improving uptake of HIV and contraception services and its societal costs in a cluster randomised trial in 16 colleges/universities. \n\n6. Explore how to adapt MASCOT for other settings.\n \n ID: GB-GOV-10-RP_06_303168\nTitle: NIHR GRP: Building fairer international research systems that minimise and manage moral distress\nDescription: The NIHR Global Research Professorship (GRP) scheme is open to all professions and all Higher Education Institutions (HEI), based in UK and low-and-middle-income-countries (LMIC), to nominate health researchers and methodologists with an outstanding research record of clinical and applied health research and its effective translation for improved health. Global Research Professors are required to have existing strong collaborations or links with collaborators or partners in institutions in countries on the OECD DAC list and the award should plan to strengthen these/support training and capacity development/mentorship in these partners.\n\nThis programme of work is being carried out in Kenya but will also include staff working in other African and Asian countries. The work is being done between March 2024 and February 2029. The programme of research will examine an essential but neglected ethics and social justice concern in global health research: How international research programmes can ensure fairer research processes that protect frontline staff from moral distress. The goal is to advance policy, practice and understanding of this neglected area and contribute to fairer research conduct, a more inclusive and creative research culture, and strengthened health and research systems.. This project has four specific objectives: \n1. Understand the nature and systemic drivers of moral distress experienced by frontline research staff and the health system staff who host them, and the functioning of support processes.\n2. Co-design & evaluate strategies that promote fairness and that address moral distress among frontline research staff.\n3. Explore the potential to extend support processes for research staff to health system colleagues experiencing similar distress and how promising interventions might be transferred and embedded into wider health systems.\n4. Develop practical ethics and social justice guidance and toolkits targeting researchers and funders that take into account a) the expectations, rights and obligations of different stakeholders (frontline health and research staff, research managers) and b) ideas from promising interventions.\n", "_version_":1864124429031702528 }] } }