Schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms including hallucinations (hearing or seeing things that don't exist), delusions (unusual beliefs not based on reality), muddled thoughts based on hallucinations or delusions and changes in behaviour. Schizophrenia is a common cause of long-term disability in the 15-49-year-old group and whilst effective treatments are available, in developing countries around two thirds of patients receive no treatment. This lack of treatment, commonly known as the 'treatment gap' arises due to factors including poor treatment adherence, a lack of primary care involvement and poor access treatments. We have previously reported a new approach (Supervised Treatment in Out-Patients for Schizophrenia (STOPS)) that resulted in improved treatment adherence and functioning in a resource poor setting in Khyber Pakhtunkhwa (KP), Pakistan. In this study we trained and supported relatives and family members to monitor medication taking, building on the success of a similar approach used for patients with tuberculosis. We now aim to implement and evaluate a 'scaled-up' version of STOPS (STOPS+) which is based on the World Health Organisation mental health guidelines and maintain treatment adherence with the help of family members and text message reminders. We will work with primary care physicians and multipurpose primary are technicians to task shift care, under the supervision of mental health experts. The study has 3 phases: PHASE 1: PRE-IMPLEMENTATION PHASE involving community engagement, modification of STOP to STOPS+ (involving patient, healthcare and wider community partners) and the identification of potential study participants. PHASE 2: IMPLEMENTATION OF STOPS+ IN PRIMARY CARE SETTINGS USING A CLUSTER TRIAL DESIGN to determine the clinical and cost-effectiveness. 24 primary care centres in district Peshawar, KP will be randomised to deliver either STOPS+ or Enhanced Treatment As Usual (ETAU). We will recruit 526 patients (263 in each arm) suffering from Schizophrenia or schizoaffective disorder based on the International Classification of Diseases (ICD)-10 criteria. The outcomes of interest will include Global Assessment of Functioning and adherence to treatment regimen. PHASE 3: EVALUATION OF THE IMPLEMENTATION IN REAL WORLD SETTING will be measured using the standardised World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS), economic evaluation, secondary data from the trial and utilisation of primary health care, and in depth interview study involving all participants. If successful this trial will improve schizophrenia care, improving lives for patients and their families. This work will provide important information for policy makers and set the foundations for reducing disability and improving long term patient outcomes.

The ReValuing Care Research Network will be an international, interdisciplinary network of academics and related third sector professionals working together to interrogate contemporary and future approaches to conceptual and normative understandings of care. Members of the network will include academics working on issues related to care from a variety of different sites, disciplines and contexts, including healthcare, childcare, eldercare, environmental issues, animal welfare and other related fields. The network builds on academic connections initially developed through the AHRC-funded Research Centre for Law, Gender and Sexuality (CentreLGS, funded 2004-2009, graded Outstanding), and will facilitate the strengthening of links between centre partner institutions, (Keele, Kent and Westminster) and the creation of new research collaborations with the Fay Gale Centre for Research on Gender at the University of Adelaide, alongside other new international and interdisciplinary academic collaborations that arise through the network activities. The Gender, Sexuality and Law research group at Keele, who will lead on the network, have an established international reputation for cutting edge scholarship in gender, sexuality and law. The Fay Gale Centre builds on interdisciplinary excellence in gender studies at the University of Adelaide to provide a focus for the development and uptake of new theoretical and methodological approaches relating to gender in society. Care has been a mainstay of feminist research for the last three decades, with different approaches to care being ascendant at different times. The research questions at the heart of this research network will contribute to future conceptual understandings of care, through providing physical and virtual spaces for scholars to interact, discuss and present their work. The participants in the research network will be drawn from a variety of different disciplinary backgrounds and will therefore draw on a multiplicity of conceptual approaches and methodological tools. At the heart of the planned research network is a commitment to creating opportunities for open dialogue between academics and activists, advocates and others working in the third sector. To do so, the network will run two international, interdisciplinary workshops. The first workshop, 'Resources for Caring' will take place in September 2012 at Keele University, UK. Workshop 2, 'Caring about Social Interconnection' will take place in September 2013 at the University of Adelaide. The workshops will be carefully structured to provide space for discussion and interaction, as well as allowing for the presentation of both empirical and conceptual academic work. The workshop organizers will ensure that the format of each event is as inclusive and facilitative of non-academic engagement as possible. Each of these physical meeting spaces for the network will be supported through the development and implementation of an interactive website. Workshop participants and network members will be encouraged to continue the conversations started at the workshops through the network website. Use of the website will be integrated with the workshop activities, in order to ensure that participants and discussions effectively cross the boundary between physical and virtual space. The research network activities will be overseen by an Advisory Panel, with both academic and third sector members. Following the workshops, three further outputs from the project will be developed: 1) an edited collection of papers from the project, aimed at an academic audience, will be drawn together, edited by Harding (PI) and Fletcher (Co-I); 2) a policy-relevant report identifying key themes, questions and issues generated at the workshops will be published on the project website; and 3) the key participants aim to put together an international collaborative research project team to take forward one or more of the identified research priorities.

The proposed research has a thematic strand (1) and a methods strand (2), as outlined below: 1) It looks at representations of Quebec's 'regions'--spaces and places outside Montreal--in post-1960 fiction in French and English. From the period of modern day nationalist assertion popularly dated as beginning in 1960 until around 10 years ago, 'hors-Montreal' (rest of Quebec, or ROQ) was marginalised in terms of literary production and criticism, as well as cultural and political debates. What became known as Quebec's Quiet Revolution sought to effect a break with the past, rejecting a pan-Canadian cultural nationalism in favour of a territorial nationalism which cast Quebec as the sole francophone 'home' within Canada. Symbol of a new, modern Quebec nation, Montreal increasingly became the preferred setting for fiction (Nepveu and Marcotte 1992, 7) and literary criticism. With the exception of a small handful of works (e.g. Laforest 2016, 2010; Sing 1995; Warwick 1968), analyses of literary representations of spaces and places outside of Quebec's main city were relegated to the occasional book chapter. Since 2000, however, 'hors-Montreal' has attracted renewed public interest with respect to politics and culture. In literature, Montreal is being displaced as authors increasingly opt to set their novels in smaller cities, villages, rural and 'wilderness' spaces (Archibald 2012, 17). Whilst this is particularly true of French-language authors, some English-language fiction on and of 'the regions' exists (e.g. Penny, Keightley). Looking beyond the discipline of Quebec Studies, the project considers trends in 'new regional writing' in the UK and North America (e.g. New Writing North). It also explores wider questions around the relationships between the urban and non-urban, the city and 'regions'. Writing in 1973, Raymond Williams argued that the boundaries between the country and the city were not clear-cut (1975 (1973): 1). Debates within rural geography (Cloke 2006, Edensor 2006) highlight the ways in which such boundaries are increasingly blurred, partly due to globalisation. 'The regions' have, of course, asserted themselves in recent years in other places besides Quebec, notably in the UK referendum on membership of the European Union (2016) and the U.S presidential elections (2016). 2) The project aims to draw on, and develop further 'walking studies' (Lorimer 2011, Morgan 2016) methods and methodologies on which I have been working since 2014, and which belong to the subdiscipline of Geohumanities. Broadly conceived, Geohumanities brings together spatial concerns in Humanities and Social Sciences. Creativity is often used to facilitate exchange and participation (see, e.g. Cresswell 2015: 7). 'Heartlands/pays du coeur' draws on methods from literary geographies, geopoetics, psychogeography and other walking, writing and creative practices, combining these with methods from oral history and geography. It will produce and co-produce a variety of knowledge forms. These include academic outputs such as a journal article and conference papers, and non-academic outputs like creative writing texts (where 'writing' encompasses a variety of practices, not all of them word-based), readings, a dance, a digital map and an audio-walk. In terms of future legacies, the project will serve as preparation for leading an inter- and multi- disciplinary project on walking (defined as a range of practices, some of which are bipedal), well-being and regions.

This work will use exploratory scientific research to help further understand, and potentially disrupt, the way that cancer cells spread. This process is called angiogenesis and is central to all cancers. A critical part of angiogenesis is controlled by enzymes within cells that regulate the extracellular environment. More specifically, these enzymes act by breaking down biologically important carbohydrate molecules, called heparan sulfates, whose function is to switch on cellular signalling cascades, effectively initiating angiogenesis. We intend to design and synthesise a series of molecular carbohydrate tools that would be capable of detecting the activity of one of these key enzymes, called heparanase. Using our combined inter-disciplinary knowledge of synthetic carbohydrate chemistry and molecular sensing technology we will design and build molecular probes that can detect the activity of heparanase. The existence of this technology would then enable the future development of research programmes that use these tools to screen for and subsequently select potential inhibitors of heparanase, providing a route towards new therapeutic strategies against cancer.

One-in-ten people experience a psychotic episode (delusion, hallucination) before 18 years of age. These experiences can be upsetting and, without adequate treatment, can have serious long-term effects (e.g. reduce quality of life, disrupt education, reduce long-term employment). Early treatment after a psychotic episode is vital to reduce long-term effects. People living in Low and Middle Income Countries (LMICs) (e.g. Pakistan) experience poorer access to care compared to those in Higher Income Countries (e.g. UK, USA). It can take over two years for someone living in an LMIC to be diagnosed and treated for psychotic episodes. This is double the time it takes for someone in the UK. We previously carried out research about psychotic episodes in the Peshawar district of Pakistan. We found that people with mental health issues often sought help from traditional and spiritual healers (TSHs). These issues are commonly linked to superstition and/or spirits. Seeking help from TSHs is a key cause of delay in treatment for psychotic episodes. Collaboration between TSHs and primary care has shown to improve healthcare provision for health conditions, such as HIV/AIDS, but the same has not been evaluated for psychotic episodes, up to now. The proposed programme of research, called THEHOPE (Traditional healers working with primary care and mental health for early intervention in psychosis) seeks to develop a new way of detecting and treating psychotic episodes among adolescents in Peshawar, Pakistan. This research will strengthen collaboration between TSHs and primary care to improve healthcare for patients reporting these issues. By working with TSHs we will develop a new approach that is culturally-sensitive and acceptable to local populations. We have designed a four-stage plan of research to help develop and test this new way of working:- (1) We will work closely with people with psychotic episodes (and their carers), TSHs, and primary care practitioners to understand the healthcare context in Peshawar. We will use this information to design THEHOPE intervention and training. (2) Experts in early intervention in psychosis will train psychiatrists who will then train primary care physicians in Peshawar. These primary care physicians will in turn train the TSH. This model of cascade training involves task shifting from mental health professionals to community health workers and lay persons and has been successfully used in resource poor settings to provide services in a cost effective way. (3) We will test whether this new way of working helps to detect the cases of first episode psychosis at earliest possible stage in a specially designed study called feasibility cluster randomised controlled trial. In this trial small geographical clusters of Peshawar city (called Union Councils) will be randomly allocated either to proposed new way of working or to a control condition (i.e. treatment as usual). This will help us to examine whether traditional healers will engage in the study, and whether patients consent to participate in the trial and complete the follow-up. Testing the feasibility of these parameters will help us to decide the design and methodology of a much larger study to evaluate the new ways of working in more rigorous way. (4) All of above stages of research will be closely examined and evaluated to see whether these are acceptable to all participants (e.g. patients and carers) and can be implemented in future studies. This research will build on existing community practices and resources in a LMIC setting, to improve healthcare for people with psychotic episodes. As TSHs often have a role in mental healthcare in LMICs, findings from this research may be relevant to other countries. The results of study will be disseminated through publications in scientific journals, meetings involving patients and carers and different stakeholders and by using the social media tools such as twitter.