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.

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.

Lung cancer is one of the most common cancers in the UK, killing around 35,000 people each year. Around 40% of lung cancer patients will develop a malignant pleural effusion (MPE), a collection of fluid which builds up between the lung and the chest wall. The volume of this fluid can be great enough to compress the lung, causing breathlessness. Some patients experience MPE very differently to others. For example, some will survive much longer or will produce fluid much more quickly. These variations between people makes predicting what will happen and choosing the best treatments extremely challenging. Most treatments for MPE rely on invasive procedures to drain the fluid, which often cause a major impact on a patient's remaining quality of life. At present, we have no reliable blood or pleural fluid tests which can help determine how best to manage patients with MPE or which might give a better idea of what will happen to them. Each person's individual DNA pattern (their genome) underpins how their body functions. Over time, or in response to certain exposures or diseases, DNA can accumulate chemical alterations which affect how its genetic information is interpreted. The study of this phenomenon is called epigenetics, with a key alteration being 'DNA methylation' (DNAm). Levels of DNAm have been found to be associated with the development of a wide range of cancers, including lung cancer. DNAm analysis techniques are improving rapidly, allowing more of the genome to be tested than in the past. DNAm testing can be applied to pleural fluid, although past research has usually focused on whether cancer is present or not rather than predicting what will happen to a person who already has cancer. The aim of this project is to assess whether the levels of DNAm in the pleural fluid of a person with lung cancer can be used to forecast what will happen to them. Primarily, we will check whether it can predict how long a patient is likely to survive, but we are also interested in whether it can provide knowledge about whether treatments will work or not and whether the different behaviours of MPE can be predicted before they happen. To do this, we will ask 100 patients with MPE due to lung cancer from Bristol and Glasgow to join an observational study for 6 months. During the study, we will collect pleural fluid and blood samples alongside comprehensive information about what is happening to each person's disease (for example with CT scans) and how they are responding to the treatments they are given, both for the cancer and the fluid. Most importantly, we will track who survives and who does not during the study. We will then apply the latest laboratory and computational techniques to some of the fluid samples we have collected, to see whether the levels of DNAm correlate with what happens to the patients in the study. Benefits from this project are expected to be: 1) The gathering of high-quality information which will allow us to design further, conclusive studies to test whether pleural fluid DNAm levels can help to predict what happens to lung cancer patients with MPE. Ultimately, we hope to create a new, accessible, DNAm-based test which can be applied to samples of pleural fluid obtained from patients in outpatient clinics. This test could be used routinely by NHS doctors to predict the likely outcome of a person's MPE, helping patients better understand their disease and informing conversations about how best to manage it in their case. 2) The collection and storage of patients' clinical information and samples with a mind to further testing, which will allow us (and future cancer researchers) to apply more of the most up-to-date scientific techniques to predict how a person's MPE will behave over time. 3) A better understanding of how and why lung cancer and MPE develops and progresses, with the potential to reveal new targets for novel drug therapies and to open up new avenues for MPE research.

Aerosol generation occurs when tiny droplets of liquid are suspended in the air. Aerosols can be generated during many medical procedures. Some procedures might produce more aerosols than others, and droplets of different sizes, but there is a lot of uncertainty about this at the moment. What is known is that aerosols can carry viruses, like coronavirus, which risks further infections if inhaled by healthcare staff or other patients. Due to this potential risk, many operations have been delayed or are being performed with extra equipment, greatly reducing the ability of the NHS to resume important services. The AERATOR study aims to rapidly study the amount and type of aerosol generated when medical procedures are performed, and how infectious this aerosol is. This will be performed using specialist equipment in operating theatres and wards to measure real-life aerosol generation. By using specialist equipment, only available at Bristol University, we can also investigate how long coronavirus survives in clinical environments. This vital information will show how best to organise operating theatres, medical procedures, out-patient clinics, wards and use of protective equipment, in order to protect patients and staff while maximising the ability of the NHS to resume life-saving work.

Design is a pressing issue in healthcare. Poor hospital design impacts staff, patients and visitors, and critiques of hospitals are increasingly widespread. Such critiques often claim that we have lost 'holistic' design in healthcare and refer to historical examples to make their case, but draw repeatedly on the same few examples (Nightingale wards, sanatoria) and focus on their visual features (colour, light). This project offers a new way of approaching hospital history, for the benefit of hospital historians, designers and users. It focuses on more recent - and under-studied - hospitals of the National Health Service. It also rethinks the history of healthcare environments through the body and the senses, focusing on how places have felt rather than how they have looked. Using a range of interdisciplinary methods, from archival research to site visits and participatory arts, the project will explore the recent history of the senses in hospitals. The project will consider how NHS hospital sensory environments (or 'sensescapes') changed as a result of new design trends, architecture, materials, technologies, nature and human behaviours. It will also consider how changing social, cultural, political, and economic factors affected people's experiences of the same 'sensescapes'. Overall, by taking the senses as productive sites of interaction between people, technologies, materials and nature, this project will rethink the history of hospitals and provide new approaches for scholars of medical humanities and sensory studies. The project's findings will also feed into an imaginative rethinking of current and future hospital design, including the development of innovative multi-sensory design interventions for healthcare environments. In line with the UKRI strategy, the project will 'identify and tackle the complex societal challenges that matter most to people, in partnership with them ... with the aim of delivering maximum societal value'. It will work with Great Ormond Street Hospital (London), Southmead Hospital (Bristol) and Architects for Health to pinpoint issues or 'problems' for specific types of hospital user/worker or hospital spaces, which might range from sensory under-stimulation to sensory overload. In turn, these 'problems' will form the basis for sensory design solutions through a prototyping and development process in collaboration with artists, designers, charities and NHS Trusts. These outputs will be produced with and of value to all those who use hospitals, from patients to professionals. Overall, the project offers a novel approach to the history of healthcare spaces that helps us to rethink hospital histories and their relevance to current-day design challenges.