London, United Kingdom

The Centre for History in Public Health is an academic research centre at the London School of Hygiene & Tropical Medicine , University of London. It specializes in historical research into public health and health services, and advocates the use of history within public health policy making. Wikipedia.


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Patent
London School of Hygiene and Tropical Medicine | Date: 2017-02-08

The invention relates to deoxyribonuclease for use in the treatment of a suspected or existing C. difficile infection; a pharmaceutical or veterinary composition or formulation comprising at least deoxyribonuclease for use in the treatment of a suspected or existing C. difficile infection; a combination therapeutic comprising at least deoxyribonuclease for use in the treatment of a suspected or existing C. difficile infection; a method of treating a mammal suspected of being infected with, or infected with, C. difficile comprising the use of at least deoxyribonuclease; a method of cleaning or sterilising a material or product comprising the use of at least deoxyribonuclease; and a cleaning or sterilising product impregnated with or containing at least deoxyribonuclease.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: PHC-24-2015 | Award Amount: 18.47M | Year: 2016

The management of febrile patients is one of the most common and important problems facing healthcare providers. Distinction between bacterial infections and trivial viral infection on clinical grounds is unreliable, and as a result innumerable patients worldwide undergo hospitalization, invasive investigation and are treated with antibiotics for presumed bacterial infection when, in fact, they are suffering from self-resolving viral infection. We aim to improve diagnosis and management of febrile patients, by application of sophisticated phenotypic, transcriptomic (genomic, proteomic) and bioinformatic approaches to well characterised large-scale, multi-national patient cohorts already recruited with EU funding. We will identify, and validate promising new discriminators of bacterial and viral infection including transcriptomic and clinical phenotypic markers. The most accurate markers distinguishing bacterial and viral infection will be evaluated in prospective cohorts of patients reflecting the different health care settings across European countries. By linking sophisticated new genomic and proteomic approaches to careful clinical phenotyping, and building on pilot data from our previous studies we will develop a comprehensive management plan for febrile patients which can be rolled out in healthcare systems across Europe.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: SC1-PM-21-2016 | Award Amount: 7.58M | Year: 2017

STRENGTHS aims to provide effective community-based health care implementation strategies to scale-up the delivery and uptake of effective mental health interventions in different country contexts. The current refugee crisis across Europe and the Middle East effects both individual refugees psychological well-being, as they face extreme stressors in their flight from their home country, but also has large effects on the healthcare systems of countries housing refugees. In reponse to this crisis, the STRENGTHS project aims to provide a framework for scaling-up the delivery and uptake of effective community-based mental health strategies to address the specific needs of refugees within and outside Europes borders. STRENGTHS will outline necessary steps needed to integrate evidence based low-intensity psychological interventions for common mental disorders into health systems in Syrias surrounding countries taking up the majority of refugees (Turkey, Lebanon and Jordan), a LMIC (Egypt) and European countries (Germany, Switzerland the Netherlands and Sweden). The consortium is a unique partnership between academics, non-governmental organisations (NGOs), international agencies and local partners with the responsibility to provide and scale-up evidence-based mental health and psychosocial support interventions for refugees. Key preparatory steps in the local political, regulatory and governance processes for uptake and scaling-up of the intervention and key contextual and system-related factors for integration will be validated for the real-life impact on the responsiveness of the system. The low-intensity interventions and training materials will be adapted and implemented in Syrian refugees within Syrias surrounding countries taking up the majority of refugees (Turkey, Lebanon and Jordan), a LMIC (Egypt) and European countries (Germany, Switzerland the Netherlands and Sweden). STRENGTHS will disseminate and promote buy-in of a validated framework for large-scale implementation of the low intensity interventions to providers of health and social services, policy makers and funding agencies.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: SC1-PM-21-2016 | Award Amount: 7.07M | Year: 2017

ImpleMentAll will develop, apply, and evaluate tailored implementation strategies in the context of on-going eHealth implementation initiatives in the EU and beyond. Common mental health disorders account for an alarming proportion of the global burden of disease. Being regarded as an evidence-based psychotherapeutic eHealth intervention, Internet-based Cognitive Behavioural Therapy (iCBT), has the potential to answer to this societal challenge by providing an efficacious and efficient treatment from which more people can benefit. As a result, various iCBT implementation projects are currently conducted across the world. We propose to use this natural laboratory to develop and evaluate a toolkit for tailored implementation strategies that is expected to make implementation trajectories more efficient. The objectives for ImpleMentAll are: 1) To develop a generic Integrated Theory-based Framework for Intervention Tailoring Strategies (the ItFits-toolkit) for data-driven tailored implementation of evidence-based eHealth services. 2) To demonstrate the impact of the ItFits toolkit on the implementation of eHealth for common mental disorders, in 9 European countries, 2 LMIC, and Australia. 3) To disseminate the validated toolkit in various healthcare contexts across Europe. ImpleMentAll is a true multidisciplinary international collaboration that unites key experts in clinical practice, health innovation, clinical research, and implementation science. Combined with its unique setup, ImpleMentAll will be able to test if tailoring implementation strategies lead to more efficient implementation. The resulting ItFits-toolkit will enable data driven evaluation of eHealth implementation projects in terms key performance indicators for process, effectiveness, and efficiency outcomes. Its methods, materials, and strategies will provide concrete guidance on tuning implementation interventions to local determinant of practice across a variety of health care systems.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: SC1-PM-22-2016 | Award Amount: 15.59M | Year: 2016

ZIKAlliance is a multidisciplinary project with a global One Health approach, built: on a multi-centric network of clinical cohorts in the Caribbean, Central & South America; research sites in countries where the virus has been or is currently circulating (Africa, Asia, Polynesia) or at risk for emergence (Reunion Island); a strong network of European and Brazilian clinical & basic research institutions; and multiple interfaces with other scientific and public health programmes. ZIKAlliance will addrees three key objectives relating to (i) impact of Zika virus (ZIKV) infection during pregnancy and short & medium term effects on newborns, (ii) associated natural history of ZIKV infection in humans and their environment in the context of other circulating arboviruses and (iii) building the overall capacity for preparedness research for future epidemic threats in Latin America & the Caribbean. The project will take advantage of large standardised clinical cohorts of pregnant women and febrile patients in regions of Latin America and the Caribbean were the virus is circulating, expanding a preexisting network established by the IDAMS EU project. I will also benefit of a very strong expertise in basic and environmental sciences, with access to both field work and sophisticated technological infrastructures to characterise virus replication and physiopathology mechanisms. To meet its 3 key objectives, the scientific project has been organised in 9 work packages, with WP2/3 dedicated to clinical research (cohorts, clinical biology, epidemiology & modeling), WP3/4 to basic research (virology & antivirals, pathophysiology & animal models), WP5/6 to environmental research (animal reservoirs, vectors & vector control) , WP7/8 to social sciences & communication, and WP9 to management. The broad consortium set-up allow gathering the necessary expertise for an actual interdisciplinary approach, and operating in a range of countries with contrasting ZIKV epidemiological status.


Grant
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: SC1-PM-22-2016 | Award Amount: 12.56M | Year: 2016

The ZikaPLAN initiative combines the strengths of 25 partners in Latin America, North America, Africa, Asia, and various centres in Europe to address the urgent research gaps (WP 1-8) in Zika, identifying short-and long term solutions (WP 9-10) and building a sustainable Latin-American EID Preparedness and Response capacity (WP 11-12). We will conduct clinical studies to further refine the full spectrum and risk factors of congenital Zika syndrome (including neurodevelopmental milestones in the first 3 years of life), and delineate neurological complications associated with Zika due to direct neuroinvasion and immune-mediated responses. Laboratory based research to unravel neurotropism, investigate the role of sexual transmission, determinants of severe disease, and viral fitness will envelop the clinical studies. Burden of disease and modelling studies will assemble a wealth of data including a longitudinal cohort study of 17,000 subjects aged 2-59 in 14 different geographic locations in Brazil over 3 years. Data driven vector control and vaccine modelling as well as risk assessments on geographic spread of Zika will form the foundation for evidence-informed policies. The Platform for Diagnostics Innovation and Evaluation will develop novel ZIKV diagnostic tests in accordance with WHO Target Product Profiles. Our global network of laboratory and clinical sites with well-characterized specimens is set out to accelerate the evaluation of the performance of such tests. Based on qualitative research, we will develop supportive, actionable messages to affected communities, and develop novel personal protective measures. Our final objective is for the Zika outbreak response effort to grow into a sustainable Latin-American network for emerging infectious diseases research preparedness. To this end we will engage in capacity building in laboratory and clinical research, collaborate with existing networks to share knowledge and tackle regulatory and other bottlenecks.


Coleman M.P.,London School of Hygiene and Tropical Medicine
The Lancet | Year: 2014

Millions of people will continue to be diagnosed with cancer every year for the foreseeable future. These patients all need access to optimum health care. Population-based cancer survival is a key measure of the overall effectiveness of health systems in management of cancer. Survival varies very widely around the world. Global surveillance of cancer survival is needed, because unless these avoidable inequalities are measured, and reported on regularly, nothing will be done explicitly to reduce them.


Taylor F.,London School of Hygiene and Tropical Medicine
Cochrane database of systematic reviews (Online) | Year: 2013

Reducing high blood cholesterol, a risk factor for cardiovascular disease (CVD) events in people with and without a past history of CVD is an important goal of pharmacotherapy. Statins are the first-choice agents. Previous reviews of the effects of statins have highlighted their benefits in people with CVD. The case for primary prevention was uncertain when the last version of this review was published (2011) and in light of new data an update of this review is required. To assess the effects, both harms and benefits, of statins in people with no history of CVD. To avoid duplication of effort, we checked reference lists of previous systematic reviews. The searches conducted in 2007 were updated in January 2012. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2022, Issue 4), MEDLINE OVID (1950 to December Week 4 2011) and EMBASE OVID (1980 to 2012 Week 1).There were no language restrictions. We included randomised controlled trials of statins versus placebo or usual care control with minimum treatment duration of one year and follow-up of six months, in adults with no restrictions on total, low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol levels, and where 10% or less had a history of CVD. Two review authors independently selected studies for inclusion and extracted data. Outcomes included all-cause mortality, fatal and non-fatal CHD, CVD and stroke events, combined endpoints (fatal and non-fatal CHD, CVD and stroke events), revascularisation, change in total and LDL cholesterol concentrations, adverse events, quality of life and costs. Odds ratios (OR) and risk ratios (RR) were calculated for dichotomous data, and for continuous data, pooled mean differences (MD) (with 95% confidence intervals (CI)) were calculated. We contacted trial authors to obtain missing data. The latest search found four new trials and updated follow-up data on three trials included in the original review. Eighteen randomised control trials (19 trial arms; 56,934 participants) were included. Fourteen trials recruited patients with specific conditions (raised lipids, diabetes, hypertension, microalbuminuria). All-cause mortality was reduced by statins (OR 0.86, 95% CI 0.79 to 0.94); as was combined fatal and non-fatal CVD RR 0.75 (95% CI 0.70 to 0.81), combined fatal and non-fatal CHD events RR 0.73 (95% CI 0.67 to 0.80) and combined fatal and non-fatal stroke (RR 0.78, 95% CI 0.68 to 0.89). Reduction of revascularisation rates (RR 0.62, 95% CI 0.54 to 0.72) was also seen. Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects. There was no evidence of any serious harm caused by statin prescription. Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life. Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta-analysis indicate that these benefits are similar in people at lower (< 1% per year) risk of a major cardiovascular event. Reductions in all-cause mortality, major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins.


Dudbridge F.,London School of Hygiene and Tropical Medicine
PLoS Genetics | Year: 2013

Polygenic scores have recently been used to summarise genetic effects among an ensemble of markers that do not individually achieve significance in a large-scale association study. Markers are selected using an initial training sample and used to construct a score in an independent replication sample by forming the weighted sum of associated alleles within each subject. Association between a trait and this composite score implies that a genetic signal is present among the selected markers, and the score can then be used for prediction of individual trait values. This approach has been used to obtain evidence of a genetic effect when no single markers are significant, to establish a common genetic basis for related disorders, and to construct risk prediction models. In some cases, however, the desired association or prediction has not been achieved. Here, the power and predictive accuracy of a polygenic score are derived from a quantitative genetics model as a function of the sizes of the two samples, explained genetic variance, selection thresholds for including a marker in the score, and methods for weighting effect sizes in the score. Expressions are derived for quantitative and discrete traits, the latter allowing for case/control sampling. A novel approach to estimating the variance explained by a marker panel is also proposed. It is shown that published studies with significant association of polygenic scores have been well powered, whereas those with negative results can be explained by low sample size. It is also shown that useful levels of prediction may only be approached when predictors are estimated from very large samples, up to an order of magnitude greater than currently available. Therefore, polygenic scores currently have more utility for association testing than predicting complex traits, but prediction will become more feasible as sample sizes continue to grow. © 2013 Frank Dudbridge.


Conway D.J.,London School of Hygiene and Tropical Medicine
Trends in Genetics | Year: 2015

More human death and disease is caused by malaria parasites than by all other eukaryotic pathogens combined. As early as the sequencing of the first human genome, malaria parasite genomics was prioritized to fuel the discovery of vaccine candidate antigens. This stimulated increased research on malaria, generating new understanding of the cellular and molecular mechanisms of infection and immunity. This review of recent developments illustrates how new approaches in parasite genomics, and increasingly large amounts of data from population studies, are helping to identify antigens that are promising lead targets. Although these results have been encouraging, effective discovery and characterization need to be coupled with more innovation and funding to translate findings into newly designed vaccine products for clinical trials. © 2014 Elsevier Ltd.

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