40% of all patients in the intensive care unit (ICU) need a ventilator to support their lungs, with many associated complications. Currently the main indication of clinical deterioration is the presence/spreading of shadowing on the chest x- ray. This has many different causes (all requiring different treatments). There is a pressing need for rapid bedside tests to provide definitive diagnostic information about what is happening in the lungs themselves. Many studies have used blood markers, but in patients with multi-system disease these are not specific for the lung and the results are too slow to be useful in the rapidly-changing ICU setting. We will employ cutting-edge technology to pass a tiny optical fibre deep into the lungs of ventilated patients and spray a 'microdose' of an imaging agent that will tell us the reasons for the lung deterioration. This approach has the potential to rapidly determine, at the bedside, if the lung shadowing is due to inflammation. Such an approach could revolutionise the way we deal with the critically ill patient and provide rapid, point of care diagnostics that would help tailor the patient's management.

Parents whose baby is in a neonatal intensive care unit (NICU) usually are under a lot of stress. Much of this stress is unavoidable, but in some cases parents are under more stress than necessary because they do not understand what is happening to their baby. Although NICU medical staff of course do their best to keep parents informed, some parents may not fully understand the terminology used by doctors and nurses (and may be reluctant to admit this), and also some parents may not be able to physically visit the NICU and talk to medical staf because of other commitments such as caring for other children.In a PhD project associated with the EPSRC-funded BabyTalk project, we have developed a software system, BT-Family, which produces summaries of a baby's status for parents. BT-Family builds on the award-winning BabyLink parent-information system used in the Edinburgh NICU, primarily by using artificial intelligence and natural language generation technology to automatically analyse and summarise the information in the baby's electronic patient record.BT-Family has been developed in consultation with parents, but it has not actually been deployed and evaluated by parents; this was not possible in the time frame of the PhD project. The goal of this project is to enhance BT-Family and deploy it in the wild where parents of NICU babies can use it, and evaluate how useful it is and also find out how parents believe the system can be improved.Although our focus in this project is specifically on parents of NICU babies, if this project is successful we believe that our ideas can be generalised to other situations where a parent or carer is responsible for someone in hospital. We believe that providing better information to parents and carers can reduce stress in many contexts (not just NICU), and that this is a major opportunity to use advanced IT to enhance the quality of life of people in the unfortunate position of having a child or dependent in hospital.

Those living in low-income areas have a much higher risk of long-term conditions such as diabetes, heart disease, depression, and frailty. Our lifestyle, such as how active we are, what we eat and if we smoke or drink alcohol in excess can greatly increase our chance of having one of these diseases. The environment that we live in, such as if we live close to or visit parks, canals, and forests, can help us live a healthier life. However, communities living in low-income areas can have poorer access to such spaces or use them less. They also have less voice in decisions affecting their local spaces, at either local or national level. We propose a new partnership: researchers, clinicians, practitioners (such as urban designers) and policymakers all working with local citizens who have the most to benefit from better access to and use of quality spaces. We will work collaboratively to identify poor quality and underused spaces through citizen-led approaches. We will then work with them to develop and/or modify outdoor spaces so that they are high quality and fit for purpose. These actions can be as small as window boxes in schools, or as large as the development of new greenways or reshaping policies regarding land use to protect our green spaces. We will also work to identify ways in which we can promote such spaces for everyone, ensuring that no community is excluded form benefit. The important aspect is that local communities are fully involved in decisions about what they want, and what they will use, thus becoming central to the decision-making process. They will also be involved in the evaluation of these actions, enabling them to directly see how the process has benefited their communities. An important part of putting actions and solutions in place is understanding if they work (or not). Data plays an important part in measuring success, particularly if the same data can be collected consistently across the different actions. Another part of the partnership will be establishing a way of bringing multiple sources of data together so we can effectively determine what works across multiple projects and settings. So, whilst citizens can be involved in collecting data about whether the space has improved their health and wellbeing (through a bespoke app), we can also use other data on health, wellbeing and the environment that is routinely collected by local councils and governments. The main research will take place in three different cities - Edinburgh, Belfast and Liverpool - all with some similar features (such as large urban areas with lower income communities) and distinct features (such as geography and culture). Each city already has policies and programmes in place to improve green and blue space, but there is much room for improvement. Working with the local citizens we will test a range of different methods and approaches, and be able to collect a large amount of data. This data can then be used to understand what works for whom and why across the cities. We can then use this knowledge to predict what could be effective over a much wider area, and also what does not work. We can also make some decisions around what is good value for money, and what is not. We also understand that individual small actions within local communities (or even within cities) are not going to solve the problem, which is why we are also going to focus on how our research can help inform future policies and programmes. Our programme of work will take a whole life course approach which will ensure inclusive environments for all; working with our youngest citizens in particular will ensure early cultural change levers are activated, empowering a new generation with lifelong health and wellbeing.

Neurological diseases cause a substantial and increasing personal, social and economic burden. Although there have been exceptions, there is increasing frustration at the limitations of learning from animal models, emphasising the importance of studying human tissue. Neuropathologists work in NHS hospitals examining samples from the brain and related tissues derived from operations (biopsies) or post mortem examinations. Their job is to identify abnormalities, make a diagnosis and try to understand how the abnormalities arise. Neuropathology has existed as a specialty in the UK for 40-50 years and, as a consequence of this work, substantial archives of diagnostically verified tissue have been established nationwide. These archives contain a wealth of tissue from a great variety of neurological conditions, including common conditions such as stroke, head injury, tumours, infections, psychiatric disorders, developmental disorders and many rare conditions, and represent an underutilised resource for research. BRAIN UK (the UK BRain Archive Information Network) networks the tissue archives of neuropathology departments based in 26 regional NHS Clinical Neuroscience Centres to form a virtual brain bank, acting as a "matchmaker" linking researchers needing tissue to the appropriate samples. Through BRAIN UK researchers can gain access to >400,000 samples from a wide range of diseases affecting the brain, spinal cord, nerve, muscle and eye. BRAIN UK has ethical approval which covers the majority of projects, saving the researchers considerable time as they would otherwise have to obtain this approval independently. Over the past 4 years BRAIN UK has supported 48 research projects in many centres around the UK and overseas. In the coming 4 years we want to continue to provide tissue to researchers from existing resources and add newly obtained samples of which >16,000 are becoming available each year. We also aim to gather the results of researchers' studies performed on tissue obtained through BRAIN UK to form a central register of findings which will benefit new researchers wanting to perform new studies on these tissue samples. Finally, we will link BRAIN UK with UK Biobank, which has 500,000 intensively studied participants from the general population, in order to learn more about the origins of neurological disease. As far as we are aware, the BRAIN UK network is unique in the world and is very economical as it makes use of tissue samples already being stored in NHS archives which would otherwise be unused and unavailable to researchers.

The EMERGENCE network aims to create a sustainable eco-system of researchers, businesses, end-users, health and social care commissioners and practitioners, policy makers and regulatory bodies in order to build knowledge and capability needed to enable healthcare robots to support people living with frailty in the community. By adopting a person-centred approach to developing healthcare robotics technology we seek to improve the quality of life and independence of older people at risk of, and living with frailty, whilst helping to contain spiralling care costs. Individuals with frailty have different needs but, commonly, assistance is needed in activities related to mobility, self-care and domestic life, social activities and relationships. Healthcare can be enhanced by supporting people to better self-manage the conditions resulting from frailty, and improving information and data flow between individuals and healthcare practitioners, enabling more timely interventions. Providing cost-effective and high-quality support for an aging population is a high priority issue for the government. The lack of adequate social care provisions in the community and funding cuts have added to the pressures on an already overstretched healthcare system. The gaps in ability to deliver the requisite quality of care, in the face of a shrinking care workforce, have been particularly exposed during the ongoing Covid-19 crisis. Healthcare robots are increasingly recognised as solutions in helping people improve independent living, by having the ability to offer physical assistance as well as supporting complex self-management and healthcare tasks when integrated with patient data. The EMERGENCE network will foster and facilitate innovative research and development of healthcare robotic solutions so that they can be realised as pragmatic and sustainable solutions providing personalised, affordable and inclusive health and social care in the community. We will work with our clinical partners and user groups to translate the current health and social care challenges in assessing, reducing and managing frailty into a set of clear and actionable requirements that will inspire novel research and enable engineers to develop appropriate healthcare robotics solutions. We will also establish best practice guidelines for informing the design and development of healthcare robotics solutions, addressing assessment, reduction and self-management of frailty and end-user interactions for people with age-related sensory, physical and cognitive impairments. This will help the UK develop cross-cutting research capabilities in ethical design, evaluation and production of healthcare robots. To enable the design and evaluation of healthcare robotic solutions we will utilize the consortium's living lab test beds. These include the Assisted Living Studio in the Bristol Robotics Lab covering the South West, the National Robotarium in Edinburgh together with the Health Innovation South East Scotland's Midlothian test bed, the Advanced Wellbeing Research Centre and HomeLab in Sheffield, and the Robot House at the University of Hertfordshire covering the South East. Up to 10 funded feasibility studies will drive co-designed, high quality research that will lead to technologies capable of transforming community health and care. The network will also establish safety and regulatory requirements to ensure that healthcare robotic solutions can be easily deployed and integrated as part of community-based frailty care packages. In addition, we will identify gaps in the skills set of carers and therapists that might prevent them from using robotic solutions effectively and inform the development of training content to address these gaps. This will foster the regulatory, political and commercial environments and the workforce skills needed to make the UK a global leader in the use of robotics to support the government's ageing society grand challenge.