Connect2 is a 138 million investment programme in walking and cycling infrastructure at 79 sites across the UK that provides a unique opportunity to determine the impact of infrastructure provision on walking and cycling and to assess the impact of other interventions including promotional activities. The challenge is to ensure this opportunity is used to fill evidence gaps, assess transferability and influence policy. The aim of this project is therefore to measure and evaluate the travel, physical activity and carbon impacts of interventions to improve the connectivity of infrastructure for walking and cycling. To achieve this aim we have developed an interdisciplinary consortium of eight institutions with expertise in energy, environmental, physical activity, public health and transport research, as well as computerised urban modelling. Our objectives are: (1) to develop and refine measurement instruments and evaluation frameworks for assessing the effects of these interventions on travel activity, physical activity and carbon emissions; (2) to apply these methods in longitudinal population-based studies at a purposive sample of up to six Connect2 case study sites; (3) to determine the likely benefits of additional promotional interventions using a randomised controlled trial at one Connect2 site (provisionally the Road to Nowhere scheme in Glasgow); and (4) to enhance and collate data at all Connect2 sites to develop strategic evaluation measures. Our methodological approach will be informed by the realist approach to evaluation which advocates determining not simply whether an intervention has worked but also understanding why it is effective (or not), in what ways, for whom and in what circumstances. We will therefore collect data on context, mechanisms and outcomes using a longer self complete household questionnaire, to which we anticipate a total of approximately 10,000 useable responses from the main case studies; a shorter user intercept questionnaire, developed in conjunction with Sustrans; and more detailed objective measures from subsets of our study cohorts. The main outputs will be an improved set of measurement and evaluation tools at the strategic and more detailed, local levels, validated using a heterogeneous set of Connect2 case studies; evidence on the impacts of infrastructural and promotional interventions, which will inform policy and practice; and strategic benefit and cost measures which will inform and influence government policy and appraisal of infrastructural interventions. These outputs will have significant generic benefits for central government, local authorities, active travel users and academia.

Osteoporosis and osteoarthritis affect millions of patients around the world and are eventually characterised by a reduction of bone strength that results in increased rates of fractures. Life expectancy continues to rise but patient specific treatment solutions to optimally manage those patients are sill not available. Such solutions could consist of tailored medication strategies and, at a later stage, tailored implant solutions which require a thorough understanding of the mechancial competence of structural tissue. While the mechanical behaviour of bone is currently well characterised at the upper level of tissue organisation, the underlying nonlinear mechanical properties of mineralised collagen fibre assemblies, however, remain obscured by structural features such as cellular porosity, lamellar organisation, cement lines, cracks and other interfaces. Starting from preliminary pilot experiments, this proposal aims at performing simultaneous uniaxial micropillar strength tests and structural measurements using small-angle X-ray scattering and wide-angle X-ray diffraction on micron-sized volumes of the extra-cellular matrix (ECM) and, thus, on mineralised collagen fibre assemblies only. This project will result in a versatile and powerful experimental framework that will be used to understand the structure-mechanics relation of ECM with an unprecedented spatial resolution of the mechanical experiment. The results of this project will inform the engineering of patient-specific material solutions in silico through all relevant length scales starting from the ECM level. This, in turn, will foster the development and realisation of production technologies for manufacturing patient-specific "implants on demand" which could be offered as a service or embedded in a hospital. The novel experimental techniques may be useful for testing and developing functional thin films such as implant coatings, investigating the impact of pathological changes on the ECM, or even to reduce, refine, and replace animal experiments.

Speech Sound Disorders (SSDs) are the most common communication impairment in childhood; 16.5% of eight year olds have SSDs ranging from problems with only one of two speech sounds to speech that even family members struggle to understand. SSDs can occur in isolation or be part of disability such as Down syndrome, autism or cleft palate. In 2015, the James Lind Alliance identified improving communication skills and investigating the direction of interventions as the top two research priorities for children with disabilities. Our programme of research aims to fulfil this need by developing technology which will aid the assessment, diagnosis and treatment of SSDs. Currently in Speech and Language Therapy, technological support is sparse. Through our previous work in the Ultrax project we showed that by using ultrasound to image the tongue in real-time, children can rapidly learn to produce speech sounds which have previously seemed impossible for them. Through this project, we developed technology that enhances the ultrasound image of the tongue, making it clearer and easier to interpret. Ultrax2020 aims to take this work forward, by further developing the ultrasound tongue tracker into a tool for diagnosing specific types of SSDs and evaluating how easy it is to use ultrasound in NHS clinics. The ultimate goal of our research is that Ultrax2020 will be used by Speech and Language Therapists (SLTs) to assess and diagnose SSDs automatically, leading to quicker, more targeted intervention. Normally speech assessment involves listening to the child and writing down what they say. This approach can miss important subtleties in the way children speak. For example, a child may try to say "key" and it may be heard as "tea". This leads the SLT to believe the child cannot tell the difference between t and k and select a therapy designed to tackle this. However, ultrasound allows us to view and measure the tongue, revealing that in many cases children are producing imperceptible errors. In the above example, an ultrasound scanner placed under the chin shows that the child produces both t and k simultaneously. Identification of these errors means that the SLT must choose a different therapy approach. However, ultrasound analysis is a time consuming task which can only be carried out by a speech scientist with specialist training. It is a key output of Ultrax2020 to develop a method for analysing ultrasound automatically, therefore creating a speech assessment tool which is both more objective and quicker to use. Building on the work of the Ultrax project, where we developed a method of tracking ultrasound images of the tongue, Ultrax2020 aims to develop a method of classifying tongue shapes to form the basis of an automatic assessment and a way of measuring progress objectively. We are fortunate to already have a large database of ultrasound images of tongue movements from adults and primary school children, including those with speech disorders, on which to base the model of tongue shape classification and to test its performance. At the same time, we will evaluate the technology we develop as part of Ultrax2020 by partnering with NHS SLTs to collect a very large database of ultrasound from children with a wide variety of SSDs. In three different NHS clinics, SLTs will record ultrasound from over 100 children before and after ultrasound-based speech therapy. This data will be sent to a university speech scientist for analysis and feedback to clinicians recommending intervention approaches. Towards the end of the project, we will be able to compare this gold-standard hand-labelled analysis with the automatic classification developed during the project. At the conclusion of our research project we will have developed and validated a new ultrasound assessment and therapy tool (Ultrax2020) for Speech and Language Therapists to use in the diagnosis and treatment of SSDs.

Viral infections pose one of the biggest global threats to human populations and agriculture. Successful prevention, monitoring and treatment of viral infections requires the availability of fast and reliable diagnostic methods which can not only sensitively, but rapidly detect a viral infection of interest and differentiate between viral infections. This is particularly important in the winter months where rapid diagnosis of viral infections emerging from SARS-Cov-2 relative to influenza strains is essential in order to assist medical practitioners to suggest the most appropriate interventions and treatment. At present, methods do not exist which can rapidly detect viral infections in a low-cost, point-of-care device. We propose to develop a biosensing technology which can not only detect viral components, but also has the potential for the platform to be reusable and regeneratable. Central to these developments is the use of fluorous technology as a tool to immobilise elements which detect viral components. Much akin to Teflon, fluorous technology has the dual advantage as a method which can immobilise molecular components which have a complementary fluorous tag, and reduces non-specific binding to non-fluorous biomolecules, thus improving the sensitivity of the approach. Furthermore, the fluorous-directed immobilisation event is inherently reversible by a simple washing step with organic solvent. In this proposal, we will demonstrate the modularity of the strategy to detect viral RNA (by RT-PCR) or protein (by direct detection of intact viral particles). This will provide a powerful new tool for the biosciences which has the potential to be used for any application which requires rapid detection of pathogenic infections.

The overarching aim of this project is to explore how community representations produced through creative arts practices (e.g. storytelling, performance, visual art) can be used as forms of evidence to inform health-related policy and service developments. Policies for health improvement tend to focus either on the impact of poverty and deprivation - but with little thought given to historical and cultural context or the experiences of living in these circumstances - or on the prevalence of 'unhealthy behaviours', with limited attempts to connect these with meaningful ways of life. However, research evidence indicates the need for studies that explore the experiences of people living in deprivation and isolation and find ways to improve dialogue between communities themselves and health policy makers. This study will develop methods for using creative art forms as a mode of communication and knowledge exchange. Through analysis of existing representations of disadvantaged and stigmatised communities in literature, film, etc, and the production of new community self-representations in arts-based workshops, it will explore the relationship between 'official' representations of community health and well-being (e.g. in statistical data) and how communities understand and present their own health and well-being. There will be a focus on the accumulated assets and resources that allow individuals and communities to cope with and navigate real and perceived structural barriers, and on the possibilities of resilience to upheaval, resistance to reputational damage, and the alternative representations that these can stimulate. The project will take place across five distinct case-study communities in Wales, Scotland and England and connect these to relevant policy makers, researchers and arts practitioners in each country. Our understanding of community is informed by a 'relational' view of place which conceptualises community as more of a process than an entity. Although we define communities in terms of spaces that are shared, we fully recognise that the meaning of those spaces will not necessarily be shared. The project will consider how perceptions and experiences of community vary across time and changing circumstances, and how communities and the people living in them are represented in relation to key differences and divisions relating to gender, class, ethnicity and age. Following an inventory and analysis of existing representations of each community, both artistic (e.g. in literature) and 'formal' (e.g. in deprivation indices), each case study will use creative engagement methods (including life mapping, drama, storytelling, and photography) to generate new community self-representations, working in partnership with local arts and health organisations. The engagement process will be documented in ways that allow all participants, though diaries, blogs, or digital soap boxes, to reflect on the process and the dynamics of engagement. In all case studies the final creative representations themselves will be co-authored by the community participants and they will have the final decision on how their own accounts are presented. These new 'data' will be presented to relevant local or national policy makers and service development officials through exhibitions, performances, and digital media. The researchers will evaluate this process, reflecting on the relationship between arts participation and community empowerment, and will examine how community values, participation, self-reliance and resilience are shaped, experienced and articulated, and can ultimately become embedded into policy. Through its rigorous analysis, its development of arts-based research methods, and its conviction that literature and the arts form a valid form of 'evidence' in policy discussions, the research will offer innovative thinking about, and will make a distinctive contribution to, the study and development of 'community health and well-being'.