Clinical microbiology laboratories undertake thousands of tests in order to identify what pathogen is present in a clinical sample. When looking for bacteria, it is common to grow these organisms on selective media and report back to the clinician as to whether the test is positive or negative. However, for many bacteria, and for some samples in which there are several bacteria present, there is either no culture media available or due to the mixed nature of the sample, the results are confusing and difficult to interpret. Furthermore, depending on the organism which is being detected, the test can take 3 to 4 days before the clinician will be informed of the results and then make a decision on how to proceed with treatment. Additionally, several different tests may need to be undertaken before a positive result is reported. The application of molecular-based methods, which detect a DNA signal, have been used for many years in clinical microbiology laboratories to identify the presence of viruses. More recently, such DNA-based approaches have started to be adopted for the detection of bacterial pathogens in stool samples from patients with diarrhoea. However, these tests are specifically targeted at known pathogens, and in order to identify what pathogen is present, several tests have to be undertaken before a positive signal is detected. Next-generation sequencing platforms can provide a solution to these problems, they can allow for high throughput screening samples to detect pathogens and at the same time, no pre-knowledge is required as to what pathogen needs to be detected. The next generation sequencing technology can provide clinical microbiology laboratories with a one-stop solution to identifying pathogens in clinical specimens. This FLIP proposal aims to take this technology, which is currently being used for understanding how microbial fuel cells work (on developing it further), so it can be applied in a clinical setting. The interchange, Dr Ann Smith who is a computer scientist, will apply the knowledge of next-generation sequencing, and by Informatics pipelines will develop a simple user-friendly interface for analysing these datasets, and provide clinical microbiologists with access to this enabling technology.

Developed in partnership with Public Health England, Public Health Wales and NHS Education for Scotland, this bid addresses key challenges that the coronavirus pandemic presents in relation to understanding the flow and impact of public health messages as reflected in public and private discourses. Our collaborators above who are charged with constructing effective public health messages have identified two particular challenges: messaging around geographical borders (e.g. between England and Wales, and in local lockdowns) and messaging aimed at BAME populations. These areas will be the focus of our research, and we will deliver benefits to our collaborators in the form of initial analytical results and discussion from month 2 onwards. As human behaviour is shaped by the reception and production of discourse, and by the reasoning about different sources of information, we propose a new approach to track the trajectories of public health messages once they are released to the public. Moving beyond corpus linguistic approaches that focus on language production, we will investigate the complex relationship between the production and the reception of discourses relating to specific types of public health messages, focusing on linguistic patterns (in particular modality and stance markers). Drawing on our track record in the construction and analysis of heterogenous corpora and our ongoing work on privacy enhancing technologies, we propose to carry out the first large scale analysis of the trajectories of public health messages relating to the coronavirus pandemic in the UK.

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'.

Wastewater-Based Epidemiology (WBE) requires relatively few resources compared to the systematic testing of populations. WBE is especially promising for novel infectious diseases, where asymptomatic cases might play a significant role in transmitting the virus. However, WBE is only now being used to monitor the spread of a pandemic infectious disease. Early studies by ourselves and others have shown that SARS-CoV-2 RNA can be recovered from wastewater, including from wastewater treatment plants (WWTP) preceding local COVID-19 hospitalisation activity. Given the challenge of making available diagnostic tests to the entire UK population, WBE represents a potentially low-cost and immediate mechanism for understanding levels of infection within large geographic areas. N-WESP aims to compare our methods with those of European & North American WBE teams in an inter-lab trial for understanding, supporting and improving the DEFRA COVID-19 measurements which will feed into the Joint Biosecurity Centre (JBC). We will also compare methods with DEFRA, the EA's and JBC whilst they explore options for finer geographical measurements. N-WESP will empower public health authorities with an optimised surveillance tool with maximal sensitivity and predictive power whose uncertainties have been well characterised. N-WESP will determine whether SARS-CoV-2 RNA in wastewater and sludge is infectious, and to what extent there might be downstream risks to human health. N-WESP will exploit catchment and, uniquely, sub-catchment-scale longitudinal surveillance to understand temporal and spatial heterogeneity, relationships to human disease burden distribution and whether there is potential outbreak 'hotspots' by surveilling sewer system nodes.