Study backed by a £1.5m grant to improve HIV/AIDS care in Ghana

This grant is one of the largest of its kind and represents a significant achievement for an early career academic with a background in nursing.

The study, titled ExtraCECI (Extra community-based enhanced care intervention) aims to recruit around 650 patients. A smaller feasibility study of CECI suggested that participants felt the approach had the potential to improve their quality of life.

ExtraCECI will see medics from randomly selected HIV clinics trained to give a holistic assessment of the physical, psychological, social, and spiritual well-being, of their patients. This will then allow them to work together to plan and deliver their care in an outcome-focused approach.

ExtraCECI is now set to get underway this month after being backed by funding from the Medical Research Council. If successful, the results of this research may provide evidence to help make ExtraCECI a part of routine HIV/AIDS care in Ghana, helping those affected for years to come.

Professor Andrea Nolan, Principal and Vice Chancellor of Edinburgh Napier University, said: “Securing such a significant level of backing for this programme of work is a major achievement for Mary.

“Given her background in nursing, she will be well aware of how ExtraCECI has the potential to make a positive difference to people’s lives in Ghana.

Although led by Dr Mary Abboah-Offei from ENU’s School of Health and Social Care and Centre of Biomedicine and Global Health, it will also involve academics and researchers from Kings College London, the University of York, and the University of Ghana. Read the full news story here:

Hear from Dr Mary Abboah-Offei:

Dr Abboah-Offei, who is from Ghana, began her journey in healthcare research by working as a nurse in emergency care there. Working as a nurse at Surgical-Medical Emergency Unit of the Korle-bu Teaching Hospital in Ghana provided the opportunity for me to care for patients with various diagnoses including HIV/AIDS. I was particularly drawn to HIV/AIDS as most of the patients I encountered with the disease often deteriorate rapidly due to the shock of discovering that they were HIV positive. I began to investigate how best to care for and support such individuals to improve their well-being, health outcomes, and quality of life. People living with HIV/AIDS (PLWHA) have complex physical, psychological, social, and spiritual needs following diagnosis and poorer health related quality of life (QoL) than the general population. However, the greatest attention has been paid to viral suppression at the expense of broader psychological, social, and spiritual concerns that persist despite treatment advances. Thus, care that addresses the multidimensional concerns of PLWHA requires a person-centered approach, nevertheless, person-centered care (PCC) is an approach that evolved in high-income settings with limited data available to model contextually and culturally appropriate PCC in Ghana.

As a staff nurse, with limited research background, I sought for an opportunity to advocate for PCC for PLWHA in the context of Ghana backed by research evidence. Therefore when I got the opportunity to study masters in nursing at Queen Margaret University, I developed a research proposal to explore the potential of integrating palliative care into HIV/AIDS care for my masters dissertation; knowing fully well that palliative care addresses broader psychosocial and spiritual concerns of patients using a person-centred approach. Considering the duration of the masters programme, I could not implement this proposal, which means that I had to find another opportunity where my proposal can come to fruition. Two years after my masters degree, I won a fully funded scholarship from the Ghana Education Trust Fund to do my PhD at King’s College London using the research proposal I developed for my masters dissertation. At this point I knew the time had finally come to implement my proposal to in order to generate evidence to enable an acceptable and feasible practice of PCC in Ghana. So for my PhD, I followed the Medical Research Council (MRC) guidelines for developing and evaluating complex interventions, where I completed the first two stages (intervention development and feasibility testing) of the MRC framework. The intervention I developed and tested was community-based enhanced care intervention (CECI) with components including : (i) a training programme for healthcare professionals on person-centred communication, (ii) holistic assessment of PLWHA’s symptoms and concerns in the domains of physical, psychological, social, and spiritual wellbeing using a structured tool, (iii) a care plan to facilitate collaborative care planning and delivery, (iv) mentorship support for healthcare professions and fidelity monitoring. The CECI gave us some potential effects that we currently want to test its effectiveness and cost effectiveness, which is also the implementation of stage 3 (Evaluation of effectiveness and cost-effectiveness) of the MRC framework. Key lesson learnt is about the value of involving PLWHA in their care decisions, which is a motivation for adherence and an ‘extra’ component being added for CECI refinement to empower PLWHA to engage, participate and contribute to their care decisions, hence the name ‘ExtraCECI’.

Consequently, I am very thrilled to have received this funding from the MRC together with my collaborating institutions, whom I have established links with during my PhD and Post-doc period to be able to deliver the ExtraCECI project. King’s College London where I developed and tested CECI will be providing mentorship to support my development as an early carrier researcher as well as lead the capacity strengthening aspect of the project, working with all early career researchers on the project on research leadership and person-centred care skills tailored to researcher needs. University of York where I did my post-doc and have established links with the York Trials Unit, with expertise in cluster randomised controlled trials, the main methodology for the ExtraCECI project. They will also lead capacity strengthening in clinical trial leadership, process evaluation, training early career researchers and to build capacity towards establishing a trials unit in Ghana. Finally, University of Ghana is hosting the ExtraCECI project in Ghana, where majority of project staff will be based, enabling strong low- and middle-income country leadership, making adequate provision for training and support for early career researchers.

I am delighted to have the opportunity to begin this study. Having previously worked in healthcare in my home country, this feels like a way of giving back. Looking back on my journey from working as a nurse and having this vision to improve care outcomes and quality of life for PLWHA about 15 years ago, this meant the world to me because I could have given up along the way. However my passion and determination to be an advocate for person-centred care has brought me this far. I am particularly excited to be leading this project as my ultimate dream would be to see person-centred care adapted as part of routine care for PLWHA as well as replicated to the whole health system in Ghana. Person-centred care puts the individual at the centre of their care, helping them to access the care they need, when they need it, by involving them in their own care decisions.

I hope this wider trial can lead to a better quality of life for people living with these conditions.

The Silent Struggle: Polycystic Ovary Syndrome (PCOS)

A hidden struggle affects many individuals: Polycystic Ovary Syndrome (PCOS).

PCOS is complex, with impacts spanning ethnicities, ages, and geographical regions, yet remains underexplored. PCOS disrupts hormonal balance, affecting ovaries and leading to irregular periods and potential fertility issues. It also goes beyond fertility issues, involving metabolic disruptions, which persist beyond reproductive years.

Breaking the Silence:

Discussing PCOS is challenging due to societal stigma, lack of awareness, and cultural taboos surrounding women’s health. Breaking down these barriers and fostering open conversations about PCOS is essential in creating a supportive environment where individuals can seek help. Understanding the diverse experiences of PCOS sufferers is critical in effectively addressing this common syndrome.

Knowledge empowers:

Providing accurate information on PCOS management is key to empowering those affected. This involves understanding the diverse ways PCOS manifests, exploring treatments, and embracing healthy lifestyles. Regular physical activity, dietary considerations and stress management techniques can significantly improve symptoms and overall well-being.

Building Support Networks:

Living with PCOS doesn’t have to be a solitary struggle.  Joining PCOS communities allows us to share experiences and find strength in one another, breaking down isolation. Connecting with others facing similar challenges allows us to share experiences and exchange advice. Support networks can also shape future resource development. Emotional support, self-care, utilising available resources and acknowledging that each person’s journey with PCOS is unique are important.

Navigating the intricacies of PCOS requires collaboration between individuals, healthcare professionals, and the broader community. Healthcare providers play pivotal roles in diagnosis, intervention, and management of PCOS. Fostering greater understanding of PCOS among healthcare professionals ensures care addresses both physical and emotional aspects of the condition. Public awareness campaigns have a powerful role in dismantling the silence surrounding PCOS, and can reach a wide audience, encouraging open dialogue, and dispelling misconceptions that contribute to the stigma associated with PCOS.

The Role of PCOS Relief (Charity Number: SC051494)

PCOS Relief has a vital role in empowering those with PCOS, including those from ethnic minority communities. By providing tailored support, resources, and information, PCOS Relief aims to bridge the gap in access to care and create a safe space to connect and share experiences.

PCOS Relief is committed to data-driven support, and promotion of research to illuminate nuances of the condition across diverse populations, whilst pushing for improved healthcare outcomes for all. Through initiatives such as culturally sensitive support groups, educational workshops, and advocacy campaigns, PCOS Relief will dismantle the stigma surrounding the condition and empower individuals from all backgrounds to take control of their health. For further information, visit


By equipping ourselves with knowledge, seeking support, and fostering open conversations, we can break the silence and build a future where PCOS is understood, managed, and ultimately destigmatised. Together, we can create a world where those affected by PCOS are not defined by their condition but empowered to live life on their terms.

Next steps:

Join us on Thursday 7 March, 6:00 – 8:30pm, at Edinburgh Napier University, to discuss the lived experience of PCOS, how a diagnosis is made, and what it really means, as well as what support exists (both medical and beyond). We will showcase local research that aims to make a difference in understanding and treating this disease. But most importantly, we want you to ask the questions that matter, we want you to tell us what’s required.

This event is a joint initiative between Edinburgh Napier University and the charity PCOS Relief. It is open to all, so if you want to learn more about what PCOS is, and how it affects people, please come along.


The Connection Between Cattle, Methane, and Human Health: Improving Animal Health for Sustainable Livestock Production

It may not be initially apparent, but there is a significant link between cattle, methane emissions, and human health. The agricultural sector is a major contributor to greenhouse gas emissions, and a substantial portion of these emissions come from ruminant animals like cattle, sheep, and goats. These animals rely on microbes in their stomachs to digest plant material, but this digestive process also produces methane, a highly potent greenhouse gas.

While there is a growing discussion about reducing livestock consumption in wealthier countries, many individuals in lower-middle-income countries (LMICs) struggle with protein deficiency, leading to various health issues, particularly in young children. As the African population continues to increase, the demand for livestock products is also on the rise, but this poses challenges in terms of sustainability and climate resilience. How can we meet the growing demand for animal products while minimizing the environmental impact of livestock production?

One approach is to focus on improving animal health. Currently, disease accounts for a significant loss of animal production worldwide, with even higher numbers in LMICs. An ongoing project aims to measure the specific effects of various conditions on productivity and greenhouse gas emission intensity (the amount of GHG produced per kilogram of product). While the results are still preliminary, recent findings have shown:

Miscarriage among Tanzanian dairy cattle leads to a loss of milk and meat production, increasing the GHG emissions intensity of existing products by up to 14%. These losses could have supplied the protein needs of 1 million Tanzanians.

The mortality rate of beef calves within the first year of life in Kenya increases the GHG emissions intensity of Kenyan beef products by 6% and results in a loss of production that could have supplied beef to 3.6 million Kenyans.

By focusing on improving animal health, we can work towards sustainably increasing livestock production while minimizing its environmental footprint. Addressing these issues is crucial for meeting the protein needs of individuals in LMICs and ensuring the long-term health of both people and the planet.

This work is a collaboration between, Edinburgh Napier University, The International Livestock Research Institute (ILRI), The Mazingira Centre (ILRI), The Centre for Tropical Livestock & Genetics, The Roslin Institute, Washington State University, The Nelson Mandela Institute (Arusha, Tanzania), Mekelle University (Ethiopia), FAO, The Global Research Alliance and the Environmental Defense Fund.

 Funding was obtained from the Environmental Defense Fund and Bill & Melinda Gates Foundation.


Lab Plastics and a Circular Economy

Lisa McMillan – School of Applied Sciences, Edinburgh Napier University

HE Sector Biological Science research labs generate an estimated 5.5 million tonnes of plastic waste annually. If we consider Industry and the NHS, volumes of such contaminated plastics enter further orders of magnitude.

Globally, the most common approach to disposal of lab plastics is incineration. Just imagine what a difference it could make to the environment if these plastics could instead be safely recycled and made part of a circular economy? My colleague Jo Brown and I are determined to further contribute to making this goal a reality.

 During 2019 – following consultation with Napier’s waste contractor Enva and development of a decontamination process – we began recycling the plastics generated in our labs. This pioneering and innovative recycling initiative has to date re-routed 3.5 tonnes of plastic from general waste to dry mixed recycling; the scope and extent of the project is, to our knowledge, unique.

 Sharing our work quickly became a key aspect of the initiative. Our first presentation to a technicians’ conference at Queens University Belfast in 2020 gave a first glimpse of what we had tapped into. We received an overwhelming response from others keen to make change in their own labs. In house since then, associated improvements to lab sustainability are now a key feature of the university’s progress towards meeting net zero obligations. Having led on Napier signing up to The Laboratory Efficiency Assessment Framework (LEAF), it’s great to see our labs recently achieving 6 awards and demonstrating savings of £6,900 and 11 tonnes of CO2! The work has even influencedthe institutions waste contract tender process, ensuring future continuity of the recycling.

 Interest has continued to grow and to date we estimate to have had the privilege of communicating the work to more than 300 organisations. To be asked to share the work at such prestigious events as the Royal Society of Biology’s 2022 Accreditation Conference and with key organisations such as the Institute for Cancer Research is so encouraging. Vitally, we continue to share and exchange best practice with many institutions and the ripple effect of positive change is a real motivator.

 The potential for change that this work represents is feeding a paradigm shift across the HE sector and beyond, leading many to question long established norms of lab waste disposal.  

This significant opportunity for change has been recognised by the THE Times Higher Education Awards 2023 with a shortlisting in the Outstanding Contribution to Environmental Leadership category.

If that all sounds positive it is (!), but here’s the thing. Since we began sharing our work the question most asked, unsurprisingly is ‘how do you decontaminate the plastics’. People really want to know the fine detail in terms of trying to replicate in their own labs. Despite an obvious appetite for change, progress elsewhere has been slow. One key reason for this is validation; people want to see our sterility proven.

It’s no longer about what we do and how we do it, rather it’s about proving the efficacy of what we do.

To this end the Institute of Science and Technology are kindly supporting development of this next phase of work, this support is hugely appreciated. This will facilitate some fundamental groundwork and the subsequent publication, by peer review of our validation processes.

This is only a beginning but, being able to validate our sterility process will be a game changer. It will provide a crucial piece of the jigsaw that will showcase these plastics (recall the quantities mentioned above!) to be a safe potential alternative to virgin resources in downstream manufacturing processes. This in turn can help influence relevant future health and safety policies, recycling policies and infrastructure, necessary markets etc.

Until now, contaminated lab plastics and circular economies have rarely been part of the same conversation.  We may have been quoted ‘accidental pioneers’ in lab plastic recycling but the time is coming where through our efforts we can truly begin to move this conversation on.

Discoveries: A journey through research and innovation at the CBGH Sandpit Events

The anticipation was palpable as our CBGH members gathered for our much-anticipated Sandpit Event, held at the Glassroom in Merchiston in April 2023, writes Professor Peter Barlow.

The event was a gathering of brilliant minds from different disciplines, all eager to share their ideas for groundbreaking research and collaboration. From community-based care for HIV/AIDS patients to cutting-edge advancements in treatments for disease, the event was a celebration of human ingenuity and a testament to the power of collaboration when addressing challenges around human disease.

The event commenced with Centre Head, Prof Peter Barlow addressing participants and explaining the purpose of the event, which was to stimulate new research ideas and reinvigorate existing areas of interest. Centre members then undertook “speed dating”, facilitated by Dr Samantha Donnellan, where members spent some time describing their areas of expertise to one another and looking for commonalities in problems that they would like to tackle.

Members were then asked to break out into different groups, where ideas had shown considerable promise, in order to discuss tangible future plans in more detail. Facilitated by Dr Craig Stevens and Dr Nick Wheelhouse, the groups generated an enormous diversity of ideas and areas for collaboration.  Prof Mick Rae closed the event by chairing a discussion around which ideas would gain traction and be followed up on at the second sandpit event.

At the second CBGH sandpit event, held in June, members provided updates on their exciting project ideas.  Presentations at this event included;

  • Mary Abboah-Offei – ExtraCECI: A cluster randomised controlled trial of community-based person-centred enhanced care for people with HIV/AIDS in Ghana
  • Sam Donnellan and Isabel Nyangu – The hidden pandemic: A patient perspective
  • Peter Barlow and Graham Wright – Treatment of drug resistant infections by Host Defence Peptides (HDP) via T cell therapy
  • Sharron Vass, Sam Donnellan and Fern Findlay-Greene – Investigating the effect of ‘vaping’ flavouring fluids and vapour on human lung epithelial cells
  • Kasia Siemienowicz, Amy Poole and Mick Rae – Preclinical modelling of sex-specific postnatal legacies of gestational progesterone supplementation.
  • David Mincher – The Antibiotic Task Force
  • Fiona Kerr, Martin Sharp and Peter Barlow – Assessing the impact of pollution exposure through drug prescriptions
  • Nick Wheelhouse, Donald Morrison and Aimeric Blaud – Impact of pig slurry application on heavy metal contamination and antimicrobial resistance
  • Nick Wheelhouse and Martin Sharp – Female reproductive health in veterinary practice
  • Frankie Brown, Graham Wright and Iain Gallagher – Cellular profiling of adipose tissue in UGI cancer

These Sandpit events highlighted the breadth and depth of enquiry in the Centre, and its potential to address the most pressing challenges facing human health. Each of these novel collaborative projects highlights the power of innovative thinking, and a relentless pursuit of knowledge. The Sandpits proved to be not just a gathering of minds but a catalyst for future breakthroughs that will shape the course of human health, well-being and a greater understanding of disease.

Until the next Sandpit Event, we look forward to keeping you updated on how these exciting projects are progressing.