Dr. Fiona L R Williams

Head of Division, Reader, Developmental Epidemiology Course Director Master of Public Health

Address:

Population Health Sciences
Medical Research Institute
The Mackenzie Building
University of Dundee
Kirsty Semple Way
Dundee DD2 4BF

Phone Number:

+(44) 01382 420117

Email Address:

f.l.r.williams@dundee.ac.uk

Biography

During her career Dr Williams has focussed on two major research themes: environmental epidemiology and developmental epidemiology.

From 1983-1999 environmental epidemiology was the major research focus, and the overall theme was monitoring the environment and evaluating the impact on health of residential exposure to point sources of airborne pollution.  During this period Dr Williams was involved in several environmental epidemiology studies within Scotland, which contributed new methodologies for assessing the impact of the environment on health. During this period Dr Williams  became a member (by election) of The Royal Environmental Health Institute of Scotland, MREHIS, and an honorary Member of the Faculty of Public Health, HonMFPH.

From 1997 she has focussed on the influences of specific conditions which impact on human postnatal brain development.  Currently Dr Williams’ work is examining the impact of iodine deficiency and iodine toxicity on human brain development

Research

The Human Brain Development group is focused on early brain development. The overarching research aim is to optimise neurodevelopmental outcome of infants through the development of a range of preventative approaches. The research design we have developed to support our programme of work is integrated, international, inter-disciplinary and translational, and reflects the concept that prevention of cerebral damage comes from applications of the metabolic and molecular bases of human development.

Our research is focussed on the influences of specific conditions which impact on human postnatal brain development and to date has included hyperbilirubinaemia, hypoglycaemia and hypothyroxinaemia.

The Group’s current research is centred on one established (the Millennium) and two developing (I2S2 and I2XS) cohorts of preterm infants.  The Millennium cohort is the largest cohort worldwide for which there is substantial intrapartum and postpartum information on thyroid hormone metabolism and clinical management.  The neurodevelopmental status of this cohort was assessed in 2005-8.  The investigation of the Millennium cohort led to the hypothesis that neonatal transient hypothyroxinaemia may be exacerbated by iodine deficiency; a hypothesis which is now being tested by I2S2, which is a large, MRC/NIHR-EME funded, trial of iodine supplementation of extreme preterm infants; 1275 neonates have been recruited and are currently being followed up with a neurodevelopmental assessment at two years.  The I2S2 trial started recruiting infants in March 2009 and will be completed in 2015.  Twenty neonatal nurses were employed by I2S2 to work in each of the neonatal units during the recruiting and supplementation phase of the trial, who were supported by administrative staff based in Dundee and in Oxford (CTU, NPEU).  We are now in the second phase of the trial and are assessing the neurodevelopment of the children once they reach 2 years. 

We have a programme of work that will sustain the group for the next 5-8 years and are developing an ambitious programme of new work.

Publications

  • Aitken J, Williams FLR.  A systematic review of thyroid function in preterm neonates exposed to topical iodine. Archives Disease Childhood Fetal and Neonatal Edition 2013: doi:10.1136/archdischild-2013-303799
  • Williams FLR, Delahunty C, Cheetham T.  Factors affecting neonatal thyroid function in preterm infants, NeoReviews 2013: doi: 10.1542/neo.14-4-e168
  • Williams FLR, Watson J, Ogston SA, Visser TJ, Hume R, Willatts P. Maternal and umbilical cord levels of T4, TSH, TPOAb and TGAb in term infants and neurodevelopmental outcome at 5½ years. J Clin Endocrinol Metab  2013;98:829-838
  • Williams FLR, Watson J, Ogston SA, Hume R, Willatts P, Visser TJ and the Scottish Preterm Thyroid Group.  Mild maternal thyroid dysfunction at delivery of infants born ≤34 weeks and neurodevelopmental outcome at 5.5 years.  J Clin Endocrinol Metab  2012: 97: 1977-1985
  • Williams FLR, Hume R.  The measurement, definition, aetiology and clinical consequences of neonatal transient hypothyroxinaemia.  Ann Clin Biochem 2011;48:7-22
  • Delahunty C, Falconer S, Hume R, Jackson L, Midgley P, Mirfield M, Ogston S, Perra O, Simpson J, Watson J, Willatts P, Williams FLR and the Scottish Preterm Thyroid Group.  Levels of neonatal thyroid hormone in preterm infants and neurodevelopmental outcome at 5½ years: Millennium cohort study.  J Clin Endocrinol Metab  2010;95:4898-4908  
  • Hume R, Williams FLR.  Iodine deficiency due to parenteral nutrition.  In: Comprehensive Handbook on Iodine: Nutritional, Endocrine and Pathological Aspects.  Preedy VR, Burrow GN, Watson RR. (Eds) Ch 40.  2009.
  • Hume R, Lang K, Williams FLR. Iodine deficiency due to artificial enteral nutritional support.  In: Comprehensive Handbook on Iodine: Nutritional, Endocrine and Pathological Aspects.  Preedy VR, Burrow GN, Watson RR. (Eds) Ch 41.  2009
  • Barlow G, Nathwani D, Williams FLR, Ogston S, Winter J, Jones M, Slane P, Myers E, Sullivan F, Stevens N, Duffy R, Lowden K, Davey P. Reducing door-to-antibiotic time in community-acquired pneumonia: controlled before-and-after evaluation and cost-effectiveness analysis. Thorax 2007;62:67-74.
  • Easton P, Sharma A, Williams FLR, Marwick C, Phillips G, Nathwani D. MRSA: infection control and management: assessing the knowledge of staff in an acute hospital setting. J Hosp Infect 2007; 66: 29-33. Impact Factor 2.003 Rank 23/41 (Infectious Diseases)
  • Williams FLR, Ogston SA, Toor van H, Visser TJ,Hume R with collaboration from the Scottish Preterm Thyroid Group. Serum thyroid hormones in preterm infants; associations with postnatal illnesses and drug usage. Journal of Clinical Endocrinology and Metabolism. 2005: 90: 5954-5963. Impact Factor 6.020 Rank 8/89 (Endocrinology and metabolism).
  • SimpsonJ, Williams FLR, Delahunty C, van Toor H, WuS-Y, Ogston SA,VisserTJ, HumeR with collaboration from the Scottish Preterm Thyroid Group. Serum thyroid hormones in preterm infants and relationships to indices of severity of intercurrent illness. Journal of Clinical Endocrinology and Metabolism. 2005; 90: 1271-1279. Impact Factor 6.020 Rank 8/89 (Endocrinology and metabolism).
  • Williams FLR, Mires GJ, Barnett C, Ogston SA, van Toor H, Visser TJ, Hume R with collaboration from the Scottish Preterm Thyroid Group. Transient hypothyroxinaemia in preterm infants; the role of cord sera thyroid hormone levels adjusted for prenatal and intrapartum factors. Journal of Clinical Endocrinology and Metabolism. 2005; 90: 4599-460
  • Hume R, Burchell A, Williams FLR, Koh DKM. Glucose homeostasis in the newborn. Early Human Development. 2005; 81: 95-101.

Teaching

Public Health has offered the Master of Public Health (MPH) http://medicine.dundee.ac.uk/course/master-public-health for 30+years and Dr Williams has been the course Director since 1996.  The degree lasts for 12 months and has 7 months of taught classes followed by 5 months of research leading to a dissertation.  In any one year, there are approximately 10-15 full time students, and 5-10 students taking stand-alone modules or studying part time.

We are currently in an exciting period of expansion and are actively designing new exit routes for students - such as a MPH (Palliative Care Research); creating new courses with shared modules - such as Public Health Dentistry and Assisted Reproduction Technology and human Embryology; and developing collaborations with China-such as Tianjin University.

All of our courses are accredited under the Scottish Credit Qualification Framework.

Dr Williams is the course Director for the Master of Public Health (MPH) and the Co-Director of the Master of Public Health (Palliative Care Research); module leader for applied epidemiology, preparation for the dissertation, and the dissertation module; and supervises dissertations.  From 2009-2013 she was one of the external examiners for the MPH, University of Glasgow

PhD Supervision

Adel Dairi (2000) Co-supervision with Charles Florey; PhD Title “Low back pain in nurses in Bahrain”

Lesley Jackson (2003)  Co-supervision with Robert Hume; MD Title "The regulation of glucose homeostasis in infants"

Judith Simpson (2003)  Co-supervision with Robert Hume; MD Title “A multi-centre study of transient hypothyroxinaemia in the premature infant”

Caroline Delahunty (2005)  Co-supervision with Robert Hume; MD Title “A pilot study of transient hypothyroxinaemia in the premature infant”

Panos Papapreponis (2009). 1st supervisor; PhD Title “Residential exposure to low levels of air pollution from municipal waste incineration and potential subtle changes in health status”

Deirdre Plews (2013) 'Evaluation of a Simple RCT in a complex, multi-centre setting, with a focus on recruitment and retention of trial participants.'