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Impact: Health and wellbeing; commerce; studies and clinical trials of the effects of progesterone receptor modulators (PRMs) underpinned their application for the benefit of women of childbearing age.
Significance: UoE studies underpinned the application of PRMs as emergency contraception including over-the-counter availability and the treatment of heavy menstrual bleeding (HMB); changed clinical guidelines; influenced Pharma R&D.
Beneficiaries: Women of reproductive age; the NHS and healthcare delivery organisations; pharmaceutical companies.
Attribution: Studies were conducted by Critchley, Baird and colleagues (UoE).
Reach: Worldwide; annually 4M women seek emergency contraception in the USA, and in the UK 1M women seek help for HMB. Drugs targeting the PR are licenced in 67 countries. Multiple global Pharma are active in the field of PRM biology.
The focus of the case is Social Network Analysis (SNA) which allows patterns of relations between actors (human and other entities) to be modelled and combined with actors' attributes. Edinburgh Napier University has applied these methods across a wide range of fields, achieving impacts both in the UK and internationally to make improvements in areas of health, commerce and policy. Methods have been applied to improve: the well-being of women and substance abusers in Bangladesh; the performance of supply chains; to demonstrate the effectiveness of prisoner management in reducing recidivism; and, to assess the effectiveness of health promotion initiatives.
Middlesex University's Applied Health Psychology research on Medically Assisted Reproduction (MAR) has impacted in three areas. First, all Parental Order Reporters and accredited Infertility Counsellors in the UK are exposed to the research through standard professional training and practice materials. Secondly, research has informed Human Fertility and Embryology Authority (HFEA) policy on surrogacy and gamete donation. Thirdly, HFEA-commissioned research on elective Single Embryo Transfer (eSET) and stakeholder group membership has contributed to national guidelines, resulting in decreased numbers of embryos transferred in UK clinical practice, dramatically reducing multiple births and associated maternal and infant morbidity and mortality.
A research programme of multi-centre clinical trials led by Professor Suzanne Hagen has established Pelvic Floor Muscle Training (PFMT) as an effective treatment for women with prolapse. Hagen's team has also successfully developed a Prolapse Symptom Scale and further tested a Prolapse Staging System to improve outcome measurement for women's health physiotherapists in the UK (20% and 15% clinical uptake respectively). The research has informed local, national and international guidelines and changed practice in 48% of UK physiotherapists. The research has also raised awareness of PFMT treatment for prolapse, with 70% of UK physiotherapists reporting an increase in prolapse referrals.
GTD is a group of pre-malignant and cancerous conditions that affect pregnancy occurring in 1800 women annually in the UK. The Charing Cross GTD centre at Imperial College is a world leader in this disease area and since 2008our impacts include the health and welfare benefits associated with the development of new combination chemotherapy regimens which have been recognised in national and international guidelines and the refinement of patient stratification to a particular treatment. Imperial researchers have taken a leading educational role both nationally and internationally on the disease and its management to help others to develop new centres in their own countries.
Impact: Health and welfare; a UK clinical trial of uterine artery embolisation (UAE), with five-year follow-up, defined the risk- and cost-benefit of UAE versus surgery.
Significance: The trial informed guidelines/recommendations internationally and changed clinical practice. Women worldwide can now make an informed choice about their treatment; economic factors have been quantitated.
Beneficiaries: Uterine fibroid patients, the NHS, healthcare providers.
Attribution: G. Murray, UoE, developed and delivered innovative trial methodology; clinical aspects led by University of Glasgow.
Reach: UK guidelines; worldwide (Australia, USA, Europe) effect on clinical practice that will impact up to 25% of women.
The University of Southampton's lifecourse cohort studies have led to a paradigm shift in the medical approach to obesity and non-communicable diseases. Research linking maternal pre-conception and early years nutrition with health outcomes for later life has directly influenced public healthcare policy at international (United Nations), national (Scientific Advisory Committee on Nutrition) and local (Southampton City) levels. Dissemination through medical practice and Southampton-designed public education programmes such as LifeLab means this research has already led to health benefits for tens of thousands of people, providing them with the information and tools to help prevent themselves and their children from succumbing to a non-communicable disease.
Impact: Health and welfare; public health studies in Sri Lanka and clinical trials in a cohort of 35,000 pesticide self-poisoning patients have led to the withdrawal of high-dose pralidoxime as a WHO-recommended treatment and bans of three toxic pesticides in Sri Lanka.
Significance: Resultant changes in clinical practice and pesticide regulation have saved 3000 lives in the last four years in Sri Lanka alone; in the rest of Asia many times this as local guidelines and practice have changed.
Beneficiaries: Patients and communities, healthcare providers, policy-makers.
Attribution: Studies designed and led, with international collaborators, by Michael Eddleston, UoE.
Reach: International, particularly Asia, changes in WHO and international guidelines on pesticide use.
Research carried out at the University of Southampton has led to the development of a new tool for detecting and managing malnutrition. The Malnutrition Universal Screening Tool (MUST) has been rolled out to more than 80% of hospitals and care homes in England and 98% in Scotland, is part of national health policy in Finland and the Netherlands, and has attracted interest internationally. The National Institute for Health and Clinical Excellence bases its current quality standard for nutritional support in adults on the MUST framework; only two NICE guidelines have saved the NHS more money. MUST has become an integral part of the UK's health policy framework, embedded in routine clinical care and supported by bodies responsible for clinical and care excellence. It is central to learning programmes on managing malnutrition.
Research carried out by LSHTM to develop and test patient reported outcome measures (PROMs), which measure health outcomes from the patient perspective, has demonstrated the feasibility of routinely collecting such measures before and after elective operations. In 2009, the Labour government mandated that PROMs should be collected on all NHS patients in England undergoing one of four surgical operations, a policy endorsed by the coalition following the 2010 election. This remains the only nationwide programme of its kind worldwide, providing essential data for comparing providers' performance, patient choice and other quality improvement approaches.