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Improvement of Biocompatibility of Peritoneal Dialysis Fluids

Summary of the impact

Research led by Professor Paul J Thornalley since 1993, (University of Warwick, 2007-present), revealed the formation of harmful reactive dicarbonyl compounds (also known as glucose degradation products, GDPs) within the glucose osmolyte of first-generation peritoneal dialysis (PD) fluids. Clinical studies confirmed the increased damage to proteins in patients on PD therapy. In response to these findings, major manufacturers of PD fluids changed their manufacturing processes to minimise GDP content by separating glucose and buffer components within two-compartment bags for heat sterilisation, and by using osmolyte that is resistant to thermal degradation. PD fluids with low GDP content have been associated with improved clinical outcomes for patients receiving dialysis, including maintained residual renal function, decreased peritonitis, and decreased fluid infusion pain. They have been widely implemented in clinical use since 2010. Globally, approximately 240,000 patients receive PD therapy.

Submitting Institution

University of Warwick

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences

05: Improving treatment for personality disorders

Summary of the impact

People with personality disorders (PD) have enduring and serious difficulties in relating to others and their treatment remains one of the most challenging areas in psychiatry. Until recently, service provision for such individuals was extremely variable in both quality and quantity. Research at King's College London (KCL) has helped highlight the considerable public health and economic impacts of personality disorders and has had a significant impact on current treatment guidelines in the UK. KCL research also led to the development of a brief and simple screening test for personality disorders — the Standard Assessment of Personality Abbreviated Scale (SAPAS) — which is now recommended for use in the UK Government's Improving Access to Psychological Therapies initiative, under which nearly a million patients a year are seen.

Submitting Institution

King's College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Improving clinical outcomes of patients with kidney failure treated by peritoneal dialysis

Summary of the impact

Peritoneal dialysis (PD) is used to treat kidney failure in 250,000 individuals worldwide, a figure growing at 20% per annum in developing economies. Critical to this therapy is the removal of adequate salt, water and uraemic toxins by the peritoneal membrane. Our research has shown how variability in peritoneal membrane function impacts on clinical outcomes, how the treatment itself affects this function over time and how the design of dialysis solutions can improve membrane performance. This knowledge has informed changes in dialysis prescription practice and fluid design contributing to the sustained improvement in patient outcomes observed over the last 20 years.

Submitting Institution

Keele University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences

2. Stopping ineffective (and possibly harmful) resource-intensive psychological debriefing for trauma patients.

Summary of the impact

UK and international government and healthcare institutes have incorporated Cardiff University research findings relating to the management of intervention for individuals post-trauma into public healthcare policy, strategy and services. Results from a randomized controlled clinical trial of psychological debriefing (PD) following traumatic events delivered strong evidence against the (then) standard approach of advocating these one-off interventions post-trauma. The Cardiff findings led to the global understanding that by not providing PD post-trauma many tens of thousands would benefit, resulting in better patient care and reduced healthcare costs.

Submitting Institution

Cardiff University

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Psychology and Cognitive Sciences: Psychology

UOA05-23: A new form of deep brain stimulation alleviates severe ‘freezing’ and loss of balance in advanced Parkinson’s disease

Summary of the impact

Research by Professors John Stein and Tipu Aziz at the University of Oxford has had a significant impact on advanced Parkinson's disease patients affected by freezing of gait and loss of balance. Since 2008 deep brain stimulation of the pedunculopontine nucleus has resulted in major improvements in both gait and posture in Parkinson's disease patients who have been treated with dopaminergic drugs for several years, but who had suffered the return of severely disabling movement problems. Around two hundred patients have been successfully treated worldwide through this pioneering surgery, with associated improvements in quality of life.

Submitting Institution

University of Oxford

Unit of Assessment

Biological Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Neurosciences

Improving Asset Management of High Voltage Equipment

Summary of the impact

Condition monitoring instrumentation for high voltage plant has been developed at GCU under contract research for Doble Engineering (Headquarters in MA, USA), a global service provider for the electric power industry. The instruments are an important new line of products for Doble providing increased sales revenue and service provision. The instruments have been widely adopted by Doble's global client base to provide improved asset management. Other beneficiaries of the work include global contract electronic manufacturing companies. In 2012 Doble invested £1.2 million in an Innovation Centre at GCU to support their product development road map.

Submitting Institution

Glasgow Caledonian University

Unit of Assessment

General Engineering

Summary Impact Type

Technological

Research Subject Area(s)

Technology: Communications Technologies

Condition monitoring of power cables and motors to prevent power plant failures

Summary of the impact

Research conducted by Glasgow Caledonian University (GCU) has changed the way power cables and motors are monitored in EDF Energy's nuclear power stations in the UK and Wuhan Electrical Power Company, China, providing the companies with innovative techniques enabling them to identify insulation defects and improve their maintenance programme. Application of the research output has helped the companies to enhance practice in PD testing, reduce maintenance and repair costs by millions of pounds whilst reliably supplying over 20% of the UK's power generation, and an area with over 10 million people in China.

Submitting Institution

Glasgow Caledonian University

Unit of Assessment

General Engineering

Summary Impact Type

Economic

Research Subject Area(s)

Engineering: Electrical and Electronic Engineering
Medical and Health Sciences: Neurosciences

Optimising antimicrobial drug use for efficacy, safety and avoidance of resistance

Summary of the impact

Dose selection for antimicrobial drug (AMD) use is fundamentally important in avoiding the emergence and subsequent spread of antimicrobial resistance (AMR), as well as for ensuring a successful clinical outcome. RVC's pioneering research and expertise in pharmacokinetic/ pharmacodynamic (PK/PD) integration and modelling for veterinary applications has introduced a novel, rigorous scientific method to dosage regimen design, which has been implemented in veterinary AMD registration, guiding national and international licensing authorities. Work on AMD dosages for livestock species, frequently undertaken in collaboration with industry, has contributed substantially to this understanding and consequent changes in drug registration practices worldwide.

Submitting Institution

Royal Veterinary College

Unit of Assessment

Agriculture, Veterinary and Food Science

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Pharmacology and Pharmaceutical Sciences

2. Cardiff-led research underpins new UK and International clinical treatment guidelines for the management of acquired haemophilia A

Summary of the impact

A Cardiff researcher has led an International 15 year programme resulting in multiple novel findings which have led to changes in the recommended diagnosis and treatment of acquired haemophilia A (AHA). The research has, for the first time, allowed the comparison of immunosuppressive regimens for inhibitor eradication and comparison of the efficacy of treatment strategies to control bleeds. Studies led directly to the production of UK and International guidelines on the management of AHA with 14 of the 18 specific recommendations in the UK guideline being underpinned by Cardiff-led research.

Submitting Institution

Cardiff University

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services

Research-driven advances in surgical techniques lead to improved patient outcomes after Deep Brain Stimulation

Summary of the impact

The clinical research of the UCL Unit of Functional Neurosurgery has led to improvements in the operative technique of Deep Brain Stimulation (DBS) with clear and demonstrable impact on patient outcomes with respect to efficacy, safety, and adverse event profiles. Our published data have been described by an independent editorial as a new "Benchmark for Functional Neurosurgery". Our Unit's excellent safety record has led to an ever-growing number of referrals, has allowed us to trial DBS for new indications, and has prompted visits from a succession of international specialists who seek to learn and disseminate our practice in their centres.

Submitting Institution

University College London

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Neurosciences
Psychology and Cognitive Sciences: Psychology

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