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This systematic evidence, evaluating the effectiveness of midwife-led care, has helped to shape policy improvements in promoting access to midwifery care and reducing health inequalities nationally (e.g. NHS, Department of Health [DH]) and internationally (e.g. Australia, Brazil & US). The review was recognised by the DH and updated rapidly to inform NICE intrapartum guidelines. As part of the Commissioning, Service Delivery and Organisation theme, the Maternal and Early Childhood Health Research Group (MACHRIG) led by Professor Hora Soltani, in collaboration with the Sheffield Teaching Hospital-Jessop Wing (STH-JW) and maternity user representatives, has initiated an awareness campaign to encourage information sharing on types of maternity care and to enhance the implications of findings for women and staff via the hospital website and targeted seminars. It is envisaged that its impact will continue to grow through an extensive dissemination strategy and media coverage.
Atopic eczema affects approximately 30% of children, causing suffering at a crucial time in their development. An increasing prevalence has raised concern that newborn skin care may be a factor. University of Manchester (UoM) research explored the effect of a range of products including commercial baby skin care products on skin integrity. We identified harmful practices related to topical oil use; established that a specially formulated newborn cleansing product was safe; and demonstrated increased maternal-reported nappy rash, when cotton wool and water, as opposed to baby wipes, were used. The findings have: changed the attitudes of healthcare professionals to baby skin care practices; informed the guidance provided to parents of newborns, allowing them to make informed choices (a YouTube video featuring the research has been viewed almost 400,000 times); and increased sales of Johnson & Johnson baby skin care products by 15%.
Maternal health and mortality remains a major concern in the developing world. Research led by Prof Arri Coomarasamy and colleagues at the University of Birmingham has demonstrated the effectiveness of non-typical support for maternal health in low- and middle-income countries worldwide, focused on the benefits of bringing in traditional birth attendants and non-physician clinicians to support the slow process of developing more capacity amongst skilled birth attendants in these regions. Prior to this work, these individuals were considered unsafe and inappropriate to support births, even though they were conducting millions of deliveries in the developing world. Prof Coomarasamy's team's research clearly demonstrated that this is not the case. This has had a major impact on international thinking about the valuable role of non-physician support for maternal health and mortality, reflected in the latest World Health Organisation task-shifting recommendations. In these and other related issues, policy and public awareness has been further supported by Prof Coomarasamy's crucial role in Ammalife, an international maternal health charity focused on the developing world.
Parents, healthcare professionals and policy makers across the globe have benefited from Professor Ian St James-Roberts's research and writing on understanding infant sleep and crying. His findings over 20 years underpin government and third-sector guidance for health staff in the UK, US, Canada and Australia. His research has also informed — and eased the minds of — countless parents in these and many other countries. It features in the practical advice provided by the National Childbirth Trust (NCT), the UK's biggest parenting charity, and is cited on many other authoritative websites for parents around the world.
Imperial College researchers have pioneered the implementation of therapeutic hypothermia to improve survival of neonates following perinatal asphyxia.
Following their programme of clinical research to prove feasibility, Professors Azzopardi and Edwards led the Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY), a multicentre, randomised trial investigating the effects of total-body cooling for 72 hours in babies with asphyxial encephalopathy from a lack of oxygen at birth. This work demonstrated that infants in the cooled group had an increased rate of survival without neurologic abnormality. This work has influenced public policy and healthcare provision, through the implementation and audit of therapeutic hypothermia nationally and internationally. In the UK, cooling therapy is now carried out in 1000- 1500 cases annually (Data reported to the UK National Register of Cooling). Cooling following perinatal asphyxia is now standard of care in most resource rich and intermediate countries.
We have developed the first ever physiotherapy guidelines (2008-) for contracted (frozen) shoulder (CFS). CFS is painful and disabling, affects c.9% of the UK working-age population,1 and costs the NHS > £13.5 million annually.2 Appropriate physiotherapy could improve outcomes and reduce costs by up to £2,000 per case.b
Endorsed by the Chartered Society of Physiotherapy (CSP), the guidelines have generated great interest and already influenced practice and will improve the quality and cost-effectiveness of clinical management, as well as patients' experiences. They will also provide a better framework for research into the condition and, as a `live', electronic document, will evolve with future research.
This case study is based on a series of major studies by academic staff at City University London relating to quality, safety, choice and organisation of birth in different settings. Their research has been widely cited and debated by policy, professional and user groups, nationally and internationally. The key impact has been on national and international guidelines for commissioning and on reconfiguration of services to include Midwife Units, to tackle the rising rates of intervention in childbirth and to underpin informed choice for patients. The research is being used by policy-makers, commissioners and managers to plan future services and by midwives to support informed choice discussions.
Our research, which identified effective and cost-effective interventions to help women, particularly those in low income groups, make informed choices and establish and maintain breastfeeding for newborn infants, has changed health policy and practice nationally and internationally. The findings have been included in national and international practice recommendations including National Institute for Health and Care Excellence guidelines. Active dissemination of our research outputs and adoption of their recommendations have been associated with stepwise increases in breastfeeding rates in the UK, particularly for socially disadvantaged women who typically have low breastfeeding rates, and is likely to be associated with improved health of infants.