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Depression and anxiety are common, cause significant disability and are costly to the individual, the NHS and wider society. UK management of depression and anxiety has been revolutionised as a result of our research at the University of Manchester (UoM) on low intensity psychological interventions (cognitive behaviour therapy (CBT) based Guided Self-Help (GSH)) which is the primary form of care for hundreds of thousands of people with depression and anxiety disorders (including generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder) through the "Improving Access to Psychological Therapies" (IAPT) scheme. Between 2009 and 2012 more than one million people used the new services, recovery rates are in excess of 45% and consequently 45,000 people have moved off benefits.
Hull-based research on critical systems thinking has been used for public, private and community benefit in Australasia, due to pivotal partnerships with the International Centre for Complex Project Management in Australia and the Institute of Environmental Science and Research (ESR) in New Zealand. Benefits include: the reconciliation of economic and environmental imperatives in NZ water management, valued at NZ$1.7bn of economic growth; NZ$6.2m for ESR projects serving government clients; improved stakeholder consultation on NZ science investments; the development of new systems thinking capacity in the Victoria Department of Primary Industries (Australia); and 5% cost savings in key Australian defence procurements.
15m people have a stroke each year worldwide. In England alone, stroke generates direct care costs of £3bn and a wider economic burden of £8bn. Service users report high levels of unmet need in relation to cognitive dysfunction (e.g. concentration). Improving cognition was the number one priority agreed by users and providers (James Lind Alliance, Lancet Neurology 2012). Research led by the University of Manchester (UoM) underpins recommendations in several recent clinical guidelines for stroke management and rehabilitation in the UK and internationally. Our 2012 aphasia trial and qualitative study made key contributions to the recommendations in the recent NICE (2013) and Intercollegiate Stroke Working Party (2012) guidelines. UoM-led Cochrane reviews (e.g., neglect, apraxia, perception) have directly influenced recommendations in guidelines produced by the Scottish Intercollegiate Guidelines Network, the European Stroke Organization and the Australian National Stroke Foundation.
Many of the millions of people worldwide with disfigurement face significant psychological challenges. Research at UWE's Centre for Appearance Research (CAR) has made a substantial contribution to the interventions and healthcare provision available for patients with the most common congenital disfigurement — cleft lip and palate — in the UK and internationally. Specifically, our research has underpinned: (1) The inclusion of psychologists as key members of all UK cleft teams; (2) The development of effective forms of psychological support and interventions currently in use by psychologists and charities across the UK and abroad; (3) The development of evidence-based training packages currently being used by practitioners across Europe.
Schizophrenia affects 1 in 100 people, with costs to society of £12 billion in England alone. Prevalence is similar across the world, with two thirds of people experiencing relapses despite medical treatment. Researchers at the University of Manchester (UoM) pioneered and disseminated psychological interventions for schizophrenia and related mental health problems which have led to improved outcomes for patients and families (e.g. 20% improvement in symptoms over standard treatment). We have implemented and delivered our intervention protocols, outcome measures, treatment manuals, and training programmes (with over 200 training courses delivered across the UK, Europe, USA, Asia, Australia and Africa). The impact of the research has been commended nationally and internationally by professional bodies (e.g., British Psychological Society, American Association of Behavior Therapy).
Falls are a common (30-40% >65 year olds fall each year) and important age-related health problem costing the NHS and social care >£5.6m each day. University of Manchester research has contributed to reducing the burden of falls worldwide.
We demonstrated that falls are better predictors of fracture than bone mineral density. We developed an effective intervention, reducing falls amongst older people by 30%; identified barriers to service use, and approaches to increasing uptake and adherence; and developed a fear of falling instrument (FES-I), now translated into 30+ languages and widely used in clinical practice.
By 2012, 54% NHS Trusts used training programmes based on our research. It moulded service provision nationally and internationally, changing the emphasis of how falls prevention services are presented, from "reducing risk" to "improving/maintaining independence".
The impact of the research described in this case study lies in its ability to identify, appraise, select and synthesise skin cancer prevention interventions, and identify the main predictors of ultra-violet (UV) behaviour. The findings have been used to highlight the power of a `tanned appearance', and to develop an appearance-based intervention, in order to bring about behavioural change in relation to UV tanning in the UK. The target audience for this research impact is both the general public, and health professionals, with the message that interventions aimed at knowledge are likely to be less successful than those focussed on appearance.
Insufficient levels of physical activity are a major public health challenge. In the 1990s, approaches to meeting the challenge of increasing physical activity (PA) shifted to a focus on the accumulation of activity during daily living and interest in the potential effects of the built environment on lifestyle physical activity. Researchers from the University of Birmingham tested methods to encourage the increased use of stairs, rather than escalators and lifts, with the aim of increasing calorific expenditure during daily life. This research made a major contribution to the evidence base for NICE (UK), as well as CDC (USA), leading to recommendations to use signage as a public health message to increase stair use. Campaigns prepared for the Department of Health (Cataluyna, Spain) were rolled out nationally, with advice currently being extended to worksite campaigns. At a regional level, councils throughout the Midlands have employed the stair use campaigns, as have the police and commercial firms, with Unilever requesting them for use nationally and internationally and an improved campaign rolled out by National Car Parks Ltd.
Our sustained impact in obesity treatment began in 1999 with Europe's first residential camp programme for overweight and obese children. Our impact on treatment grew sufficiently to warrant the formation of a dedicated spin out company, MoreLife. Underpinned by our research, MoreLife is an award winning, Department of Health accredited provider, delivering specialist weight management services, both nationally and internationally. Through NHS and other contracts we are delivering high quality, evidence based services to over 3,500 adults and 3000 young people per year. Our impact on the policy and practice of obesity treatment and public understanding continues in the UK and has been extended internationally.