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Maternity staff from hospitals in the UK and around the world have benefited from training to improve their communication and team-working skills in emergency situations. This has been achieved through input into a standard training manual now in wide use, and through the development of course content used in `train-the-trainer' sessions for consultant obstetricians, consultant anaesthetists and senior midwives who have in turn been able to train their colleagues. Research findings at UWE, Bristol, contributed to showing that clinically better results correlate with specific linguistic behaviours. The findings of the work made a direct contribution to this training content.
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.
This case study has improved the quality of life for patients suffering with visual field defects after brain injury such as hemianopia, which affects more than 4,000 people in the UK each year. Different types of rehabilitation, such as those aimed at enhancing exploration or reading, have been shown to have a direct positive impact on patients, improving their confidence, independence, self-esteem and general quality of life. Approximately 200 individuals have benefitted from Durham University's visual rehabilitation programmes to date, including some patients internationally, with a CD toolkit being provided to countries such as Belgium, Denmark, and Chile. This research therefore has direct impacts on health and wellbeing worldwide and has influenced the care offered by NHS practitioners.
Because of the arduous nature of recruit training, high wastage (due to failure or withdrawal) has always been a problem for the Armed Services. A ten year programme of research funded by the Ministry of Defence (MoD) led to changes in the delivery of training across the three Armed Services (especially the Army), the formation of a new Army training establishment, a new tri-service monitoring and training body, better mental health in military recruits, and significant reductions in wastage rates (up to 15%). The model developed by this research has also informed training in the Canadian and United States Armed Services.
Policymakers in the government departments responsible for health and education, Local Safeguarding Children Boards (LSCBs) and many thousands of professionals with child-protection roles have benefited from Bristol's research into inter-agency training. The research provided crucial information on efficient organisational partnerships for training and strong evidence of the effectiveness of inter-agency training in promoting mutual understanding, changing attitudes and developing confidence. Bristol's findings underpinned statutory guidance in the Government's Working Together to Safeguard Children (2010) [b], which required LSCBs to provide such training. The research ended a 30-year period during which inquiries into the deaths of children at the hands of their parents consistently criticised the failure of professionals to communicate and work together effectively and advocated inter-agency training as a solution, but had little or no supporting evidence.
Specific impacts are evidenced in: the citation of the research findings in support of LSCBs' training strategies; the increased provision of training programmes in the three years since publication, in spite of budget restrictions; the successful targeting of previously disengaged groups, particularly GPs; and the use of an NSPCC-sponsored bespoke evaluation toolkit developed by the research team.
Since 2010, infants around the world have been saved from death or severe disability as a result of research conducted by Professor Marianne Thoresen and her team at the University of Bristol. Translational research conducted between 1998 and 2010 by the Thoresen group showed that mild cooling of newborn children who had suffered a lack of oxygen during labour and delivery reduced death and disability by over 50%. Extensive publication on this treatment and practical training for neonatal staff, led by the Bristol team since 2008, has transformed the management of neonatal brain injury. By 2010/11, therapeutic cooling had been adopted as standard treatment throughout the developed world, saving thousands of children from death or severe disability, including cerebral palsy and epilepsy. Therapeutic hypothermia also saves the NHS and UK families about £200 million/year in care and compensation costs.
Within the UK Armed Forces, stress fractures during training in military recruits represent the single largest cause of lost duty days, resulting in substantial costs for the Ministry of Defence.
Research by the University of Surrey has established unique associations between physical characteristics, bone health and nutrition on stress fracture incidence during Royal Marine and Royal Air Force recruit training. This has led the MoD to change entry criteria and to update nutritional advice both in training and during deployment for military personnel. The resultant reduction in number of stress fractures has had both economic and health and wellbeing impacts.
Sport and exercise research at Southampton Solent University commenced in 2007 and comprises a young research team focussed on strength and conditioning within sport. The overarching methodological approach is defined in the work of Fisher et al (2011) as momentary muscular fatigue (MMF) whereby training is undertaken to maximal exertion. Using MMF the research team have published findings and their conclusions for public benefit, thus improving performance with a range of client groups in sport. The impact of this methodological approach is far reaching, improving performance in elite performers, whether they are able or disabled. The beneficiary groups include; two Paralympic squads in the build up to, and including, the London 2012 Paralympic Games and a premiership football team.
Fallowfield designed, ran and demonstrated the long-term effectiveness of a comprehensive three-day training programme that significantly improved cancer doctors' communication skills. Publications from a major randomised trial showed that improvements transferred into the clinical setting and were enduring. These findings were pivotal and led to key components of courses being embedded in a Department of Health initiative called Connected; this trained facilitators, and provided materials for training all health-care professionals (HCPs). Attendance at Connected courses became mandatory for all consultant staff. Over 16,000 UK HCPs have participated since 2008.
Professor McKenna and his team demonstrated that it was possible to assess the ability to detect potentially hazardous events, by producing and testing a hazard perception test. They showed that new drivers have relatively poor hazard perception skills (are slower to detect hazards) than more experienced drivers, and that hazard perception skills can be improved by training. After discussions with and presentations to key stakeholders, McKenna's hazard perception test was introduced into new driver testing in the U.K., and subsequently the Netherlands and Queensland, Australia. The introduction of this test has improved road safety for drivers and other road users and is associated with a reduction of certain types of road traffic accidents by 11%. The research has also led to increased public awareness of the importance of hazard perception among drivers and the general public.