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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.
Building on work which has contributed, via NICE guidance, to £1 billion in annual savings to the NHS in its healthcare provision for osteoporotic fractures in older adults, research at the £14.4 million MRC Lifecourse Epidemiology Unit (LEU), University of Southampton, has inspired the world's first randomised controlled trial of vitamin D supplementation versus placebo in pregnancy. This work was designed to provide a definitive answer to the question of whether supplementing pregnant women with vitamin D leads to increased bone mineral accrual in the offspring. This work has also shaped national and international guidance on vitamin D supplementation both during pregnancy and in older age; Southampton's programme of osteoporosis research has attracted £10 million in research funding from health organisations and the EU.
As a consequence of a research-based training programme developed at the University of Bristol, the rates of perinatal hypoxia and intrapartum fetal injury in Bristol and two pilot units in Australia and the US are now among the lowest in the world. The improvements achieved in Bristol, the US and Australia have also been successfully achieved in a low resource setting in Zimbabwe.
In response to demand from maternity units across the world, the Bristol team has developed PROMPT — a PRactical Obstetric Multi-Professional Training package, which has been successfully implemented in over 20 countries worldwide. PROMPT has had a major health and welfare impact on more than a million mothers and their babies, as well as bringing substantial economic benefits and supporting international development.
Research at the University of Bath has had a significant impact on reducing the burden of injury and illness in military training and sport. We have engaged practitioner communities in evidence-based approaches to injury and illness prevention. Our research has contributed directly to reducing the burden of musculoskeletal injuries and heat illness by informing military personnel selection, training and healthcare policies. This affects approximately 20,000 military trainees per year and has resulted in reduced morbidity and estimated training/medical costs of over £60 million per annum. Our injury surveillance research has helped shape the Rugby Football Union's (RFU) medical safety policy and, based on our research, the International Rugby Board (governing 5 million players worldwide) announced in May 2013 a global trial of new scrum laws designed to reduce the incidence/severity of neck injuries.
The University has been at the forefront of Vitamin D research over the past decade, with the findings of the work used to change the dietary intake guidelines on the international stage, most notably in the U.S by the Institute of Medicine, the international body responsible for agenda setting of dietary recommendations worldwide. The extensive research has also been crucial in informing UK and Irish Health Service reports on vitamin D assessment and use during pregnancy and in infants and has provided robust scientific evidence to the food industry for fortification strategies. In addition to establishing the vitamin D requirements of population sub-groups, the research at Ulster has also focused on investigating the relationship between vitamin D status and skeletal & cardiovascular health and immune function.
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.
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.
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.
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.
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.