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A series of projects focusing on the medical, social, and emotional experience of pre-pregnancy, pregnancy, and early motherhood have been undertaken since 2006 at Plymouth University. The impact of these projects is wide ranging covering both policy and practice. The research has: changed the physical environment of the antenatal clinic specifically to suit the needs of pregnant women with pre-existing diabetes; developed an online leaflet for women with Polycystic Ovary Syndrome (PCOS); developed training programmes for health and social care professionals; provided baseline information to inform practitioners and patients involved in UK screening programmes; and, informed screening strategies for Downs Syndrome.
The Million Women Study of 1.3 million UK women over the age of 50, coordinated by the Cancer Epidemiology Unit at Oxford, has established the relationship between hormone replacement therapy (HRT) and breast, endometrial, and ovarian cancer, and has had a dramatic effect on HRT prescription patterns and prescription guidelines worldwide. This has had a major impact on women's health. Prior to the study, one third of UK women aged 50-64 were using HRT. The marked decline in HRT use following publication of the study's findings has led to a reduction in the incidence of breast cancer among menopausal women.
Researchers at the University of Oxford instituted a rapid study of pregnant women hospitalised across the UK with 2009/H1N1 infection, which demonstrated that early antiviral treatment improved maternal outcomes of infection and led to actions by the Department of Health to ensure rapid availability of antivirals specifically for pregnant women. The poor maternal and perinatal outcomes identified by this study also led to an on-going policy change, so that all pregnant women in the UK are now recommended to receive annual immunisation against seasonal influenza.
Pre-pregnancy care (PPC) significantly reduces the risk of poor pregnancy outcomes among women with diabetes. Yet, lack of awareness has resulted in poor participation, with two thirds of women receiving suboptimal PPC (CEMACH, 2007).
An innovative preconception counselling resource (DVD/website) to inform women about PPC and improve pregnancy outcomes is embedded in routine care in Northern Ireland and beyond since 2010. The UK's first widely distributed multimedia preconception counselling resource for women with diabetes is already having a significant impact on pregnancy planning. In early evaluation results 76% of all pregnant women with diabetes in Northern Ireland reported receiving PPC.
Professor Peter Sasieni's team at Queen Mary showed that the efficacy of cervical screening was age-dependent. Their recommendations were adopted as policy in England in 2003 and led many other countries, including the USA, to raise the recommended age of first screening. This research was central to the 2009 re-evaluation of the most appropriate age for first screening in England, resulting in some 300,000 fewer screening tests per year in women aged 20-24, with a cost saving to the NHS of some £15 million annually. Annually, 45,000 fewer women now have an abnormal cervical screening test, of which an estimated 8,500 would have received unnecessary surgical treatment. The estimated annual saving to the NHS is £17.5 million.
Research conducted by LSHTM has played a key role in supporting the global elimination of congenital syphilis. Two studies providing evidence of the health burden of congenital syphilis in Africa and the effectiveness of benzathine penicillin treatment form a pillar upon which WHO established its new syphilis elimination initiative. Further research has resulted in the adoption of new point-of-care tests for screening pregnant women for syphilis in 30 countries. As a result, more women are diagnosed and fewer babies die of syphilis.
Research on risk assessment and screening led by Wright at Plymouth University and including clinical participants from the Centre for Fetal Medicine at King's College Hospital and Tübingen University, has improved fetal and maternal healthcare. This research and work supporting the Fetal Anomaly Screening Program (FASP) has contributed to reductions in the number of unnecessary invasive diagnosis procedures in the UK, and has improved screening performance through the implementation of the NHS-endorsed Down's syndrome screening Quality Assurance Support Service (DQASS). The research has also contributed to the risk algorithms of the Fetal Medicine Foundation (FMF) which are used by the NHS and national and international companies that provide technologies for the clinical management of pregnancies by identifying high-risk groups for chromosomal abnormalities and preeclampsia.
Research by Dr Garikipati identifies that microfinance is most beneficial to women when it enables them to enhance their livelihoods and participate in the local enterprise economy. It also shows that over 80% of the microfinance loans in Andhra Pradesh, India, did not meet these conditions. Using these research findings, Dr Garikipati directly lobbied the Government of Andhra Pradesh (GoAP). This has had an impact on governmental organisations and other stakeholders within the microfinance industry and lead to the introduction of the Livelihood Enhancement Plan (LEP), which is used at the time of loan application. Dr Garikipati collaborated with the GoAP in designing and implementing the LEP. It impacts 500,000 women per year who join the microfinance program and enables them to enhance livelihoods in keeping with the demands of the local economy.
The findings of empirical research conducted by Professor Jim Barry and Dr Trudie Honour of UEL were shared at two focused capacity building sessions held in 2008 and 2009 for women leaders in middle and senior positions of responsibility and decision-making in the public and third sectors of a number of developing countries. Workshops were attended by women from Albania, Bahrain, Brazil, Burma, Cambodia, Cameroon, Ecuador, Egypt, Ethiopia, Jordan, Kenya, Malaysia, Mexico, Oman, Pakistan, Philippines, Tunisia, Turkey, and Uzbekistan. Participants considered the relevance and application of the research findings for their own countries, and worked together and with the researchers to formulate potential capacity development implementation strategies for women in positions of responsibility in those countries.
Atrial fibrillation (AF) is the commonest heart rhythm abnormality, affecting around 8.8 million people in the European Union, and confers a substantial risk of stroke and death. It accounts for one third of hospital admissions for cardiac rhythm disturbances, and the rate of AF-related admissions has continued to rise in recent years. The work of Prof Gregory Lip and Dr Deirdre Lane has made Birmingham an internationally-respected centre of excellence for research in AF, delivering crucial impacts in international clinical practice guidelines and improvements in patient care within three main areas: treatment decisions related to stroke and bleeding risk, screening practice in primary care, and stroke and bleeding risk assessment, ultimately reducing morbidity and mortality for a significant proportion of the population, particularly among the elderly.