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Bournemouth University (BU) research into the obstacles to and facilitators for breastfeeding has generated impacts for a wide range of beneficiaries at a local, national and international level. Research has influenced and informed policy and guidelines in the UK and Australia. It has informed research-based training modules for midwives, lactation consultants and other related professionals. The research-based online resources produced by BU are regularly used by around 1,500 breastfeeding mothers from across the globe every month. This level of breastfeeding promotion and support presents an opportunity to improve individual well-being, lessen health inequalities and reduce health care costs.
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.
Essex research, conducted between 2009 and 2012, has used cohort studies to investigate the sources of intergenerational social mobility in the UK. The results show that two variables have highly significant effects on children's social mobility patterns: the educational level of parents and the prevalence of maternal breastfeeding. The cohort analysis conducted by Professor John Ermisch and Dr Emilia Del Bono shows that there are strong intergenerational correlations in educational attainment across different cohorts of UK individuals. The findings have informed UK Government policy and influenced the work of a major US charitable foundation. Analysis conducted by a team of researchers led by Del Bono has demonstrated the cognitive and socio-emotional benefits of maternal breastfeeding, and shown that its uptake can be used to foster social mobility. These findings have been vital to UNICEF UK's Baby Friendly Initiative and have provided evidence to demonstrate its efficacy and to justify its continuation.
The societal, economic and health benefits of breastfeeding include reduced infections in infants, cancers in mothers, cardiovascular disorders in both, and costs to the NHS (UNICEF UK 2012). Breastfeeding initiation rates in England improved from 66.2% in 2005/6 to 73.7% in 2010/11. Swansea work improved services, health and welfare because we:
We recommended that doses of analgesia be minimised and mothers receiving multiple medicines in labour targeted for additional breastfeeding support (R1-3). These recommendations reached most midwives and students in the English-speaking world through NICE (National Institute for Health and Care Excellence), Intrapartum Care Guideline 2007 (C1 p.123) and our textbooks (R4, 5). NICE guidelines form the basis of hospital policies and procedures in the UK and beyond. Doses were lowered (details below) and breastfeeding rates improved.
University of Aberdeen research has directly impacted on clinical practice with regard to the treatment of varicose veins. The University's Health Services Research Unit (HSRU) developed and validated the Aberdeen Varicose Vein Questionnaire (AVVQ), which allows patients to self-assess the severity of their varicose veins. Current national and international guidelines now recommend that as part of the assessment of outcome for patients with varicose veins, patients' self-assessment of their veins be routinely undertaken — with the AVVQ the most commonly recommended measure. The Department of Health in England also mandated the use of the AVVQ and all patients in England are now required to complete the AVVQ before and after treatment. Results from these questionnaires are being used by individual NHS providers to assess the quality of their care, to improve their services, and for planning and commissioning of services nationwide.
The claimed impact, as defined by REF guidance, therefore includes impact upon public policy and services; practitioners and professional services and health and welfare.
Health inequalities are recognised as a critical UK policy issue with life expectancy gaps of up to 28 years between the least and most deprived areas. This case-study demonstrates how Durham University research has led to: (a) changing health service commissioning (with County Durham and Darlington Primary Care Trust [PCT]): (b) influencing NHS funding policy (by generating Parliamentary debate); as well as (c) contributing to the development of the new public health system in England and Wales (as part of the Strategic Review of Health Inequalities in England post-2010 [Marmot Review]).