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The University of Southampton's lifecourse cohort studies have led to a paradigm shift in the medical approach to obesity and non-communicable diseases. Research linking maternal pre-conception and early years nutrition with health outcomes for later life has directly influenced public healthcare policy at international (United Nations), national (Scientific Advisory Committee on Nutrition) and local (Southampton City) levels. Dissemination through medical practice and Southampton-designed public education programmes such as LifeLab means this research has already led to health benefits for tens of thousands of people, providing them with the information and tools to help prevent themselves and their children from succumbing to a non-communicable disease.
Impact: Health and welfare; public policy; the work led to UK and international guidelines advising against progesterone use to prevent preterm birth in twin pregnancy.
Significance: Thousands of women now avoid this unpleasant procedure annually, with a saving to the NHS of £25M.
Beneficiaries: Pregnant women, policy-makers, the NHS and healthcare-providers.
Attribution: The work was initiated by a five-centre UK collaborative group including UoE. Data analysis, interpretation and translation into practice were led by Jane Norman, UoE.
Reach: The data are cited in guidelines and have changed clinical practice on three continents: Europe (NICE), North America and Australasia. Applies to 11,000 women annually in UK alone.
Research at the University of Nottingham (UoN) has had influence on development of health policy in the UK and internationally. It is recognised that the risk of diseases related to obesity and insulin resistance, is partly determined by the nutritional environment experienced during early life. Against a background of scepticism researchers at the UoN have generated data that has been critical in demonstrating the biological plausibility of such associations. This has influenced expert panels and non-governmental organisations in framing their current recommendations for nutrition in pregnancy and infancy, which benefit women and children worldwide.
Dietary fat plays an important role in the causation of cardiovascular disease (CVD). Using randomized controlled trials of dietary fat modification, King's College London researchers have provided information about the effects of specific fatty acids on CVD risk which the Food Standards Agency have used to inform its policy decisions and future research strategy. The research also contributed to the development of international guidelines on the intakes of specific types of fatty acids and helped the food industry reformulate fats to be low in trans fatty acids. This research has also had an impact on dietary advice given by health professionals, the media and patient groups.
(1) Enhancing the awareness of (i) women of childbearing age suffering from epilepsy and prescribed new and/or older generation AEDs, and (ii) their healthcare professionals. Empowering both to make informed decisions through evidence-based practice that will reduce/prevent the risk of harm to unborn children potentially exposed to AEDs in early pregnancy.
(2) A change in the process by which GlaxoSmithKline (GSK) practices post-marketing epidemiological surveillance of the new generation AED `lamotrigine' in pregnancy.
(3) Benefit to the methodological practice of other researchers in Europe involved with AEDs and epidemiological surveillance
(4) Contribution to building European system for reproductive safety evaluation
Approximately 25,000 people in the UK die each year from venous thromboembolism (VTE); furthermore, VTE affects 1 in 100,000 women of childbearing age and causes one-third of all maternal deaths. Thrombophilia, pregnancy and the use of oral oestrogens can all place women at increased risk of VTE when compared with other individuals. University of Glasgow researchers quantified the probability of VTE among at-risk women and analysed the benefits and cost-effectiveness of thrombophilia screening. Their research is cited in the recommendations and evidence bases of leading national and international clinical guidelines. This work also galvanised an overhaul of VTE prevention policy within NHS Scotland by emphasising the need for regional health boards to implement and audit standardised in-house protocols and provide accessible patient information on VTE.
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.
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.