The English Language Support Academy for Medics will work with the gynaecologists, surgeons, paediatricians, emergency medical doctors and GPs in 2025.

The Belfast programme is supported by REACHE, a 21-year-old medical education programme funded by NHS England that in 2024 has helped 123 health professionals, mainly doctors and nurses on their journey to regain their professional registrations in England.

The programme is being led by Dr Aisha Awan, Director of REACHE at the Northern Care Alliance NHS Foundation Trust, and a clinical lecturer at The University of Manchester. 

Dr Awan said: “REACHE offers an excellent return on investment. Its nearly six times cheaper and takes half the time of training medical students in the UK.

“The fall of the Assad regime in Syria brings the plight of refugees and asylum seekers sharply into focus.

“But rather than wasting the experience of these skilled medical professionals when we need doctors and nurses desperately, REACHE supports them to be part of the solution to our national challenges.”

She added: “Refugee doctors have an average of seven years post-registration experience under their belt.

“With specialist language and acculturation training alongside strong pastoral support, they are well able  to fill the estimated shortfall of around 50,000 doctors in the NHS.”

According to REACHE, the recruitment of refugees and asylum-seeking doctors and nurses prevents them from becoming deskilled through inactivity in their host country.

That way they can then return to their nations after conflicts end and provide health services to traumatised citizens and rebuild their country.

• Image 1 : the Lord Mayor of Belfast, Councillor Micky Murray welcomes a refugee group of doctors at the opening of the programme. From L to R they are  Dr Ghaleb Daher,  Lord Mayor, Dr Yasmeen Ahmed and Dr Mohameden Omer 
• Image 2: From Left to right they are: Jennifer Taggart, NHS service manager; Councillor Micky Murray; Aisha Awan; Dr Kathy Cullen, interim Centre Director, Queen's University

The study - led by two University of Manchester researchers and published in Nature Communications - significantly advances our understanding of how Aspergillus fumigatus rapidly develops drug resistance.

 The mould, found in soil, composts, and decaying vegetation, is potentially deadly to people with a range of health conditions including those with weakened immune systems and respiratory problems.

Millions of people develop invasive and chronic aspergillosis infections around the world every year, with mortality rates ranging between 30% to 90%.

Only three classes of antifungal drugs available to treat disease, and only one class, the azoles, is suitable for long-term oral administration.

Resistance to azoles is spreading due to the use of a class of fungicides in agriculture, known as the DMIs. Resistance can double the risk of mortality from invasive aspergillosis.

According to the study funded by The Wellcome Trust, strains resistant to azoles are over five times more likely to acquire resistance to new treatments currently in clinical trials. 

The study follows previous research by the team showing how an agricultural fungicide called ipflufenoquin- currently under consideration by authorities worldwide - could have a devastating effect on a new drug, olorofim, currently being trialled to treat Aspergillus fumigatus infections. 

F2G Ltd – a spin out company from The University of Manchester – invested more than £250 million over 20 years in the development of olorofim, which is in late-stage clinical trials and aims to be clinically deployed within the next few years. 

Because olorofim works against azole resistant infections, it could save many lives of affected patients. 

However, ipflufenoquin, could severely impact the new drug because it has the same biological target and kills the fungi the same way as olorofim. 

Co-author Dr Michael Bottery from The University of Manchester said: “Our discovery, coupled with our previous research on the impact of an agrochemical on antifungal resistance, highlights the urgent need for innovative strategies to combat the growing public health threat of antifungal resistance. 

“Aspergillus fumigatus produces billions of spores. Even slightly elevated rates of mutation mean it is highly likely resistant mutants will arise.” 

By exposing billions of spores from genetically different natural strains of Aspergillus fumigatus to a range of drugs they accelerated evolution in the lab to predict how likely it was for resistance to evolve. 

Strains that evolve faster, they found,  were also the ones already resistant to azoles. These strains had genetic changes in genes that control the fungus’s system which repairs mutated DNA  -  known as the mismatch repair system. 

By using CRISPR-Cas9 to reproduce these variants in the lab, they were able to directly link the changes in the mismatch repair system with the ability of Aspergillus fumigatus to evolve resistance to new drugs. 

Co-author Prof. Michael Bromley from The University of Manchester said: “Specific strains of Aspergillus fumigatus are resistant to azoles, the only effective long-term treatment for chronic aspergillosis.

“But these strains also have elevated mutation rates due to changes in their DNA mismatch repair system - the fungus’s system which repairs errors in its DNA.

“This means that isolates that are already resistant to our first line treatments could develop resistance to new drugs 5 times faster than drug resistant isolates, potentially leading to strains that are resistant to all antifungal medications.”

The  paper "Elevated mutation rates in multi-azole resistant Aspergillus fumigatus drive rapid evolution of antifungal resistance," to be published in in Nature Communications, is published in Nature Communications.

The duration reduction of around 10% could provide significant cost savings to health systems, limit unwanted drug side-effects, reduce overtreatment and reduce the development of antimicrobial resistance in individuals, across communities and internationally.

The study was commissioned and funded by the National Institute for Health and Care Research (NIHR), and its leading partners were The University of Manchester, Northern Care Alliance NHS Foundation Trust and Warwick Medical School’s Clinical Trials Unit,  who specialise in research in emergency and critical care.

Chief investigator Paul Dark, Professor of Critical Care at the University of Manchester will present the findings to a global online audience at the prestigious this week (10/12/24), where it will be scrutinised and debated by some of the world’s leading experts in the field.

The research team are also to publish their peer reviewed findings in JAMA-  one of the world’s leading medical  journals today

According to the charity Sepsis Research FEAT, around 50,000 people are estimated to die of sepsis in the UK each year, which develops when the body's immune system overreacts to an infection and starts attacking its own tissues and organs.

Accounting for 100,000 hospital admissions a year in the UK, it is estimated that there are 49 million cases and 1 million deaths a year globally.

Recognising sepsis and starting antibiotics  early are crucial but until now the recommended duration of such treatment has been uncertain.

The only available option recommended for doctors currently is to use their judgement  to decide when to discontinue the potent  broad spectrum antibiotics, usually reserved to treat the condition.

The new decision support system is based on a simple blood test, carried out daily and available in most  NHS hospital laboratories.

It tests for levels of a circulating protein called procalcitonin (PCT), which is produced as part of the body’s immune system responses to bacterial infections.

Higher levels indicate a greater likelihood of bacterial infection and sepsis, with subsequent falling levels indicating favourable responses to treatments

A computer automated response, based on the PCT levels from the blood test,    advises doctors whether to discontinue antibiotic treatment or not.  A further commonly measured circulating inflammation protein (C-reactive protein or CRP) was also tested.

The randomized controlled trial was based at 41 intensive care units across the UK, involving 2,760 adults from January 2018 to June 2024.

It compared 918 patients on a  PCT protocol with 924 patients on a  C-reactive protein (CRP) and 918 patients on current standard care.

Clinicians responsible for managing patients received daily standardized written advice on either standard care or on PCT or CRP biomarker-guided antibiotic discontinuation.

The protocols in the study were uniquely designed to  conceal laboratory test results  from clinical  staff to reduce potential bias and patients were randomly assigned to one of the three groups.

The team found that a PCT protocol reduced total antibiotic duration by 10% and all-cause mortality, a key patient safety measure, was the same as standard care .

There was no difference in total antibiotic duration between standard care and CRP protocols..

Professor Dark, who is also an NHS Consultant in Critical Care Medicine at Salford Royal, said: “This simple protocol, if implemented, could significantly change the way sepsis is treated and safely help to combat antimicrobial overuse and resistance-  one of the world’s leading health challenges.

“It is also a powerful illustration of how precision medicine can make a real difference to patient care  when treatment is tailored to  individual test results  of each patient.

“It’s also important to acknowledge that this study would not have been possible without the generous contribution  of patients with this life threatening condition who like all of us, are committed to finding better ways to deal with sepsis.”

He added: “Sepsis has been at the forefront of policy makers minds ever since the publication of 2013 Health Service Ombudsman report which focused on sepsis patients who were not treated urgently enough.

“Ever since then, developing better diagnostics and treatment guidance for GPs and hospital clinicians to help them recognise sepsis at an early stage has been a national priority.

“This trial has been planned to address NICEs recommendations so that its results will inform their future guidance on antibiotic duration in sepsis.”

Sepsis Research FEAT trustee Beth Budgen developed sepsis as a result of a seemingly innocuous Strep A infection on Christmas Day 2022, resulting in quadruple amputations.

She said: “Within 24hrs I was fighting for my life and have been left with life changing injuries as a result. If this can happen to me, it really can happen to anyone. It really is that scary

“The University of Manchester study is one of several significant projects currently being undertaken in the UK in the field of antibiotic treatment for sepsis patients - an extremely important area of research which Sepsis Research FEAT fully endorses.

“The priority setting partnership exercise that the charity recently completed with the James Lind Alliance will also now be crucial in ensuring that the best research into sepsis takes place UK-wide.”

Professor Gavin Perkins, Warwick CTU Trial Lead said: “Sepsis claims tens of thousands of lives each year in the UK.  The findings from ADAPT-sepsis will help doctors ensure that critically ill patients with severe infections get the right duration of treatment with life-saving antibiotics.”

• Critically ill patients recruited to the trial had already commenced antibiotics for sepsis, so the study does not provide evidence for biomarker use in initiating antibiotic therapy.
• The University of Manchester, University of Warwick and Northern Care Alliance NHS Foundation Trust researchers would like to thank the NIHR Clinical Research Network (CRN) for help delivering the study in the NHS and the NIHR Health Technology Assessment Programme for funding the trial.  The collaborative  co-investigator  funded team  in this national study are linked here    .  We would also like to thank Abbott and Roche Diagnostics for their contracted support to assist NHS laboratories participate in the study. 
• Beth’s story is available to read in full and she also appears on the Sepsis Research FEAT  . The PSP outcomes page on their  website can be found .

Professor Adam Greenstein, Professor of Medicine at the University of Manchester, said: “The team and I are delighted to have been chosen as the winners of the British Heart Foundations Research Story of the Year award. Our research marks a revolutionary step forward in understanding the vascular causes of dementia by uncovering new routes for drugs which could slow the progression of  this devastating condition.

The British Heart Foundation has been funding my work for the last 12 years, and it has been the privilege of a lifetime. None of these breakthroughs would exist if it wasn’t for their unwavering and continuous support. Dementia in the over 65’s is largely a vascular illness – together with the British Heart Foundation we are going to stop it in it’s tracks”

The Research Story of the Year category invites the public to vote for their favourite BHF-funded research project addressing some of the biggest challenges in cardiovascular disease.

The 91ֱ�� team, co led by Professor Greenstein and Dr Harry Pritchard won for their study that unmasked the hidden dangers of even slightly high blood pressure, revealing how it disrupts communication between the cells that make up the arteries in the brain.

Blood flow in the brain is regulated by two cell structures. When blood pressure increases, these structures help to transmit messages that tell arteries to dilate, allowing more blood to flow through them.

But the researchers found that, when blood pressure remains consistently high, these two structures move further apart. This stops messages reaching their target, causing arteries to remain permanently constricted and limiting blood flow to the brain.

Brain cells that don’t receive enough blood are starved of oxygen and nutrients, causing them to become damaged over time and die. This can lead to lack of concentration and poor memory, both symptoms of dementia.

These results in mice still need to be confirmed in humans, but the team are already looking at potential drugs that could restore this communication. They hope that this could improve blood supply to affected areas in the brain, slowing the progression of all dementia syndromes.

Dr Charmaine Griffiths, Chief Executive at the British Heart Foundation, said:

 “Cardiovascular disease affects the lives of too many families, leaving a trail of devastation in its wake. But, thanks to the incredible commitment and generosity of our BHF supporters and researchers, there is hope on the horizon.

“This study is just one example of the incredible research happening in labs and hospitals across the UK. Every day, our awe-inspiring BHF-funded researchers bring us one step closer to the next breakthrough that will save and improve lives of people affected by cardiovascular disease.”

2025 will mark two decades since the partnership between The University of Manchester and Mansoura University was forged, a relationship which led to the development of Egypt’s first international medical programme.

In 2006 an initial cohort of 60 students were welcomed on to the scheme. Today the programme takes on just under 400 trainees annually, with 50% of these being international students. These students to date have hailed from 45 different countries, including students from neighbouring countries in crisis who receive their medical education through scholarships in Mansoura.

With many medical schools closed in these regions, Mansoura is helping to ensure a medical service can continue in these countries and is playing an instrumental role in educating the next generation of doctors, while helping to meet the urgent global need for an increased health workforce.

Professor Keith Brennan, Vice Dean for Internationalisation, Faculty of Biology Medicine and Health, at The University of Manchester said: “As we continue to celebrate our 200th year anniversary and the impact of our teaching and research partnerships, we can also see how our international partnerships are directly contributing to meeting global need and the huge difference they are making towards meeting the UN Sustainable Development Goals (SDGs) particularly Goals 3 Good Health & Wellbeing and 4, Quality Education”.

Additionally, The World Health Organization (WHO) predicts that there will be a global deficit of 10-14.5 million healthcare workers by 2030, 6.1 million of this deficit will be in Africa and a further 1.7 million will be in the Eastern Mediterranean and Middle East.

The Mansoura 91ֱ�� Medical Program directly addresses this deficit, providing training for the next generation of doctors in the region. As the programme provides an integrated training, graduates are able to work in any healthcare system globally.

The programme takes the best approaches to medical education seen globally, which put the patient first and emphasise competencies meaning graduates are in a better place to diagnose and treat patients.

Professor Ashraf Shoma, Dean, Faculty of Medicine, Mansoura University said: “International partnerships such as this brings enormous benefits for our students, staff and local populations. Our graduates are able to join a global workforce that can meet patient needs, both here in Egypt and overseas”.

Professor Lucie Byrne-Davies, Associate Dean for Internationalisation, Teaching & Learning Partnerships, Faculty of Biology, Medicine & Health at The University of Manchester said: “The Mansoura 91ֱ�� Medical Program is a truly collaborative initiative that combines The University of Manchester’s holistic curriculum with the quality teaching delivered by our colleagues in Egypt. Our programme provides healthcare education that will equip students with the lifelong learning and research skills they need to thrive in their future careers.”

Attending the latest cohort’s graduation were Professor Keith Brennan, Professor Lucie Byrne-Davis and Professor Joanne Hart.

The first Whitworth debate in November 2023, called Culture of care or culture of concern - let’s debate animal research, received the accolade on Monday at a ceremony at the Crick Institute in London. 

Wendy Jarrett CEO of Understanding Animal Research (UAR), Penny Hawkins Head of the Animals in Science Department, RSPCA Science and Policy Group and  Celean Camp CEO of the Fund for the Replacement of Animals in Medical Experiments (FRAME) took questions from students and staff at the event. 

The event kicked off with Dr Maria Kamper, Director of the University's Biological Services Facility signing a public pledge to uphold a culture of care within the unit. 

The University, a winner of two other openness awards over the past 7 years, is a signatory of the Concordat on openness on animal research, a set of commitments to enhance animal research communications. 

It has been recognised internationally as a leading exponent of openness in animal research. 

The judges, who included senior figures from science, academia and the RSPCA, praised the event as a space for people to come together to ask questions and hear issues around animal testing. 

They particularly recognised the efforts that would have been needed to obtain the necessary internal support for holding such an event. 

“We hope its success inspires other signatories [of the Concordat] to hold similar events, with a continuing broadening of the perspectives represented on the stage, and of those attending,”  they added. 

Dr Kamper said: “We are so proud to be recognised as a leading exponent in openness by our distinguished peers. 

“There is absolutely no doubt that openness reaps huge rewards for science, scientists-  and ultimately the public who are the beneficiaries of new medical treatments and procedures. 

“And shining a light on animal research, also ensures that the highest standards of care and welfare are adhered to by those who work in the sector.” 

The debate was chaired by communications lead for animal research Mike Addelman, from the Directorate  of communications, marketing and student recruitment. 

He said: “This event was conducted in the best possible way. Though our panellists covered many of the hotly debated areas in animal research, they were constructive in what they had to say, and engaged a lively and appreciative audience. 

“It was clear that audience members went home feeling as though they had learned something - and that they understood where people with differing views were coming from."

• Image  from left to right:  Mike Addelman, animal research comms lead University of Manchester, Val Summers, Regulatory Affairs Manager at Envigo who presented the award, Dr Jo Stanley,  Named Training and Competency Officer and 3Rs manager at The Biological Services Facility, University of Manchester

The review also finds that 15% of people with chronic pulmonary aspergillosis (CPA) die in the first year following other lung diseases.

The international study of CPA - which kills 340,000 people a year around the world - is  led by Professor David Denning from The University of Manchester and published today in the leading journal Lancet Infectious Diseases.

Though still high, CPA patients with prior tuberculosis (TB) had a lower overall 5 year mortality of 25%, according to the study.

Though patients with TB tend to be younger, a multivariable analysis showed prior TB was 24% less lethal than other lung conditions, even accounting for age, though the reason for the difference in outcome was not identified.

Being older than 60, having interstitial lung disease, current cancer and smoking-related lung disease carried worse outcomes.

Co-authors Dr Abinhav Sengupta and Dr Animesh Ray from All India Institute of Medical Sciences in Delhi examined the death rates in 8,778 patients described in the literature from all continents except Antarctica.

CPA, in which lungs gradually scar over months and years, is a debilitating condition which causes severe tiredness, weight loss, breathlessness and coughing up blood.

Caused by exposure to airborne spores of the mould Aspergillus, it is harmless to most people, but not to those with lung damage.

A small group of patients with disease in only one lung have it removed surgically have a much lower mortality.

In contrast, very ill patients tend to be treated with the antifungal drug voriconazole and had a significantly higher mortality.

David Denning, Professor of Infectious Diseases in Global Health at The University of Manchester who led the study said: “This truly international collaboration highlights the poor outcome of diagnosed and treated patients with CPA.

“Many are not diagnosed or misdiagnosed as having TB, and then not treated with antifungal agents.

“Treatment with antifungal drugs or surgery improves symptoms and probably reduces deaths from this truly disabling disorder, although as this study shows new strategies to reduce deaths are required, especially straight after diagnosis.”

Earlier in 2024, Professor Denning that CPA developed in 1.8 million people each year, leading to 340,000 deaths (18%), taking into account diagnosed and undiagnosed patients.

Of the deaths, an estimated 204,000 were directly attributable to CPA. This new research takes the CPA mortality down and consequently the number of patients living with CPA up. The last figure (prevalence) was estimated by Denning at over 6 million.

The paper Mortality in chronic pulmonary aspergillosis: a systematic review and individual patient data meta-analysis is available

In a position statement published today, British Society of Audiology, the British Academy of Audiology and the British Society of Hearing Aid Audiologists say the misinformation is promoting a sense of alarm and stigma around hearing loss, and may discourage people experiencing hearing difficulties from seeking help.

They also argue the focus on what causes the co-occurrence of hearing loss and dementia could inadvertently distract from much needed research on how to assess and help people who live with both conditions.

The statement published by the organisations, provides a more balanced view of the link between the two, arguing there is no evidence to support or refute either of the claims.

Factors which are predictive of dementia include depression, traumatic brain injury, diabetes, lower levels of education, and social isolation. Hearing loss comes much further down the ranking and has a clear but weak association.

The lead author Kevin Munro, Professor of audiology at The University of Manchester, said: “It is true that hearing loss and dementia both increase with age. But it does not follow that one causes the other.

“Social responsibility is paramount, and any misleading negative messaging may distract from the importance of good hearing in its own right.

“Hearing loss is a huge challenge because it ranks third in terms of years lived with a disability.“

There is clear evidence that treating adult-onset hearing loss facilitates an active, engaged, independent, and healthy older age, and that could be good for people with or without dementia.

“The topic of dementia raises considerable fear and alarm because of the potential devastating consequences for individuals, with a significant impact on families and carers, as well as the health and care system.”

Siobhan Brennan, Chair of the British Society of Audiology said: “While the nature of the link has yet to be determined, it is a mistake to think that if two things co-occur, one must have caused the other.

“We can say with certainty that just because someone experiences age-related cognitive change, and changes in their hearing, this does not mean that they will go on to develop dementia.”

Listening and trying to communicate with others when you have a hearing loss can be a challenge. Hearing aids have proven benefits for improving communication and this helps to keep the user cognitively and socially active.

Professor Munro added: “If hearing aids help you to hear more easily, this means your brain probably doesn’t have to work so hard. That could free up your brain to do other things. This is a simple and clear message: hearing better can help you to live better.”

Claire Benton, President of the British Academy of Audiology said: “We need to change the narrative, so society appreciates the importance of healthy hearing. We are in an ageing society and the more people who enter older age in good health, the better. Healthy hearing is an important component of healthy ageing.”

Michael Marchant, Vice President of the British Society of Hearing Aid Audiologists, said: “This document is designed to reassure our members and help them navigate any concerns. Since causation between hearing loss and dementia has not been proven, it’s essential that our members approach this topic with sensitivity, ensuring patients feel informed and supported rather than alarmed.”

The authors of the report stress that the content is specific to adult-onset hearing loss. It does not apply to people who identify as being Deaf and are members of a vibrant community that uses sign language to communicate.

The position statement and clinical guidance is called: The link between adult-onset hearing loss and dementia. It is published this week by the British Society of Audiology, the British Academy of Audiology and the British Society of Hearing Aid Audiologists.

The full mission statement is  available  

Developed by researchers at Saint Mary’s Hospital, part of Manchester University NHS Foundation Trust (MFT) and The University of Manchester, in collaboration with 91ֱ��-based firm genedrive Plc, the rapid bedside test could save the NHS £5 million every year by reducing the need for interventions, such as cochlear implants.

The innovative test was first piloted at Saint Mary’s Hospital and Liverpool Women’s Hospital, in 2020 as part of the Pharmacogenetics to Avoid Loss of Hearing (PALOH) study. Following its success, the test was implemented into routine clinical practice at Saint Mary’s Hospital in 2022 and extended to all three maternity units at MFT, Saint Mary’s Hospital, Wythenshawe Hospital, and North 91ֱ�� General Hospital, in 2023.

The National Institute for Health and Care Excellence (NICE) conditionally recommended the genedrive test for use in the NHS last year. It has since been implemented into routine clinical practice at all eight Greater 91ֱ�� neonatal units, with funding from Health Innovation 91ֱ�� (HInM). So far, the test has prevented the hearing loss of 11 babies at MFT and across Greater 91ֱ��, with 4,000 babies tested to October 2024.

As part of its recommendation, NICE identified areas requiring more information to determine whether the test should be recommended for use at all neonatal sites across the NHS. This includes how the test impacts the time it takes for a baby to be given antibiotics, how the results affect antibiotic prescribing decisions, and the technical performance and accuracy of the test.

Now, having successfully received £1.4m funding from the National Institute for Health and Care Research (NIHR) and the Office for Life Sciences, researchers at MFT will lead PALOH-UK, a new two-year study across 14 neonatal units, from large intensive care units to small special care baby units.  

Dr John McDermott, Clinical Geneticist at MFT and joint lead for the PALOH-UK study said: “We are incredibly proud to be leading this research at MFT, having already seen the difference this new genetic test has made across Greater 91ֱ��. We are excited to explore how it can be used effectively at other neonatal units across the UK.  

“The PALOH-UK study will demonstrate how the test can be used in a timely way to ensure babies get a safe, effective antibiotic without affecting normal clinical practice, on a much larger scale.”

Using a cheek swab, the test can identify in 26 minutes whether a critically ill baby admitted to intensive care has a gene change that could result in permanent hearing loss if they are treated with a common antibiotic, gentamicin.

While gentamicin is used to safely treat approximately 100,000 babies a year, one in 500 babies carry a gene change that can result in permanent hearing loss when given the drug.

The test replaces a previous method that traditionally took several days and is the first use of a rapid point of care genetic test in acute neonatal care. Babies found to have the genetic variant can be given an alternative antibiotic within the NICE recommended ‘golden hour.’

The 24 month, PALOH-UK study, due to start in November 2024 will be co-led by Professor Bill Newman, Consultant in Genomic Medicine at the 91ֱ�� Centre for Genomic Medicine, Saint Mary’s Hospital and Professor of Translational Genomic Medicine at The University of Manchester.

Professor Newman, who is also Rare Conditions Co-Theme Lead at the National Institute for Health and Care Research (NIHR) 91ֱ�� Biomedical Research Centre (BRC), said: “While we were delighted that NICE recommended the use of the genetic beside test, we understand that evidence is needed to understand implementation in smaller centres and in more diverse populations, which is what this study will do.

“We are looking forward to working with partners across the NHS to take this research to the next level and hopefully bring this test closer to implementation across every NHS neonatal unit in the UK.”

Dr Gino Miele, Chief Executive, genedrive plc, said: “We are delighted with the successful funding award to MFT, to address the areas where NICE has identified a need for further information.  We are proud to be at the forefront of pharmacogenetic testing in emergency care settings and look forward to working with all partners across the UK to progress implementation of this worlds-first rapid genetic test in neonatal settings, positively impacting patient outcomes and healthcare finances.”

Dr John McDermott, who is also a NIHR Fellow at The University of Manchester added: “It’s fantastic to see this research moving forward and highlights how genomic medicine can be integrated into routine clinical practice to improve healthcare outcomes. Most importantly, having this test available nationally will ensure no baby will go deaf unnecessarily.”

• Image: using the genetic test

The supports healthcare professionals and students in developing leadership skills essential for shaping the future of healthcare.

Al-Saffar, a Final Year Medical Student, will join a community of scholars selected from a competitive pool of applicants from across the world. Scholars will attend several leadership workshops throughout the year, along with mentorship, coaching and networking opportunities with HLA Alumni and prominent healthcare leaders.

During the programme, each scholar will undertake a Scholar Project aimed at addressing a key healthcare challenge. Al-Saffar plans to focus on improving access to medical school for students from disadvantaged backgrounds.

Of the award, Noor said: “I am thrilled to have been accepted onto the HLA with a scholarship. As someone who is passionate about global health leadership and policy-making, this is an excellent opportunity to cultivate and develop my leadership skills. I am very much looking forward to collaborating with Scholars from around the world, and sharing expertise. Very grateful and honoured to be part of the HLA community, and for the support and mentorship that I will undoubtedly derive from it for years to come.”

Johann Malawana, Director of The HLA, said: “After a rigorous and competitive application process, we are delighted to welcome our new cohort of 2024-2025 scholars. At a time of great global challenge in healthcare, it is important that the next generation of healthcare leaders are motivated, inspired, and prepared in order to best look after the populations they serve.”

Founded in 2016, The HLA recognises individuals with proven leadership potential  and offers an opportunity to future nurture their leadership skills to the next level. This year’s cohort has a mix of medical students from across various healthcare professions from over 10 countries.

The HLA is an associate member of The Council of Deans of Health in the UK, commissioned by NHS England, works with institutions across multiple countries and partners with Medics Academy.

The new tool -  now used across the world - was developed by research fellow Dr Richard Naylor who made it possible to use zebrafish larvae to easily and quickly screen new drugs for treating different kidney diseases. 

Replacement, reduction and refinement – known collectively as the 3Rs -  are an increasingly important area of biological research. 

By law scientists must demonstrate they have adhered to the principles of the 3Rs before their project license is granted by the Home Office. 

Dr Naylor will pick up his award today (14 November) at the second ever University of Manchester  3Rs symposium, organised by the University’s animal unit, where  scientists will hear about the latest advances in 3Rs science. 

Using organisms that are not able to feed independently and are therefore considered to be minimally sentient - the judges recognised the tool as a novel alternative to mammals but also for its ability to reduce animal numbers and enhance the care they receive. 

Kidney disease is a major cause of illness and accounts for 10% of all deaths in humans. 

Protein in urine is produced when kidneys do not work properly and is easily tested in humans with a simple dipstick. 

Zebrafish- which have similar genetics to humans and possess 80% of human disease-causing genes - are a popular species used by research scientists because they produce large numbers of eggs (200 to 300 per week per female), which develop externally. 

In the past it was virtually impossible to test for protein in the urine of zebra fish larvae because the tiny amounts of urine produced are immediately diluted in the fish tank. 

However, a new genetically modified zebrafish larvae model, designed and generated by Dr Naylor and his team, contains a luminescent molecule called NL-D3 in its blood. 

When kidneys are damaged, NL-D3 leaks out of the kidneys and into the urine. NL-D3 can easily be detected in embryos using a luminometer which measures the light produced by urine in the water. 

As a result, scientists can now easily test for the level of protein in high numbers of the organisms which - at less than 5 days old - are not considered to be fully sentient under the law. 

The team tested the new tool by generating a zebrafish model of Alport syndrome, a kidney disease characterized by protein in the urine, publishing their results in the prestigious journal . 

In Alport zebrafish, levels of NL-D3 increased but could be subsequently reduced using captopril, a drug that lowers blood pressure, demonstrating the efficacy of the tool. 

Dr Naylor said: “Finding 3Rs solutions to animal research is incredibly important because as scientists we care about the welfare of the animals we are privileged to work with. 

“That is why it is so exciting we have demonstrated how is possible to conduct fundamental research on kidney disease without necessarily relying on mammalian models. 

“Testament to this, we have had seven research groups in the US and Europe request embryos be sent to them. 

“And even more excitingly, we are currently collaborating with a large pharmaceutical company to model acute kidney injury and screen drugs to treat it.” 

Dr Maria Kamper, Director of the animal unit at the University of Manchester said: “As Director of the Biological Services Facility, I am delighted to present our inaugural University of Manchester 3Rs prize to Dr Naylor and his team. 

“Their innovative work exemplifies our commitment to advancing scientific discovery while upholding the highest standards of animal welfare. The widespread adoption of this model by kidney disease researchers worldwide proves it is an outstanding achievement in the 3Rs space.” 

Replacing mouse models
Until now, protein in the urine as a marker of kidney dysfunction in disease and in response to drug treatments was mainly used in mouse models or from human patients. But with the new tool, the ability to use zebrafish to accurately monitor kidney dysfunction increases the appeal of pre-independent feeding stage zebrafish to model kidney disease for researchers worldwide. 

Fewer numbers needed
Previously, high numbers of embryos were needed due to high variability in methods used to test kidney dysfunction in zebrafish. The new tool, however, has reduced the number of procedures needed to be performed on zebrafish embryos to zero.  As the scientists now only need to analyse embryo medium, no animals are injected or are required to be anaesthetized. And fewer larvae are needed to achieve statistical significance. 

No need to anaesthetize the embryos
Before the paper was published, the only way to measure kidney dysfunction in zebrafish was to inject fluorescent dextran directly into the animals and observe how quickly the fluorescence was lost from the blood vasculature over the subsequent days. The approach meant having to anaesthetize zebrafish embryos repeatedly, which is now lo longer necessary.

• The paper A novel nanoluciferase transgenic reporter measures proteinuria in zebrafish is published in
• Images are of zebrafish larvae

The findings from a survey and interviews provide an important context to the retention crisis for pharmacy technicians, who are leaving their current employers or the role altogether in numbers. 

Published in the journal Research in Social and Administrative Pharmacy this week, the study reveals their role is characterised by heavy workloads, inadequate staffing, and lack of support. 

A minority of the 603 respondents - 489 of which were women - also reported favouritism, bullying, and racism, especially in community pharmacies and some hospitals. 

The findings are a stark warning to policy makers that urgent action is needed to retain the 26,500-strong English pharmacy technician workforce. 

After formal recognition of the role in the early 2000s, registration was made mandatory in 2011, requiring two years of study. 

Pharmacy technicians are now regulated pharmacy professionals, who are taking on increasing levels of responsibility in community and hospitals, and increasing numbers are working in general practice. 

Government plans for newly qualified pharmacists registering as independent prescribers from 2026 and delivery of increasing levels of clinical services through community pharmacies will mean pharmacy technicians are needed to take on more responsibility to free up pharmacists’ time. 

However, according to NHS England, current workforce projections (Based on 2021 figure from Health Education England. Pharmacy Technician and Pharmacy Support Staff Workforce Development Strategy) suggest the number of pharmacy technicians will not meet the demand, which could lead to a vacancy rate of 9% across the acute and primary care sectors.

NHSE also estimates that vacancy rates in community pharmacies are even starker at 20% and rising. 

Lead author Dr Imelda , research fellow at The University of Manchester said: “Our study discovered many complexities behind the falling numbers of pharmacy technicians. 

“These include low pay, limited career advancement, lack of recognition by employers and stressful work environments, characterised by heavy workloads, inadequate staffing, and lack of support. 

“Our evidence shows that staff turnover is influenced by a multitude of factors such as career commitment, organisational commitment, job satisfaction and job stress.

“But as Government policy sees their role as increasingly important, these issues need to be resolved.”

Co-author and the study’s principal investigator Professor Ellen said: “There are challenges preventing pharmacy technicians from effectively fulfilling their expanded roles.

“One is the lack of clarity surrounding their roles and responsibilities, particularly in community pharmacy settings.

“But the heart of the problem could lie in the lack of adequate support and recognition of their inherent value, leading to job dissatisfaction and high turnover rates.

She added: “Employers need to address compensation disparities, offering fair and competitive wages that reflect the pharmacy technician's extended roles and responsibilities. 

“Prioritising career development opportunities, such as mentorship, demonstrates a commitment to pharmacy technician growth and job satisfaction. 

“Cultivating supportive and inclusive work environments is equally important. This involves fostering a culture that values pharmacy technician contributions and promotes work-life balance. 

“A stable, committed workforce, will benefit the organisation, the pharmacy technician’s workforce and ultimately, patient care.”

It was sent by the NHS England funded Centre for Pharmacy Postgraduate Education (CPPE) to 11,762 people who had agreed to be contacted for marketing and evaluation purposes. 

The team also carried out 19 qualitative interviews to understand the views and experiences of pharmacy technicians and the factors that contribute to their intention to leave practice.

One of the respondents told the researchers:  “Within the career itself, I don't think pharmacy technicians’ role is very well described. People don't actually know what we do.” 

Another said: “I have left community pharmacy after 10 years of stress and bullying by customers, staff and management.”

And another commented: “you could get £3 an hour more stacking shelves in supermarket, which is pretty eye opening.…In pharmacy you make a mistake and you have got a whole raft of things that you need to be seriously worried about and that is only worth 30 pence more an hour.”

The paper Why are pharmacy technicians leaving?: Factors contributing to turnover intention and strategies for retention is available

Funded by the National Institute for Health and Care Research (NIHR), the research will investigate how current youth worker services for children and young people with physical or mental health LTCs are organised, provided and experienced across the UK.

Around a quarter of young people aged 11 to 25 have an LTC, such as diabetes, depression or autism, and the number of young people with mental health problems has increased significantly in England since 2017. Recent figures published in 2023 indicate that 20 per cent of 8 to 16-year-olds, 23 per cent of 17 to 19-year-olds and 22 per cent of 20 to 25-year-olds are now reporting LTCs.

Youth workers have been introduced into healthcare settings to support young people, however there is little evidence to support this introduction, and little is known about their role and the best way of providing youth work services.

The 30-month study, jointly led by Professor Marie Marshall MBE, Deputy Director of NMAHP for Research and Innovation at MFT and Professor Sue Kirk, Professor Family and Child Health at UoM, aims to fill this evidence gap and to standardise and improve how support is delivered in healthcare settings across the UK, to benefit the health and wellbeing of young people.

Professor Marie Marshall at MFT, said: “Adolescence is a life stage when patterns of health behaviour are established that continue into adult life, which makes this a key time to intervene, to improve health, social and educational outcomes in adulthood.

“The study findings will help services develop and provide youth work services that will be used in the NHS and other organisations, to improve young people's health, confidence, social relationships and resilience. This could support young people living with LTCs to have a better quality of life both now and in adulthood.”

The study will be carried out in two stages; in stage one researchers will conduct a national survey to find out what types of youth worker services there currently are for young people with LTCs in the UK. This will include those provided by the NHS and other organisations.

In stage two, six youth worker services drawn from the survey will be selected to compare the different ways of providing youth work services. Researchers will study these services in detail and talk to young people, parents, professionals and managers about their views on the services.

12 young advisors and parents, including one or two young people at Royal 91ֱ�� Children’s Hospital, part of MFT, with a LTC will also help with the research.

Their input will ensure the work is relevant and matters to young people by developing the study materials, advising on the best way to carry out the research, helping researchers understand the findings and co-develop the guidance for developing the future of youth work services.

Joint study lead, Professor Sue Kirk at The University of Manchester, said: “This study will develop the evidence-base for youth work services for young people with LTCs and identify the best way of providing these services to improve health and wellbeing. We are a multidisciplinary team of clinicians, practitioners, managers and researchers from across the UK, working closely with our young people’s advisory group and study advisory group to help ensure the guidance we develop is appropriate and used by commissioners and services.”

The study will run until 31 March 2027, and findings from the research will be used to develop guidance on the best way of providing youth work services for young people with LTCs in the NHS and other healthcare settings.

The research, led by researchers at The University of Manchester and McGill University in Canada which analysed over 1 million patients newly initiated on opioids, found prescription of strong opioids was associated with higher risk of all-cause mortality compared to taking codeine.

 Strong opioids include morphine, fentanyl, and oxycodone, as well as combination opioids. 

Funded by the Canadian Institutes of Health Research the UK , the study findings, published today in  the journal Pain is one of the first to provide clarity on the comparative safety of different types of opioids across different countries. 

Additionally, patients taking 50 or more morphine milligram equivalents per day experienced an incremental higher risk of death. 

Morphine milligram equivalents are a way to compare the strength of different opioid medications to morphine which enables measurement of how much opioid a person is taking, no matter which specific drug is prescribed.

 The researchers also found that:

• UK patients on morphine had more than 12 times the risk of all-cause mortality compared to codeine users after adjusting for confounding factors. Similarly elevated risks were observed in the US and Canada after such adjustments. Elevated risks were also seen with fentanyl, oxycodone and buprenorphine.
• A history of depression and prior substance abuse were associated with an increased risk of death across all cohorts and in most subgroups.
• In the UK, the use of antipsychotics and benzodiazepine medications at the same time as an opioid was associated with higher risk of death across all three subgroups.
• Being on more than one type of opioid was associated with a significantly higher risk of mortality.. 

Dr Meghna Jani, NIHR Advanced Fellow and Senior Clinical Lecturer at the Centre for Epidemiology Versus Arthritis, The University of Manchester was the lead author of the study. 

She is also based at the North Care Alliance NHS Foundation Trust  and a researcher within the NIHR 91ֱ�� Biomedical Research Centre. 

She said: “It is understandable that some people do need to be prescribed opioids for pain especially in the short term given the limited options for pain relief. 

“What these study findings allow is for people to make more informed choices about the types of pain relief or specific opioid to get started on based on scientific evidence across multiple countries.” 

She added: “The morphine milligram equivalent thresholds at which the risks of opioid use are considered to outweigh the benefits, vary considerably across current international guidelines. 

“This study highlights the importance of closely monitoring patients on or approaching doses of 50 or more morphine milligram equivalents per day. 

“It also suggests having earlier, open discussions with patients on such doses to explore alternative treatments and provide additional support, especially for those with risk factors for serious opioid-related harms. 

“However instead of stopping the use of stronger opioids outright, shared decisions need to be made collaboratively between patients and healthcare professionals, considering each person’s unique situation”.

An embargoed copy of the paper Comparative risk of mortality in new users of prescription opioids for non-cancer pain: results from the International Pharmacosurveillance 91ֱ�� , published in Pain  - the journal from the International Association for the 91ֱ�� of Pain -is available

The research examines the unmet healthcare needs of marginalised communities in Greater 91ֱ�� during the pandemic and how community-based organisations and networks stepped up to help address these challenges.

Led by researchers at the University of Manchester and the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater 91ֱ�� (ARC-GM), the study highlights the frustration, fear and loss of faith in the healthcare system from people within these communities, who felt they were not supported sufficiently by mainstream services.

VCFSE organisations and community networks mobilised to meet health and wellbeing needs, such as providing food and care packages to vulnerable households, food bank services, support for people experiencing homelessness, and online support groups.

The research found that these community-based approaches were deemed crucial to the success of the vaccination drive thanks to the unique position to reach members of diverse communities to boost uptake of the vaccine.

These efforts included VCFSE group helping run vaccine pop-up sites in community spaces, such as mosques and other religious sites, children’s centres, and local specialist charities such as refugee and sex worker charities.

The findings suggest that the support delivered by the VCFSE sector remains under-recognised and under-valued by the health system and decision-makers, and has prompted calls for more inclusive, community-driven solutions in future health crises.

Lead author Stephanie Gillibrand from The University of Manchester and NIHR ARC-GM, said: “The important contribution of community engagement initiatives during the pandemic and vaccine rollout is made clear in this study. Not only did VCFSE organisations and community-led networks provide significant health and wellbeing support to people across Greater 91ֱ��, but they also played a pivotal role in building trust within hard-to-reach communities to help boost vaccine uptake.

“The value of this work needs to be recognised and learned from so steps can be taken to remove the current barriers within the health system that are stifling effective joined-up working with VCFSEs.

“Our study underscores the need to create a broader, more inclusive system which allows and promotes cross-sector collaboration, with flexibility and adaptability at the heart of future service delivery.

“With the right mechanisms in place, there is real potential to harness capacity to tackle inequalities and build trust through shared learning and greater collaborative working.”

The qualitative study, which is published in , drew insights from interviews and focus groups with people from local marginalised communities, health and care system stakeholders and VCFSE representatives.

Community participants involved groups that had been disproportionately affected by the COVID-19 pandemic in England, including ethnic minority groups, young adults, and those with long-term physical and mental health conditions.

During the research, concerns were raised about inability to access health services during the pandemic, including GP and specialist services. Participants also described their fear of catching the virus if they did attend healthcare settings, as well as fear of insufficient care due to well-publicised pressures in NHS settings. 

The study also found that:

• Participants felt strongly that this increased support provided by the VCFSE sector and community networks remains under-recognised and under-valued by the health system and wider public.
• Operational and logistical barriers created dissonance between communities and the system. This included difficulties with decision-making and power-sharing between VCFSE and commissioning or clinical organisations, organisational cultural clashes, red-tape and bureaucracy, and complex systems and power structures to navigate.
• Health systems should engage with the full breadth of the VCFSE sector, encouraging the involvement of smaller scale and less formal organisations as partners.
• Traditional health and care partners such as the NHS and local authorities should consider how their ways of working may need to change to foster full VCFSE inclusion on an equal standing.

in BMC Health Services Research at: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-10921-4#Abs1

The researchers, from The University of Manchester publish their findings in the journal Child Development.

Children start to say words around their first birthday, and for a while only say one word at a time, though they rapidly build their vocabulary during their second year.

But the researchers found  they do not do this by adding a complete form of new words to their own personal dictionary.

Instead, they put a new word in their dictionary which has some, but not all of the meaning, slowly finetuning  it as they hear more language.

To show how children do this, the researchers set up a study in 91ֱ�� Museum, working with a group of three to eight-year olds.

An experimenter built either 4 blocks stacked up, or 4 blocks lined up flat on a table, and then the children were asked to respond to different size words by building a bigger, smaller or taller version.

The researchers compared how their structure differed from the experimenter’s in each dimension , using mathematical modelling  to describe what types of changes children made, and how patterns varied with age.

Three and four-year-olds tended to treat bigger, smaller, and taller with the same meaning: they built things that were bigger in all directions.

“It seems that when children first learn words, they pick up a general idea of what they mean- in this case, that the words mean a size change”, said co- author Dr Alissa Ferry,  a lecturer at The University of Manchester.

“This seems to be how we end up with children  calling a cow a dog, or all round fruit apples, even though they’ve never heard an adult do that. But with more experience they fine tune their word meanings.

“We do think all children go through this process of fine-tuning word meanings, but which words are fine-tuned and when depends on what they hear around them.”

“Size words”, explained Co Author Dr Katherine Twomey, also from the University of Manchester, “are trickier to learn because they describe relations between all different kinds of objects, which makes it harder to find what is common.

“That makes it easier for us to see how the meaning changes with age development.”

By around  age 5, the children generally worked out that smaller meant they should use fewer blocks.

But it was not until about age seven they reliably worked out that taller really means bigger but specifically in the ‘up’ direction.

Most of the 3-year-olds built bigger things when the researchers asked for smaller ones, though some of them seemed to work it out faster than others.

It was not until about age 7 when most of the children  knew that taller meant specifically ‘up’.

However some 3- and 4-year-olds already seemed to know that taller meant ‘up’, probably because they had exposure to those words more frequently in conversations with their caregivers.

Dr Ferry added: “Learning a language is a uniquely human experience; children just pick it up from being exposed to it.

“Yet, we don’t quite know how that happens, which is why we carried out this study.”

Also on the research team were four sixth form Nuffield Research Placement summer internship students who helped design and collect the data.

The paper Bigger Versus Smaller: Children's Understanding of Size Comparison Words Becomes More Precise With Age is published

Cancer Research UK is investing a total of £5.9 million to develop new radiotherapy technologies and techniques over the next five years. In close collaboration with The Christie, the funding will support University of Manchester researchers to discover ways to improve radiotherapy treatments with the use of virtual clinical trials.

A virtual clinical trial is a computer simulation used to predict how medical treatments might work. It creates "virtual" groups of patients based on real-life data and tests how different treatments or devices would perform. These simulations let researchers explore questions and test ideas at a faster rate than traditional clinical trials and without the need to involve real patients.

The grant, awarded this month, is the second wave of investment into the multimillion-pound Cancer Research UK RadNet radiotherapy research programme which saw 91ֱ�� chosen as one of just seven centres of excellence in a UK-wide network that will accelerate advances in radiotherapy research.

Professor Rob Bristow, Director of the 91ֱ�� Cancer Research Centre and Chief Academic Officer at The Christie, is lead researcher for the project. He said: “We are very proud that 91ֱ�� has been awarded this grant to continue our work on bringing the next generation of precision radiotherapy treatments to patients sooner. The funding supports basic and discovery science to develop new approaches using state of the art radiotherapy technologies to help more people survive cancer, with fewer side effects and a better quality of life after treatment.

Our work will investigate patient-specific genetics and the microenvironment of the tumour and apply this knowledge to the latest technologies in tandem with other therapies, including immunotherapy.

Importantly, we will also be delving further into the use of artificial intelligence in radiotherapy trials. Virtual clinical trials are a new and exciting way to preview and test out new ideas using computerised simulation and improve the results of clinical trials. They help reduce the risk associated with investing in large-scale clinical studies by allowing a better tailoring of trials to patients which makes the research trial process faster, safer and less expensive, and less burdensome on our patients.

“All of this is only possible with the world leading infrastructure and expertise we have built here in 91ֱ��."

One project will focus on the use of virtual trials to compare a form of pioneering proton beam therapy to standard radiotherapy using photons for lung cancer treatment.

Martin Storey, 70, from Wythenshawe knows all too well why radiotherapy research is so important. In 2009 he was diagnosed with lung cancer and treated with intensive radiotherapy alongside chemotherapy as part of a clinical trial.

The retired delivery driver went to see his GP after work one day when he was worried about being off his food. Countless tests found nothing of concern but eventually a scan on his lungs discovered a mass.

Now after 15 years in remission, Martin, who is married to Julie, 69, is delighted that funding is being awarded by Cancer Research UK into the development of advanced radiotherapy techniques, which he says helped to save his life.

The great-grandad who also has two children and six grandchildren said: “I feel blessed every day. Not everyone survives lung cancer, and I was one of the lucky ones to be able to go on a trial. Now thanks to research I’ve lived to be a great grandad. I think artificial intelligence is the future and if more can be done with virtual trials to improve the effectiveness of clinical trials, then it will help more patients, and more people will be able to survive their cancer like I did.”

Cancer Research UK and the Christie supported some of the earliest research into the treatment of cancer with radiation and pioneered the first use of radiotherapy in the 1920s. In its simplest form, this treatment works by blasting tumours with x-ray radiation, killing cancer cells by irreversibly damaging their DNA. Today, over 130,000 patients are treated with radiotherapy on the NHS every year.

Cancer is the number one cause of death in the UK*, and in the North West, around 44,100 people are diagnosed with the disease every year.**

In the 1970s, 1 in 4 people in the UK survived cancer for 10 years or more. But today, thanks to progress in research, it’s 2 in 4.***

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes said: “Cancer Research UK, and its predecessors, have been at the forefront of radiation research for the past 120 years. Thanks to research, radiotherapy treatment is becoming kinder, more precise and less intensive across different cancers. 

“This funding marks a new phase of our RadNet network, advancing research which will further accelerate improvements in radiotherapy treatment in the clinic. This funding will work alongside our investments in pioneering radiotherapy clinical trials to ensure more people can live longer, better lives, free from the fear of cancer.”

The database study, which looked at the records of 613 people who died by suicide among adult patients in England between January 2001 and May 2019, also found that more than 40% of those who died within two weeks of being discharged had at least one primary care consultation before taking their lives. It further revealed  that discharged patients who died by suicide were more likely to have diagnoses of anxiety, adjustment or related disorders, depression, or personality disorders, than schizophrenia. 

Researchers at the NIHR GM PSRC, University of Manchester and at Keele University, say the study, published in BJGP Open, highlights the opportunity  that general practices have in helping to reduce suicide risk among people recently discharged from inpatient psychiatric care. 

The research team has called for hospitals to arrange post-discharge appointments for patients with a GP as soon as possible and for GPs to be given more support, with the study also finding earlier visits are linked to lower suicide risk. 

The study’s principal investigator, Professor Roger Webb (NIHR Greater 91ֱ�� Patient Safety Research Collaboration, University of Manchester) said: : “These findings will inform healthcare providers, especially those in primary care. They indicate the need for GPs and mental health practice colleagues to provide timely enhanced support for discharged patients in helping to reduce their risk of dying by suicide as they return to living back in the community.”

Professor Carolyn-Chew Graham OBE, Professor of General Practice Research at Keele University, said: “The investigation revealed that most patients who died by suicide within a year of discharge engaged with primary care services, and that more than 40% of those who died by suicide within two weeks of their discharge consulted with a GP. This shows there are opportunities to monitor these patients following discharge and intervene during this risky transition period. 

“General practice has a key role to play in preventing suicides among people recently discharged from inpatient psychiatric care. Most recently discharged people do access primary care, and each contact presents an opportunity to reduce suicide risk.” 

In England, the National Institute for Health and Care Excellence (NICE) guidance on transition between inpatient mental health settings and the community includes two primary care specific recommendations - the discharging hospital should consider organising a GP follow-up appointment within two weeks of discharge; and ensure that a discharge letter is emailed to the patient’s GP within 24 hours, and a summary sent within a week, subject to the patient’s agreement.

However, Prof Chew-Graham, who is also a practising GP, said this does not always happen, adding: “Letters often don't arrive in the practice for a few weeks after a patient has been discharged, and our practice is not contacted to ask us to offer a patient an appointment just after discharge.”

The researchers say clear communication and liaison between services is essential to provide timely support.

 

 [RW1]The study was led from UoM and it was funded by the GM PSTRC, so I reckon that the two institutions ought to be mentioned in the order that I’ve indicated here.

Professor Carolyn-Chew Graham OBE, Professor of General Practice Research at Keele University, said: “The investigation revealed that most patients who died by suicide within a year of discharge engaged with primary care services, and that more than 40% of those who died by suicide within two weeks of their discharge consulted with a GP. This shows there are opportunities to monitor these patients following discharge and intervene during this risky transition period. 

“General practice has a key role to play in preventing suicides among people recently discharged from inpatient psychiatric care. Most recently discharged people do access primary care, and each contact presents an opportunity to reduce suicide risk.” 

In England, the National Institute for Health and Care Excellence (NICE) guidance on transition between inpatient mental health settings and the community includes two primary care specific recommendations - the discharging hospital should consider organising a GP follow-up appointment within two weeks of discharge; and ensure that a discharge letter is emailed to the patient’s GP within 24 hours, and a summary sent within a week, subject to the patient’s agreement.

However, Prof Chew-Graham, who is also a practising GP, said this does not always happen, adding: “Letters often don't arrive in the practice for a few weeks after a patient has been discharged, and our practice is not contacted to ask us to offer a patient an appointment just after discharge.”

The researchers say clear communication and liaison between services is essential to provide timely support.

The new , also the first of its kind in the UK, evaluated the specific clinical conditions that lead to the initiation of opioid prescriptions using data from nationally representative GP electronic health records.

The study team from The University of Manchester, The Northern care Alliance and the National Institute for Health and Care Research (NIHR) 91ֱ�� Biomedical Research Centre (BRC) publish their results in the journal Pain. The research was funded by NIHR and FOREUM.

The findings are published amid a backdrop of a considerable rise of opioid prescriptions over . A 48.9% increase in opioid-related hospitalisations from 2008 to 2018 has also been reported, paralleled by an increase in opioid-related harms over two decades.

From a statistical evaluation of over 2 million records of patients prescribed opioids for non-cancer pain, 61% were women and 77% were aged over 45.

The researchers also discovered a pattern of opioid use for respiratory conditions such as cough, infections, trauma and injuries such as sprains and strains, neurological issues such as headaches, and post-surgical pain.

The most frequent musculoskeletal conditions were osteoarthritis and lower back pain.

The most common surgical indications were total knee and hip replacements, followed by hernia repairs.

In 2021, previous research has shown that opioids were involved in nearly half (2,219) of all UK drug poisoning deaths.

Organisations including the National Institute for Health and Care Excellence (NICE) and the Royal College of Anaesthetists, currently suggest alternatives to weak opioids unless other types of pain relief is contraindicated.

Strong opioids are no longer recommended for or .

Joint first author of the study and research associate, Carlos Ramirez Medina from The University of Manchester said: “While our study does not aim to evaluate the appropriateness of opioid prescriptions, it uses nationally representative data to increase awareness of the possible reasons for opioid initiation in UK primary care and encourage a re-evaluation of prescribing practices."

Senior author of the paper is Dr Meghna Jani, an NIHR Advanced fellow and Senior Clinical Lecturer at The University of Manchester, Consultant Rheumatologist at Salford Royal Hospital.

She said: “Our study indicates that opioids are commonly prescribed in patients with musculoskeletal conditions, despite scientific evidence suggesting limited effectiveness, especially in conditions such as osteoarthritis.

“For chronic lower back pain and osteoarthritis in particular, the ongoing prescription of opioids may suggest a complex landscape of pain management given limited drug treatment options for these conditions and access to helpful interventions such as physiotherapy.

“The increasing proportion of opioid use in musculoskeletal conditions over time in our study may also be reflective of an aging population who are more at risk of developing conditions such as osteoarthritis and chronic low back pain.

“Making informed shared decisions between health care professionals and patients is especially important, especially in such groups where opioids may cause more harm due to side effects and interactions with other medicines.”

Primary care electronic health records from January 2006 to September 2021 were used from the Clinical Research Practice Datalink (CPRD) to identify opioid prescriptions.

She added: “We hope these findings will help inform targeted interventions in specific disease areas and future policies to support non-pharmacological interventions in the most common conditions where opioid associated harms outweigh benefits.”

Research led by University of Manchester academics funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater 91ֱ�� (ARC-GM), examined the attitudes of people from minoritised ethnic groups, young adults and those with long-term physical and mental health conditions toward the COVID-19 vaccination programme.

Researchers found that a “perfect storm” of marginalisation and experience of structural inequalities led to distrust of the COVID-19 vaccination drive – and that marginalised communities felt ‘left behind’ by policy and decision-makers prior to and during the pandemic. 

The study, which is published , concludes that wider social inequalities, combined with experiences of marginalisation and discrimination, have long-lasting and widespread implications for vaccination uptake and health outcomes.

During the pandemic, Greater 91ֱ�� experienced higher levels of mortality from COVID-19, higher case rates and greater impacts to productivity than the national average – with disproportionately high COVID-19 mortality rates in the most deprived areas and amongst Black African, Pakistani and Black Caribbean groups.

For some study participants:

• The choice to not have the vaccine became almost a metaphor for political dissent against institutionalised failures.
• Elements of distrust appeared to be established prior to the pandemic – and enhanced due to intensified episodes of racism experienced over the course of the pandemic.
• Feelings of distrust were emphasised via the perceived mishandling of the pandemic by the government and paradoxical government policy-responses to aspects of the pandemic, including U-turns and mixed public messaging.
• Culturally insensitive public messaging and practices during the pandemic heightened longstanding and widespread disenfranchisement.
• Longer-term injustices were perceived to be further intensified during the COVID-19 pandemic - links were made between long-term failings for underserved communities and the disproportionate impact of the pandemic.
• Pushback against the vaccine was articulated via a sense of establishing boundaries against an oppressive system.

Stephanie Gillibrand, Research Fellow at The University of Manchester, said: “Existing research in this area tends to focus on the psychological or socio-economic factors that influence an individual’s uptake of vaccination. We sought to understand the complexities around vaccination motivations, exploring broader social and historical contexts or people’s experiences of marginalisation.

“We found that wider social inequalities, intersecting with experiences of marginalisation during the pandemic, have long-lasting and widespread implications when it comes to vaccination – and public health policy must recognise this broader context for future public health crises and vaccination drives..

“These implications may already be apparent, where new data has suggested that MMR vaccination rates are at a ten-year low since the start of the pandemic, and other childhood immunisations rates have also fallen.”

This - made possible by the collaboration of experts including Dr Joanna Taylor from The University of Manchester and the work of thousands of volunteers - highlights Davy's immense contributions to science, and even reveals that two common chemical elements could have had different names.

The platform, funded by the UKRI Arts and Humanities Research Council, allows the public to explore Davy's notebooks and gain insight into his groundbreaking discoveries, such as the isolation of potassium and sodium – which his notes reveal were almost labelled "potarchium" and "sodarchium."

In addition to scientific insights, the platform includes fascinating details of Davy’s experiments with nitrous oxide, including his personal experience as the first person to inhale the gas and recognise its pain-relieving properties. The notebooks also reveal Davy's frustrations over the lack of recognition for his inventions, such as his miner’s safety lamp which saved tens of thousands of lives.

Led by Professor Sharon Ruston of Lancaster University, the project is the result of a major international effort involving , the Adler Planetarium in Chicago, University College London, and .

The platform, which launches officially on Saturday 19 October, was made possible through the work of 3,841 volunteers who transcribed more than 13,000 pages of Davy’s notes, creating a valuable resource for researchers and the general public alike. The collection is now publicly available on Lancaster University Library’s digital platform.

Dr Taylor’s expertise in understanding how Davy’s scientific work intertwined with his personal reflections on nature and poetry was pivotal in interpreting the notebooks in a way that reveals Davy’s deep intellectual engagement with the world around him.

“The publication of these notebooks, images of the pages, their transcription and explicatory notes is a beginning rather than the end of a project,” said Professor Ruston. “Now everyone can read what Davy wrote 200 years ago and, I hope, will make full use of this new resource.”

The announcement has been made as part of a collaboration agreed between Lilly and UK Government today, unveiled at the Government’s International Investment Summit. 

The study will evaluate the real-world effectiveness of tirzepatide in weight loss, diabetes prevention, and prevention of obesity-related complications for adults with obesity. 

The evidence generated will seek to increase the global evidence base on the long-term impacts of weight loss medicines and potentially inform the UK's care pathway approach to the treatment of obesity. Significantly, the five-year study will also aim to collect data on healthcare resource utilisation, health-related quality of life and changes in participants’ employment status and sick days from work. 

Health Innovation 91ֱ�� has worked with the University of Manchester and local digital trials company NorthWest EHealth to develop the study approach.

Mayor of Greater 91ֱ��, Andy Burnham, said: “Greater 91ֱ�� is worldrenowned as a hub for innovation in health and life sciences. The results of the trial announced today could have a far-reaching impact on how we treat obesity globally, and our city-region is ready to make a significant contribution through our outstanding health data assets, R&D expertise, and the strong partnerships between industry, universities and public sector organisations.

“The International Investment Summit will provide an opportunity to showcase our local strengths in health innovation to an audience of global business leaders and investors. This partnership could be the first of many and give Greater 91ֱ�� residents access to other innovative treatments.”

Professor Rachel Batterham, Senior Vice President for International Medical Affairs at Lilly, said: “At Lilly, we are deeply committed to improving lives by partnering across the health system to address complex health challenges like obesity. We’re delighted to partner with Health Innovation 91ֱ�� on our plans for the SURMOUNT-REAL UK study. This collaboration will add to the evidence base on the real world impact of obesity treatments on the health of people with obesity, and will explore a broad range of outcomes including health-related quality of life and impact on individuals’ employment status.”

Martin Rutter, Professor of Cardiometabolic Medicine, University of Manchester, and principal investigator for the Greater 91ֱ�� study, said: “This five-year real-world study aims to demonstrate the long-term efficacy and safety profile of tirzepatide in a primary care setting compared to usual care. It will specifically quantify the medicine’s long-term effects on obesity, diabetes incidence, and obesity-related complications, as well as its impacts on employment and health economic outcomes.” 

Ben Bridgewater, CEO at Health Innovation 91ֱ��, commented: “Greater 91ֱ�� (GM) is well placed to deliver novel trials and real-world evidence studies to develop a deeper understanding of the impact that industry-led innovation can have on population health. Through this landmark partnership with Lilly we will show how a medicine impacts people’s long-term health outcomes. This will help us understand its effects people with obesity in GM as well as inform national strategies and pave the way for further research and development in this critical area.”

Mark Britnell, Chair of Health Innovation 91ֱ��, said: “Owing to our strengths in life sciences, academia and digital, Greater 91ֱ�� has all the ingredients to be truly world-leading in health innovation. This is demonstrated through our partnership with Lilly, which will help to propel our sector strengths even further forward for the benefit of local patients.”

Mark Fisher, CEO of the NHS Greater 91ֱ�� Integrated Care Board, said: “Around 600,000 adults in Greater 91ֱ�� live with obesity, many of whom also suffer with other obesity-related illnesses which reduces their quality of life and puts additional pressure on the health and care system. Working collaboratively with industry to solve these problems is paramount, and I am delighted to support the study coming to the Greater 91ֱ�� integrated care system.” 

Jonathan Wogel, Chief Executive Officer, NorthWest EHealth, said: “We are excited to be partnering with our colleagues at Health Innovation 91ֱ�� to deliver this new study which is aimed at generating data to support patients with obesity. It is not only a milestone for NWEH and Greater 91ֱ�� (GM), but a significant moment for the UK clinical trials industry. By combining GM’s well established health system with our innovative technology, we are demonstrating the future of clinical trials, where technology and health data integrate to make research more efficient, helping develop and deliver better care for patients.”

The analysis shows that regionally, Yorkshire and the Humber and the North East had the lowest resilience scores, while London and the South East had the highest.

In addition, rural and coastal areas showed significantly lower resilience compared to urban and inland areas of the country.

Led by academics from Health Equity North (HEN), the University of Manchester and the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater 91ֱ�� (ARC-GM), the study examined local authority data to identify geographical patterns in different communities’ ability to navigate and thrive in the face of prolonged challenges.

The research, which has been published in the , provides the first detailed assessment of community resilience in England at a local authority level.

The timely findings come off the back of a number of “chronic shocks” in the UK including the global financial crisis, the social and economic impacts of leaving the European Union, the COVID-19 pandemic and an ongoing cost of living crisis.

Researchers developed a Community Resilience Index (CRI) which measures multiple elements, such as employment, education, social and community context and housing, to measure resilience in local authorities, enabling them to be ranked from most to least resilient.

It is hoped the framework will serve as a tool for policymakers to identify priority areas and to guide the equitable allocation of funding to address geographical inequalities.

The study found that:

• The average community resilience index score for local authorities in England was 83.1, ranging from 53.3 in Tendring to 108.9 in Elmbridge.**
• Yorkshire and the Humber and the North East were the least resilient regions, with CRI scores of 75.2 and 77.5, respectively. Comparatively, London and the South East were the most resilient regions, with scores of 95.2 and 87.3 respectively.
• A North-South disparity was evident with the North of England having lower resilience scores (80.6) than the South (including the Midlands) at 83.9.
• Coastal areas featured heavily in the lowest ranking local authority areas with significantly lower resilience scores (76.0) compared to inland areas (84.9).
• Similarly, rural areas were less resilient scoring 79.1 compared to 85.1 in predominantly urban areas.
• When examining the specific social and environmental measures assessed as part of the overall index, there were further geographical disparities found:
• Access and infrastructure: London achieved the highest score followed by the North West and North East. The North of England scored higher in this domain than the rest of the country conversely, coastal and rural areas scored lower.
• Economic wellbeing and opportunity: The South East and London scored highest, indicating robust economic activity and employment opportunities. The North overall and coastal areas had lower scores, suggesting lower economic resilience.
• Social capital and connectivity: London again scored highest. There was no significant North-South divide or difference between coastal and inland areas. However, rural areas scored lower.
• Diversity and inclusion: There were higher scores for the North of England and rural areas, while coastal areas had significantly lower scores.
• Equity and stability: London was the most resilient and the North East was the lowest. Northern and coastal areas scored lower in this domain, but urbanicity did not significantly affect the scores.
• Academics behind the research are now calling on government to prioritise targeted interventions to build resilience where this is most needed.

Christine Camacho, lead author and PhD Fellow at NIHR ARC-GM, said: “Understanding a community’s capacity to cope, adapt and transform in the face of adversity is critically important to create a more resilient country.

“The Community Resilience Index we developed offers an invaluable insight into the social, economic and environmental factors that can hold communities back making them less able to overcome unexpected challenges. Perhaps unsurprisingly, the findings of our research highlight yet further regional inequalities with the North, rural and coastal areas among the least resilient in the country.

“Addressing these challenges requires both bottom-up approaches, such as community empowerment, and top-down strategies from central government to provide the necessary infrastructure and economic opportunities to enable these communities to thrive.”

Dr Luke Munford, Co-Academic Director at Health Equity North, and Senior Lecturer in Health Economics at the University of Manchester, said: “The CRI provides a framework that could be used to explore associations between community resilience and health outcomes. This makes it a potentially valuable tool for examining inequalities in broad aspects of people’s everyday lives, therefore offering a more nuanced understanding of the factors that contribute to health inequalities.

“We hope that policymakers take advantage of this opportunity to enhance understanding of how resilient communities foster better health and well-being, providing insights for targeted public health interventions and policies that are data-driven and effectively targeted.”

A breakdown of Local Authority data can be accessed in an online CRI tool available at:  

The report, led by researchers from the Universities of Bristol, New South Wales, Glasgow, and 91ֱ�� and involving an international team of experts, is published today9/10/24).

Self-harm remains neglected worldwide.  There are at least 14 million episodes every year, with the greatest number in low- and middle-income countries (LMICs).

It is defined as instances of people hurting or injuring themselves intentionally, regardless of the reasons.

However, shame and stigma can often stop people from seeking help. Self-harm can occur at any age but is most common in young people and is increasing in this group.  Self-harming behaviour leads to an elevated risk of death by suicide. People attending health services only represent the ‘tip of the iceberg’ for self-harm. 

The Commission makes a number of recommendations that could change the experience of people who have self-harmed for the better.

They include suggestions for more compassionate and effective delivery of health and social care services as well as whole of government approaches to address the causes of self-harm and reduce stigma.

The commission also highlights the necessity of seeing self-harm through a global lens, responsible handling of the topic of self-harm in all types of media, and the involvement of people with lived experience in designing and delivering care.

Prof Nav Kapur, Professor of Psychiatry and Population Health at the University of Manchester has helped lead a number of NICE guidelines on self-harm and suicide prevention.  He co-led the Commission with Professors Paul Moran, Helen Christensen and Rory O Connor.  The report includes over 40 authors from around the world. 

Prof Kapur said: “It was great to be part of the team which produced this Commission.  I’ve been working in services for self-harm for 30 years but what was striking for me with this piece of work was the integration of mental health and public health with global, indigenous, and lived experience perspectives”.

The team of researchers from the Universities of Manchester, Dundee and Aberdeen reviewed the evidence from 157 studies which compared communities that had fluoride added to their water supplies with communities that had no additional fluoride in their water. They found that the benefit of fluoridation has declined since the 1970s, when fluoride toothpaste became more widely available.

The contemporary studies were conducted in high-income countries. The impact of community water fluoridation in low- and middle-income countries is less clear, due to the absence of recent research.

Fluoride, used in many commercially available toothpastes and varnishes, is known to reduce tooth decay. Governments in many countries have added fluoride to the drinking water supply to improve population oral health, although there are polarized views on whether this is the right action to take.

“When interpreting the evidence, it is important to think about the wider context and how society and health have changed over time,” says co-author Anne-Marie Glenny, Professor of Health Sciences Research at the University of Manchester. “Most of the studies on water fluoridation are over 50 years old, before the availability of fluoride toothpaste. Contemporary studies give us a more relevant picture of what the benefits are now.” 

Results from studies conducted after 1975 suggest that the initiation of water fluoridation schemes may lead to slightly less tooth decay in children’s baby teeth. Analysis of these studies, covering a total of 2,908 children in the UK and Australia, estimates that fluoridation may lead to on average 0.24 fewer decayed baby teeth per child. However, the estimate of effect comes with uncertainty, meaning it’s possible that the more recent schemes have no benefit. By comparison, an analysis of studies with 5,708 children conducted in 1975 or earlier estimated that fluoridation reduced the number of decayed baby teeth, on average by 2.1 per child.

The same contemporary studies (conducted after 1975) also looked at the number of children with no decay in their baby teeth. The analysis found that fluoridation may increase the number of children with no tooth decay by 3 percentage points, again with the possibility of no benefit.

The review was only able to draw conclusions about the impact on children’s teeth, with similar findings across both baby and permanent teeth. There were no studies with adults that met the review’s criteria.

“The evidence suggests that water fluoridation may slightly reduce tooth decay in children” says co-author Dr Lucy O’Malley, Senior Lecturer in Health Services Research at the University of Manchester. “Given that the benefit has reduced over time, before introducing a new fluoridation scheme, careful thought needs to be given to costs, acceptability, feasibility and ongoing monitoring.”

Advocates have suggested that one of the key benefits of water fluoridation is that it reduces oral health inequalities. This updated review sought to examine this question and did not find enough evidence to support this claim, although this doesn’t necessarily mean there is no effect.

The review’s findings accord with recent observational studies including the , which compared anonymised dental health records with water fluoridation status for 6.4 million adults and adolescents in England between 2010 and 2020. People in fluoridated areas needed slightly fewer invasive dental treatments with no significant impact on inequalities.

“Contemporary evidence using different research methodologies suggest that the benefits of fluoridating water have declined in recent decades,” says Tanya Walsh, Professor of Healthcare Evaluation at the University of Manchester, co-author on both the Cochrane review and the LOTUS study. “Oral health inequalities are an urgent public health issue that demands action. Water fluoridation is only one option and not necessarily the most appropriate for all populations”.

“Whilst water fluoridation can lead to small improvements in oral health, it does not address the underlying issues such as high sugar consumption and inadequate oral health behaviours” says co-author Janet Clarkson, Professor of Clinical Effectiveness, University of Dundee. “It is likely that any oral health preventive programme needs to take a multi-faceted, multi-agency approach.”

The study published today (2/10/24) in the open-access journal PLOS ONE was led by researchers from The University of Manchester and University  Alberta, in collaboration with colleagues world-wide.

The study also looked at women’s quality of life in different age groups and found:

• Younger women under 45, reported the poorest health-related quality of life of any age group, and on every domain, although their quality of life was adequate.
• Women over 45, reported that  quality of life in every domain except physical, had improved and was reported as good or very good.
• By 60, older women generally had the best quality of life level in their life. These high levels were sustained up to 75 years of age and beyond, peaking for environmental quality of life. 

Commonly cited measures of quality of life for use in health (such as EQ-5D) have often focussed their assessments on the physical and psychological dimensions.

But that means the environmental, social, and spiritual dimensions of quality of life, internationally agreed to be important, are overlooked, with consequences for how we understand women’s health and wellbeing.

Data from four World Health Organisation (WHO) surveys was collected in 43 countries world-wide and included responses from 17,608 adults, aged15 to 101 years.

A cross-culturally developed measure known as the WHOQOL-100 assessed respondents’ quality of life and health on six key dimensions: physical, psychological, independence, social, environmental, and spiritual.

The researchers found that environmental quality of life explained a substantial 46% of women’s overall quality of life and health, and home environment  was the biggest contributor.

Other important factors included having enough financial resources to meet their needs, perceptions of opportunities for recreation and leisure, access to health and social care, and their physical environment.

Evidence of better spiritual quality of life in some women was derived from spiritual connections and faith. Studies of gender inequalities have tended to report that physical and psychological quality of life is better for men, which the study confirmed.

Co-author Professor Suzanne Skevington from The University 91ֱ�� said: “From our study it is possible to speculate about the  environmental actions by younger women around the issue of climate change and its effects on the environment.

“We speculate these actions may be initiated by their self-awareness that their environmental quality of life is only acceptable rather than good, during the early adult years; hence a desire to improve it.

“Very good environmental quality of life in older women could provide sufficient reason for them to work towards retaining this nourishing feature of their life for their family, and future generations”.

The study data was collected before it was widely appreciated that reducing climate change and biodiversity loss would depend upon changing human behaviour, which, say the authors, could be the topic of future research.

She added: “ These findings underscore the importance of choosing a quality of life measure  in healthcare clinical or research that includes assessments of environmental, social, and spiritual quality of life

“That, will more fully capture knowledge about women’s quality of life and health.

“Many existing surveys have ignored factors more relevant to women, which has meant that our understanding of quality of life has been skewed toward the experiences of men and not women.

“This profile of information could be useful in enhancing the quality of life of women from all age groups.”

DOI of the study is: 

The Nature Genetics communication , published today (02/10/24), has shown that around a year with rare genetic diseases never receive a diagnosis, many dying without the underlying cause being determined.

The researchers also emphasise existing research that calculates the of pursuing lengthy diagnostic journeys rare genetic diseases to the NHS is over £3 billion per decade. 

Hospital geneticists rely on published evidence to make diagnoses, but because of inconsistent variant naming, say the authors, they are often unable to locate relevant information, even if it exists. 

Many geneticists, they say, are using simpler but less accurate nomenclature, preventing databases like ClinVar and the Leiden Open Variation Database (LOVD) from properly identifying and adding literature to their records. 

However, a system called devised by researchers at the University of Leicester and now based at The University of Manchester is being used by leading medical journals to give each variant a standardized name.  That allows diagnostic evidence to be shared and found. 

In the communication paper the authors urge doctors to use the system to name genetic variants.

Though rare diseases, caused by variations in DNA sequences, affect fewer than 1 in 2,000 people the sheer number of rare genetic disorders at around 8,000 impact about 8%-10% of births worldwide.

Lead author Dr Peter Freeman from The University of Manchester, whose son has an undiagnosed genetic disorder, is lead scientist in the team that devised and develop VariantValidator.

He said: “It’s widely recognized that doctors often describe DNA variants using various outdated or non-standard naming systems.

“But the accurate naming of variants is crucial so that doctors can reference them and provide a diagnosis for patients with a genetic disorder.

“Sadly, many people, including my son, have not received the diagnosis they need which has difficult implications for them.

“For example without a diagnosis it can be very difficult to get a place at an appropriate school, or access desperately needed services.

“It’s galling to know that someone out there might have identified the variant which caused his illness, but may not have named it correctly so there’s no way of finding it.”

He added: “VariantValidator has been around for 7 years and is considered the gold standard in terms of naming genetic variants accurately so other clinicians will be able to find the definition and use them.

“But in a vast number of cases that is just not happening because it’s easier and quicker to cut corners or rely on outdated systems only recognisable in specific clinical disciplines.

“The problem is so widespread I’ve even come across experts responsible for setting clinical standards making these errors when naming variants in genetics focussed policy guidelines”.

“Our work is with the Human genome, but the nomenclature of genetic variants in viruses and other pathogens are also similarly non-standardised - and that’s also a problem which needs to be addressed.

“Nomenclature should accurately describe the changes in DNA sequencing observed when there is a variant when compared to a standard sequence. But in many cases, this is simply not happening and is part of a complex set of problems that is causing miss or missed diagnoses.”

The paper Standardising variant naming in literature with VariantValidator to increase diagnostic rates is available

Natalie has extensive experience of social responsibility (SR) and Equality, Diversity and Inclusion (EDI), most recently as Director for SR in the School of Medical Sciences for six years, and since 2022 as Associate Dean for EDI. In this role, Natalie has had many successes, developing and delivering a number of sustained initiatives in the Faculty of Biology, Medicine and Health (BMH). She recently brought together a team for a successful Faculty-level Athena Swan application, and has contributed to several recent successful University-level Race Equality Chartermark, Disability Confident and Stonewall applications. Natalie is particularly passionate about patient and public involvement and engagement (PPIE) and engagement with our communities, and increasing access to, and equity within, higher education.

Her collaborative and collegiate approach is demonstrated through her support and encouragement to staff and students seeking to make a positive change. This is evident in the many nominations for the ‘’ awards for staff and students across this Faculty. Natalie herself was also recognised for her commitment to SR&EDI, through her nomination for an ‘Agent of Change’ Award in 2022 from Northern Power Women, and a ‘Making a Difference’ award for Widening Participation’ in 2018.

This role was previously held by Professor Mahesh Nirmalan, who stepped down in July 2024. Mahesh transformed the way the Faculty viewed social responsibility, seeking to embed it in all aspects of our teaching and research.

Professor Gardiner said: “Mahesh is a hard act to follow. He has had a tremendous impact on the SR agenda in BMH and across the University, and globally.  I am very much looking forward to building on his work and working with you all to further strengthen and embed SR&EDI in everything we do – whether teaching and learning, research and innovation, internationalisation or operations. I am privileged to work with such a fantastic team of people and in a Faculty which already has so much of social responsibility built into its ethos.”

Feri Anita Wijayanti spoke at the event, ‘Investing in the Future: Unlocking Sustainable Financing for Sexual and Reproductive Health’, which took place in New York last month.

Co-convened by the UNFPA, the Bill and Melinda Gates Foundation, and the , the summit invited prominent figures across different sectors to promote sustainable investments towards SRH.

Feri was a Young Midwife Leader in a programme organised by the , from 2021 to 2023. She was invited to speak as a representative of frontline SRH workers, particularly midwives, and in recognition of the real-world impact she has in advocating for improvements in SRH.

Feri told the summit: “I live in the fourth most populous country in the world, spanning over seventeen thousand islands. My country is home to diverse communities, with nearly half the population residing in rural areas.  Around 14 % of women in Indonesia faced an unmet need for family planning services.

“In my country, a midwife is the heartbeat of health and well-being of the entire community - our responsibilities extend far beyond delivering babies as we are at the forefront of whatever reproductive health needs a woman might have.”

Wijayanti is now studying for a PhD in Medicine, under the supervision of Professor Alexander Heazell and Dr Kylie Watson at the School of Medical Sciences, Faculty of Biology, Medicine and Health. Her research focuses on health professionals’ and women’s perceptions of reduced fetal movement in Indonesia.

Throughout the summit, speakers emphasised the life-changing power of SRH. The event raised awareness, as well as promoting financial investment, into the importance of effective and accessible SRH services. Many speakers pledged support via financial investments in SRH services, increasing access to contraceptives and maternal healthcare, and donating resources to family planning organisations.

The commitment demonstrated by Wijayanti and her fellow speakers at the summit illustrates a step forward in closing the considerable financing gap in SRH faced by many countries.

Cystic fibrosis (CF) is one of the UK's most common life-limiting inherited diseases, affecting over 11,000 people and nearly 200,000 people worldwide.

The condition causes mucus to build up in the internal organs, especially the lungs and digestive system. This can lead to chronic chest infections, lung inflammation and other complications such as digestive problems. For many people, managing their health involves a rigorous daily treatment regime including physiotherapy and antibiotics which can be given orally, through a nebuliser (a device where liquid medicine is turned into a mist that can be inhaled) and occasionally intravenously (through a vein).

Despite recent advances in treatment, there is still no known cure for CF, and the average age of death is just 33.

The multi-million-pound Innovation Hub in 91ֱ�� will be part of a new £15 million Translational Innovation Hub Network, funded by medical research charity LifeArc and leading charity Cystic Fibrosis Trust.

Research in 91ֱ�� will take place at Wythenshawe Hospital, part of MFT, focusing on understanding why people develop lung exacerbations (flare-ups) and how to personalise treatments for them. By sharing samples, recording results at home, and measuring their home air pollution levels, people with CF will play an important part in studying what triggers these flare-ups and who is most affected.

The responses of people with CF to intravenous (IV) treatments for exacerbations will also be studied using similar monitoring systems. The results of these studies will be essential in helping researchers to find different ways of preventing and treating exacerbations.

Research space, laboratories and specialist lung function support will be provided by the at Wythenshawe Hospital. Samples will be processed by the NIHR Centre for Precision Approaches to Combatting Antimicrobial Resistance, also at the hospital site.

The 91ֱ�� CF Innovation Hub Director is Professor Alex Horsley, a Consultant at the 91ֱ�� Adult Cystic Fibrosis Centre at MFT and Professor of Respiratory Medicine at The University of Manchester.

Professor Horsley, who is also Clinical Director of the NIHR 91ֱ�� CRF at Wythenshawe Hospital and leading researcher in the Respiratory Medicine theme at the NIHR 91ֱ�� Biomedical Research Centre (BRC), said: “This is an amazing opportunity to improve the lung health of people with CF in a way that we’ve never had the opportunity to do before. Together with scientists at The University of Manchester and clinicians at Wythenshawe Hospital, part of MFT, we’re building on existing partnerships with doctors and scientists in teams around the country. We hope our research will help us understand why people with CF get flare-ups (exacerbations) and how to better prevent and treat these. This will lead to more effective, shorter and tailored or personalised treatment plans that will reduce exacerbations and the disruptions they cause to people’s lives.”

Researchers from the Respiratory Medicine theme, which aims to identify better ways to diagnose lung disease and which factors decide how well people respond to treatments, will act as Principal Investigators for the studies delivered by the 91ֱ�� Hub.

Laura, 35, has Cystic Fibrosis and is Patient Lead for the Innovation Hub in 91ֱ��. She said: "CF has a huge impact on my daily life, it's 24/7. Even if I want to go out for the day, I have to think about getting all my treatment done, have I got enough tablets and how long am I going to be out for. The symptoms change frequently and can change from one day to the next. As soon as I wake up and until I go to bed, it does occupy a lot of my thoughts and impacts how I live my life.

Laura, who receives care at the 91ֱ�� Cystic Fibrosis Centre at MFT, added: "I had an exacerbation when I was 9 or 10, and that really changed the trajectory of my health. Research looking into exacerbations, what the triggers are, and the treatments, is massively needed. I think these Innovation Hubs are a fantastic opportunity to be able to change the way CF is managed."

The Network will be made up of four Innovation Hubs, led by the universities of Manchester, Liverpool, Cambridge and Imperial College London, as well as partners across the UK and overseas. Guided by insights and experiences of people with cystic fibrosis, the Hubs will address areas of unmet medical need and help to overcome some of the barriers that can prevent scientists from turning their discoveries into real outcomes for patients.

Dr Catherine Kettleborough, Head of Chronic Respiratory Infection at LifeArc said: “Even with the development of new treatments like Kaftrio, people with cystic fibrosis still face many challenges which impact their quality of life and life expectancy. The Innovation Hub Network is a unique approach to addressing these problems, using shared knowledge, partnerships and investment to accelerate new tests and treatments for people living with CF.”

Through innovative research, including using AI, sniffer dogs and new home monitoring tests to detect and even predict infections, the Innovation Hubs will aim to transform the way lung infections are managed.

Dr Lucy Allen, Director of Research and Healthcare Data at Cystic Fibrosis Trust, said: “We’re thrilled to be partnering with LifeArc and expanding our Innovation Hub programme, combining our expertise and exploring exciting areas of research to maximise the impact for people with CF.

"Those with the condition are particularly susceptible to lung infections, meaning they often have to spend time in hospital having IV antibiotic treatments and this has a huge impact on all areas of their life. These new Innovation Hubs will help transform our understanding and lead the way to new ways to test and treat lung infections.”

Based at Wythenshawe Hospital, the specialist 91ֱ�� Adult Cystic Fibrosis Centre at MFT is one of the largest and longest established adult CF centres in the UK, with an international reputation for excellence and innovation.

Images: Laura and Alex Horsley

The rankings are determined by scholars’ H-index, a metric evaluating productivity and citation impact, following examination of over 166,000 profiles across all key scientific disciplines.

, Emeritus Professor of Rheumatology and Musculoskeletal Epidemiology at the University, placed 29^th in this year’s list with a H-index score of 122 and 82,294 citations.

Deborah said of the recognition: “I retired and published my last paper in 2016. It is pleasing to find that the cumulative citation of my research leads to this high ranking and I hope that gives encouragement to those who are currently working in the field of musculoskeletal epidemiology.”

, Emeritus Professor of Physiology and former President and Vice-Chancellor of The University of Manchester, placed 37^th on the list with 49,760 citations and a H-index of 119.

In 79^th position in this year’s ranking is , Emeritus Professor of Evidence Based Care, with a H-index of 105 and 46,311 citations.

Helen said of the achievement: “I have spent my career collaborating with, and supporting, many extremely talented female researchers, and I feel that my success has only been enhanced through these positive working relationships. I jointly led Cochrane Oral Health until 2020, developing a team that continues to undertake methodologically rigorous systematic reviews that inform policy in areas of international policy.

“I have also been responsible for the design of several NIHR funded randomised controlled trials in dental primary care. The reviews and trials I have collaborated on frequently challenged orthodox care and impacted on the global understanding of effective oral health interventions and practices.”

This year’s ranking, the third instalment of the list to date, is based on data from a variety of sources including OpenAlex and CrossRef.

The ChUSE[1] trial, led by Dr Sarah Parry, strategic research lead at Pennine Care NHS Foundation Trust’s young people's mental health research centre, Professor Filippo Varese of the University of Manchester and in collaboration with Greater 91ֱ�� Mental Health NHS Foundation Trust, follows six-years of research with children and parents.

Dr Sarah Parry explains: “Distressing sensory experiences are a common development phenomenon, although these experiences can be frightening and confusing, especially for children already struggling with their mental health.

“Very few children who have distressing sensory experiences will ever receive a diagnosis of early-onset psychosis; but the associations between voice hearing and psychosis in our culture can cause great anxiety for families of children who hear voices.”

The new talking therapy, the ChUSE intervention, has received over £260,000 in funding from the National Institute for Health and Care Research (NIHR), and will provide much-needed support for parents and children.

Anxiety and stress about distressing sensory experiences can adversely impact the ability of young people and families to cope, which is why it is so important children and families can access timely and tailored support.

Many mental health practitioners feel ill-equipped to offer psychological therapies for distressing sensory experiences for younger children due to a lack of child-centred research to inform national clinical guidelines.

Delayed access to support often increases anxiety further, exacerbates family stress, and often worsens the original symptoms.

Professor Filippo Varese from The University of Manchester, adds: “In the UK, we have made great progress in offering psychological support to people who begin to struggle with hearing voices and other unusual and distressing perceptions for the first time.

“These treatments, however, are only available to young people that are at serious risk of future severe mental health problems. The ChUSE trial represents an important step forward in extending psychological support to a much wider group of children and young people and their families.”

The trial will work with 60 children aged 8 to 15 years old and their parents in Greater 91ֱ�� over the next 12 months. They will take part in the ChUSE talking-therapy intervention and parent support sessions, to develop new skills for coping and space to talk about.

The results will then be used to develop future therapeutic approaches for young people in in children and young people’s mental health services with distressing sensory experiences across England.

You can find out more about the trial at .

[1] ChUSE - Children and young people with unusual sensory experiences

Since joining the University in 2003 as a clinical academic, Paul built an impressive career and, in addition to his substantive role as Chair of Clinical Medicine within the Faculty, Paul is also an honorary Consultant in Critical Care Medicine with the Northern Care Alliance NHS Foundation Trust and an honorary NHS Research Consultant at the 91ֱ�� University NHS Foundation Trust.  

Alongside these roles, Paul has also held national and international positions. This included being seconded to the UK Chief Medical Officers’ Urgent Public Health pandemic research advisory committee during Covid and, most recently, holding the position of National Deputy Medical Director for the National Institute for Health and Care Research (NIHR). 

Professor Allan Pacey, Interim Dean for the Faculty said "Paul’s knowledge of the healthcare sector and experience in engaging with a broad and complex range of stakeholders will be instrumental in continuing to foster those critical partnerships integral to achieving our institutional and common goals across the region" 

Professor Dark said: "I am thrilled to be taking on this new role and look forward to working closely with Faculty colleagues and our health and care partners as we develop and align our strategic responses to key challenges and opportunities presented by changes in legislation, technology or government policy"

The increase – identified from data between 2015 and 2022 - occurred alongside an overall drop in GP supply of 2.7% over the same period, due to falling contractual hours.

The Health Foundation funded study found the median contracted full-time equivalent (FTE) for each fully qualified GP fell from 0.80 to 0.69 between 2015 and 2022.

This reduction was driven primarily by male GPs, who have significantly reduced the hours they are contracted to work from 0.99 to 0.85 FTE.

However the figure for male GPs remains above the levels of their female counterparts, whose hours fell slightly from 0.67 to 0.65 FTE.

Practices in the most deprived areas had 17% more patients and 19% more chronic conditions per GP FTE, compared with the least deprived areas.

All regions reported more chronic conditions per GP FTE than London, which had less demand for GPs.

Lead author of the study published in the British Journal of General Practice today (17/09/24), is Dr Rosa Parisi.

Dr Parisi said: “The NHS in England is facing a year-on-year reduction of the total working hours by general practitioners.”

“This decrease is down to early retirement, high levels of GP turnover and low retention, insufficient number of newly trained GPs joining the workforce, and lack of overseas recruitment.”

“But reduction in working hours is also a major factor. We show that while GP supply decreased by 2.7% from 2015 to 2022 practice population increased by 9%, while the demand, as measured by the total presence of chronic conditions, increased by 32%.”

“The largest contributor to the overall decrease in supply was a fall of 8.7% in GP’s contractual hours of GPs, especially male GPs.”

“We’re not entirely sure why male GPs are reducing their hours, but policies are desperately needed to incentivise them to work longer.”

She added: “We fear GPs are likely to be unwilling or unable to face more of the intense day to day pressures in UK primary care.

“However, policies to reduce administrative workload, increasing support by allied healthcare professionals could incentivise GPs to increase their work hours.

Senior author Professor Evan Kontopantelis said: “In 2015 and 2019, the Government promised 5,000 more GPs by 2020 and an additional 6,000 GPs by 2024, respectively.

“Though there was a rise in GP headcount of 5.9%, specifically 2,154 GPs between 2015 and 2022, the promised increase has not happened. That is why the change in working patterns of GPs makes the challenges facing primary care even more acute.”

He added: “Our results also highlight an existing disparity in GP supply between practices located in the least and most deprived areas.

“Practices in the most deprived areas had 17% more patients and 19% more chronic conditions per GP FTE, compared with the least deprived areas.

“So, in addition to policies aimed to recruit and retain more GPs, it is also necessary to incentivise GPs to work and remain in deprived areas to achieve more equitable levels of care – something easier said than done, we acknowledge.”

The paperGP working time and supply, and patient demand in England in 2015–2022: a retrospective study"., published in the British Journal of General Practice is available here.

The comment piece -  published in The - was coordinated by scientists at The University of Manchester, the Westerdijk Institute and the University of Amsterdam.

According to the scientists most fungal pathogens identified by the World Health Organisation - accounting for around 3.8 million deaths a year - are either already resistant or rapidly acquiring resistance to antifungal drugs.

The authors argue that the currently narrow focus on bacteria will not fully combat antimicrobial resistance (AMR).

September’s United Nations meeting on antimicrobial resistance (AMR) must, they demand, include resistance developed in many fungal pathogens.

Resistance is nowadays the rule rather than the exception for the four currently available antifungal classes, making it difficult - if not impossible – to treat many invasive fungal infections.

Fungicide resistant infections include Aspergillus, Candida, Nakaseomyces glabratus, and Trichophyton indotineae, all of which can have devastating health impacts on older or immunocompromised people.

Dr Norman van Rhijn from The University of Manchester coordinated the comment piece with Professor Ferry Hagen from the Westerdijk Institute in the Netherlands.

Dr van Rhijn said: “Most people agree that resistant bacterial infections constitute a significant part of the AMR problem.

“However many drug resistance problems over the past decades have also been the result of invasive fungal diseases largely underrecognized by scientists, governments, clinicians and pharmaceutical companies.

“The threat of fungal pathogens and antifungal resistance, even though it is a growing global issue, is being left out of the debate.”

Unlike bacteria, the close similarities between fungal and human cells which, say the experts, means it is hard to find treatments that selectively inhibit fungi with minimal toxicity to patients.

Professor Ferry Hagen from the University of Amsterdam added: “Despite the huge difficulties in developing them, several promising new agents including entirely new classes of molecules, have entered clinical trials in recent years.

“But even before they reach the market after years of development, fungicides with similar modes of action are developed by the agrochemical industry resulting in cross-resistance.

“That sets us back to square one again. It is true many essential crops are affected by fungi, so antifungal protection is required for food security. But the question is, at what price?”

The scientists recommend:

• Worldwide agreement on restricting the use of certain classes of antifungal molecules for specific applications.
• Collaboration on solutions and regulations that ensure food security and universal health for animals, plants, and humans.
• Adding priority to AMR to fungal infections at the UN’s meeting in September.

Comment pieces are written by experts in the field, and represent their own views, rather than necessarily the views of The Lancet or any Lancet specialty journal. Unlike Articles containing original research, not all Comments are externally peer reviewed. 

The paper Beyond Bacteria: The Growing Threat of Antimicrobial Resistance in Fungi is available

This list coincides with the publication of the Home Office’s report on the statistics of scientific procedures on living animals in Great Britain in 2023.

These ten organisations carried out 1,435,009 procedures, 54% of the 2,681,686 procedures carried out on animals for scientific research in Great Britain in 2023*. Of these 1,435,009 procedures, more than 99% were carried out on mice, fish and rats and 82% were classified as causing pain equivalent to, or less than, an injection.

The ten organisations are listed below alongside the total number of procedures they carried out in 2023. Each organisation’s name links to its animal research webpage, which includes more detailed statistics. This is the eighth consecutive year that organisations have come together to publicise their collective statistics and examples of their research.

69 organisations have published their 2023 animal research statistics

UAR has also produced a list of 69 organisations in the UK that have publicly shared their 2023 animal research statistics. This includes organisations that carry out and/or fund animal research.

All organisations are committed to the ethical framework called the ‘3Rs’ of replacement, reduction and refinement. This means avoiding or replacing the use of animals where possible, minimising the number of animals used per experiment and optimising the experience of the animals to improve animal welfare. However, as institutions expand and conduct more research, the total number of animals used can rise even if fewer animals are used per study. 

All organisations listed are signatories to the , which commits them to being more open about the use of animals in scientific, medical and veterinary research in the UK. More than 125 organisations have signed the Concordat including UK universities, medical research charities, research funders, learned societies and commercial research organisations.

Wendy Jarrett, Chief Executive of Understanding Animal Research, which developed the Concordat on Openness, said:

“Animal research remains a small but vital part of the quest for new medicines, vaccines and treatments for humans and animals. Alternative methods are gradually being phased in, but, until we have sufficient reliable alternatives available, it is important that organisations that use animals in research maintain the public’s trust in them. 

"By providing this level of information about the numbers of animals used, and the experience of those animals, as well as details of the medical breakthroughs that derive from this research, these Concordat signatories are helping the public to make up their own minds about how they feel about the use of animals in scientific research in Great Britain.”

Dr Maria Kamper, Director of the Biological Services Facility at the University of Manchester said:

“At The University of Manchester we are deeply committed to the highest standards of animal welfare and quality in research as well as transparency and openness as signatories of the Concordat on Openness, as one of the organisations to achieve Leaders in Openness status. 

"As a result of this commitment, we have recently achieved accreditation from  AAALAC International. A prestigious global benchmark, AAALAC accreditation signifies an institution’s dedication to achieving and maintaining high standards in animal care. It demonstrates that we are at the forefront of responsible and cutting-edge research and underscores our commitment to advancing science responsibly and humanely.

“We have a proud culture of care among our staff working with animals at the University, based on collaboration and the highest standard of animal husbandry. That is why we pledge to be committed to pro-actively building and maintaining a sustainable environment where animal welfare, human wellbeing, scientific quality and transparency with stakeholders and the public are paramount. This commitment reflects our desire to contribute to The University of Manchester’s vision of advancing education, knowledge, and wisdom, for the good of society.”

Examples of severity
Severity assessments measure the harm experienced by an animal during a procedure. A procedure can be as mild as an injection, or as severe as an organ transplant. Severity assessments reflect the peak severity of the entire procedure and are classified into five different categories:

Sub-threshold: When a procedure did not cause suffering above the threshold for regulation, i.e. it was less than the level of pain, suffering, distress or lasting harm that is caused by inserting a hypodermic needle according to good veterinary practice.

Non-recovery: When the entire procedure takes place under general anaesthetic and the animal is humanely killed before waking up.

Mild: Any pain or suffering experienced was only slight or transitory and minor so that the animal returns to its normal state within a short period of time. For example, the equivalent of an injection or having a blood sample taken.

Moderate: The procedure caused a significant and easily detectable disturbance to an animal’s normal state, but this was not life threatening. For example, surgery carried out under general anaesthesia followed by painkillers during recovery.

Severe: The procedure caused a major departure from the animal’s usual state of health and well-being. This would usually include long-term disease processes where assistance with normal activities such as feeding and drinking were required, or where significant deficits in behaviours/activities persist. Animals found dead are commonly classified as severe as pre-mortality suffering often cannot be assessed.

*The Home Office recorded 2,681,686 completed procedures for Great Britain in 2023, 1,435,009 (54%) of which were carried out at these ten organisations.

Find out more:

Animal Research at The University of Manchester website.

 (UAR) is a not-for-profit organisation that explains how and why animals are used in scientific research in the UK. Supporters include government agencies, scientific societies, universities, veterinary schools, research funding bodies, industry and charity. Supporters both use animals and lead the development of non-animal methods.

Further information on the Concordat on Openness on Animal Research in the UK can be found here:

A leading nanomedicine researcher at The University of Manchester has secured a €1.5m (£1.3m) European Research Council (ERC) Starting Grant to push forward pioneering research on Alzheimer’s disease and glioblastoma.

The five-year project, NanoNeuroOmics, aims to combine breakthroughs in nanotechnology, protein analysis, and blood biomarker discovery to make advances in two key areas.

First, the team led by will explore the use of nanoparticles to enrich and isolate brain-disease specific protein biomarkers in blood. These discoveries could pave the way for simple, reliable blood tests that diagnose Alzheimer’s and glioblastoma in their early stages.

Second, the research will investigate the phenomenon of “inverse comorbidity,” which suggests that having one of these conditions may reduce the risk of developing the other. Dr. Hadjidemetriou and her team will explore this surprising relationship to uncover any deeper biological connection that could lead to new treatment pathways.

Building on her 2021 research, where Dr. Hadjidemetriou developed a nanoparticle-enabled technology to detect early signs of neurodegeneration in blood, this project has the potential to transform how these brain diseases are diagnosed and treated.

Dr. Hadjidemetriou’s previous work involved using nano-sized particles, known as liposomes, to "fish" disease-specific proteins from the blood. This breakthrough enabled her team to discover proteins directly linked to neurodegeneration processes in the brain, among thousands of other blood-circulating molecules. In animal models of Alzheimer’s, this nano-tool successfully captured hundreds of neurodegeneration-associated proteins. Once retrieved from the bloodstream, the molecular signatures on the surface of these proteins were analysed, offering a clearer picture of the disease at a molecular level.

Now, Dr. Hadjidemetriou's team will evolve this expertise to identify highly specific biomarkers by tracking protein changes in both blood and brain over time and across different stages of Alzheimer's and glioblastoma. By working with different nanomaterials, they hope to isolate these key protein markers from the complex mix of molecules in the blood.

The  NanoNeuroOmics project’s multidisciplinary approach brings together experts in nanotechnology and omics sciences to develop methods for detecting and potentially treating these diseases with greater precision. Research will be conducted at The University of Manchester’s , a cutting-edge facility dedicated to advancing nanoscale technologies. The Centre's focus spans multiple fields, including omics, neurology, therapeutics, and materials science.

Dr. Hadjidemetriou’s team is also part of Manchester’s vibrant 2D materials science community, home to the discovery of graphene 20 years ago, continuing the university’s legacy of scientific innovation.

Nine fathers were given legal access by private family court law proceedings (PLP) to the children they were accused of sexually abusing, according to a qualitative study.

The groundbreaking UKRI funded , published  in the Journal of Social Welfare and Family Law, was carried out by University of Manchester researchers in partnership with members of and The Survivor Family Network.

It is based on the experience of 45 women from across England in PLP who along with some of their children accused the men of abuse, including child sexual abuse (CSA) in nine cases.

A tenth father, a convicted paedophile, had groomed the mother as a child and been convicted of child sex offences but hadn’t yet harmed the child sexually. Other fathers convicted of child sex offences were also given direct access to their children.

Of the 45 studied, fathers were given access in 43 cases.

PLP cases occur when two or more private individuals try to resolve a dispute, usually around child arrangements or financial disputes.

All ten cases involving CSA resulted in some form of direct child contact with the alleged perpetrator father, sometimes giving unsupervised overnight stays or 50% shared residency.

Some of the 10 fathers were either convicted child sex offenders or had admitted to CSA. In some of the cases digital evidence was submitted to the court.

Only fathers who had criminal convictions for CSA were considered to meet the threshold for concern for risk or harm, though they were still given overnight contact with the children, supervised by paternal family members.

Four of the mothers, accused of coaching their child to falsify abuse claims – so called parental alienation - lost residency of their children to the alleged perpetrator father.

The researchers applied a feminist-informed framework to understand the experience of 10 women  from within the larger sample of 45, who were also interviewed.

The analysis identified 5 themes:

• Minimisation by the courts of the harm to the child and mother from CSA by the father, overemphasising the rights of fathers.
• The courts rely on whether a father was ‘gratified’ by the abuse to determine whether harm has occurred and a ‘sorry’ from the father was enough to reassure the court that their children will now be safe from future harm.
• The family courts at times intervened to close down active CSA criminal investigations into the fathers.
• Mothers who persisted in their attempts to resist the court and advocate for their children were those who lost their children.
• The court actors were frequently reported as bound by a pro-father narrative in their regard to each other.

Lead author Dr Elizabeth Dalgarno said: “We found disturbing evidence that private family courts are letting down some mothers and their children who accuse the fathers of child sex abuse and or rape.

“Many of the fathers had a history of abusing others. All had allegedly abused the mothers and children, yet this was deemed ‘alienation’, ‘historic’ or ‘irrelevant’ by the court, with one child repeatedly raped for several years after her mother was erroneously dubbed an ‘alienator’.

“Fathers’ actions and behaviours were repeatedly minimised and made invisible if harmful. For mothers, there was no such grace shown in the court, who sometimes had their children removed.”

The researchers argue CSA findings should not be determined within existing PLP, where prevailing bias against mothers and children leaves room for abuse to continue.

Use of ‘parental alienation’ or ‘alienating behaviours’ as a defence, they say, should be prohibited and that the Sexual Offences Act 2003 must re-consider the notion of perpetrator gratification to define harm and also review the use of a child’s personal and private space in defining criminality.

She added: “False allegations of CSA are extremely rare at around 0.01%- 2% and there is little evidence that children can be coerced into making false CSA claims.

“So we contend that this treatment of vulnerable women and their children is effectively an act of state sanctioned abuse, and state gaslighting.”

Support resources available:

The paper has been double blind peer reviewed and has been  published in the journal of social welfare and family law.  

The DOI of the paper, called ‘Let’s excuse abusive men from abusing and enable sexual abuse’: Child Sexual Abuse Investigations in England’s Private Family Courts’   is: 10.1080/09649069.2024.2382501. and it  is published in the Journal of Social Welfare and Family Law

Anonymous quotes from some of the mothers:

“‘…there’d been sexual videos made of my son. My son had come home with bruises. My son had specifically said he didn't want to go to his dad's. [son] disclosed a lot of things… but because [father] said, “I'm sorry…we were only messing around and there wasn't actually any penetration”, he got away with it… And I've got to live with those videos in my head and they even upset the police officers… There was no empathy [from the family court]. There was nothing… Just “fathers have rights”, very, very, pro, pro, pro father’”

‘[police] didn't really do anything, they kind of left it up to social care…the social worker came and said, “we'll come and make sure you've got food in the fridge and a roof over your head”, saw [son]…then they went and saw him…with his father and wrote a report and said there was nothing wrong… she completely and utterly blamed me, said I “was emotionally abusing [son]”…by this time, we'd had one [family] court case [with] a district judge [who] said “social care couldn't find any issues”, and awarded my ex overnight contact every other weekend and holidays’

‘But this same social worker went out again, and again, and just had a word, all the time, while pushing it as parental alienation.  Because I was “making [child] over-anxious”.  And because [father] said “it was accidental”, and social services actually said that “they would not consider it as sexual abuse because they didn’t believe it was sexually gratifying for him’

‘So, my ex-husband had the biggest collection of pornography that I had ever seen, and a lot of the titles were ‘Teen’, and he had used sex as a controlling mechanism within the relationship… This was mentioned…in court, and it was as if I was just being vindictive and trying to find something else wrong with him, to pin something else on him [and] there clearly “wasn’t a problem”’.

My children had accused their father of sexual abuse and he came back with parental alienation after a number of years of not mentioning it…they're not allowed to use any form of disclosing tool or not allowed to buy them any diaries…I’ve been told if I report further allegations then basically my ex has got a fast-track back to court for immediate change of residence…so they threatened me and gagged the girls effectively.’

‘Even the psychologist said, “there is no parental alienation”. He wrote it specifically and he contradicted Cafcass, he overruled Cafcass, and guess who the judge went with? Cafcass’

The damning research – published by Health Equity North  – has laid bare the unequal challenges faced by women living in the North of England.

It exposes the growing regional inequalities over the last decade and the impact this has on women’s quality of life, health, work, their families and communities.

‘Woman of the North: Inequality, health and �ɴǰ���’ finds that women living in the North have lower healthy life expectancy, fewer qualifications, worse mental health, and are more likely to suffer domestic violence or to end up in the criminal justice system than their counterparts in the rest of England. In addition, infant mortality is higher and abortions are more common.

The economic cost of these inequalities is also explored in the report which estimates women in the North lose out on a staggering £132m every week, compared to what they would get paid if wages were the same as women in the rest of the country.

Women in the North also contribute £10bn of unpaid care to the UK economy each year.

The report, which has been backed by the North’s two female Mayors Tracy Brabin and Kim McGuinness, puts into sharp focus the devastating effects that austerity, the cost-of-living crisis, economic uncertainty, the pandemic and unequal funding formulas have had on women in northern regions.

The research found:

• Girls born in the North East, North West and Yorkshire and the Humber between 2018 and 2020 can only expect to live in good health until 59.7, 62.4 and 62.1 years, respectively. This is up to four years less than the national average and up to six years less than girls born in the South East.
• Women in the North are paid less for their work. They lose out on £132m every week, around £6.86bn a year, compared to what they’d get if they were paid the same wages as women in the rest of the country.
• The average weekly wage for a full-time working woman in the North East is £569, £598 in the North West and £567 in Yorkshire and the Humber - much lower than the national average (£625) and considerably lower than for women in London (£757).
• Women in the North contribute £10bn of unpaid care to the UK economy each year. This is £2bn a year more than if they provided the national average of unpaid care.
• One in five women aged 55-59 in the North of England provides care to a family member because of illness, disability, mental illness or substance use.
• The North showed the biggest increases in abortion rates between 2012 and 2021. There has been a demonstrable relationship between austerity, the implementation of the two-child limit, and increased rate of abortions.
• Over 25% of pregnant women in the northern regions of England are living in the most deprived 10% of areas with 40% living in the top 20% most deprived areas. In contrast, fewer than 5% of pregnant women in the South East live in the most deprived 10% of areas.
• There is higher prevalence of severe mental conditions, such as bipolar disorder and schizophrenia the North West and North East compared to the South and Yorkshire and Humber. The proportion of women with a diagnosis of a mental health condition who were receiving a treatment was lower in the North West and North East than in the South and Yorkshire and the Humber, indicating a treatment gap between regions.
• Women in the North of England suffer the highest rates of domestic violence abuse in the country. The highest rates are in the North East at 19 per 1,000 population followed by 17 in Yorkshire and the Humber then 15 in the North West. The average for the rest of England is 11.
• Of the recorded deaths per 100,000 from alcohol-specific causes in 2021, women in the North East (13.9), North West (13.8) and Yorkshire and the Humber (11.7) had the highest rates of deaths in women in England.
• In 2022, nine of the 10 police areas with the highest rates of female imprisonment were in the North of England.

A team of more than 70 academic, health, social care and policy professionals from across the North contributed to the report to explore some of the social determinants of health for women, and how they play out in the overall health of women in the region.

The extensive research covers employment and education, Universal Credit, poverty, caring, health and life expectancy, pregnancy and reproductive health, sexual health, mental health, domestic violence, criminal justice involvement, stigma, and marginalised women.

The report recommends a wide range of evidence-informed policy solutions for central government, regional government and the health service which, if implemented, could improve the current situation for women’s health.

Hannah Davies, Executive Director at Health Equity North, said: “Our report provides damning evidence of how women in the North are being failed across the whole span of their lives. Over the last 10 years, women in the North have been falling behind their counterparts in the rest of country, both in terms of the wider determinants of health and, consequently, inequalities in their health.

“There is a lot of work that needs to be done to turn the tide on the years of damage detailed in this report. But the situation for women’s health in the North can be changed for the better through evidence-based policy interventions.

“We need to see policymakers build on the ambitions outlined in the Women’s Health Strategy for England with focused effort to understand and address the regional inequalities in the many different facets of women’s health.”

Professor Kate Pickett OBE, Academic Co-Director at Health Equity North, and Director of the Public Health & Society Research Group and the York Cost of Living Research Group at the University of York, said: “This report unpacks some of the wide-ranging challenges women face across many aspects of their lives, and the impact of these on their health. For women in the North, these challenges are often felt more deeply.

“We know that much of the inequality we see affecting women in the North is a direct consequence of poverty, which is completely unacceptable in the 6^th largest economy in the world. Cuts to welfare and public health funding, the pandemic and the cost-of-living crisis have hit the most deprived communities and the North hardest.

“We hope that the findings and recommendations act as a wake up call for government to make health and addressing health inequalities central to policies going forward.”

Dr Luke Munford, Academic Co-Director at Health Equity North, and Health Economist from the University of Manchester, said: “The significant economic impact of regional health inequalities relating to women in the North is made staggeringly clear in the findings of our report.

“Women across northern regions have heavy burdens placed on them – they work longer hours and are paid less, and they provide some of the highest levels of unpaid care for their loved ones. But all too often, this can come at a price as we can see in the health outcomes detailed in this research.

“To ensure a more economically prosperous region, we need policies that target the widening health inequalities faced by women in the North.”

Tracy Brabin, Mayor of West Yorkshire, said: “While the findings of this report will resonate with every woman and girl in West Yorkshire, they must now act as a vital wake up call to everyone in a position of power.

“As political leaders, we all have a responsibility to listen to and act on the lived experience of women and girls, and devolution is helping us to turn the tide in West Yorkshire, with the first ever women’s safety unit in the country and bold action to deliver a Sure Start renaissance.

“I welcome this timely and significant report, and pledge to do all I can to continue building a brighter region that works for all, by always working in partnership with the women and girls of West Yorkshire.”

North East Mayor Kim McGuinness said: "From leaving school to the boardroom, at home and at work, women and girls across the North bear the brunt of failings in our economy, society and public services. The lack of equality and opportunity that remains ingrained in modern Britain is unacceptable.

"As Mayor I'm determined to make the North East the home of real opportunity - and that means breaking down barriers which hold women and girls back. I will drive wholesale reform of the support we provide in schools, in our skills system, in childcare and in industries where too often women are shut out or overlooked. I welcome this report as a roadmap to a fairer, more equal North of England."

Woman of the North: Inequality, health and work will be launched at an event in parliament on Wednesday, September 11, with the Women’s Health Ambassador for England, Professor Dame Lesley Regan, speaking.

The report recommendations include:

Regional government

• Targeted support delivered to 11–18-year-olds through Careers Hubs at areas of greatest deprivation.
• Negotiate for higher levels of the Adult Education Budget in the North of England than counterparts in the South of England.
• Support benefits uptake for women and help claimants navigate the benefits system. Financial support beyond the current social security system should be extended to groups most in need.
• Support needed for women to transition back to their families and integrate into the community after involvement in the criminal justice system.

Central Government

• Deliver a national health inequalities strategy, convening government departments across Whitehall to put health at the heart of all policies.
• Make a long-term commitment to update benefits in line with inflation. Additionally, policies that punish families, such as the two-child limit, sanctions and the benefit cap must be abolished.
• The Treasury should improve targeted support for pregnant women including reversing restrictions to the Sure Start Maternity Grant and reintroducing the Health in Pregnancy Grant.
• Deliver a sustainable childcare model – linking in with family hubs and next generation Sure Start centres - that enables more women to access education and work opportunities. Also, abolish zero hours contracts to ensure jobs provide stability and security.

Health System

• NHS England should provide additional financial support and investment for Women’s Health Hubs that are established across the North.
• Health services need to be supported to collect routine data on ethnicity and other key demographic data as standard to help deliver better information for service development and improve our understanding of different health needs.
• Explore ways in which their work can be adapted to address health inequalities across different population groups (cultural sensitivity training, adopting a trauma-informed approach to care, and promoting person-centred approaches, including for transgender people and sex workers).

Health Equity North is a virtual institute focused on place-based solutions to public health problems and health inequalities across the North of England. It brings together world-leading academic expertise from the Northern Health Science Alliance’s members of leading universities and hospitals.

The report is  available  

Navigating the Long Haul: Understanding Long Covid in Northern England, published by Health Equity North, reveals the striking inequalities in Long Covid rates and a clear North-South divide.

Analysis of General Practice Patient Survey data from 2022 found the North West had the highest number of people reporting Long Covid symptoms (5.5%) followed by the North East and Yorkshire (5.1%).

In some northern GP practices as many as one in five patients (20%) reported having Long Covid.

The regions with the lowest rates were the South West (3.4%) and the South East (3.6%), and the average for England as a whole was 4.4%.

The research suggests that people in the North of England are among the worst affected by Long Covid, which follows patterns evidenced in previous highlighting the devastating impact of Covid-19 across northern regions.

The link between deprivation and higher rates of Long Covid is also explored in the report. Nationally, the prevalence rate in the most deprived areas (6.3%) is almost double that in the least deprived (3.3%).

Within region inequalities are also evident in the North East and Yorkshire, where rates in the most deprived areas (8.3%) were 5.2% percentage points higher than in the least deprived areas (3.1%).

The report, a collaboration between Health Equity North, Newcastle University, University of Manchester, Insights North East, Public Health South Tees and Healthworks, explores the impact of Long Covid on the health, wellbeing and employment prospects of adults living in northern England.

The findings have prompted calls for more research into Long Covid and for Government to undertake a consultation with Long Covid patients to better understand the condition and to implement care plans to facilitate rehabilitation and management of the condition.

Further findings from the report include:

• In England, 1.9 million people were experiencing a myriad of self-reported Long Covid symptoms as of March 2023, with 79% saying it has had a negative impact on their day-to-day activities.
• Fatigue was named as the most experienced symptom, and over half reported reduced functionality in their everyday activities, which resulted in their inability to return to work.
• The 10 GP practices with the highest prevalence of Long Covid were all in the North.
• While many employers in the North provide support for Covid-19, this is specified on an acute basis, rather than in response to later Long Covid/post Covid illnesses.
• Only three out of 10 northern employers contacted offered a specific rehabilitation package to employees living with Long Covid despite the high prevalence in the region.
• There is considerable evidence of socioeconomic inequalities in Long Covid in the North East and Yorkshire, where rates in the most deprived groups (8.3%) were 5.2 percentage points higher than in the least deprived areas (3.1%).
• The most deprived areas in the North had higher Covid-19 mortality rates than equally deprived areas in the rest of England, indicative of ‘deprivation amplification’ where the negative health effects of local deprivation is worsened for those living in deprived regions.

Long Covid encompasses physical, cognitive and mental impairments, with brain fog, fatigue, breathlessness, low mood, and depression among the most common symptoms.

As part of the research, academics conducted interviews with people who have experienced or continue to experience Long Covid.

The findings lay bare the significant impact it has on the personal and professional lives of those with the condition. Many of the people involved in the research had been demoted, fired, forced to resign or switch to part-time work because of Long Covid.

During the research, one participant said: “At one point, more than once, I was surprised to wake up the next morning. I felt like I was having stroke-like symptoms, the pressure in my head. I couldn’t move enough to either call for my children or to reach for my phone to get help. I think I lost consciousness. The next morning, I was like, I can’t believe I’m waking up. I wrote my end of life wishes and told my kids what to do if I didn’t make it.”

The report recommendations centre on the need for more research into Long Covid – covering both biomedical and social research – and also the importance of drawing on learnings from other post-viral conditions to ensure better diagnosis and treatment for patients in future.

Dr Stephanie Scott, lead author of the report and Senior Lecturer in Public Health at Newcastle University, said: “Long Covid is a complex condition that goes beyond physical and mental symptoms, affecting other parts of people’s lives including their sense of self and professional identity. This can then lead to experiences of social isolation.

“Currently, there is little evidence-based treatment for Long Covid and the health system focuses on symptom management. This needs to change. Our research has offered a glimpse into the reality of what it is like to live with this often-debilitating condition and the knock-on effects it has on people’s personal and professional lives.

“I hope that the evidence presented in this report cuts through to policymakers and gets the attention it deserves so more research into Long Covid is funded, and so measures can be put into place which enables employers to better support their workforce with Long Covid.”

Hannah Davies, Executive Director at Health Equity North and Deputy Chief Executive at the Northern Health Science Alliance, said: “Covid-19 hit the country unevenly with a disproportionate effect on northern regions – more people died, we spent more time in lockdown, had higher unemployment, and experienced a larger drop in mental wellbeing. Yet again, we are seeing the lasting impact of the pandemic being felt the hardest in the North of England.

“This pattern is reflected in our latest report which shows the North as having the highest rates of people experiencing Long Covid. And it’s likely that these figures could be much higher as many people may not report their symptoms.

“The report provides a timely analysis of the health and economic repercussions of Long Covid, which we hope will prompt action from Government. The regional differences in rates of the illness and the relationship between deprivation is clear. It is also clear that more research needs to be done to understand this devastating condition so people can be diagnosed, treated and supported.”

The report recommendations are:

• Research funders should prioritise biomedical research into Long Covid to establish accurate diagnostic tests, understand the illnesses’ pathophysiological mechanisms and develop treatments.
• Research into the impact of known social determinants of health and their relationship with Long Covid should be undertaken.
• Learning from overlap with other post-viral conditions such as myalgic encephalomyelitis / chronic fatigue syndrome (MF/CFS) should harnessed during Long Covid research and further funding into these conditions should be allocated to assist with treatment and future pandemic preparedness.
• The relationship between disability figures, sex and Long Covid should be the basis of further research.
• Priorities for government: Government should develop programmes for employers to support members of their workforce with Long Covid;  A government consultation with Long Covid patients should be undertaken to better understand their condition and to implement care plans to facilitate rehabilitation and management of the condition.

View the full report here:

Health Equity North is a virtual institute focused on place-based solutions to public health problems and health inequalities across the North of England. It brings together world-leading academic expertise from the Northern Health Science Alliance’s members of leading universities and hospitals.

Carried out by scientists at the Universities of Manchester and Oxford working in collaboration with the KEMRI/Wellcome Trust Unity in Kenya, the study is published in the journal Nature Communications and funded by the Wellcome Trust. 

The findings come amid recent reports showing Gonorrhoea - a sexually transmitted disease - is becoming increasingly resistant to antibiotics and could become untreatable in the future. 

People infected with gonorrhoea may experience pain or burning though, if untreated, they may go on to develop more serious problems including infertility, systemic infection and increased risk of HIV/AIDS. 

There are now multidrug resistant strains of the Neisseria gonorrhoeae (Ng) bacterium -  which causes gonorrhoea - making many antibiotics ineffective as first-line treatments.

The bacterium has a range of mechanisms to dampen immune responses, meaning there is insufficient immunological ‘memory’ to combat subsequent infections.

Attempts to develop a vaccine against gonorrhoea have been largely unsuccessful; however, in 2017 a study showed that vaccination against a related bacterium Neisseria meningitidis (Nm) led to a reduction in the incidence of gonorrhoea.

Although the efficacy of the Nm vaccine against Ng was limited, it provided an important clue to making an effective Ng vaccine.

Working with a marginalised community of sex workers in coastal Kenya who have high exposure to gonorrhoea, Prof Ed Sanders and his team in Kenya conducted a trial of an Nm vaccine to examine their immune responses.

Prof Jeremy Derrick and the team in 91ֱ�� then identified the pattern of antibody responses in the vaccine recipients and compared them to individuals infected with gonorrhoea.

To unpick the complicated antibody responses, the 91ֱ�� team fabricated a ‘microarray’- a library of the different components, or antigens, which could react with the antibodies induced by the Nm vaccine.

Using this powerful technology, the complex profiles of antibodies against the different components were determined for each vaccinee, or each infected individual.

Comparison of the profiles revealed a detailed picture of the antibody responses to the vaccine, and showing how they differ to those following infection.

The project lead Professor Chris Tang from The University of Oxford said: “This work takes an important step along the road to developing Ng vaccines, as we have a better idea of which responses are generated by partially protective vaccination compared with infection.”

Professor Derrick added: “This study has wide implications about revisiting vaccine design for other bacterial pathogens using these new methods, including those where antimicrobial resistance is a problem.

“We hope that the application of these technologies will enable progress towards vaccines against other pathogens.”

Image : raw microarray scan. Each spot is an antibody reacting with a specific antigen or protein from the bacterium Neisseria gonorrhoeae.

Stejskal et al 2024 ‘Profiling IgG and IgA antibody responses during vaccination and infection in a high-risk gonorrhoea population’ is published in nature Communications and is available

Clostridioides difficile (C. diff), a type of bacteria which often affects people who have taken antibiotics, is responsible for approximately 2,000 deaths annually in the UK.

Researchers from the University of Sheffield and the University of Manchester have found C. diff is able to evolve high levels of vancomycin resistance very quickly - in less than two months the bacteria could tolerate 32 times the normally effective antibiotic concentration.

Currently, the antibiotics used to treat C. diff damage beneficial gut bacteria, leading to a high reinfection rate—up to 30 per cent of patients treated with vancomycin experience a second infection within weeks, with the likelihood of further relapses increasing thereafter.

Despite vancomycin's critical role within UK healthcare, routine monitoring for resistance in clinical settings is lacking, so resistance may be emerging under the radar in hospitals. If widespread resistance were to arise it would remove this critical treatment option from UK healthcare.

Antimicrobial resistance (AMR) has been identified by the World Health Organisation (WHO) as one of the top global public health and development threats. It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.

Jessica Buddle, PhD student at the University of Sheffield and lead author of the study, said: “Our findings highlight the need for vigilant monitoring of vancomycin resistance in UK hospitals. Unchecked resistance could contribute to the large number of patients who have a relapsing infection after successful treatment with vancomycin. More research is essential to inform healthcare policy and determine if vancomycin remains the best treatment option.

“Our ongoing work aims to understand the extent and mechanisms of resistance development, simulate these conditions within the complex human gut ecosystem, and collaborate with UK epidemiologists to identify potential resistance signatures in hospitals.

“These efforts are crucial to prevent a future where antibiotics are no longer a viable option for treating bacterial infections and infections that are readily treatable today, become life-threatening once again.”

Although this rapid evolution is concerning, resistant strains exhibited reduced overall fitness, potentially limiting their clinical threat. The resistant strains also commonly had defects in sporulation. Sporulation is essential for C. diff to transmit from one person to the next and to survive on surfaces in hospitals.

Future work will seek to understand this interplay between resistance and the ability of the bacteria to cause severe disease. Researchers will be able to leverage this knowledge to improve surveillance of emerging resistance in hospitals.

Professor Michael Brockhurst from The University of Manchester said: “Our study highlights the value of using lab-based pathogen evolution to understand clinical drug resistance. This can reveal not only which genetic mutations cause resistance, but also the associated fitness costs that might limit the success of resistant strains in the clinic. Such fitness costs are a pathogen’s Achille’s Heel and could potentially be exploited to devise new treatments that reduce the burden of drug resistant infections in the future.” 

Read the full paper in the journal PLOS Biology

The study led by scientists at The University of Manchester and The Institute of Cancer Research, London, could potentially benefit patients by using a technique called Oxygen-enhanced magnetic resonance imaging (OE-MRI).

Using the non-invasive technique, the scientists were able to map parts of tumours that had oxygen deficiency - known as hypoxia - in patients with head and neck cancer. Patients with hypoxia in their tumours respond less well to treatment.

This will enable future work to use the MRI technique to target and fine tune treatment more precisely, reducing damage to healthy tissue in some patients.

Funded by Medical Research Council, Cancer Research UK, The National Institute for Health and Care Research, the study is published in a journal of the American Association for Cancer Research, today (15/08/24).

The study was supported by the NIHR 91ֱ�� Biomedical Research Centre (BRC) and the NIHR BRC at The Royal Marsden and The Institute of Cancer Research.

Though the study was performed on patients with head and neck cancer, it raises the prospect that OE-MRI could be useful in patients with other cancers.

The oxygen enhanced imaging provides detail similar to an expensive PET scan, but can be performed on standard - and much cheaper - MRI systems.

The researchers enrolled 27 patients who were given OE-MRI scans of their primary and nodal tumours before they began their standard chemotherapy or radiotherapy treatments.

Additional scans were then performed during their treatment.

Using sophisticated mathematical modelling, the method was found to have the potential to help patients whose tumours had reduced levels of hypoxia by the second week.

Michael Dubec, principal clinical scientist at The University of Manchester and The Christie NHS Foundation Trust said: “Cancers can be destroyed by radiation and chemotherapy, but the problem is healthy tissues and organs can be destroyed as well. So our aim is to destroy the tumour while preserving healthy tissue thus reducing toxicity.

“So our aim is to destroy the tumour while preserving healthy tissue thus reducing toxicity.

“Using Oxygen-enhanced magnetic resonance imaging to map hypoxia in patients’ tumours, may improve the accuracy of their treatment.

“Now we have proved the principle, we hope to move on to clinical trials so it can be validated on greater numbers of patients.”

Professor James O’Connor of The Institute of Cancer Research, London and The University of Manchester led the study. He added: “Few studies have compared the hypoxia modification observed in both primary tumour and nodal metastases following treatment, or the timing of these changes.

“So our findings amount to a potentially important way to determine optimum radiotherapy planning for patients with locally advanced disease.”

The study “Oxygen-enhanced MRI detects incidence, onset and heterogeneity of radiation-induced hypoxia modification in HPV-associated oropharyngeal cancer” is published in

Forty-one year old Ben Moorhouse from Halifax will take on the dangerous challenge in gruelling temperatures on August 17 in memory of his daughter Kallipateira who was stillborn at 37 weeks in October 2018.

Ben has already made history on the Greek island when in August 2021 he became the only person to walk around the full perimeter of the island nonstop – a total of 150 miles in 42 hours.

He has set himself a target of £10,000 for two summer extreme challenges with all funds going to Professor Alexander Heazell and his team at the Tommy’s 91ֱ�� Maternal and Fetal Health research to support research and to help save babies’ lives.

In July he completed a 110-mile nonstop walk from Wainhouse Tower in Halifax to Blackpool then onto Saint Mary’s Hospital in 91ֱ��, where Professor Heazell and his team are based.

Ben and his partner Gaynor Thompson launched the Kallipateira Moorhouse Foundation charity to help save babies lives through research and support other parents who have experienced the death of a baby.

Ben said “On Saturday I am proud to be able to take on my next extreme challenge on the beautiful and magical island of Rhodes for my daughter Kallipateira.

“I am ready and prepared to put myself through the mill again on Saturday in the current extreme heat and humidity in Rhodes.

“Thankfully most people who see my extreme challenges will not have had to experience the devastation of holding their dead baby or child.

“I ask for the public’s kindness in please supporting me with a donation no matter how big or small. I am just a normal dad trying my best to make sure my baby girl did not die for nothing.”

Every day in the UK eight babies stillborn on average, many which are preventable. These are beautiful fully developed babies who should be alive.

“As a grieving dad who each day feels the pain of Kallipateira’s devastating death I must now raise more vital funds for Professor Heazell and his team to support research so that other families nationally don’t have to experience the pain that we do every day.”

Professor Alexander Heazell, Director of the Tommy's Stillbirth Research Centre said: “It was great to be able to walk the last 33 miles of Ben’s Walk from Preston to 91ֱ�� with him in July.

“I am always amazed at the depth and strength of his commitment to raise funds in memory of Kallipateira.

“The money Ben has raised previously has funded projects to understand partners needs in pregnancy after loss and to improve understanding of stillbirth risks in women who don’t speak English.

This important work comes from donations, so please support Ben in this second extreme challenge of the summer to support work that saves babies lives and improves care.”

 Dignity Funerals are the headline sponsor of the extreme challenge walk.

Stuart Cox, Head of Public Affairs at Dignity Funerals, who are sponsoring the challenge said: “As a socially responsible business Dignity is delighted to continue our support for the Kallipateira Moorhouse Foundation.

“After Ben initially approached us, we could immediately see the value of the work the Foundation does and his inspiring enthusiasm for fundraising. We all wish him the best of luck with his latest challenges.”

• You can donate to Ben via his just giving
• For more information about the Kallipateira Moorhouse Foundation, visit their

Cancers develop partly through genetic abnormalities within cells of the body. Colorectal cancer is a major cause of death worldwide, but we don’t yet have a full understanding of the genetic changes that cause it to grow. New research – published today in Nature – delivers an unprecedented view of the genetic landscape of CRC and its responses to treatment.

Utilising data from 2,023 bowel cancers from the 100,000 Genomes Project led by Genomics England and NHS England**, the research team has identified new gene faults that lead to CRC. They’ve also uncovered new CRC cancer sub-groups (categories of cancer with specific genetic characteristics that affect how cancer behaves and responds to treatment). These findings offer profound insights into the disease's development and potential treatment strategies.

Key Findings of the 91ֱ��:

• Identification of Over 250 Key Genes: The study has pinpointed more than 250 genes that play a crucial role in CRC, the great majority of which have not been previously linked to CRC or other cancers, expanding our understanding of how CRC develops.
• New Sub-Groups of CRC: Four novel, common sub-groups of CRC have been discovered based on genetic features. In addition, several rare CRC sub-groups have been identified and characterised. These groups have different patient outcomes and may respond differently to therapy.
• Genetic Mutation Causes: The research reveals a variety of genetic changes across different regions of the colorectum, highlighting differences in CRC causes between individuals. For example, a process has been found that is more active in younger CRC patients’ cancers; the cause is unknown, but might be linked to diet and smoking.
• New Treatment Pathways: Many identified mutations could potentially be targeted with existing treatments currently used across other cancers.

Commenting on the findings, co-lead researcher, Ian Tomlinson, Professor of Cancer Genetics at the University of Oxford, said:

"Our findings represent a significant advancement in understanding colorectal cancer. By better understanding the genetic changes in CRC, we can better predict patient outcomes and identify new treatment strategies, quite possibly including the use of anti-cancer drugs that are not currently used for CRC."

The research provides a vital resource for the scientific community and a promising foundation for future studies. The results from the study are available to other researchers, who are invited to build on the data by undertaking more focussed projects based on the CRC genome.

Co-lead researcher, Professor Richard Houlston, Professor of Cancer Genomics at The Institute of Cancer Research, London, said:

“This research is a great insight into the biology of colorectal cancer, uncovering the clues as to how it develops, grows, and responds to treatments. I look forward to seeing future studies use these findings to develop tailored treatments for people with colorectal cancer, based on their genetics.”

Co-lead researcher, Professor David Wedge, Professor of Cancer Genomics and Data Science at the University of Manchester, said:

“This is the first really large study to come out of the 100,000 Genomes Project led by Genomics England and NHS England. In the coming months and years, I expect it to be followed by many more studies of different types of cancer as well as combined studies across all types of cancer, fuelled by the fantastic data resource provided by Genomics England.”

Dr Henry Wood, Lecturer in Translational Bioinformatics from Pathology in the University of Leeds’ School of Medicine, said:

“This study is the first to provide in-depth, whole-genome sequencing and characterisation of the microbiome - the community of bacteria and viruses that live in the gut - in a large number of cases of bowel cancer. This means that we are now in a position to investigate the importance of the microbiome in the development of these cancers, and whether we can change it to influence the tumour and improve patient outcomes.”

*The research team spanned the Universities of Oxford, 91ֱ��, Birmingham, Edinburgh and Leeds, as well as The Institute of Cancer Research, London and the Centro de Investigación Biomédica en Red Cáncer, Barcelona. 

** The 100,000 Genomes Project is an ambitious initiative that sequenced 100,000 genomes from NHS patients affected by rare conditions or cancer, providing both diagnoses and access to treatment for thousands of patients with research and analysis still ongoing. The Project laid the foundations for the NHS to become the first national health system to offer whole genome sequencing as part of routine care via the NHS Genomic Medicine Service. 

Professor Jason Wong, who is part of the Dermatology Theme at the NIHR 91ֱ�� BRC, has been awarded the funding through a 3-year UK Research and Innovation (UKRI) Medical Research Council (MRC) Development Pathway Funding Scheme.

Wounds are breeding grounds for microbes such as bacteria, fungi and viruses. Wound infection can cause delayed healing, loss of skin grafts (where healthy skin is removed from an unaffected area of the body and used to cover lost or damaged skin) and sepsis (a life-threatening reaction to an infection).

Delayed wound healing has a significant functional and psychological impact on patients. It can result in loss of limbs (particularly in diabetic foot disease) or even loss of life (particularly in burn injuries).

Jason Wong, who is an Honorary Consultant at 91ֱ�� University NHS Foundation Trust (MFT) and Professor of Reconstructive Plastic Surgery and Regenerative Medicine at The University of Manchester, said: “Wound dressings are important for wound care and management, but there is little evidence to support the routine use of current antimicrobial dressings for complex wounds, which aim to prevent or stop the growth of microbes. Most antimicrobial dressings do not show clear advantages, and this could be due to the active agents preventing wound healing or not working against certain microbes.

“The repeated or prolonged use of traditional antibiotics in wound care, especially chronic wound treatments, can cause the emergence of bacteria, fungi and viruses resistant to these commonly used antimicrobials. This highlights the urgent need for new, more powerful, yet safe dressings.”

Using this funding, Professor Wong and the research team will aim to develop new dressings that contain antimicrobial peptide (AMP) releasing hydrofibres (microbe killing proteins).

Unlike traditional antibiotics, AMPs are effective against a broad range of  microbes, can act quickly and penetrate through microbes’ resistant barriers.

The team have already developed an AMP which has been tested against a range of microbes, is easy to produce and is non-toxic. This study will aim to show it has low side effects and develop it towards a clinical product.

The project will be in collaboration with Convatec, a global medical products and technologies company focused on solutions for the management of chronic conditions, who are providing in-kind support throughout the study.

Professor Wong said: “I am delighted to have been awarded this grant with such an accomplished multidisciplinary team of scientists from The University of Manchester, MFT and industry. The development of this wound dressing could be invaluable for patients and clinicians in helping to prevent infection and improve healing. Through our work we will recognise their healthcare needs, which will include controlling local infection, making sure the dressings are easy to apply and remove, and exudate management (help prevent excess fluid leakages).”