A networking event at University Hospital Southampton explored new ways to improve the health and wellbeing of Armed Forces communities. Clinicians, researchers, innovation leads and military representatives gathered during Armed Forces Week. The event was hosted by the NIHR Wessex Experimental Medicine Network. Armed Forces community Wessex is home to one of the largest and most concentrated Armed Forces communities in the UK. Census and local authority data show veteran populations of around 7–8% of adults in Dorset and Wiltshire, roughly double the national average. In Hampshire, the wider Armed Forces community accounts for around 10% of the population. These areas include a significant serving population alongside veterans and families. It makes the region of strategic importance for Armed Forces health and research. The NIHR Wessex Experimental Medicine Network expands the work of the NIHR Southampton Biomedical Research Centre (BRC) across the region. Professor Nicholas Harvey, Director Designate of the NIHR Southampton BRC, said: “The challenges facing our armed forces communities are complex and evolving. They cannot be addressed by any single organisation working alone. “Events like this are vital in bringing together the breadth of expertise we have across Wessex to build the partnerships needed to translate research into real-world impact.” Building stronger partnerships The event highlighted the importance of collaboration between defence, health professionals, academia and industry. This approach reflects the national direction set out in the Defence Medical Research Strategy 2026–31. Delegates discussed key health challenges affecting those who serve, their families and veterans. These include physical injury, rehabilitation, mental health, infection and emerging threats. Workshops focused on new collaborative research and innovation approaches to meet these health needs. Attendees also joined the Armed Forces community represented within the hospital at their annual flag raising. Shared research priorities Dr Philip Woodgate, Director of Research for Defence Medical Command, delivered one of the keynotes. “The Strategic Defence Review highlighted the need for closer collaboration between defence, the NHS, academia, and industry,” he commented. “Defence Medical is grateful for the opportunity to engage at events like this in order to share its priorities. These span significant breadth, from mental health to blast injury, and tackling them will require cross-organisation and interdisciplinary working.” Another speaker, Dr Jo Fallowfield, Head of Musculoskeletal Injury Mitigation and Nutrition, added: “Through our multidisciplinary work specifically addressing musculoskeletal injury mitigation in the Royal Navy, we have demonstrated how partners from academia and industry can effectively work together with defence to address complex, interconnected health challenges. “The outputs from our work will benefit our Service men and women, but are also relevant to the wider Wessex community – and beyond.” Ash Boreham, Deputy Director of Partnerships for Research and Innovation, NHS Dorset, reflected after the event: “Wessex has a unique opportunity to connect local expertise with national defence priorities. By working together across organisations, we can ensure research is both high quality and directly relevant to the needs of the Armed Forces community and their families.” Supporting collaboration The event featured a series of speed pitches and seed-funding opportunities. This enabled attendees to share early-stage ideas and identify collaborators. Afternoon workshops supported teams to develop project proposals, helping to strengthen the pipeline from research concept through to funded delivery. By connecting regional expertise with national priorities, the aim was to strengthen partnerships, identify shared research priorities, support collaborative funding applications and raise the profile of Armed Forces health research. Looking ahead The event marked an important step in building a more connected and coordinated research community across Wessex. Conversations during the session indicated an appetite for connections to develop into a more formalised network. If this is something you would be interested in being involved in, please do get in touch via enquiries@wessexhp.org.uk.

Dr Thomas Daniels is a Consultant in Respiratory and General Medicine at University Hospital Southampton (UHS). His research has been supported at UHS through the Research Leaders Programme. This Clean Air Day, he talks about his recent appointment as the new NIHR Southampton Biomedical Research Centre (BRC) Sustainability Champion. He shares why the role is important, what he hopes to achieve through it, and what we can all do to help. Why is sustainability important in healthcare? The short answer is that there is no healthcare on a dead planet. The Climate Emergency is just that – an emergency. Without a liveable planet, all our other endeavours, both in our personal and professional life, become meaningless. As the World Health Organisation’s boss stated at COP30, “The climate crisis is a health crisis – not in the future, but now.” Not only is rapid global warming causing increased morbidity and mortality, but healthcare itself has a disproportionately large impact on global warming. If healthcare was a country, it would have the 5th biggest carbon footprint of any country in the world. What tangible impacts have you seen sustainability initiatives have so far at UHS? Where to start? Within the estate there have been many initiatives. These include the switch to LED lighting, the replacement of many insulated double-glazed windows, solar panels on every new building, and an industrial heat pump being built by the Coxford Road Energy Centre. There have been many clinical changes as well. Changes to the use of volatile anaesthetic gases, for example, have had a huge environmental impact. Probably my favourite project has been the switch from single use theatre caps to reusable cotton ones. These reusable ones now have the users name and role embossed on the front. This small change has had five benefits. The three expected ones were: environmental (through reduced single use plastic), financial (£30k/year), and improved patient safety (through better communication between staff in safety critical situations in theatres). The unexpected ones were that patients preferred them too. When patients see an anaesthetist at the bedside, they forget the introduced name all too quickly. The caps allowed the name and role to be better remembered. These named theatre caps have also improved staff integration and cohesion, particularly for staff who trained overseas. How can staff at all levels get involved in sustainability efforts? Absolutely everyone has a role to play. The first step is starting to see our actions through a ‘sustainability lens’ – the paper we use, the tests we perform, the food choices we make, how and when we chose to commute or travel. The next step is to be brave and speak up – be the first to ask, “why are we doing it like this?” Join with other like-minded people, both at work and at home. There are a number of sustainability action groups at UHS and the University of Southampton. Then, with a small team, choose a manageable project where you can make a change. And make a start! There are lots of people to ask for help and support. How can sustainability be embedded into research practice at the BRC? The key is seeing the things we do through a ‘sustainability lens’. More specifically though, there are three main areas in which sustainability can be embedded into BRC research. The first is reducing the impact of how we go about the business of research. Here, reducing the use of resources is key – everything from petrol to paper, from plastic to planes, and everything in between. The second is recognising the environmental impacts of the research we are generating. For example, medicines account for about 25% of the entire carbon footprint of the NHS. If our research reduces excess medication use (for example by showing that over-prescribing harms patients), then we should be reporting the environmental benefits of this, as well as all the other benefits. Other examples could be research that prevents ill-health and reduces the need for hospital or GP attendances. Each time we reduce illness and reduce healthcare attendances, this reduces the environmental impact of the care we deliver. What do you hope to achieve as BRC Sustainability Champion? It might be too ambitious to want to save the planet, but maybe together we can start to reduce our environmental impact and do our part of avoiding the worst ravages of the Climate Emergency that are yet to come.

A new trial is investigating a personalised treatment for patients with a rare and aggressive form of cancer. Mesothelioma is a cancer that forms in the lining of the lungs or abdomen. It is linked to exposure to dangerous asbestos fibres. Around 2,700 people are diagnosed with the disease each year. Outcomes and survival rates are poor. The SELECTmeso1 trial is investigating whether a targeted cancer treatment can improve outcomes for patients who have a particular genetic biomarker. It is due to open at 10 hospitals across the UK, including at University Hospital Southampton. The trial is led by Professor Dean Fennell from the NIHR Leicester Biomedical Research Centre (BRC) and Professor Gareth Griffiths from the NIHR Southampton BRC. It is run by the Cancer Research UK Southampton Clinical Trials Unit (SCTU), with funding from Asthma + Lung UK. The trial is sponsored by the University of Southampton. Targeting a ‘weak point’ There are currently very few treatment options for people with mesothelioma. The cancer often returns after initial treatment. Only around five per cent of people diagnosed with the disease will survive for five years or more. Recent trials by the NIHR Leicester BRC and SCTU have shown targeted treatments can improve survival for people with relapsed mesothelioma, where the disease has come back. However, these treatments often only work for some patients, but not for others. Professor Fennell is Chief Investigator of SELECTmeso1. He is Chair of Thoracic Medical Oncology at the University of Leicester. “This is due to the genetic make-up of people’s individual cancer and the specific biomarkers, or genetic signals, their cancer has,” he said. “But imagine if there was a way to tell which treatment is likely to work best for each patient and personalise the care they get, giving them best chance of a successful outcome. “The SELECTmeso1 trial is doing just that. We know that almost half of patients with mesothelioma have a deletion of a particular gene called MTAP. This means they have a more aggressive cancer, and don't respond as well to existing treatments. “However, the absence of this gene creates a unique weak point in their cancer cells that healthy cells don't have, meaning the cancer cells are able to grow uncontrolled. This is the genetic pathway we are targeting in this trial.” The team are working with pharmaceutical company Bristol Myers Squibb, who have developed a treatment called Navlimetostat. This medicine targets the weak point created by the absence of the MTAP gene. The drug selectively kills those cancer cells, leaving the healthy cells largely unaffected. Promising anti-tumour properties Professor Gareth Griffiths is co-Chief Investigator of SELECTmeso1. He is Director of the SCTU. “This drug has already been trialled in some other cancers and has been shown to have promising anti-tumour activity,” he said. “It was also well tolerated by patients without causing too many side effects. “Through the SELECTmeso1 trial, we therefore hope to find out whether this could be a viable treatment for patients with this specific genetic signal. If we find evidence that patients benefit, this will hopefully lead to future practice-changing trials.” Patients with relapsed mesothelioma who are found to have the deleted MTAP gene will be invited to join the SELECTmeso1 trial. They will be given the targeted treatment in the form of tablets every day, in three-weekly cycles, for up to six months. The research team will monitor how much their tumour shrinks. They will also record any side effects they experience. Progress ‘desperately needed’ The trial recently opened at Leicester Royal Infirmary, where the first patients have been recruited. Dr Samantha Walker is Director of Research and Innovation at Asthma + Lung UK. “Asthma + Lung UK is proud to be funding this vital research, which could be a real breakthrough and has the potential to improve the lives of people living with mesothelioma,” she said. “With life expectancy remaining low and no current cure available, progress on treating this devastating condition is desperately needed. “Targeted therapy has already shown to be effective for other types of cancer. If this trial is successful, it would offer new hope for the more than 2,000 people who are diagnosed with mesothelioma every year. “Cutting edge research into new types of treatment for lung conditions is vital to improve health outcomes. However, funding for lung health research is currently on life-support, despite lung conditions remaining the third biggest cause of death in the UK.” It is the first trial supported by the newly formed UK collaborative for clinical cancer research's (UK3CR’s) Mesothelioma Clinical Research Group, chaired by Professor Fennell. This has the remit to develop trials for mesothelioma patients in the UK. Looking for more targets SELECTmeso1 is the first trial in a much larger planned platform clinical trial. This aims to test several drugs that target genetic biomarkers that may be present in a patient’s tumours. Dr Emma Knox is Senior Trial Manager for SELECTmeso at the SCTU. “The idea of the platform trial is that we can run several different trials at once, giving patients more chance of receiving a treatment that works for them,” she said. “Once the full platform is open, patients will be invited to join, and will have a sample of their cancer tested in a laboratory. This will tell doctors about the particular genetic make-up of their cancer and what biomarkers their mesothelioma has. “If there is a trial within the platform that is testing a drug that works specifically for that biomarker, they will be invited to join that particular trial.” If there is no trial running for that biomarker at that time, patients will remain in the platform database. They will be contacted if a new trial of a treatment that may work for them starts. Each separate trial within the SELECTmeso platform will recruit 26-30 patients. The trials will take place at hospitals around the UK. “The aim of the platform is to test how effective each drug is for patients with those specific biomarkers, and to see whether stratifying treatment in this way can improve outcomes for patients,” said Professor Fennell. “The hope is that in the future, doctors treating people with this aggressive cancer will be able to use a more personalised approach, selecting the best possible treatment for each individual patient.”

Researchers across the UK are joining forces to develop a ‘national blueprint’ for care and support before and between pregnancies. Southampton researchers are part of a new £50 million programme from the National Institute for Health and Care Research (NIHR). The aim is to transform maternal health through pioneering research. Driving forward vital research Maternal health inequalities remain one of the most pressing challenges facing the NHS. In the UK, Black women continue to face a substantially higher risk of dying during or after pregnancy than white women. Women and families living in the most deprived communities continue to experience worse outcomes. The programme is known as the NIHR Inequalities Challenge: Maternity Disparities Consortium. It is led by the universities of Newcastle and Birmingham. The consortium brings together higher education, NHS, community and voluntary organisations. Together, they aim to reduce disparities in maternity outcomes. The NIHR has committed £50 million over five years to drive forward this vital research. This will be led by clinicians, researchers and communities across the consortium. It marks the most significant step forward in maternal health research in a generation. Improving care before pregnancy The University of Southampton (UoS) is leading research into health before and between pregnancies, capitalising on research from the NIHR Southampton Biomedical Research Centre (BRC). Their aim is to reduce inequalities in maternity care experienced by minoritised groups. The programme will work with minoritised communities and care providers. They will help develop a practical 'blueprint' to improve care and support before and between pregnancies. Professor Keith Godfrey leads the NIHR Southampton BRC's nutrition, lifestyle and metabolism theme. He said: “People who are healthy before they get pregnant have a higher chance of keeping healthy during pregnancy and of having healthier babies. “Many health problems can be hard to fix once someone is already pregnant, so it’s important to provide care and support before and between pregnancies. “No such system of care and support currently exists in the UK, so this research to develop a national blueprint is urgently needed.” The Southampton team will work with Queen’s University Belfast and University College London. They will also work with Hampshire and Isle of Wight and Central East Integrated Care Boards, public contributors and Wessex Health Partners. Dr Danielle Schoenaker is an emerging Co-lead at UoS and the NIHR Southampton BRC. She said: “Developing a national blueprint for care and support before and between pregnancies lays the foundation for healthier mothers, children and families. “It can help mums and babies stay well. It also builds a kinder, more supportive community, where every family can have a better future.” Pivotal moment for maternity care The launch comes at a pivotal moment for maternity care in the UK. National attention increasingly focuses on improving safety, equity and women's experiences of care. The Government's renewed Women's Health Strategy highlights the need to improve care before and between pregnancies for marginalised communities. Against this backdrop, the consortium will generate evidence, interventions and research capacity. This will help translate national ambition into practical changes for women, babies and families. Professor Judith Rankin OBE from Newcastle University is Consortium Co-lead for Research and Capacity Development. She said: “This funding represents a critical opportunity to make the step change we need to improve outcomes for women and their babies. “Alongside the research, the Consortium will be investing in tomorrow's research leaders today. This will ensure we have the capacity to deliver on improving pregnancy outcomes, access to, and experience of, care.” Professor Joht Singh Chandan from the University of Birmingham is Consortium Co-lead for Research. He said: “National attention on maternity safety and equity has never been greater. Ambition must now be matched by evidence and implementation. “Through this consortium, we will work across the UK to understand what works, for whom and in what contexts. We will work to ensure that research leads to practical changes in care for the women, babies and families who need them most.”

A new ‘universal’ coronavirus vaccine trialled at University Hospital Southampton (UHS) could protect against viruses yet to emerge. Experts say this could potentially save millions of lives and avoid costly lockdowns. The study took place at the NIHR Southampton Clinical Research Facility (CRF) and the NIHR Cambridge Clinical Research Facility. It was sponsored by UHS. Creating a 'super antigen' The vaccine was developed by a team at the University of Cambridge and spin-out company DIOSynVax. They used all available genetic sequence data logged by surveillance programmes around the world relating to a large group of viruses. This included SARS-CoV-2, the virus that caused the COVID pandemic. This led to the creation of a ‘super antigen’. This contained all features common to these viruses, known as Sarbeco coronaviruses. The aim is to provide lasting protection against multiple viruses, even as they mutate. 'Future proofed' vaccine The Southampton-Cambridge trial involved 39 healthy volunteers. The vaccine triggered immune responses in the volunteers not only to SARS-CoV-2 and SARS, but also to related bat viruses. These could potentially jump from animals to humans and cause future pandemics. It is the first time that a vaccine whose active component was designed entirely by computer simulations has been tested in humans. The results, published in the Journal of Infection, show the vaccine is safe and has no significant side-effects. Professor Saul Faust is Chief Investigator of the trial. He is Director of the CRF at UHS and a theme co-lead at the NIHR Southampton Biomedical Research Centre. He said: “Viruses like influenza, coronaviruses and the Ebola group are evolving continuously, and by the time vaccines are rolled out, they may be poorly matched. The current ‘reactive’ vaccine system struggles to keep pace. “This new class of universal vaccines are future proofed. They not only protect against many variants simultaneously, but potentially against related viruses that haven’t yet emerged and spilt over to humans. “If we can develop and clinically advance this new class of vaccines before a virus outbreak begins, millions of lives could be saved, lockdowns avoided and the economy preserved.” Needle-free delivery The super antigen is compatible with most vaccine delivery systems. In this trial, it was administered as DNA vaccine through a micro fluid jet – and was needle-free. Further development of the vaccine is needed before it is ready for public use. A larger Phase 2 trial will next assess the vaccine’s ability to induce immune responses in a wider and more diverse population. This will also aim to confirm that it generates strong, broadly protective immune responses. Professor Jonathan Heeney, from the Lab of Viral Zoonotics, University of Cambridge’s Department of Veterinary Medicine, is the scientific lead for the research programme. He said: “We’ve converted vaccine development from being reactive to being future proof. Our vaccines will continue to provide protection against viruses even as they mutate into new strains. “We’ve overcome the problem of traditional vaccines, which have limited protection. It means we can escape the constant cycle of chasing the virus variants circulating in humans and updating the vaccines to try to catch up, like a dog chasing its tail.” 'Pivotal leap forward' Professor Marian Knight is Scientific Director for NIHR Infrastructure. She said: “The remarkable success of this AI-designed ‘super-antigen’ trial marks a pivotal leap forward in our ability to deliver broad, lasting viral protection. “This milestone was only made possible through partnerships between the life sciences sector and our world-class NIHR infrastructure in Cambridge and Southampton, whose Clinical Research Facilities provided the vital expertise and environment needed to safely fast-track this innovation, and bring it one big step closer to patients.” The research was primarily funded by Innovate UK. The DIOSynVax pipeline includes vaccine candidates for human seasonal flu and the pandemic influenza threats, haemorrhagic fever viruses, and coronaviruses including SARS-CoV-2.

A new blood-based testing approach could help improve early diagnosis of tuberculosis. Tuberculosis (TB) remains one of the world’s deadliest infections. Earlier diagnosis could reduce the risk of severe lung damage and limit the spread of the disease. Dr Hannah Schiff is leading research into whether protein signals in the blood can reveal TB before patients become seriously ill. Dr Schiff is a Senior Clinical Lecturer in Respiratory Medicine at the University of Southampton. She is part of the NIHR Southampton Biomedical Research Centre. ‘Particularly challenging’ “Mycobacterium tuberculosis is an ancient organism that we’ve never eradicated,” says Dr Schiff. “What makes it particularly challenging is that whether it causes disease depends as much on the person as it does on the bacterium.” Often associated with low‑ and middle‑income countries, TB is now an increasing concern in the UK. England records more than 5,000 cases each year and is at risk of losing its low‑incidence status. The disease spreads through microscopic droplets released when someone with active TB coughs. This is typically during prolonged contact. However, infection doesn’t always lead to illness. An estimated one-third of the global population carries latent TB. This is a dormant form in which the bacteria lie ‘asleep’ in the body. It causes no symptoms and often remains undetected for decades. “The immune system can contain the infection for a long time,” explains Dr Schiff. “But later in life – through ageing or immune suppression – it can reactivate and cause disease.” When that happens, TB can cause extensive damage to the lungs, including scarring and cavitation. Even after successful treatment, many patients are left with permanently reduced lung function. Closing the diagnostic gap TB is curable, but timing is critical. “Even in countries with strong health systems, it can take months from symptom onset to diagnosis,” says Dr Schiff. “During that time, the disease continues to spread and lung damage progresses.” Currently, diagnosis relies largely on sputum (phlegm) samples. These are examined under a microscope, cultured or tested for bacterial DNA. These methods can be slow, poorly sensitive and costly, with lung damage progressing during the wait for results. Closing this diagnostic gap is the central aim of Dr Schiff’s research. “If we can diagnose TB earlier, especially in people who don’t yet know they’re sick, we can protect their health and the health of everyone around them.” Detecting TB in blood Dr Schiff’s work explores whether TB leaves detectable traces in the blood long before severe symptoms develop. Her research focuses on protein biomarkers. These are molecular signals released into the bloodstream in those with the disease. “My PhD looked at what happens in the blood during TB,” she says. “The cavitation caused by the disease is thought to release proteins into the blood, and we wanted to know if we could detect them.” Using large patient datasets, her research has identified combinations of blood proteins. These can distinguish TB not only from healthy individuals, but also from other lung infections. Dr Schiff is now working with collaborators in Southampton and Liverpool to validating these findings. She is using advanced protein array technology, which allows many biomarkers to be tested at once. The ultimate goal is to develop rapid, point‑of‑care tests that could be used in clinics, hospitals and low‑resource settings worldwide. “TB has never been eradicated,” says Dr Schiff, “but if we can detect it earlier and more accurately, we have a real chance to change how the disease is controlled.”

A multi-million pound clinical trial is exploring treatment for childhood asthma attacks. The EVITA trial (Evaluation of Intravenous Therapy in Asthma) is comparing three medicines currently used to treat children and young people with severe acute asthma. The study has received £2.3 million in funding from the National Institute for Health and Care Research (NIHR). It is co-led by experts from UHS and University Hospitals of Leicester NHS Trust. Trio of current medicines When a child or young person experiences a severe asthma attack, they are admitted to hospital and treated with medication. Clinicians currently use one of three medicines – aminophylline, magnesium sulphate, or salbutamol. These work by relaxing the muscles in the airways and improving airflow. As part of the study, children and young people admitted to hospital with severe asthma are randomly allocated to receive one of these three established treatments. Research teams then monitor how quickly their symptoms improve. They also collect information on length of hospital stay, side effects, and treatment costs, as well as how acceptable each treatment is to patients, families and healthcare professionals. Dr Katrina Cathie, Consultant Paediatrician at Southampton Children's Hospital (based at UHS), Associate Director for Paediatrics at the NIHR Southampton Clinical Research Facility, and trial Co-lead, said: “At the moment, doctors have three options but very little evidence to guide which one works best for each child. This has led to variation in practice across the UK and around the globe. The evidence collected in this trial should shape future clinical guidelines so patients with severe asthma attacks receive the best possible care.” Professor Graham Roberts, Professor of Paediatric Allergy and Respiratory Medicine at the University of Southampton, Theme Co-Lead at the NIHR Southampton Biomedical Research Centre, and EVITA Co-lead, said: “Getting treatments right for children with severe asthma attacks is absolutely critical. These episodes can be life threatening and require urgent, effective care. The EVITA trial will help ensure we use the treatment that works best and is most acceptable to children and families.” Improving asthma treatment Asthma affects around 1 in 11 children and young people in the UK, making it the most common long-term condition in this age group. Severe acute asthma is a potentially life-threatening condition that occurs when symptoms do not respond to standard inhaled reliever medication. It remains a leading cause of childhood hospital admissions nationwide. Finding out which medicine is most effective in treating severe asthma attacks will help reduce the time that children and young people spend in hospital. It will also enable clinical teams to deliver faster, more targeted care. This can ensure patients receive the most appropriate treatment with the fewest possible side effects and the best value for money for the NHS. Hope for the future Amy took part in the EVITA trial with her daughter Bethany, when she was admitted to UHS for a severe asthma attack. She said: “We’re really grateful that we live near University Hospital Southampton, because it’s such an amazing research centre.” Both Amy’s children have asthma. “It makes winter quite stressful,” she explained. “Cold seasons are difficult. Every time they get a little bit poorly, we’re on edge. You’re worried about the impact that it will have on work and family life.” Amy is keen for the trial to identify the best treatment for children like Bethany when they have a severe asthma attack. “I really hope that it will help those children going into the emergency department,” she said. ‘Answering an important question’ Overall, the study aims to recruit 357 children and young people aged 2 to 18 years from hospitals across the UK. Sites currently include Leicester, Southampton, Liverpool and Edinburgh, with further hospitals expected to join. The study is being coordinated by the Centre for Trials Research, funded by Health and Care Research Wales, hosted by Cardiff University, and the Liverpool Clinical Trials Centre. Professor Damian Roland, Paediatric Emergency Medicine Consultant at the University Hospitals of Leicester NHS Trust and Co-lead for the EVITA trial, said: “This study will provide answers to an important question for children, families and healthcare professionals. When we spoke to children and their families before we began the study, they told us that their child feeling better and looking well was the most important outcome. We have taken great care to design this study with this specific approach in mind. “We hope that our results will help to standardise asthma treatment in the UK, ensuring that children and young people receive the fastest, most appropriate and best possible care.” Learn more about the study at: http://www.evita.org.uk.

Researchers are joining forces to understand why the current ‘one size fits all’ approach to osteoarthritis is not working. There are 10 million people living with osteoarthritis in the UK. Yet people experience the condition in different ways. The SOLVE consortium is bringing together researchers from across the UK, including Southampton, to ask why. Working collaboratively Osteoarthritis symptoms include pain, stiffness and swelling. They can have a huge impact on people’s everyday lives. Current treatment plans rarely consider lifestyle factors, menopause or joint injury. These can all impact disease severity. In most cases, this generalised approach will not be the most effective way to reduce symptoms. SOLVE will focus on identifying different types (or subgroups) of osteoarthritis. This will enable better matching of treatments to individuals. The consortium is being led by the University of Leeds and Keele University. It is enabled by £3m funding from Arthritis UK. Professor Nicholas Harvey is leading Southampton's involvement. He is Director Designate for the NIHR Southampton Biomedical Research Centre. “The SOLVE consortium is a fantastic example of what we can achieve when we combine expertise across the UK to tackle a condition as complex as osteoarthritis,” he said. “At Southampton, we are proud to lead the development of a new clinical risk calculator for severe osteoarthritis. “By building on our ongoing collaboration with the NIHR Biomedical Research Centre in Leeds, we are creating a tool that has the real potential to transform how we assess patients and deliver personalised interventions for this devastating disease.” Guided by patients The research will be guided by patient voices throughout all stages. This will help to drive tailored and improved patient outcomes. Zeyd Kateregga is patient partner on the SOLVE consortium. “After my diagnosis, the exercises and pain relief I was given hadn't worked,” he said. “Keyhole surgery helped, but 10 years later my symptoms worsened. I couldn't walk 20 minutes without being in lots of pain and taking strong pain killers. “Osteoarthritis has really impacted my life. I joined gym classes with other people who live with osteoarthritis. They're aged between 18 and 80 and we all experience the condition in our own way. “I try to stay positive even though my experience with healthcare hasn't always been great. Knowing that SOLVE is taking a compassionate and informed approach to researching osteoarthritis gives me hope that things are changing for the better.” Understanding osteoarthritis better SOLVE aims to find out how biological factors, social factors and life events influence osteoarthritis. The researchers will gather a comprehensive understanding of the condition. They plan to do this by dividing research into four key areas: Analyse the different subgroups - Use advanced technology to study tissue samples and gain a better understanding of the different types of osteoarthritis and how to treat them.  Study the impact of life events - Research how menopause and joint injuries can increase the risk of osteoarthritis. Identify risks of disease progression - Identify other health conditions which may result in faster osteoarthritis progression. Turn this into a tool to inform NHS healthcare professionals. Study the impact of social factors - Explore how income, education, or where somebody lives affects their ability to follow recommended exercise routines for those living with osteoarthritis. The consortium will bring together leading researchers from the universities of Edinburgh, Imperial College London, Keele, Leeds, Nottingham, Oxford and Southampton. They will work with healthcare professionals and people with lived experience. Professor Philip Conaghan and Professor Melanie Holden are the lead researchers. “The new Arthritis UK Consortium, SOLVE, is an exciting programme that will, for the first time, bring together previously separate fields, data, and expertise to create the evidence needed to improve care and outcomes for people living with osteoarthritis,” they said. “By putting people with lived experience at the heart of the consortium and collaborating with implementation scientists from the start, we will ensure our findings are relevant and actionable.”

Most people living with severe asthma are also living with other health conditions, a major new study has found. Researchers analysed data from thousands of patients. They discovered the extra illnesses – which range from obesity to osteoporosis – tend to appear in clusters. They say identifying patterns could be the key to unlocking more effective treatment for those hit hardest by the condition. The study has now been published in Lancet Regional Health. It was led by researchers at the University of Southampton (UoS), University Hospital Southampton (UHS) and the NIHR Southampton Biomedical Research Centre (BRC). First detailed description The study provides the first detailed description of how long-term health conditions are regularly found together in patients with severe asthma. The researchers worked with the Severe Heterogeneous Asthma Research collaboration: Patient centred (SHARP). This is a European Respiratory Society Clinical Research Collaboration. Professor Ramesh Kurukulaaratchy is the study lead author. He is Professor in Respiratory Medicine and Allergy at UoS and an Honorary Consultant at UHS. He is also part of the BRC’s Respiratory and Allergy theme. He said the results showed nearly all asthma patients have at least one other major health issue. Most have three or more. “The patterns we found were linked to how well asthma was controlled, how often attacks happened and the treatments needed,” he said. “Better understanding these patterns will help us look beyond asthma alone and improve the care for people living with severe asthma.” Professor Ramesh Kurukulaaratchy and Dr Anna Freeman Understanding the links The study analysed data taken from 2,700 patients across 11 European countries. Asthma affects everyone differently. Yet the researchers identified three distinct profiles. These appeared consistently across the patient groups: High steroid use – patients reported high rates of osteoporosis and weight gain caused by steroid treatments Severe allergies – including from eczema alongside hay fever, or rhinitis Sinusitis – chronic sinusitis and nasal polyps Dr Anna Freeman, Respiratory Consultant at UHS, is joint first author. She is part of the BRC’s Respiratory and Allergy theme. “People with severe asthma often live with a heavy burden of other conditions. But, until now, we didn’t fully understand how they were linked,” she said. “With our results, we can improve the quality of life for millions of people across Europe who currently struggle to keep their severe asthma under control.”

Taking fish oil supplements might be better than eating oily fish for improving heart health, according to an award-winning research paper. Southampton researchers Professor Philip Calder and Dr Helena Fisk are co-authors for the study, which has been named the British Journal of Nutrition’s Paper of the Year. They are both part of our NIHR Southampton Biomedical Research Centre’s nutrition, lifestyle and metabolism theme. Preventing blood clots The study was led by Professor Parveen Yaqoob at the University of Reading, in collaboration with researchers in Southampton and Liverpool. The study aimed to find out whether eating oily fish or taking fish oil supplements is better for heart and blood vessel health. Both are a source of EPA, a type of omega-3. To do this, the team looked at extracellular vesicles in the blood of 42 adults. They either ate oily fish like salmon or mackerel, took fish high-dose oil supplements, or continued with their normal diet (the control group) for 12 weeks. Extracellular vesicles are tiny ‘packages’ that help cells to communicate. However, too many can raise the risk of blood clots, a factor linked to cardiovascular disease. Supplements more effective Only participants who took high-dose fish oil supplements had a significant reduction in the number of extracellular vesicles in their blood. Participants who ate oily fish had no change. Supplements also reduced how strongly the vesicles triggered the production of thrombin, a key protein involved in blood clotting. Again, this was not seen in those who ate oily fish. The research shows that eating oily fish is not enough to give cardiovascular benefits related to extracellular vesicles. However, high-dose fish oil supplements could help. The Paper of the Year award recognises an outstanding piece of research published in the British Journal of Nutrition. The winning paper needs to demonstrate exceptional scientific rigour, originality, and significance in the field of nutritional science.

A research-based initiative to prepare cancer patients for surgery is coming to leisure centres across Southampton. Researchers at University Hospital Southampton (UHS) developed the programme with Wessex Cancer Alliance. It was first introduced at Bournemouth’s BH Live Active Littledown Centre in 2018 as part of the WesFit trial. The scheme has already improved the post-surgery experience for hundreds of patients across Bournemouth and Portsmouth. Now, it is being expanded to support people with cancer in Southampton. Based on evidence from research Patients who are physically fit are more likely to have better outcomes from surgery. Prehabilitation, or prehab, uses exercise to support patients to improve their fitness beforehand. WesFit aimed to see if prehab in leisure centres improved surgery outcomes for patients with cancer. The trial showed patients' physical fitness returned to pre-chemotherapy levels before their surgery. They also had shorter hospital stays and fewer complications afterwards. Wesfit was part of years of prehabilitation research led in Southampton by Professor Sandy Jack. Her research forms part of the NIHR Biomedical Research Programme’s perioperative and critical care theme. Improving cancer patients’ outcomes The programme is aimed at people aged 18 and over with stage 3 and 4 cancer who are preparing for surgery. People are referred onto the scheme via their NHS health practitioner. They receive a personalised exercise plan to improve their fitness before their surgery. Activities include one-to-one personal training. They also include group exercise classes such as cycling, yoga, Pilates and swimming. Benefits include fewer post-treatment complications and reduced length of stay in hospital. People also report better fitness levels, confidence and quality of life. Expanding this 'life-changing support' The scheme is now available at BH Live Active centres in Bitterne, Chamberlayne and The Quays. These are owned by Southampton City Council and operated in partnership with BH Live. Professor Sandy Jack, co-lead of the prehabilitation service at UHS, said: "Expanding the offering of prehabilitation in our city is a really positive step in helping people prepare both physically and mentally for cancer treatment, improving recovery and long-term health outcomes." Sally Rickard, Managing Director at Wessex Cancer Alliance, said: "We are really pleased that this partnership is continuing to support people with cancer across Wessex." Karen Tillyer, Southampton Health and Wellbeing Manager at BH Live, said: “Expanding the PREHAB Cancer programme across our BH Live Active centres is an important step in supporting people through a challenging stage of their cancer journey. “We’ve already seen how personalised prehabilitation can boost patients’ confidence, fitness and overall recovery. “Working with University Hospital Southampton and Wessex Cancer Alliance, we’re proud to bring this life‑changing support to even more people in our community.”

Image credit: World Obesity Federation A new analysis of global obesity trends since the 1980s challenges the idea of a ‘global epidemic’ of obesity. The research reveals rising levels of obesity have slowed, stabilised and possibly even reversed in many nations. The global report was put together by a collaboration of researchers, including from Southampton. It has now been published in the journal Nature. A more optimistic picture The analysis was led by researchers from Imperial College London, via the NCD Risk Factor Collaboration (NCD-RisC). The research looked at more than four decades of health data from 200 countries and territories, covering the period from 1980 to 2024. The findings come as experts from around the world meet at the European Congress on Obesity (ECO 2026) in Istanbul this month. They provide a more optimistic picture of progress than previously reported. The research shows that the increase in obesity rates has slowed or levelled off in most high-income countries. This is despite rapid rises at the end of the 20th Century. In some high-income countries rates may have even begun to decline. This includes France, Italy and Portugal. The researchers say these results suggest previous claims of a ‘global epidemic’ of obesity are likely to be an oversimplification. They say these claims mask the huge diversity seen across countries. This can be driven by a range of factors, especially the availability and affordability of healthy food. However, obesity prevalence continues to rise in many low‑ and middle‑income countries. This includes Africa, Asia, Latin America, and Pacific and Caribbean island nations. The researchers suggest we should focus on the pace of change in obesity over time, rather than just the prevalence. By doing so, they say we can learn where urgent action is needed. This includes robust health and food policies to help nations adapt and manage public health during economic, technological and nutritional transitions. Professor Majid Ezzati, from the School of Public Health at Imperial College London, led the analysis. He said: “We now need to find out why some countries are doing so much better than others, and apply the lessons to stop obesity from increasing. “Ultimately, this analysis shows that the trend towards obesity is not inevitable, and that it is possible for policy makers to intervene to stop and even reverse growing obesity.” Children improving first Obesity rates in high-income countries slowed first in school-aged children and adolescents. Adults followed the same pattern about a decade later. In most high-income western countries, the rise in obesity among children occurred before the millennium. This trend slowed, plateaued and even reversed slightly after the year 2000. Denmark experienced the earliest documented slowdown, around 1990. This was followed by other European countries during the 1990s. These included Iceland, Switzerland, Belgium and Germany. By the mid-2000s, growing obesity rates among school-aged children and adolescents in most high-income countries started to stabilise. In some, they even started to decline. The exceptions were among children in Australia, Finland and Sweden. There, obesity increased steadily or accelerated. However, the levelling off has happened at very different national prevalences across countries. In many western European countries and Japan, obesity growth plateaued or reversed when prevalence was below 10% of the school-age population. This meant fewer than one in ten children had obesity. By comparison, in the USA and New Zealand, obesity stabilised when levels were much higher, at 19-23% of the school-age population. This meant as many as one in four school children had obesity. The same trend was seen in adults. In the UK, the research showed the rise in obesity has slowed or plateaued for both children and adults. However, this has happened at moderately high prevalence. 10-12% of children and 27-30% of adults had obesity in 2024. The UK remains mostly in the top 10 countries among high-income western countries for obesity rates. Professor Keith Godfrey from the NIHR Southampton Biomedical Research Centre and the University of Southampton contributed to the research. He said: “In England, the most recent National Child Measurement Programme data show that 10.5% of school children in reception and 22.2% of year 6 children were living with obesity. “Excluding the 2020 to 2021 peak during the COVID pandemic, this is the highest obesity prevalence seen in reception since the measurement programme began in 2006. “At national, regional and local levels, there are large and widening variations in obesity prevalence in young children, associated with persistent inequalities by ethnic group and deprivation. “The findings are encouraging in showing that obesity rates have stabilised or even started to decline in several European countries. “They give hope that concerted action to improve our national food system could likewise start to reduce the wide disparities in child obesity in the UK.” Global obesity trends Previous reports on the global state of obesity have typically compared prevalence of obesity over decades. This includes those conducted by NCD-RisC in collaboration with the World Health Organization (WHO). This approach can provide valuable insights. However, it can make it difficult to track progress in controlling obesity. This is especially true for recent changes that reflect policy innovation. In the latest analysis, researchers used velocity of obesity as a key measure. This is calculated as the annual absolute change in prevalence of obesity. It is reported in percentage-points-per-year. Using this method, they were able to provide a clearer picture of where increases in obesity are accelerating, stabilising, or reversing. The team analysed weight and height measurements from over 232 million people. This included 70 million people aged five to 19 years, and 162 million aged 20 years or above. The analysis covered 200 countries and territories. More than 1,900 researchers contributed to the study. It looked at body mass index (BMI) to understand how obesity rates have changed worldwide from 1980 to 2024. Obesity was defined as a BMI of 30 kg/m2 or above for adults. It was defined as a BMI over two standard deviations above the median of the WHO growth reference for children and adolescents. Estimates of obesity were adjusted for differences in how the population was distributed in different ages. This was done through a process called age standardisation. Growing gap between countries The analysis shows that obesity continues to rise, and is even accelerating, in most low- and middle-income countries. This divergence from high-income nations highlights growing global inequalities in nutrition and health. The researchers recommend tailored public health policies to address the growing gap. These could include policies focused on the availability and affordability of healthy foods for countries and communities who cannot currently afford and access them. Over the last decade, new obesity medications have become widely available. These include GLP-1 receptor agonists. The researchers state that the introduction of these drugs does not yet explain the changes seen in their study. However, they say these are likely to play an important role in future trends, especially if access and affordability are improved. Professor Ezzati explained: “At this stage it’s probably too early to say whether GLP-1 drugs have had a direct impact in entire populations, even though they are beneficial for patients who use them. The focus should be on making them more affordable to all who need them around the world.” The authors highlight a number of limitations to the study, including the amount of data available, which varied by region. The research was funded by the UK Medical Research Council and UK Research and Innovation. It was supported by funding through the European Union.