Category / REF Subjects

What happens when things go wrong in medicine?

1-day BU conference/workshop examining what happens when things go wrong in surgery, 8th September 2017

Every day we make mistakes; we pick up the wrong set of keys from the kitchen drawer, pick up the wrong identical suitcase from the airport carousel, or, in the case of the Oscars, a near identical envelope is given to Warren Beatty who then announces the wrong Best Film winner.

What happens when things go wrong in surgery where the consequences can be much more serious?  While attention, quite rightly, focuses on patient need when things go wrong, the aim of this event is to examine how medical professionals can be better supported and trained to cope with these adverse events.

Eminent speakers from around the UK will present the latest research in the area, share insights from their surgical careers and personal experiences and will consider:-

Impact – The personal impact when complications and errors arise in surgery

Resilience – Dealing with stress and maintaining wellbeing

Restoration – what can be done when things go wrong?

While the focus is on surgeons, it is clear that those in other medical professions (e.g. nurses, midwives, GPs) face similar issues in the workplace. Anyone with an interest in the topic is welcome to attend (attendance is free for BU staff).   For further details and to register for the conference please visit www.surgeonwellbeing.co.uk or contact Professor Siné McDougall (smcdougall@bournemouth.ac.uk; ext. 61722).

BU’s PhD student Juan Camilo Avendaño Diaz and Dr. Xun He presented their research at the 7th Joint Action Meeting.

On July 22-26, Dr. Xun He and Juan Camilo Avendaño Diaz (PhD student) attended the 7th bi-annual Joint Action Meeting (JAM), held at Queen Mary University of London. This meeting brought together researchers from many different fields (psychologists, philosophers, physicists, musicians, engineers and neuroscientists, just to name a few), interested in studying people’s ability to act together (they had a full day covering human-robot interaction as well!).

Dr. Xun He gave a talk titled “A dual-EEG study of the shared attention effect in dyads: Sensory processing or top-down control?”, examining the information processing in the brain when people co-attend to the same spatial locations. Juan Camilo presented the poster “Visual attention in dyads: The role of group membership”, suggesting that co-attending with members of the same vs. different social group could have distinct effects on visual attention.

Attending JAM 2017 was a great opportunity to meet some key figures in the field, and to hear and discuss about the research that is been performed worldwide, including the research carried out at BU.

If you would like to learn more about our research, please do not hesitate to contact me at javendanodiaz@bournemouth.ac.uk

Denyse King’s Health Education England project ‘NoObesity’

NoObesity

The government’s key priority of reducing childhood obesity through adult education (as announced by Jeremy Hunt in Sept 2015), prompted BU’s Denyse King to write a proposal to Health Education England. Denyse is a Midwifery Lecturer / Public Health Practitioner in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) at Bournemouth University. The proposal outlined her wish to develop a stand-alone mobile learning resource for health workers who care for families of overweight or obese children, and for families who need to identify individual needs to facilitate behavioural changes.

Afbeeldingsresultaat voor childhood obesity statistics uk, 2016

The development of this project pivoted on putting patients and the public in the centre of the process. Patients and the public were engaged through focus groups where insights were gathered to identify the challenges and issues to the problem. A series of online focus groups were undertaken with service users and professionals to understand the key challenges and issues respondents came across when trying to prevent/manage overweight and obesity. Key themes from the focus groups were:

  • Empowering – the solution needs to recognise the experiences people bring and therefore the tools need to be empowering in supporting families to address obesity.
  • Parenting tips – to address challenges with encouraging positive health behaviours with children.
  • Responding to barriers – from parent/carers who are being supported by health professionals.
  • Obesity isn’t a quick fix – recognising that sustained behaviour change takes time and support to overcoming barriers is vital.
  • Healthy snacks and activities – provide easy and simple ideas to support parents/carers and professionals to identify quick ways to support healthier eating and increase activity.
  • Portion size – understanding that portion size is important in addition to eating healthily.

Topic experts were identified and invited to join the project steering group where they provided the governance and steer of the overall development of this project whilst Denyse King wrote the content. The following Apps have been developed as a result and will be available to all as free download in IOS and Android platforms from late September 2017:

  • NoObesity Family Focused App – After consultation with a healthcare worker, families set health goals, identify potential barriers and strategies to overcome them, record their progress towards their goals, earning points and awards as they go. Families are encouraged to link accounts to healthcare professional accounts (see below). The tool also includes parenting tips, games and useful links.
  • NoObesity Professional Focused App– Healthcare professionals can see the goals, barriers, strategies, progress, points and awards of linked families, making them better able to provide tailored advice to the families, to help them achieve their goals. This is based on research findings that ‘one-size- fits-all’ health advice simply doesn’t work for most families. The tool also includes the Wessex MECC-based guidance on how to best support families, how to handle common objections, games and useful links.

Denyse would like to thank Dr. Joanne Newton project proposal support, Felicity Hargreaves and Helen Bingham for approval of the final project proposall. Thanks to all those who contributed to answering the research questions, as well as those who tested and fed back on the prototype, and also to Bournemouth University, University of Southampton, and NHS England for their support of this project.

 

List of the members of the steering group

Name Job Title Organisation Steering Group Role
Em Rahman Head of Public Health Workforce Development Programmes Health Education England (Wessex) Steering Group Chair
Alison Potter Technology Enhanced Learning Lead (South) Health Education England (South) Deputy-Chair
Dr. Jenny Godson (MBE) National Lead for Oral Health Improvement Public Health England Dental and dental aspects of nutrition
Prof. Edwin van Teijingen Professor – Centre for Midwifery, Maternal & Perinatal Health Bournemouth University Research supervision and education governance
Dr. Juliet McGrattan General Practitioner Cumbria Medical Chambers GP role governance
Kate King-Hicks Health and Wellbeing Programme Lead Public Health England (South East) Obesity governance
Tony Hewett Intervention Manager and behaviour change specialist Miltoncross Academy School staff role governance
Dr. Jo Walker Consultant Paediatrician Portsmouth Hospitals Trust Consultant doctors role governance
Dr. Wendy Marsh Lead Midwife for Safeguarding Portsmouth Hospitals Trust Safeguarding governance
Kate Lees Consultant in Public Health and Dietitian Lees & Latouze Nutrition governance
Denyse King Lecturer in Midwifery and Public Health Practitioner Bournemouth University Content author and governance

HE Policy update – week ending 4 August **updated**

TEF

Wonkhe bloggers imagine alternative ways to run (ideally improve) the TEF in Visions for the AlterniTEF – can we do TEF better?  Ideas ranged from:

  • individual institution-specific targets as a condition of registration OfS (and therefore accountable under the Higher Education and Research Act);
  • metrics produced through relational analyses and cross referencing – this complex idea stemmed from measuring the quality and impact of reciprocal relationships;
  • individual learning statements setting institutional goals which the provider would be measured against – similar to current Fair Access Agreement;
  • ignoring undergraduate TEF and focusing on bringing post-graduate TEF online, including the influence of social capital and the added value of the post-graduate qualification on social mobility. This approach controversially espouses a metrics only approach and abolishes the provider statements.

Wonkhe also continue to unpick the influence of the provider statement in changing an institution’s initial metrics-based TEF rating. Marking the TEF creative writing challenge suggests the panel compensated providers who appeared to be effectively addressing poor NSS scores, took into account a London effect, and rewarded institutions with successful outcomes for part time study.

 

Brexit and Erasmus

A Times Higher article on the alternative to Erasmus post-Brexit highlights the downsides inherent in an Erasmus alternative. The EU exit agreement will determine whether the UK continues to participate in Erasmus, however, the government is currently pursuing a hard line on free movement which decreases the likelihood Erasmus would continue in its current form. An alternative is to establish bilateral agreements to exchange students with key European universities – just as we do now with international institutions. However, the article highlights the negative impact on social mobility – bilateral agreements mean the students must cover their own costs to some extent – decreasing the likelihood lower income students could afford to participate. While the obvious answer (to divert the UK’s contribution to the EU budget which funds Erasmus to a home-grown scheme) seems reasonable the budget required would be in excess of €113 million and the government have yet to confirm this as an option. Furthermore the time and administrative costs for universities to individually negotiate grants and agreements is excessive. The article also touches on lower demand from EU students to come to the UK suggesting exchanges may not be viable.

Parliamentary Questions

Q: Catherine West: What discussions he has had with the Secretary of State for Education on the future of the UK’s participation in the Erasmus scheme.

A: Mr Steve Baker: The Department has regular conversations with officials and Ministers from other governmental departments about a range of policy issues arising from EU exit. With regards to the Erasmus+ programme, the Government recognises the value of international exchange and collaboration in education as part of our vision for the UK as a global nation. There may be European programmes in which we wish to continue to participate after we exit. This will be considered as part of ongoing negotiations with the European Union

Brexit – staff and students

The Russell Group published 10 points requiring greater clarity in response to the UK Government’s position on EU nationals. This included calling for:

  • ensuring academic and student time abroad for study, training, career development and research purposes does not negatively impact on continuous residency
  • interpreting ‘strong ties’ broadly to ensure academics and students spending 2+ years abroad do not lose their settled status once this has been established
  • EU students starting courses in 2017/18 and 2018/19 should be able to stay and work here after their studies and be eligible for settled status after accruing five years residence
  • ensuring that professional qualifications obtained in either the UK or the EU before the UK’s withdrawal continue to be recognised across borders

 

Education-related exports and transnational education activity

The government released experimental statistics estimating the value of exports from the UK education section, the respective contribution of the higher and further education sectors, and transnational activity for 2010-2014. (Transnational education is education provided in a country different to that of the awarding institution.) The total value was estimated to be £18.76 billion – an increase of 18% against 2010. HE was the main contributor accounting for 92% of the total value, with revenue from transnational education contributing the remaining 8%. The full report is here.

Accompanying the experimental statistics is a report analysing the value of transnational education to the UK (originally published November 2014). The report discusses the benefits of transnational education to UK HE institutions (see page 11 for a summary).

 

Nursing & midwifery places

The Royal College of Nursing spoke out this week highlighting the discrepancy between the Government’s plans to expand the mental health workforce and the significant downturn in nursing applications attributed to the introduction of fees and the withdrawal of the NHS bursary. The Government has earmarked £1.3 billion for mental health services, pledging to treat an additional one million patients by 2020-21 through 24/7 services. The RCN says there is already a dangerous lack of workforce planning and accountability, and warns the Government will need to work hard just to get back to the number of specialist staff working in mental health services in 2010. They state that under this Government there are 5,000 fewer mental health nurses.

Janet Davies, RCN Chief Executive & General Secretary, expressed skepticism at the government’s plans and stated: “If these nurses were going to be ready in time, they would be starting training next month…but we have seen that the withdrawal of the bursary has led to a sharp fall in university applications and we are yet to see funding for additional places.” [The government previously stated the removal of bursaries will mean an additional 10,000 training places for healthcare students could be made available by 2020.]

On the ending of the bursary Jon Skewes, Director, at Royal College of Midwives (RCM) said: ‘We believe this decision is a fundamental mistake by the government and have warned about the wide reaching implications of removing the student midwifery bursary given the existing crisis in our maternity services. In England alone we remain 3500 midwives short. This, coupled with younger midwives leaving, an ageing workforce and the loss of EU midwives post-Brexit, means the RCM has grave concerns for staffing our maternity services. The government has completely ignored RCM advice to make any loans forgivable if students then go to work in the NHS. The axing of the bursary and introduction of tuition in England will without doubt worsen the current shortage of midwives.’

 

Tuition Fees

The Centre for Policy Studies released an Economic Bulletin on tuition fees: Wealthy Graduates: The Winners from Corbyn’s tuition fees plan. It reiterates known messages including increases in disadvantaged pupils accessing HE and the social unfairness of expecting non-graduates to subsidise education for degree students. It also makes the following points:

  • The maximum fee ceiling is charged by most universities, there is little differentiation. This means the intended competitiveness was unsuccessful as there is no clear link between tuition fees paid and job prospects. (See page 8 of the full report for more detail.) While TEF still intends to differentiate fees paid on quality the scale of the difference is limited.
  • It calls on ministers to avoid retrospectively increasing graduate’s fee repayments, to consider reducing loan interest rates, and to incentivise courses linking to labour shortages.
  • It also recommends policy makers consider intergenerational fairness but without abolishing tuition fees
  • Scotland’s previous no tuition fee policy which resulted in a student numbers cap means their social mobility outcomes are lower than England’s.

Widening Participation

Statistics – progression and outcome

The Department for Education have published statistics on the 2014/15 entry cohort –  Widening Participation in HE. These are the regular annual statistics detailing young participation in HE with social background comparisons and graduate outcomes. Headlines:

  • The progression rate of free school meals (FSM) pupils has increased, but so has the gap between FSM and non-FSM. Page 5 has a diagram breaking this down by region.
  • The state school Vs independent school gap in progressing to the most selective HE institutions has widened slightly
  • Graduate outcomes – disadvantaged students employed in the most advantaged occupations is up by 1%, although the gap between most and least advantaged students in these high-end jobs remains static at 6%.

School-age attainment trends

The Education Policy Institute has published Closing the Gap? Trends in Educational Attainment and Disadvantage. The report focuses on school aged children analysing the attainment gaps between children from disadvantaged backgrounds and their peers plus other pupil characteristics. It covers the progress made, the enduring challenges (including magnitude of learning gaps and lack of progress for the most persistently disadvantaged pupils). It recommends an additional 8 local authority districts on top of the 12 Opportunity Areas currently identified by the Department for Education. Finally, it states that without significant acceleration in the rate at which gaps are being addressed it take until 2070 before disadvantaged children did not fall further behind other students during their time in education.

 

UK UG Vs International Student numbers

The Sunday Times led with an article claiming universities recruitment of the financially more lucrative international students was crowding out intake of UK undergraduates: Universities take foreign students ahead of British.

The sector responded on Twitter and Wonkhe set out what is misleading in the Times article in their blog: What the Sunday Times got Wrong. This states that the Times article used inappropriate statistics and reminded that UK school leavers now enter university at the highest ever levels.

David Morris (Wonkhe) writes: when I confronted Gilligan about this on Twitter, his response suggested (to me at least) a realisation that a mistake had been made. He argued that his piece “was mainly about the fact that non-EU undergrads are admitted with lesser qualifications” and that we shouldn’t suggest that part-time and second degree students “don’t count”.

In his critique Morris also acknowledges the difficulty navigating HESA statistics for the uninitiated: HESA’s website is not the easiest to use, and one could easily look at overall undergraduate numbers and make an assumption about a story that simply isn’t there. I would urge HESA to make finding historic data more ‘journalist friendly’ for hacks with a deadline. To write this piece I have had to have six different tabs open on HESA’s website, plus three different Excel sheets and the HESA mobile app. No wonder mistakes can be made.

 

Case Studies

Universities UK have published a directory of case studies illustrating how universities are tackling harassment, violence against women and hate crime. The case studies cover a range of areas including prevention, improving incident reporting procedures, effective responses, student and staff training, and good practice.

 

First PhD in Project Management from the Faculty of Management

Yogarajah Nanthagaopan has successfully completed the first PhD in Project Management from the Faculty of Management. He was supervised by Dr Nigel L. Williams and Professor Stephen Page and his thesis was titled: A Resource Based Perspective on Project Management in NGOs. Dr Nanthangaopan has returned to his native Sri Lanka and is the current Head of Economics and Management department and Coordinator for the BBM in Project Management degree program at the Faculty of Business Studies, Vavuniya Campus of the University of Jaffna, Sri Lanka.

Good month for BU reproductive health publications

This month has been exceptionally good for BU publications in the field of midwifery and maternity care.  Two PhD students has their articles published in international academic journals, one member of staff had a textbook chapter published, an interdisciplinary team has been accepted for publication in the British Journal of Midwifery, and a member of the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) co-authored this month’s editorial in the Journal of Asian Midwives  as well as an epidemiology paper on the HPV (Human Papilloma Virus) in Nepal.  

The first of this success story was CMMP PhD student Preeti Mahato whose  her latest paper ‘Factors related to choice of place of birth in a district in Nepal’ appeared in the Elsevier journal Sexual & Reproductive Healthcare  [1].  The second PhD paper was also based on research in Nepal this time by Sheetal Sharma whose paper ‘Evaluation a Community Maternal Health Programme: Lessons Learnt’ appeared in Journal of Asian Midwives [2].  The textbook chapter was by Dr. Jenny Hall who contributed a chapter to the latest edition of Mayes Midwifery , which is the classic midwifery textbook and now in its 15th edition [3].  The interdisciplinary paper is by Angela Warren, service user and carer coordinator PIER partnership, Dr Mel Hughes, principal academic in social work, academic lead for PIER partnership, and  Dr Jane Fry and Dr Luisa Cescutti-Butler who are both senior lecturers in midwifery in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) [4]. The latest issue of the Nepal Journal of Epidemiology carried a CMMPH co-authored paper on the HPV in young women in Nepal [5].   The final piece, an editorial, appeared yesterday in the latest issue of the Journal of Asian Midwives [6].


Congratulations to all authors!

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1. Mahato, P., van Teijlingen, E., Simkhada, P., Sheppard, Z., Silwal, R.C. (2017)  Factors related to choice of place of birth in a district in Nepal, Sexual & Reproductive Healthcare 13 : 91-96.
  2. Sharma, S., Simkhada, P., Hundley, V., van Teijlingen, E., Stephens, J., Silwal, R.C., Angell, C. (2017) Evaluation a Community Maternal Health Programme: Lessons Learnt. Journal of Asian Midwives. 4 (1): 3–20.
  3. Hall, J. (2017) ‘Fertility and it’s control’ In: Macdonald, S. & Johnson, G.  Mayes’ Midwifery, 15th Edition,  London: Elsevier.
  4. Warren, A., Hughes, M., Fry, J., Cescutti-Butler, L. (2017) ‘Involvement in midwifery education: experiences from a university service user and carer partnership’ British Journal of Midwifery (forthcoming).
  5. Sathian, B., Babu, MGR., van Teijlingen, E.R., Banerjee, I., Subramanya, H.S., Roy, B., Subramanya, H., Rajesh, E., Devkota, S. (2017) Ethnic variation in perception of Human Papillomavirus and its Vaccination among young women in Nepal, Nepal Journal of Epidemiology 7 (1): 647-658.  http://www.nepjol.info/index.php/NJE/article/view/17757
  6. Jan, R., van Teijlingen, E. (2017) Exciting Times in South-Asian Midwifery, Journal of Asian Midwives 4 (1):1

New publication Sheetal Sharma (PhD graduate 2017)

Congratulations to Sheetal Sharma whose latest article appeared in today’s new issue of Journal of Asian Midwives [1]. Sheetal wrote the paper ‘Evaluation a Community Maternal Health Programme: Lessons Learnt’ with her PhD supervisors Dr. Catherine Angell, Prof. Vanora Hundley, Prof. Edwin van Teijlingen and Prof. Padam Simkhada (Liverpool John Moores University & FHSS Visiting Professor) and the director of Green Tara Nepal Mr. Ram Chandra Silwal and the founder of Green Tara Trust, London, Dr. Jane Stephens. The Journal of Asian Midwives is an Open-Access journal hence this article is freely available across the globe.

(c) Sheetal Sharma

Focus groups in open air in rural Nepal, (c) Sheetal Sharma

 

Reference:

Sharma, S., Simkhada, P., Hundley, V., van Teijlingen, E., Stephens, J., Silwal, R.C., Angell, C. (2017) Evaluation a Community Maternal Health Programme: Lessons Learnt. Journal of Asian Midwives. 4(1): 3–20.

New publication by FHSS PhD student

Congratulations to Faculty of Health & Social Sciences (FHSS) PhD student Folashade Alloh and Dr. Pramod Regmi, newly appointed lecturer in International Health.  They just published ‘Effect of economic and security challenges on the Nigerian health sector’ in the journal African Health Sciences.  The paper is Open Access and can be found here!

Well done!

 

Prof. Edwin van Teijlingen

CMMPH

New maternity research paper on Nepal

Congratulations to Preeti Mahato, PhD student in the Centre for Midwifery, Maternal & Perinatal Health, on the publication of her latest paper ‘Factors related to choice of place of birth in a district in Nepal’ in the Elsevier journal Sexual & Reproductive Healthcare  [1].  The paper based on her research work in Nawalparasi, southern Nepal.  This new paper is the third paper form Preeti’s PhD work [2-3].

 

Reference:

  1. Mahato, P., van Teijlingen, E., Simkhada, P., Sheppard, Z., Silwal, R.C. (2017)  Factors related to choice of place of birth in a district in Nepal, Sexual & Reproductive Healthcare 13 : 91-96.
  2. Mahato, P., van Teijlingen, E., Simkhada, P., Angell, C. (2016) Birthing centres in Nepal: Recent developments, obstacles and opportunities, Journal of Asian Midwives 3(1): 18-30. http://ecommons.aku.edu/cgi/viewcontent.cgi?article=1033&context=jam
  3. Mahato, P.K., Regmi, P.R., van Teijlingen, E., Simkhada, P., Angell, C., Sathian, B. (2015) Birthing centre infrastructure in Nepal post 2015 earthquake. Nepal Journal of Epidemiology 5(4): 518-519. http://www.nepjol.info/index.php/NJE/article/view/14260/11579