Category / Research communication

UK government sets out bold vision for the future of clinical research delivery

Patients, clinicians and researchers across the whole of the UK are set to benefit from the ambitious vision for the future of clinical research delivery according to this press release from the UK Government.

The plan includes:

  • Strengthening the UK’s renowned research expertise as a world-leader in designing and delivering research
  • An ambitious vision to unlock the true potential of research putting patients and NHS at its heart
  • Using the lessons from COVID-19 to build back better, the government will create a patient-centred, pro-innovation and digitally-enabled research environment.

Saving and improving lives: the future of UK clinical research delivery, published on March 23rd was developed by the UK government and devolved administrations. The policy paper sets out how they will deliver faster, more efficient and more innovative research – from the streamlining of costing, contracting and approvals processes to the Health Research Authority’s rapid ethics review pilot, which aims to halve the time to provide a final opinion for research applications.

Using best practice, it is hoped that participating in research will become more accessible, increasing diversity and allowing more people across the whole of the UK to take part. They will work with Centres of Excellence, such as the Centre for BME Health in Leicester, and there will be more support for research in more diverse and under-served communities and innovative approaches.

The NHS will be encouraged to put delivery of research at the heart of everything they do, making it an essential and rewarding part of effective patient care. This included building a culture across the NHS and all health and care settings that is positive about research, where all staff feel empowered and supported to take part in clinical research delivery as part of their job.

The vision is built around 5 key themes:

  1. Clinical research embedded in the NHS: to create a research-positive culture in which all health and care staff feel empowered to support and participate in clinical research as part of their job.
  2. Patient-centred research: to make access and participation in research as easy as possible for everyone across the UK, including rural, diverse and under-served populations.
  3. Streamlined, efficient and innovative research: so the UK is seen as the best place in the world to conduct fast, efficient and cutting-edge clinical research.
  4. Research enabled by data and digital tools: to ensure the UK has the most advanced and data-enabled clinical research environment in the world, building on our unique data assets to improve health and care.
  5. A sustainable and supported research workforce: which offers rewarding opportunities and exciting careers for all healthcare and research staff of all professional backgrounds – across both commercial and non-commercial research.

The vision reflects the ambition of all 4 UK governments and has been developed through a broad cross-sector approach involving NHS, medical research charities, life sciences industry and academia. Continued collaboration across sectors and organisations will ensure the key action areas will be delivered.


Remember – support is on offer at BU if you are thinking of introducing your research ideas into the NHS – email the Research Ethics mailbox, and take a look at the Research Governance and Integrity website.

Conversation article: How lockdown changed the sex lives of young adults – new research

Lockdown significantly affected our health (for good and bad), our work and how we socialise. These consequences have been widely discussed, but far less attention has been given to the effect on our sex lives.

When lockdown came into force in the UK in March 2020, people from outside the same household were not allowed to meet indoors, and only at set distances outdoors. This meant that sex between people who didn’t live together was effectively criminalised.

In some ways, these restrictions disproportionately affected young adults, who are more likely than older adults to be exploring their sexuality and developing romantic relationships. But the impact of lockdown on people’s sexual desires and sex lives and how this affected their sense of wellbeing was not known. We decided to find out.

For our study, we surveyed 565 people aged 18-32 in the UK at the end of peak lockdown restrictions in May 2020. People were recruited using a survey recruitment site. They were a convenience sample, meaning they were people who were easily available rather than representative of the population as a whole.

Respondents were asked if they engaged in a list of sexual activities both before lockdown and during lockdown. This included intercourse, solo masturbation, and watching pornography. They were also asked to rate their health and wellbeing.

The number of respondents who engaged in each of these activities during lockdown decreased compared with before lockdown. The biggest decrease was for sex with a partner, with just over a quarter of respondents stopping this activity during lockdown (25.5%).

For those participants who continued to engage in sexual activities, we also asked whether the frequency increased or decreased during the period. There were both increases and decreases. Regarding increases, just over a quarter (26%) of people masturbated more often on their own, 20% reported having more intercourse with their partner, and 20% reported watching more pornography on their own.

Yet the same three sexual activities also decreased in frequency for some participants, with a third of people having less sex with their partner, a quarter masturbating alone less, and around a fifth (22%) watching less pornography alone.

People were more likely to report increases in sexual activity if they were male, in a serious relationship, and if they weren’t heterosexual.

We also investigated sexual desire. In our sample, women reported lower sexual desire than men overall, with a significant decrease in sexual desire during lockdown compared with before lockdown. Women with a greater enjoyment of casual sex reported a greater perceived effect of lockdown on their wellbeing.

Our findings, which are published in the Journal of Sex Research, support other reports into the effects of lockdown restrictions. Lockdown measures have disproportionately affected some groups more than others. The reported increase in domestic chores and stress for women during the lockdown may explain the decrease in sexual desire and the negative effect on wellbeing.

Moving out of lockdown

There are many health benefits, both physical and mental, to engaging in regular sexual activity. Sex can be an important component of people’s lives and their identity, particularly for sexual minorities.

There are other concerns about COVID-19 and sexuality. Most sexual health and reproductive services in the UK have been severely limited or closed. There is evidence that access to condoms and contraception was disrupted for young adults during social lockdown.

Some sexual health charities have been offering home testing kits of sexually transmitted infection screenings, but there will be people who do not or cannot use these services. Similarly, there is evidence that birth rates have dropped significantly over the year, which might lead to an associated large increase in births over the next 12 months once people see some stability returning to their lives.

As the UK follows the road map out of lockdown, it is important to consider how those whose sex lives have been restricted will respond to the extra freedom. It has been suggested that we could see a new “roaring 20s” as we return to a new sense of normality.

Government policy ignored sex during lockdown. It needs to actively support sexual health and wellbeing as we return to some kind of normality.

Liam Wignall, Lecturer in Psychology, Bournemouth University and Mark McCormack, Professor of Sociology, University of Roehampton

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health Research Authority UPDATE: undergraduate and master’s research projects

Please see below for a further update from the HRA on Master’s and undergraduate research. Any queries or concerns please email Suzy Wignall, Clinical Governance Advisor.

Update on student research – new eligibility criteria from 1 September 2021

The HRA and the devolved administrations, supported by the Wessex Institute at the University of Southampton, have reviewed their approach to study approval for student research.
The review aimed to ensure students have the best learning experience of health and social care research, and to reduce the time that the HRA, DAs and NHS Research Ethics Committees (RECs) spend advising on and reviewing student applications.

In March 2020 we paused student research approvals to create capacity for urgent COVID-19 research. Now, from 1 September 2021, we are introducing new eligibility criteria for standalone student research.


New critera

The new criteria mean that some Master’s level students will be able to apply for ethics review and HRA/HCRW Approval or devolved administration equivalent. Standalone research at undergraduate level that requires ethics review and/or HRA/HCRW Approval (or devolved administration equivalent) cannot take place. Arrangements for doctoral research remain unchanged.

Full details are in table one – permitted student research table. We’ve also made it clear when students are able to take the role of Chief Investigator, see table two – which type of students may act as Chief Investigator?


Alternative ways of learning about health and social care research

It is possible for students to learn about health and social care research without completing standalone projects. Looking at other ways to build skills and experience better reflects modern research and emphasises team science. View the video of our event ‘Exploring good practice in Student Research’ to hear from course leaders about how successful these alternative approaches have been (registration is required to view) or read our website for further information and ideas: https://www.hra.nhs.uk/student-research/.


Queries

If you have any queries about the eligibility criteria, please contact queries@hra.nhs.uk.

Conversation article: Sea levels are rising fastest in big cities – here’s why

It is well known that climate-induced sea level rise is a major threat. What is less well know is the threat of sinking land. And in many of the most populated coastal areas, the land is sinking even faster than the sea is rising.

Parts of Tokyo for instance sank by 4 metres during the 20th century, with 2 metres or more of sinking reported in Shanghai, Bangkok, and New Orleans. This process is known as subsidence. Slow subsidence happens naturally in river deltas, and it can be accelerated by the extraction of groundwater, oil or gas which causes the soil to consolidate and the surface to lose elevation.

Subsidence leads to relative sea level rise (sea level rise plus land sinking). It turns croplands salty, damages buildings, causes widespread flooding and can even mean the loss of entire coastal areas.

Subsidence can threaten flooding in low-lying coastal areas, much more so than rising sea levels, yet scientists are only just realising the global implications of the threat with respect to coastal cities.

In fact, while the average coastal area experiences relative sea level rise of less than 3mm per year, the average coastal resident experiences a rise of around 8mm to 10mm per year. This is because so many people live in deltas and especially cities on deltas that are subsiding. That’s the key finding of our new research, where we analysed how fast cities are sinking across the world and compared them with global subsidence data including less densely populated coastlines.

Map showing relative sea level rise in 23 coastal regions around the world.
When weighted by population, relative sea level rise is worst in south east Asia, followed by south and east Asia, and the southern Mediterranean.
Nicholls et al, CC BY-SA

Our finding reflects that people often choose to live in river deltas, floodplains and other areas that were already prone to sinking, and in doing so will further enhance subsidence. In particular, subsiding cities contain more than 150 million people in the coastal zone – that’s roughly 20% of people in the world who live by the sea. This means relative sealevel rise will have a more sudden and more severe impact than scientists had originally thought.

Here are a few of the most affected cities:

Jakarta

The Indonesian capital Jakarta is home to 10 million people, and is built on low-lying land next to the sea. Groundwater extraction caused the city to sink more than three metres from 1947 to 2010 and much of the city is still sinking by 10cm or more each year.

Subsidence does not occur evenly, leading to uneven risks that make urban planning difficult. Buildings are now flooded, cracks are appearing in infrastructure which is being abandoned.

Jakarta has built higher sea walls to keep up with the subsidence. But since groundwater pumping continues, this patching-up policy can only last so long before the same problems occur again. And the city needs to keep pumping since groundwater is used for drinking water. Taking water, the very thing that humans need to survive, ultimately puts people at risk from inundation.

The battle against subsidence is slowly being lost, with the government proposing in 2019 to move the capital to a purpose-built city on the island of Borneo more than 1,000km away, with subsidence being one of many reasons.

Shanghai

Developing rapidly in the past few decades, and now with a population of 26 million, Shanghai is another sinker. The city has maximum subsidence rates of around 2.5cm a year. Again this is mostly caused by lowering groundwater levels, in this case thanks to drainage to construct skyscrapers, metro lines and roads (for instance Metro Line 1, built in the 1990s, caused rapid subsidence).

Body of water in front of lots of skyscrapers.
Shanghai is found where the river Yangtze meets the sea.
John_T / shutterstock

If no additional protection is built, by 2100 this rate of subsidence and sea level rise mean that a storm surge could flood around 15% of the city.

New Orleans

In New Orleans, centuries of embankments and ditches had effectively drained the city and sunk it, leaving about half of it below sea level.

Map of New Orleans with shaded areas below sea level.
Much of New Orleans is below sea level (red) and relies on sea walls to stay dry.
The Data Center, New Orleans, CC BY-SA

When Hurricane Katrina breached the levees in 2005, the city did not stand a chance. The hurricane caused at least US$40 billion (£29 billion) in damage and particularly took its toll on the city’s African American community. More than 1,570 people died across the state of Louisiana.

If the city had not subsided, damage would have been greatly reduced and lives would have been saved. Decisions that were made many decades or more ago set the path for the disasters that are seen today, and what we will see in the future.

There are no simple solutions

So what can be done? Building a sea wall or dike is one immediate solution. This of course stops the water coming in, but remember that the sea wall is sinking too, so it has to be extra large in order to be effective in the long-term. In urban areas, engineers cannot raise ground easily: that can take decades as buildings and infrastructure are renewed. There is no simple solution, and large-scale urban subsidence is largely irreversible.

Some cities have found “solutions”. Tokyo for instance managed to stop subsidence from about 1960 onwards thanks to stronger regulations on water pumping, but it cannot get rid of the overall risk as parts of city are below sea level and depend on dikes and pumps to be habitable. Indonesia’s bold proposal to move its capital city may be the ultimate solution.

Increased urbanisation especially in deltas areas and the demand for freshwater means subsidence will remain a pressing issue in the coming decades. Dealing with subsidence is complementary to dealing with climate-induced sea level rise and both need to be addressed. A combination of rising seas and sinking lands will increasingly leave coastal cities at risk.

Sally Brown, Scientist, Bournemouth University and Robert James Nicholls, Professor of Climate Adaptation, University of East Anglia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Conversation article: Coronavirus one year on: two countries that got it right, and three that got it wrong

On March 11 2020, the World Health Organization declared that the COVID-19 public health emergency had become a pandemic: 114 countries were affected, there were 121,500 confirmed cases and more than 4,000 people had succumbed to the virus.

One year on, we have now seen 115 million confirmed cases globally and more than 2.5 million deaths from COVID-19.

“Pandemic is not a word to use lightly or carelessly,” said the Director-General of the WHO, Tedros Adhanom Ghebreyesus on that day in 2020. But in the year since that announcement, the fates of many countries have depended on how leaders have chosen their words.

The impact of the pandemic was unprecedented and all governments faced challenges dealing with a severe but highly unpredictable threat to the lives of their citizens. And some governments responded better than others.

My colleagues and I recently carried out a comparative study of how 27 countries responded to the emergence of the virus and first wave, and how they communicated that response to their citizens.

We invited national experts to analyse their government’s communication style, the flow of information on coronavirus and the actions taken by civil society, mapping these responses onto the numbers of cases and deaths in the country in question. Our work reveals contrasting responses that reflect a nation’s internal politics, suggesting that a government’s handling of the pandemic was embedded in existing patterns of leadership.


Read more of our coverage of the first anniversary of the pandemic:

COVID-19: how to deal with a year of accumulated burnout from working at home

Pandemic babies: how COVID-19 has affected child development


With news of the spread of COVID-19 flowing across international borders, domestic preventative measures needed to be explained carefully. The WHO proved ill-equipped, provided equivocal and flawed advice regarding international travel, even from Hubei province, and equivocated on the efficacy of wearing masks. So much came down to how individual leaders communicated with their citizens about the risks they faced.

Experts in crisis management and social psychologists emphasise the importance of clarity and empathy in communicating during a health emergency.

So who did well and who missed the mark?

South Korea and Ghana

We found two major examples of this style of communication working well in practice. South Korea avoided a lockdown due to clearly communicating the threat of COVID-19 as early as January, encouraging the wearing of masks (which were common previously within the nation in response to an earlier Sars epidemic) and quickly rolling out a contact-tracing app.

Each change in official alert level, accompanied by new advice regarding social contact, was carefully communicated by Jung Eun-Kyung, the head of the country’s Centre for Disease Control, who used changes in her own life to demonstrate how new guidance should work in practice.

A graph showing coronavirus case numbers for the UK, Brazil, India, South Korea and Ghana
Our World in Data, CC BY

The transparency of this approach was echoed in the communication style of the Ghanaian president, Nana Addo Dankwa Akufo-Addo.

Akufo-Addo took responsibility for coronavirus policy and explained carefully each measure required, being honest about the challenges the nation faced. Simple demonstrations of empathy earned him acclaim within his nation and also around the world.

“We know how to bring the economy back to life. What we don’t know is how to bring people back to life,” he famously said.

Brazil, the UK and India

South Korea and Ghana adopted a consistent tone highlighting the risks of the new pandemic and how they could be mitigated. Nations that fared less well encouraged complacency and gave out inconsistent messages about the threat of COVID-19.

In March 2020, just three weeks prior to placing the country under lockdown and catching COVID-19 himself, UK Prime Minister Boris Johnson downplayed the threat, and said he had been shaking hands with infected people, against the recommendations of his expert advisers. Today, the UK has one of the highest per capita death rates from COVID in the world.

Avoiding a full initial lockdown, Brazilian president Jair Bolsonaro – who also contracted COVID-19 – called for normality to continue, challenging expert guidance and polarising opinion along partisan lines. Such practices led Brazilians to mistrust the official information and spread of misinformation, while adhering to containment measures became an ideological, rather than a public health, question.

Meanwhile, Indian prime minister, Narendra Modi, announced a snap lockdown with just four hours notice, which caused an internal migration crisis, with poor labourers leaving cities to walk hundreds or thousands of miles to their rural homes. Understandably, the labourers prioritised their fears of homelessness and starvation over the risk of spreading COVID-19 around the country.

None of these responses effectively considered the impact that coronavirus would have on society, or that credibility is earned through consistency. The poor outcomes in each case are a partial reflection of these leadership mistakes.

Bad luck or bad judgement?

Of course, the unfolding of the pandemic was not solely down to good or bad communication from leaders. Health systems and demographics may also have played a role, and the worst impacted nations not only had strategic weaknesses but are also global transport hubs and popular destinations – London, New York, Paris and so on. With hindsight, closing borders would have been wise, despite the contrary advice from the World Health Organization.

Still, it’s evident that leaders who adopted clear, early, expert-led, coherent and empathic guidance fared well in terms of their standing with the public and were able to mitigate the worst effects of the virus.

On the other hand, those who politicised the virus, exhibited unrestrained optimism or took to last-minute decision-making oversaw some of the nations with the most cases and deaths.

Darren Lilleker, Professor of Political Communication, Bournemouth University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Conversation article: Three ways to ensure ‘wellness’ tourism provides a post-pandemic opportunity for the travel industry

The effects of COVID-19 vaccination programmes have led to a glimmer of hope that some of the things we used to enjoy may soon be part of our lives once again. High on many people’s priority lists will be foreign travel.

In the UK, the official declaration of a “roadmap” to normality was quickly followed by a surge in online bookings for flights and holidays. This is a welcome development for one of the industries hardest hit by the pandemic. It is good news for countries that depend on tourism, and it is undoubtedly good news for people who are desperate to get away.

Importantly, it is also a step towards an end to the uncertainty and isolation that in 2020 led to warnings of a global mental health crisis.

The pandemic also raised awareness of the importance of “wellness” – a state of physical, mental and social wellbeing – in people’s lives. Even without a pandemic to deal with, attempting to achieve this state is the basis of a global industry said to be worth around US$4.5 trillion a year.

The travel side of this, “wellness tourism”, was worth US$639 billion globally in 2017, a figure expected to increase to US$919 billion by 2022.

And while wellness tourism was growing rapidly before COVID-19 struck, last year saw a reported growth in internet searches about travel to “wellness destinations]”.

Destination-wise, places known for yoga, meditation and pilgrimage routes, such as Chiang Mai in Thailand and Bali in Indonesia, stand to benefit from increased demand.

Our own tourism research leads us to believe that countries which actively improve infrastructure to target wellness tourism will enjoy a particular boost in any post-COVID period.

shutterstock.

To make sure of this, governments and tourism authorities need to optimise wellness tourism resources. Here are three things they should consider:

1. Encourage domestic tourism

One widespread response to the pandemic was the rediscovery of local natural beauty. New Zealanders for example, prohibited from international travel, flocked to the remote and previously under-visited Chatham Islands. Cambodians capitalised on the absence of some three million annual tourists to visit the Angkor Wat World Heritage site.

The pandemic has been seen as a time to reset longstanding social imbalances that barred local people from enjoying their own spaces. Not only would improved domestic tourism help support local businesses at these destinations, but it would also contribute to the wellbeing of the communities who live close to them.

2. Understand differences

Wellness can mean different things to different people and cultures. In Indonesia, the Balinese travel to religious or spiritual sites for rituals linked to their ancestors and families. This runs parallel to most western tourists’ experiences in Bali, who often visit centres targeted at their personal requirements, with spa treatments or yoga classes. Although westerners generate more profits than locals, it is important for the wellbeing of the surrounding community to ensure equal access to these sites.

Local Balinese yoga instructors often lack the marketing and financial resources to attract global wellness tourists. During the pandemic, some foreign-owned facilities (such as Yoga Barn, one of the most popular studios for westerners) sustained their business through digital video platform. Meanwhile, local facilities struggled without the technical skills and hardware to compete. And while large resorts are well positioned to benefit from post-pandemic wellness travel, they usually provide only low-paid jobs to locals. Support should be provided for small, locally owned wellness tourism businesses as well.

3. Support the small scale

The lack of social sustainability has often plagued tourism development schemes. Our concern is that as tourism gradually opens up again, businesses and governments will simply focus on the high-end luxury wellness market. They may look to smaller numbers of wealthy tourists to remedy economic damage, limit the possibility of spreading the pandemic, and mitigate the high costs of hospitalising sick visitors.

But they would be misguided to focus solely on this competitive niche. Many high-value tourism businesses are owned by foreign investors without local involvement or economic benefit. Local governments, tourism authorities, large businesses and international organisations must support community-based, small-scale enterprises in remote areas to build a more comprehensive wellness tourism sector.




Read more:
How Bali could build a better kind of tourism after the pandemic


Overall, wellness tourism programmes should be developed in a way that empowers local communities, helps to reduce economic inequality and creates new livelihoods, especially in rural areas where poverty rates are high. It should also be developed beyond the popular destinations of Thailand and India to include poorer destinations, such as Laos, Nepal and Sri Lanka.

For while wellness tourism was gaining attention before the COVID period, the trend
will probably continue as COVID restrictions (hopefully) ease. And with the necessary pause in arrivals right now, the industry has an opportunity to reflect on how to create a more sustainable approach to everyone’s wellbeing, wherever they live.

Jaeyeon Choe, Senior Academic in Sustainable Tourism Development, Bournemouth University and Michael Di Giovine, Associate Professor of Anthropology, West Chester University of Pennsylvania

This article is republished from The Conversation under a Creative Commons license. Read the original article.

High Resolution 3D Digital Assets of Whole body Human Anatomy available for BU Research and Education

As one of the products from the HEIF6 Project, our team has developed a wide collection of digital assets to represent human anatomy. The understanding of human anatomy is vital to the delivery of healthcare. For medical students, this necessary awareness of anatomy and 3D spatial orientation is traditionally learned through cadaveric dissection. This is expensive and has practical as well as ethical constraints to available teaching time. The digital models can be used as assets for interdisciplinary research between the fields of Arts, Science and Healthcare. We welcome ideas from the BU community for proposals of novel use cases, research, grant applications and availability as teaching tools or base models for complex animation techniques.

Contact:

Learn more about the available assets and how to collaborate with the Neuravatar team by contacting Dr Xiaosong Yang (xyang@bournemouth.ac.uk) or Dr. Rupert Page (Rupert.Page@poole.nhs.uk).

👀 A glance at the 3D models available so far 👀

 

NIHR issues final update on implementation of the Restart Framework

The NIHR published a Framework on 21 May 2020 – when the NHS started to restore routine clinical services – to support the restarting of research paused due to COVID-19. Developed in partnership with multiple stakeholders and the devolved nations, the Framework provides a flexible structure for local decision-making.

You can read the latest and final update here.