Category / Nursing & Midwifery

The portrayal of childbirth in the mass media

BU research, Fusion

Marilyn Cash from HSC’s Centre for Midwifery, Maternal and Perinatal Health recently delivered a paper on the Portrayal of Childbirth in the Mass Media, at the Reimagining Birth International Research Symposium held at the Humanities Institute University College Dublin, Ireland.  The research symposium brought together academics, medics and artists from around the world to explore how childbirth has been portrayed/represented/imagined in the worlds of art and medicine. 

The symposium provided an opportunity for contemporary critical debates into the visual culture of childbirth.  This was a unique opportunity for researchers and practitioners to explore/discuss the visual and sensorial culture of birth, and to contribute to our reimagining of this fundamental personal life experience for mother and child.  Central to the vision of the symposium is the ambition to build connections between interested parties, providing a forum for transcending current knowledge silos and contributing to innovative change in this important personal/cultural domain of human experience.

The paper is part of an ongoing collaboration between academics in the Centre for Midwifery, Maternal and Perinatal Health and the Media School and the University of Stirling, exploring the medicalisation of childbirth.  As a direct result of the symposium academics from the group have been invited to present at the Perinatal Care Online Conference to be held in November 2013. For further information please contact a member of the Media and Childbirth research team (which includes: Prof Vanora Hundley: vhundley@bournemouth.ac.uk, Prof Edwin van Teijlingen: evteijlingen@bournemouth.ac.uk, Dr Ann Luce: aluce@bournemouth.ac.uk, Dr Marilyn Cash: mcash@bournemouth.ac.uk , Prof Helen Cheyne: h.l.cheyne@stir.ac.uk, Dr Catherine Angell: cangell@bournemouth.ac.uk .

HSC student wins Santander Travel Grant to go to Yale

BU research, PG research, Post-award, Research news, Training, Uncategorized

Mrs. Anita Immanuel has just been awarded a travel award from Santander to visit the Yale Cancer Centre in the USA. Anita studies the quality of lives of adults in Dorset who have survived cancer of the blood or immune system. Cancer is a devastating disease and with the advances in treatment patients are living longer, however left with debilitating side effects which can negatively affect their quality of life.

Anita’s research will identify any unmet needs in this group of patients and will give a better understanding into comprehensive survivorship care thereby maximising quality of life. This study uses a mixed methods approach in examining the quality of lives of these patients who have been treated for a haematological cancer. Data will be collected across three Dorset hospitals: The Royal Bournemouth Hospital, Poole Hospital and Dorset County Hospital.

Dr. Helen McCarthy, Consultant Haematologist at The Royal Bournemouth Hospital and Anita’s clinical supervisor, highlighted: “At Yale Cancer Centre Survivorship Clinic, Anita will be introduced to their comprehensive survivorship care programme which can help improve the quality of lives of adults treated with cancer in Dorset.

Dr. Jane Hunt, the lead supervisor and senior lecturer at Bournemouth University’s School of Health & Social Care added: “The survivorship programme at the Yale Cancer Centre Survivorship Clinic integrates a multidisciplinary approach for following up patients treated for cancer by leading experts, which differs significantly from our own. I am convinced Anita’s PhD study will benefit from collaborating with the Yale experts.

BU Prof. Edwin van Teijlingen, Anita’s third supervisor, commented “We are grateful to Santander for this funding. We know Anita’s research will significantly contribute to the underdeveloped area of research on adult haematological cancer survivors”.

For more about Santander Awards see: http://microsites.bournemouth.ac.uk/graduate-school/pgt-santander-mobility-awards/

Burdett Trust for Nursing Grant

‘Delivering Excellence in Nutrition and Dignity in Dementia Care – Empowering Nurses and Care Home Staff to Enhance the Care Environment’.

Dr Jane Murphy and Joanne Holmes from the School of Health & Social Care, working in collaboration with representatives from local council (Partners in Care), the Local Enterprise Partnership, local and national care home organisations have won significant grant income from the Burdett Trust for Nursing to tackle the increasing and yet unresolved problems of nutrition and delivering dignity in dementia. Over a two year period, the project will identify best practice guidelines for delivering nutrition in dementia care by providing a new nutrition education programme based on fundamental principles of self-leadership and nutrition to empower nurses and care home staff. The programme will be easily translated and adopted widely to induce a long-lasting culture change towards excellence in dementia care that is person-centred and upholds dignity.

 

For further details, contact either Jane (jmurphy@bournemouth.ac.uk) or Joanne (holmesj@bournemouth.ac.uk).

 

Burdett Trust for Nursing Grant: Humanising Services: A new transferable leadership strategy for improving ‘what matters to older people’ to enhance dignity in care

Awarded & submitted bids, Featured academics

In collaboration with Bournemouth University, Professor Kathleen Galvin of the Faculty of Health and Social Care, University of Hull has been successful in attracting a grant from the Burdett Trust for Nursing to apply a new theoretical framework for the purpose of ‘humanising services’ in two clinical settings. The experience of dignity is linked to what makes people ‘feel human’. Conversely, what leads to dehumanisation and therefore loss of dignity needs to be understood and acted upon in meaningful service improvement. (Patients Association, 2009; 2012). Using a lifeworld orientation and grounded in phenomenological philosophy eight key considerations that are relevant to the challenge to improve peoples’ experiences of the human dimensions of services have been defined (Todres et al., 2009; Galvin & Todres, 2012). These are not detailed lists of ‘do’s’ and ‘don’ts’ or abstract generalities such as the need for more ‘user /customer focus’ or ‘choice’. Rather, they are eight dimensions about what makes a person feel human, which could help nurses, with service providers, to effectively focus their leadership when improving services to enhance dignity in care.  The team from University of Hull, Professor Steven Ersser, Dr Fiona Cowdell, Professor Roger Watson, Jane Wray, Kathleen Galvin and the team from Bournemouth University, Professor Les Todres and Dr Caroline Ellis-Hill are interested in what older people with long term skin conditions (being treated at a dermatology outpatient clinic) and people who have had a stroke (being cared for in a stroke rehabilitation unit with outreach service) point to that would make human perspectives more central in treatment. Our key practice partners include: Dr. Shernaz Walton, Consultant Dermatologist, Hull and East Yorkshire, NHS Trust and Dr Damien Jenkinson, National Stroke Lead, Royal Bournemouth Hospital Trust. Within these two settings, dermatology clinic and a stroke rehabilitation unit, a tripartite humanising improvement team group comprising older service users, nurses, and academics will engage in a robust ‘humanising improvement’ process that will be evaluated.

Galvin, K.T. &  Todres, L (2012) Caring and Well-being: A lifeworld approach. London: Routledge

The Patients’ Association (2009) Patients…not numbers, People…not statistics.

 The Patients’ Association (2012) Stories from the present, lessons for the future.

Todres, L., Galvin, K. and Holloway, I. (2009) The humanisation of healthcare: a value framework for qualitative research.  International Journal of Qualitative Studies on Health and Well-being, 4, 68-77.

A royal birth? Lucky Kate

BU research, PG research

With the Queen’s Jubilee, the Olympics and Andy Murray winning at SW1 Wimbledon (again) it seems Britain is still riding a wave of optimism with the birth of a male heir to the throne; the Prince of Cambridge. The baby was delivered on 22 July 2013 at St Mary’s Hospital in Paddington, west London, weighing 8lb 6oz. The document said: “Her Royal Highness, the Duchess of Cambridge was safely delivered of a son at 4.24pm today. He and the duchess will remain in the hospital overnight. A bulletin signed by the Queen’s gynaecologist Marcus Setchell, who led the medical team that delivered the baby – was taken by a royal aide from St Mary’s to the palace under police escort.

The implications are wide -reaching, in multi-cultural Britain the royal baby is unusual for London in having a mother originally from the UK and most babies delivered in the capital these days (57%) are to mothers born overseas and nearly half of all babies (48%) are born outwith marriage. With midwifery cuts and the further medicalisation of birth where the “cascade of interventions” often occurs when birth is induced.  For instance, in the USA which spends more money on healthcare than any country in the world and yet the maternal mortality rate is among the highest of any industrialised country.

And on July 19, 2013, the USA the House State-Foreign Operations Appropriations Subcommittee today approved a steep cutback in international family planning assistance for fiscal year 2014. Rejecting President’s Obama’s 2014 budget request of $635.4 million, the Subcommittee capped appropriations for international family planning and reproductive health programs at $461 million, $174 million less than the President’s request, and $137 million (23% below the current funding level).  The cuts, if approved by the full Congress, would have a devastating impact: Several million women in the developing world would lose access to contraceptives services, resulting in more unplanned pregnancies and deaths from unsafe abortions. Each pregnancy multiplies a woman’s chance of dying from complications of pregnancy or childbirth. Maternal mortality rates are particularly high for young and poor women, those who have least access to contraceptive services. It is estimated that one in three deaths related to pregnancy and childbirth could be avoided if all women had access to contraceptive services.

Not so lucky, therefore, are Kate’s counterparts in the South – Frightening statistics include that daily, approximately 800 women die from preventable causes related to pregnancy and childbirth. In our study site, Nepal every year, 4,500 Nepali women die in childbirth due to lack of medical care. In low-income countries, most maternal deaths are avoidable, as the health-care solutions to prevent or manage complications are well known. All women need is access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth.

To make every birth worldwide as joyful an event as the royal birth in London we need is: a) more and better midwifery services; and b) improved access to care for pregnant women globally.

Sheetal Sharma is a HSC PhD student and currently a visiting researcher in Barcelona, supervised by Dr. Elisa Sicuri at CRESIB on an evaluation of a health promotion programme in rural Nepal aiming to improve access to care; in which socio-economic and cultural barriers exist.

Thanks to Edwin & Elisa for their input in this piece.

References:

http://www.populationinstitute.org/newsroom/press/view/57/

http://midwifeinternational.org/how-to-become-midwife/business-of-baby/

http://www.bbc.co.uk/news/uk-23408377

http://www.unfpa.org/public/home/mothers/pid/4382

http://www.bbc.co.uk/news/uk-23403391

Joint PhD studentships: an example of FUSION in practice.

BU research, Fusion, PG research, Research news

For many clinicians undertaking a PhD means choosing to either give up clinical practice for a period of time or studying on top of an already demanding full-time job. Now a partnership between the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and Portsmouth Hospitals NHS Trust (PHT) is making it easier for midwives to undertake a doctorate while still maintaining their clinical skills. The team has developed a novel joint studentship that will allow midwives to combine clinical practice with a research role, working across BU and PHT. The studentships will run for four years and PhD students will spend two days per week working as a midwife in clinical practice and three days per week working on their thesis. This set up facilitates the co-creation of knowledge.

In addition to providing the individual midwives with excellent education, these studentships are designed to examine an area of clinical practice identified by PHT where the evidence is lacking and research is needed. As a consequence the research studies will be directly relevant to practice and will have a demonstrable impact in the future. Hence BU will be able to show that its research and education have a direct benefit to the wider society. Finally, the studentships benefit midwifery practice by building a critical mass of researchers, which will help translate research findings into practice and so create a culture of evidence-based practice.

The result is a studentship that truly fuses research, education and practice.

The CMMPH/PHT partnership has developed three matched-funded PhD studentships for midwives, which will begin in September 2013. These joint PhD studentships will be supervised by both BU academics (Sue Way, Catherine Angell, Carol Wilkins, Maggie Hutchings, Edwin van Teijlingen & Vanora Hundley) and supervisors from PHT based in practice.  We are excited about this novel approach to PhD studentships and hope that we will have many more studentships with other NHS Trusts in the future.

For further information please contact Prof. Vanora Hundley or Prof. Edwin van Teijlingen.

Research Ethics: Insights from the Centre for Midwifery, Maternal & Perinatal Health and the Centre for Social Work, Sociology & Social Policy

BU research, PG research, Publishing, Research Ethics, Research Integritiy, Uncategorized

Ethics contributions

Collage of research ethics contributions

Academics based in HSC have experience in a wide-range of research.  In the process of reflecting on all aspects of the research process several members of HSC have published about ethical issues that they have had to address in their own research.    This BU Blog highlights some of these key HCS papers which may help fellow academics and students across the globe address similar ethical questions.  HSC has a history of publishing on research ethics, Professor Emerita Immy Holloway wrote about the researcher who may have a dual role, or even conflicting role, as researcher and health care professional (1).  More recently, several midwifery researchers in the Centre for Midwifery, Maternal & Perinatal Health wrote about the issues facing practitioners doing research in the field where they work, especially concerning the similarities and differences between professional ethics and research ethics (2-3).  Negotiating ethical paths cleaved by competing concerns between protecting research participants and over-managing the ethical process is tricky.

In her book Rainforest Asylum: The enduring legacy of colonial psychiatric care in Malaysia Dr. Ashencaen Crabtree in the Centre for Social Work, Sociology & Social Policy, addresses the problematic issue of gate-keepers in research together with the ethics of critical observation of abuse (potential or actual), as well as the ethics of advocating on behalf of research participants (4).

The fear that the ethical application process in the UK is becoming more and more cumbersome and bureaucratic has been widely recognised as highlighted by Prof. van Teijlingen and colleagues (5-6).

Research ethics review processes are also considered in terms of access to participants regarded as ‘vulnerable’ in a recently published paper by Dr. Ashencaen Crabtree (7) of ethnographers working in health settings who are seeking to understand the context of care and patient/service user experiences.  She concludes that paternalistic control of participation on the grounds of ethical protection of vulnerable people seriously disenfranchises potential participants in preventing them from being able to share their relevant, lived experiences as recipients of service provision.

Prof. van Teijlingen and BU Visiting Fellow Dr. Padam Simkhada highlighted that the social, cultural and economic contexts in which research is conducted often differ between developing and developed countries.  However they stress that researchers need to apply for research ethics approval to the relevant local authority, if national legislation requires one to do so (8).

A new and challenging area of research is the use of discussion boards as a source of research data.  In their paper Dr. Bond and BU colleagues discuss both practical and ethical dilemmas that arise in using such data (9). In earlier research, Prof. Parker of the Centre for Social Work, Sociology & Social Policy, highlighted some of the benefits and dangers of using email and the Internet for research as the potential for electronic media continues its rapid growth (10).

Obtaining informed consent is something that all researchers need to consider. However, in some research situations obtaining consent can be particularly challenging.  Prof. Hundley and colleagues discuss the ethical challenges involved in conducting a cluster randomised controlled trial, where consent needs to be considered at a number of levels (11).  In a second paper issues of consent during pregnancy, where there is the potential for harm to two participants, are considered (12).

In research into the implications of the Mental Capacity Act 2005 for social research, Prof. Parker explored the contested meanings and difficulties associated with informed consent in social research, highlighting some of the challenges raised by an almost unquestioned acceptance of biomedical research ethics in social research and questioning whether potential ‘harm’ is different in this context (13, 14). This research has led to further explorations of the potential for ethical covert research by Prof. Parker and Dr. Ashencaen Crabtree.

 

The way forward

There a plenty of challenges to research ethics in both the health and social care sectors.  Ethical considerations relate to technological developments such conducting research over the Internet or the analysis of tweets.  HSC staff will continue to publish on a range of moral dilemma as well as practical issues related to research ethics.  Moreover, academic from the two centres are planning a Masterclass on research ethics to be held in early 2014.

 

 

References

  1. Holloway, I., Wheeler, S. (1995) Ethical Issues in Qualitative Nursing Research, Nursing Ethics 2: 223-232.   Web address:  http://nej.sagepub.com/content/2/3/223.full.pdf+html
  2. Ryan, K., Brown, B., Wilkins, C., Taylor, A., Arnold, R., Angell, C., van Teijlingen, E. (2011) Which hat am I wearing today? Practicing midwives doing research, Evidence-Based Midwifery 9(1): 4-8.
  3. van Teijlingen, E.R., Cheyne, H.L. (2004) Ethics in midwifery research, RCM Midwives Journal 7 (5): 208-10.
  4. Ashencaen Crabtree, S. (2012) Rainforest Asylum: The enduring legacy of colonial psychiatric care in Malaysia, London: Whiting & Birch.
  5. van Teijlingen, E., Douglas, F., Torrance, N. (2008) Clinical governance and research ethics as barriers to UK low-risk population-based health research? BMC Public Health 8(396)                            Web address: www.biomedcentral.com/content/pdf/1471-2458-8-396.pdf
  6. van Teijlingen, E. (2006) Reply to Robert Dingwall’s Plenary ‘Confronting the Anti-Democrats: The unethical Nature of Ethical Regulation in Social Science, MSo (Medical Sociology online) 1: 59-60  Web address:  www.medicalsociologyonline.org/archives/issue1/pdf/reply_rob.pdf
  7. Ashencaen Crabtree, S. (2013) Research ethics approval processes and the moral enterprise of ethnography. Ethics & Social Welfare. Advance Access: DOI:10.1080/17496535.2012.703683
  8. van Teijlingen E.R., Simkhada, P.P. (2012) Ethical approval in developing countries is not optional, Journal of Medical Ethics 38 :428-430.
  9. Bond, C.S,  Ahmed, O.H., Hind, M, Thomas, B., Hewitt-Taylor, J. (2013) The Conceptual and Practical Ethical Dilemmas of Using Health Discussion Board Posts as Research Data, Journal of Medical Internet Research 15(6):e112)  Web address: http://www.jmir.org/2013/6/e112/
  10. Parker, J.  (2008) Email, ethics and data collection in social work research: some reflections from a research project, Evidence & Policy: A Journal of Research, Debate & Practice, 4 (1): 75-83.
  11. Hundley, V, Cheyne, HC, Bland, JM, Styles, M, Barnett, CA.. (2010) So you want to conduct a cluster randomised controlled trial? Lessons from a national cluster trial of early labour, Journal of Evaluation in Clinical Practice 16: 632-638
  12. Helmreich, R.J., Hundley, V., Norman, A., Ighedosa, J., Chow, E. (2007) Research in pregnant women: the challenges of informed consent, Nursing for Women’s Health 11(6):  576-585.
  13. Parker, J., Penhale, B., Stanley, D., 2010. Problem or safeguard? Research ethics review in social care research and the Mental Capacity Act 2005. Social Care & Neurodisability, 1 (2): 22-32.
  14. Parker, J., Penhale, B., Stanley, D. (2011) Research ethics review: social care and social science research and the Mental Capacity Act 2005, Ethics & Social Welfare, 5(4): 380-400.

 

Vanora Hundley, Sara Ashencaen Crabtree, Jonathan Parker & Edwin van Teijlingen

 

 

PechaKucha – presenting research in a fast and furious manner!

BU research, Research news

The Normal Labour and Birth Conference allowed me to experience a novel way of showcasing research and exchanging ideas – the PechaKucha. Pronounced “peh-chak-cha”, the PechaKucha session is made up of a series of short presentations. Presenters must use 20 slides, each of which must be displayed for exactly 20 seconds – no more, no less. The concept, conceived by two young architects (Astrid Klein and Mark Dytham) in Japan in 2003, is to enable individuals to exchange their ideas in a fast moving, concise and exciting format. Not one to ignore the call to try something new, I decided to undertake this challenge as a double act with my colleague Professor Helen Cheyne from the University of Stirling. We presented our team’s work on the media’s portrayal of labour and birth, which was also being displayed as a poster.

Poster
Research team includes Ann Luce, Marilyn Cash, Vanora Hundley, Helen Cheyne, Edwin van Teijlingen and Catherine Angell

The PechaKucha was quite an undertaking, as the slides move automatically and you cannot stop them moving on! However, it really focused the mind and helped us identify the key messages from our work. The session was very lively and the energy generated a lot of discussion that continued into the coffee break afterwards. As for the PechaKucha method, I’d say that it is definitely a useful tool for our community research meetings, and perhaps also for our doctoral students to use as they prepare for their vivas.

The conference was also an opportunity to catch up with colleagues from the International Early Labour Research Group. The group have been involved in producing a series of research papers featured in a special issue of Midwifery. We also discussed future research and opportunities for research collaboration.

Dizzy the dog attends midwives forum

Fusion

 

Left to Right: Mandy Williams - Community Midwife, Gay Rogers - Breakfast Host and Hospital Midwife and Luisa Cescutti-Butler, Senior Lecturer (Midwifery)

Every three months hospital and community midwives at Salisbury NHS Trust Hospital attend a forum dedicated to matters relating to Examination of the Newborn (EXON).  The aims of the forum are to support healthcare professional undertaking newborn examinations, sharing of experiences/case studies, interprofessional working, maintenance of competence, formulate and review internal  processes and peer support for professionals in training. Members consist of midwives, nurses, a consultant Paediatrician and Children’s physiotherapists. BU student midwives are welcome to attend when working with their community midwives and on this occasion two students were present. As unit leader for EXON at BU and one of the link lecturers at the hospital, I chair, coordinate and facilitate the forums, with venues alternating between hospital and community.  This month we met for breakfast at a colleague’s home, where midwives were greeted with the smells of freshly brewed coffee and a newly prepared home cooked frittata. Further offerings included fresh strawberries, raspberries, warm croissants, cocktail sausages and quails eggs.  

Minutes and agendas are sent out in advance. A standing item is a report from senior children’s physiotherapist Karen Robinson, whose department leads the service for Developmental Dysplasia of the Hips (DDH) in newborns.  A recent case was brought to our attention, where a baby had been examined by midwives and doctors and found to have an unstable right hip. The baby was appropriately referred for an ultrasound scan which subsequently found the right hip normal, but considered the left hip abnormal.  The Barlow’s and Ortolani manoeuvres used by both professions at the time of the examination had not detected any left hip abnormality. A robust discussion ensured as to the complexities of examining babies for DDH and the difficulties in detecting unstable hips when the manoeuvres used by all professionals were themselves unreliable. However Karen was able to reassure us by indicating that in the seven years of the Children’s Physiotherapy Department leading the DDH service, very few babies had been ‘missed’. Karen also emphasized the significance of caring for babies’ hips in general and the importance of educating parents around their baby’s ‘hip health’. The 3rd year midwifery students are currently taught theory around DDH with opportunities to practice manoeuvres on ‘Baby Hippy’. As facilitator for these sessions I realized that our midwifery curriculum had to include general baby hip health in the first year of the student’s programme. Rachael, a 3rd year student midwife, was in agreement: “the discussion around hip care for newborns was great to listen to. I agree that it would be really beneficial to have a lecture on hip care for students”. 

Left to Right: Rachael Callan - 3rd year student midwife, Carol Bremner - Community Midwife, Beccy Seaton-Harris - 1st year student midwife and Fiona White - Community Midwife

On other matters Karen highlighted a number of babies diagnosed with Erb’s Palsy following birth had recently been treated by the department. Various options were offered as to why these babies had sustained these birth injuries, resulting in the forum unanimously agreeing that education around Erb’s Palsy and Brachial Plexus Injuries would benefit all professionals involved with childbirth.  Terri Coates, an expert on Brachial Plexus Injuries and a midwife at Salisbury, agreed to arrange a study day with the national Erb’s Palsy Support Group, to be held at either Salisbury Hospital or BU for midwives and students.

There are many advantages in having a regular forum to discuss issues relating to newborn examination.  Case studies are presented and debated and education around various topics are provided at regular intervals. The forum also supports midwives from other trusts who are having difficulties with undertaking the examination in their areas. Beccy, the 1st year student midwife had the following to say: “It was very informative. It was good to see community and hospital midwives coming together as a team. I am also interested in learning more about Erb’s Palsy and attending a study day. Learning about general hip care would also be beneficial. The breakfast was lovely too”.

Dizzy

The last bark, I mean word, goes to Dizzy. He gets terribly excited when breakfast is served and runs from one midwife to another hoping for a dropped sausage or at least a titbit from a kind soul. After not having much luck, he eventually settles down and gently snores in the corner of the room. 

                                                                              

 

                                                                                        

 

 

 

Its Fika Time

Awarded & submitted bids, BU research, Fusion

 

Presentation – Birth in the UK to the 1st year Swedish Student Midwives at the Karolinska Institiute

Sue Mant (left), Helena Lindgren (Our Host representative), Sara Stride (right)

A colleague and I participated in an exchange visit to the Karolinska Institute (KI) in Sweden in May 2013 thanks to an Erasmus Mobility award. During the trip we visited several clinics and hospitals and had the opportunity to meet and talk with many Midwives, Student Midwives and Nurses working in different settings. When spending time at the KI with the Student Midwives we were able to provide an overview of Birth in the UK, where Waterbirth provision was of great interest and provoked much discussion.

During a visit to the Kista Barnmorskemottagning (a Midwife clinic) it was evident that as the Midwives are based in the clinics, they are able to provide good continuity of care. Midwives complete electronic records for every episode of care, there are no paper records or hand held notes for women to carry; in fact they are only issued with a printed copy of their blood group.

One of my objectives was to learn more regarding Group Antenatal Care provision in Sweden. A joint venture with a phd student from the KI enabled an exchange of information and a discussion of progress to date and to share ideas from a recent project regarding Group Antenatal Care in the UK.

During our many visits we were also introduced to the custom of “Fika”  –  or social time where work colleagues meet mid morning and mid afternoon for a drink and a chat. It is considered to be part of everyone’s daily routine, and is definitely a concept that might encourage staff in the UK to take regular breaks.

We also joined a social evening,  where First year Swedish Student Midwives were each presented with a Pinnard’s ready for practice.

Come to the Cabaret

Awarded & submitted bids, BU research, Fusion

 

1st Year swedish students with Sara Stride(centre) and myself, Sue Mant (right)

1st Year swedish students with Sara Stride(centre) and myself, Sue Mant (right)

Thanks to an Erasmus mobility award myself and a colleague were able to engage in a teaching exchange with the Karolinska Institute (KI) in Sweden. For the midwifery team, this is an annual reciprocal arrangement which fosters education/practice links and ensures the continuation of a programme of support for exchanges between Bournemouth University (BU)  midwifery students and KI midwifery students. A very comprehensive itinerary allowed us to visit midwife led units, clinics, birthing units, and hospitals. We were enabled to spend time with student midwives in the classroom and with clinical teachers in practice.

This was my first visit, and a personal objective was to explore practice education. Student midwives in Sweden study midwifery for 18 months prior to qualification and this contrasts with the three year course mainly offered at home. Notably, the direct entry route to midwifery is not yet available in Sweden and even though this is an approach that KI is considering for the future, current applicants to the course have to be qualified nurses. KI student midwives move around various placements and student support mechanisms there were very similar to BU. Where things begin to differ is that there is no formally recognised mentor system. At the Sodra BB birth unit I learned from the Chef Barnmorska (Lead Midwife), that clinical teachers have often been qualified for a minimum of 5 years and though very experienced, they receive no formal preparation for their clinical teaching role. This perhaps reflects the lack of any formal ongoing post-registration development programme.  At Danderyds birth centre we met a midwife who has recently taken on a role similar to that of Practice Educator. She has adopted a progressive programme of regular meetings between clinical teaching midwives and the Institute link allowing them an opportunity to discuss individual student’s needs and achievements. Attending one meeting, we were invited to contribute to the discussion and as a cohesive group we were able to discuss strategies and share ideas. Issues arising with learners seem to bear common threads internationally

Helena Lindgren (our host representative) with Sara Stride

.

Finally, if you are wondering what ‘Come to the Cabaret’ has to do with this blog…. Our visit happily coincided with end of course celebrations, a chance for the cohort to dress as characters from that very musical. I learned….. Swedish midwives know how to party!

BU Research Blog Exclusive: Design & Look of eBU leaked

BU research, PG research, Publishing, Research news, Research themes

The first screenshot of the eBU interface has been exclusively leaked to the BU Research Blog, and is expected to go viral across the BU community over the next week.

eBU will provide both an internal and external forum for the development of research papers by undergraduate to Professor around the eight BU research themes:

–          Creative & Digital Economies

–          Culture & Society

–          Entrepreneurship & Economic Growth

–          Environmental Change & Biodiversity

–          Green Economy & Sustainability  

–          Health, Wellbeing & Ageing 

–          Leisure & Recreation

–          Technology & Design

Submissions will be open to immediate publication (in a safe internal environment) and open peer review by 2 appropriate BU academics. Authors will be encouraged to act upon these reviews by either reworking papers for submission to an external journal or by opting for publication on the external eBU site.

For BU academics this is a great opportunity to get critical appraisal on your research papers or ideas from colleagues. For academics it also an opportunity to encourage the submission of high quality student output, and possibly to facilitate the co-creation and co-production of publishable material to an external journal or to publish externally with eBU. For students, this is a fantastic opportunity to turn high quality essays or dissertations into scholarly outputs, which will be attractive to employers across many sectors and industries.

If you have any questions or would like to become involved in this exciting venture, please get in touch with me via email aharding@bournemouth.ac.uk or by telephone 01202 963025.

Celebrating diversity of women: a theme day provided for Level C student midwives

BU research

Undergraduate pre-registration first year midwifery students were enthralled at a recent theme day which formed part of their Intrapartum unit. The day is designed to celebrate diversity of women’s experiences during labour where students get to listen to stories of women and midwives. This year’s gathering was no exception.  First up was Rachel Arnold, a PhD student from BU. Her rich story, supported by beautiful photographs of Afghanistan, highlighted the plight of women in that country, where maternal mortality is amongst the highest in the world. Rachel in her role as a midwife has worked with Afghan people for many years and as she shared her experiences we began to see that Afghanistan is more than ‘suicide bombers and conflict’, it is about ordinary people who struggle to survive each and every day. Rachel’s talk inspired the whole audience and many students were interested to find out if they could go to Afghanistan for their elective which occurs in the 3rdyear of their training.

“It was wonderful to have a midwifery perspective from this country and the lecture was inspiring and passionate”

“Very interesting and thought provoking talk which has made me think about my own attitudes on diversity”

Jane Evans, an independent midwife, spoke about breech birth as a normal event during pregnancy.  She shared a number of photographs showing how a breech birth should be facilitated with the mantra “hands off”,  and students were able to see how the baby rotated , flexed and birthed itself with the help of his/her mother adopting a variety of positions. The mechanisms were reinforced through Jane using a doll and pelvis to further enhance student understanding. Many midwives are losing their skills within breech birth as women are often opting for caesarean section, but Jane was fortunate in that she was taught the craft of breech  (bottom down) birth by Mary Cronk, who specialised in independent midwifery practice with a keen interest in breech presentation. Mary is now retired but thankfully her many years of experience were passed onto Jane who shares her knowledge widely through study days and of course with the midwifery students at BU.  Many of the students’ views were changed following Jane’s presentation, as the following quotation demonstrates: “It was a privilege to hear this lecture. It offered a contrast to other breech perspectives and gave me more confidence as a student midwife to educate women that breech is merely another type of normal”

Sheetal Sharma, another BU PhD student provided the students with her insight into midwifery care in Nepal. She warned us that she was not a midwife, and was observing and recording midwifery practice as part of her doctoral studies. She provided a fascinating insight into how pregnancy and childbirth are perceived in Nepal where women have no rights within their own homes and are subject to the control, whims and superstitions of their ‘mother-in-laws’.  There were also parallels with Afghanistan in relation to maternal mortality, as around 4,500 Nepalese women die in childbirth due to a paucity of adequate healthcare or even skilled birth attendants.  Sheetal’s presentation included fabulous photographs of idyllic scenes in Nepal, but also of women and children where smiles were abundant and hope was evident. Nepal has made significant strides to reduce maternal mortality and is now on track to meet Millennium Development Goal (MDG)4.

Sheetal explaining her photograph where a woman is shown holding a scythe. Not only is this a tool used in the field to cut vegetation but also as an implement to cut the baby’s cord at birth.
 

The last presentation by Vanora Hundley, BU’s Professor of Midwifery, focused on the global picture of maternal and child health, where some of the key interventions that save mothers and babies lives were highlighted. Vanora reminded the audience that, for example, having a skilled attendant at birth may not always be thought of as ‘intervention’,  but evidence shows that countries where women have access to midwives or an attendant with midwifery skills have significant lower maternal mortality rates. Finally, a note of caution was provided by Vanora around the challenges faced in high income countries, as the over-use of interventions by health professionals are having a damaging impact on mothers and babies.

 
The students really enjoyed the day as the following quotes illustrate:

“I have thoroughly enjoyed the theme day, it has been very informative and insightful – more so than I had anticipated”.

“Fantastic to have a (nearly!) whole day of the wider context of midwifery. Inspirational – thanks”.

“Absolutely superb day. Reignites the fire in your belly!”

“Really insightful day. Demonstrated the importance of the midwife and our roles, not just at home but around the world. It’s nice to see the bigger picture”.

 

Does Guinness taste different in Dublin?

BU research, Featured academics

In August 2012 a call was put out through the midwifery networks by the Preterm Birth Clinical Study Group (CSG) who were seeking to recruit new members. The Preterm Birth CSG aims to identify important research questions around preterm birth and to work with the originators of supported studies around preterm birth, and to improve clinical outcomes following preterm birth by prevention or intervention.

This group, one of 11 CSGs, is a Royal College of Obstetrics and Gynaecology (RCOG) specialist group supported by British Maternal and Fetal Medicine Society (BMFMS), British Association of Perinatal Medicine (BAPM) and by Action Medical Research. Applications were welcomed from obstetricians, neonatologists and midwives who were interested in preventing preterm birth or in improving outcomes. I (Luisa Cescutti-Butler) was successful in my application and attended my first meeting on the 23rd April 2013 in Dublin.

Most of us were new to the group and following introductions we set to business. An urgent consideration was the representation of lay members. There were a number of suggestions put forward as to how lay members could be approached and groups such as MumsNet, Bliss and Bounty were to be approached for their views on research priorities within preterm birth. The group also felt that establishing a focus group of women who had experienced a preterm birth would be valuable and I offered to facilitate this.

A number of research projects were discussed and whilst many of these studies were focused on RCT’s and not within my comfort zone, I was able to provide input into some where a qualitative approach would work. Many of the professors around the table were comfortable with scientific methodologies, but were open to the possibilities of where proposed projects might benefit from a qualitative perspective, i.e. inviting women to speak about their experiences of possible interventions to prevent preterm birth.

Following the Preterm Birth Clinical Study Group meeting on the 23rd April 2013, I was fortunate to attend on the following two days a conference arranged by the British Maternal and Fetal Medicine Society (BMFMS) of which I am a member. The programme, which consisted of high quality clinical and basic science key lectures and presentations were fascinating for me as a midwife, although I did feel at various points throughout the two days that if it were left to ‘science’, women would never have an opportunity to have a normal pregnancy and birth. It appeared that every step of the childbirth continuum could be researched, with outcomes managed in some way because of ‘evidence,’ which for some women who experience life threatening conditions such as pre-eclampsia is of vital importance. In the event, I was able to gain information that would benefit BU undergraduate midwifery students. At the end of the conference I was in awe of all the high quality research being undertaken in the UK to prevent preterm birth and obstetric conditions such as pre-eclampsia, but also a little sad. Sad at the prospect that if midwives don’t continue to protect normality for women, it might fall forever within the realms of ‘medicine’ and who knows where pregnant women will end up? And finally in conclusion, I never did get to taste a Guinness in one of the many traditional Irish Pubs scattered around the city, so couldn’t say whether it tasted better in Dublin or not!

BU and University of Ljubljana working together to enhance midwifery practice

BU research, Featured academics

Slovenia, once part of communist Yugoslavia, is now an independent country which borders Italy, Croatia, Austria and Hungary. It is a modern and young economy with a strong infrastructure.  Midwifery has been practised in the region for hundreds of years; however a decision to suspend midwifery training in the 1980s resulted in a severe shortage of midwives.  In 1996 midwifery education was reinstated, but this time within higher education. In 2002 the first midwives were able to qualify with a degree from the University of Ljubljana, which offers the only undergraduate midwifery programme in Slovenia.

The role of the midwife in Slovenia is mainly concentrated within the area of intrapartum care; a consequence of the midwifery shortage that saw midwives drawn from other areas to cover labour and birth. Very little antenatal and postnatal care is offered by midwives. These aspects of care are typically provided by gynaecologists, obstetricians, paediatricians and community nurses. Thus there have been calls for midwives to increase their role within public health and to develop primary care services. One aspect of care that could develop midwifery practice is examination of the newborn.

A scoping visit funded by ERASMUS (British Council) and EUNF (Bournemouth University) was undertaken by Luisa Cescutti-Butler (Senior Lecturer) and Professor Vanora Hundley at the behest of the Head of Midwifery Dr. Ana Polona Misvek at the University of Ljubljana. The visit explored whether midwives, paediatricians, neonatologists and midwifery lecturers would be receptive to a course that would teach Slovenian midwives to examine normal healthy term babies. This examination is currently only undertaken by paediatricians.

A round table discussion was arranged with key professionals from the medical and midwifery community. The discussion was at times fairly animated; for example there was strong opposition from the neonatologist who believed that midwives were not ready to take on this role. In contrast, there was encouraging agreement from Professor Dr. Ciril Kržišnik (Senior Paediatrician and Head of the Paediatric Association) who was present, and Anita Prelec (Head of the Slovenian Nursing/Midwifery Association).

A positive outcome was the desire from all professionals to strengthen the midwife’s role within the initial examination of the newborn and it is this aspect of care and knowledge that offers further opportunities for future collaboration and training.

For further details about this study contact: Luisa Cescuttti Butler, Senior Lecturer, Lansdowne Campus.

How’s our Slovene?

BU research, EU, Research news

BU’s Centre for Midwifery, Maternal & Perinatal Health was well represented at a recent conference run by the Midwifery Association of Slovenia in Čateẑ.  Professor Vanora Hundley and Luisa Cescutti Butler were invited by the President Anita Prelec to speak to midwives, nurses and students at their bi-annual conference: Skrb Za Dravje Žensk In Otrok.

I was asked to speak on the issue of intervention in early labour, something that is causing concern in many European countries, and whether midwives should be encouraging women to stay at home for longer. I started my session with a tentative “Dober dan” (Good morning) – my pronunciation must have been acceptable as I received a round of applause! However, the rest of my presentation was thankfully in English. The presentation was well received and clearly generated a lot of interest with discussion continuing over lunch.

Luisa, a senior lecturer in midwifery, spoke about the examination of the newborn baby and who should be involved – the midwife or the doctor. This was a question that we had discussed the previous day at a round table event with key stakeholders in Slovenia. Her presentation also gave us the opportunity to ask midwives what they thought. Participants were asked to complete a short questionnaire before the presentation and a second brief questionnaire afterwards. We are looking forward to seeing their responses – although we will rely heavily on colleagues from the University of Ljubljana to translate them!

Funding for our Slovenian trip was through networking grants – an EUNF award for Vanora to discuss research collaboration and an ERASMUS Preparatory Visit award for Luisa to explore the possibility of a staff mobility exchange. We both achieved these aims (more on that in our next blog), but this additional opportunity was too good to miss.

Open Access journals: Remember to check for changes!

BU research, PG research, Research news

BUI Research BlogThe BU Research blog has seen various pieces on Open Accessing Publishing, including http://blogs.bournemouth.ac.uk/research/bu-internal-funding-opportunities/open-access-publication-fund/  or http://blogs.bournemouth.ac.uk/research/files/2011/08/Open-Access-Fund-policy-180711.pdf).  Moreover, Bournemouth University professors are actively involved in Open Access journals.  For example  Prof. Vanora Hundley and I are both Associate Editors of a major Open Access journal (see:  http://blogs.bournemouth.ac.uk/research/2012/10/23/prof-hundley-associate-editor-bmc-pregnancy-childbirth/ .

This blog highlights that journals can change and that some become Open Access that were not before.  This happened to some of my methods papers in the scientific journal of the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (RCOG).  Their journal the Journal of Family Planning & Reproductive Health Care used to be published in house as one of the RCOG journals.  The journal had a fairly closely defined readership and a very traditional way of paper-based publishing.  This meant very few academics, practitioners or students had access to my papers published over the years in the Journal of Family Planning & Reproductive Health Care. Then, a year or two ago, the journal became part of the BMJ Group (http://group.bmj.com/), which publishes over 40 journals in the health and health care field.

 

The deal between the Journal of Family Planning & Reproductive Health Care and the BMJ Group must include some arrangement to make previous issues available through Open Access.  All of a sudden seven of my research methods papers are freely available on the web through Open Access [1-7].   One of the key messages here is that it is worthwhile to see which journals offer Open Access, and to check regularly for changes in journals’ policies and publishers.

 

 

Prof. Edwin van Teijlingen, School of Health & Social Care, Bournemouth University

 

References:

  1. van Teijlingen, E.R., Forrest, K. (2004) The range of qualitative research methods in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 30(3): 171-73.
  2. Forrest Keenan, K., van Teijlingen, E.R. (2004) The quality of qualitative research in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 30 (4): 257-59.
  3. Forrest Keenan, K., van Teijlingen, E.R., Pitchforth, E. (2005) The analysis of qualitative research data in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 31(1): 40-43.
  4. Pitchforth, E., Porter, M., van Teijlingen, E.R., Forrest Keenan, K. (2005) Writing up and presenting qualitative research in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 31 (2): 132-135.
  5. van Teijlingen, E., Hundley, V. (2005) Pilot studies in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 31 (3): 219-221.
  6. van Teijlingen, E.R., Pitchforth, E. (2006) Focus Group Research in Family Planning and Reproductive Health Care, Journal of Family Planning & Reproductive Health Care 32 (1): 30-32.
  7. van Teijlingen, E.R., Pitchforth, E., Bishop, C., Russell, E.M. (2006) Delphi method and nominal group techniques in family planning and reproductive health research, Journal of Family Planning & Reproductive Health Care 32 (4): 249-252.