Tagged / Health

Key role of volunteers in the health system

This week saw the publication of ‘Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study’ [1].  This article in the Open Access journal PLoS ONE highlights the key role volunteers play in delivering health services to minorities/the poorest people, especially in low-income countries like Nepal.

This paper studies community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different parts of Nepal with varying degrees of access to local healthcare centres. Semi-structured interviews were conducted with twenty FCHVs, 26 women service users and 11 paid local health workers. In addition, 15 FCHVs participated in four focus group discussions.

A thematic analysis of the data identified five major themes underlying barriers to accessing available maternal and child healthcare services by ethnic minority groups. These themes include: a) lack of knowledge among service users; b) lack of trust in volunteers; c) traditional beliefs and healthcare practices; d) low decision-making power of women; and e) perceived indignities experienced when using health centres.  The paper concluded that community health programmes should focus on increasing awareness of healthcare services among ethnic minority groups, and the programmes should involve family members (husband and mothers-in-law) and traditional health practitioners. Both the FCHVs and local healthcare providers should be trained to communicate effectively in order to deliver respectful care among ethnic minorities if we want to achieve universal healthcare coverage for maternal and child health in low- and -middle income countries.

The paper is based on the PhD research conducted by Dr. Sarita Panday in ScHARR at the University of Sheffield.  Dr. Panday is currently affiliated with the Walter H. Shorenstein Asia-Pacific Research Centre (APARC) at Stanford University in the USA.  Her co-authors are Prof. Paul Bissell at the University of Huddersfield, FHSS’s Visiting Prof. Padam Simkhada at the Liverpool John Moores University and BU Prof. Edwin van Teijlingen.  This is the second paper from Dr. Panday’s excellent thesis, the first paper was also published in an Open Access journal BMC Health Services Research [2].

 

References:

  1. Panday S, Bissell P, van Teijlingen E, Simkhada P (2019) Perceived barriers to accessing Female Community Health Volunteers’ (FCHV) services among ethnic minority women in Nepal: A qualitative study. PLoS ONE 14(6): e0217070.
  2. Panday S, Bissell P, van Teijlingen E, Simkhada P (2017) The contribution of female community health volunteers (FCHVs) to maternity care in Nepal: a qualitative study. BMC Health Services Research 17(1):623.

Setting up clinical research – the ‘Organisation Information Document’

If you are currently conducting research within the NHS or Health & Social Care (HSC), then please bear in mind the following update if you wish/plan to add new NHS/HSC research sites to your study.

As of 5th June, the set-up procedure for clinical research projects involving NHS or HSC organisations changed (see blog post) –

  • If you applying for HRA/NHS REC approval you will be required to follow the new procedure using the Organisation Information Document (OID), as referenced in the above post;
  • If you are already conducting a study with HRA/NHS REC approval, in NHS/HSC organisations, and wish to involve new sites, then please be aware that the OID should be used, even if existing sites were set-up using the previous document, the Statement of Activities.

Further help and guidance

Guidance on the use of the new UK Local Information Pack has now been published in the Site Specific page of IRAS Help to help applicants with the change.

If you have any queries regarding any of the information provided above, information in the referenced blog post, or would like some guidance with regard to implementing your research in a healthcare setting – please get in touch with BU’s Research Ethics team.

You can also take a look at the Clinical Governance blog for documents, links and training opportunities.

Breastfeeding paper published today

The journal Women and Birth (by Elsevier) published the latest academic paper by Dr. Alison Taylor today.  Alison’s paper ‘The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers’ had been online as a pre-publication for a while but today in appeared officially in print [1].  Alison is a Senior Lecturer in Midwifery in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and this scientific paper is part of her completed PhD research project. 

 

 

The paper is based on a large number of video clips recorded by new mothers.  The total recording time exceeded 43 hours. This paper focuses on one theme, the therapeutic role of the camcorder in qualitative research. Four subthemes are discussed highlighting the therapeutic impact of talking to the camcorder: personifying the camcorder; using the camcorder as a confidante; a sounding board; and a mirror and motivator.  Dr. Taylor and colleagues conclude that frequent opportunities to relieve tension by talking to “someone” without interruption, judgement or advice can be therapeutic. Further research needs to explore how the video diary method can be integrated into standard postnatal care to provide benefits for a wider population.

This is the second paper originating from Alison’s PhD research, the first one appeared in Midwifery (also published by Elsevier) [2].   Dr. Taylor’s PhD thesis was supervised by Prof. Emerita Jo Alexander, Prof. Edwin van Teijlingen (in CMMPH) and Prof. Kath Ryan at the University of Reading.

[Drawing of Breastfeeding Woman by Allison Churchill.]

 

REFERENCES:

  1. Taylor AM, van Teijlingen E., Alexander J, Ryan K. (2019) The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers, Women & Birth 32(3):276-83. https://www.sciencedirect.com/science/article/pii/S1871519218300064
  2. Taylor A, van Teijlingen E, Ryan K, Alexander J (2019) ‘Scrutinised, judged & sabotaged’: A qualitative video diary study of first-time breastfeeding mothers, Midwifery 75: 16-23.

NIHR Clinical Research Network Portfolio

The National Institute for Health Research (NIHR) is one of the largest funders of clinical research in Europe and have a number of funding streams that you can apply for in order to conduct health-related research. The NIHR then has a number of Clinical Research Networks or ‘CRNs’ that are spread out to each region of England. The local CRN is Wessex, based in Hedge End, Southampton.

The ‘Portfolio’

At the heart of CRN activities is the NIHR CRN Portfolio of studies. This consists of high-quality clinical research studies that are eligible for consideration for support from the CRN in England. Adoption onto the portfolio has a number of benefits for researchers, such as help in identifying potential research sites, access to patients and the public to carry out ‘PPI‘ and advice on recruitment strategy at any point during the study. The CRN offers support to researchers via their Study Support Service and likewise via each portfolio manager and their team. You can see a breakdown of each portfolio here on the Wessex CRN page.

The Portfolio and the NHS

Portfolio adoption is usually vital to participating NHS Trusts when considering the research studies they wish to undertake, as they are reimbursed for the resource given to conduct the study (e.g. research nurse support, data manager time). As a result, it is strongly advised that external funding is considered for BU clinical research projects – the amount of funding doesn’t have to be substantial.

Each CRN is given a budget for the financial year by the NIHR, which is then distributed to sites based on their recruitment figures.

Requirements

In order to be eligible for portfolio adoption, there are three criteria a study must meet:

  • The study must be ‘research’ (this is stipulated, as often what’s classed as research outside the NHS setting, is sometimes a service evaluation, quality improvement etc. within the NHS – see this table);
  • Have appropriate ethical approval; and Health Research Authority (HRA) Approval where required;
  • Have full research funding – this has to have been awarded via open competition and by the NIHR, other areas of central Government, or an NIHR non-commercial partner (for which there is a list). If the study has received support from multiple funders, then it will be still considered automatically eligible, if one of the funding streams is the NIHR, an area of central Government or a non-commercial partner.

You can read more about study eligibility here, including research funded by overseas partners.

The Portfolio and BU

The source of research funding is the principal determinant of eligibility for NIHR CRN support and so it is encouraged that researchers seek external funding where possible and appropriate, from the NIHR, another area of central Government or one of their non-commercial partners. The amount of funding doesn’t need to substantial in order to be eligible.

For any queries to do with the portfolio or for guidance regarding implementing your research in a healthcare setting, take a look at the Clinical Governance blog. You can also get in touch with BU’s Research Ethics team with any queries.

Setting up NHS / HSC research in the UK– changes from TODAY

The new ‘UK Local Information Pack‘  has been introduced today, 5th June to support the set-up of NHS / HSC research in the UK.

The ‘UK Local Information Pack’ is the set of documents that NHS / HSC organisations use to formally start preparing to deliver the study. You can find more information here, including what comprises the pack. All researchers wishing to set-up their study at an NHS/HSC site from today, 5th June, need to be aware of this change.

The Organisation Information Document

Researchers and research teams may be aware of a document called the ‘Statement of Activities’ – this is essentially a document that allows the sponsor to make clear to the research site, what activities will be undertaken locally. The document can also act as the agreement between the sponsor and site.

From today the Statement of Activities has been replaced by a document called the ‘Organisation Information Document‘. For non-commercially sponsored studies, that are not clinical trials or clinical investigations, the ‘Organisation Information Document’ should be used as the agreement between sponsor and participating NHS / HSC organisation.

A new delegation log template

Another feature of the new UK Local Information Pack is the inclusion of a delegation log template, which is intended to be used at participating NHS / HSC organisations. This will allow NHS/HSC organisations to locally record who will be working on the study and who is authorised to undertake study tasks. The delegation log can be found here and should be used for studies submitted for approvals from today.

Schedule of Events or Schedule and Events Cost Attribution Tool (SoECAT)

For non-commercially sponsored studies studies an IRAS Schedule of Events or a SoECAT will be a part of the IRAS Form submission and is used in the UK Local Information Pack as a way of providing clarity to participating NHS / HSC organisations on the cost attributions associated with a study.

Further help and guidance

Guidance on the use of the new UK Local Information Pack has now been published in the Site Specific page of IRAS Help to help applicants get ready for the change.

If you are making an IRAS Form submission or planning to set up research in an NHS / HSC organisation from today, 5th June 2019 please read the transition guidance so that you prepare the correct materials.

If you have any queries regarding any of the information provided above, or would like some guidance with regard to implementing your research in a healthcare setting – please get in touch with BU’s Research Ethics team.

You can also take a look at the Clinical Governance blog for documents, links and training opportunities.

NIHR Research Participant Experience Survey 2018/19 – final report

You may have seen the blog post back in April regarding the results from a recent patient research experience survey, conducted by National Institute for Health Research (NIHR) Clinical Research Network (CRN) Wessex.

The survey results showed that across the 10 NHS organisations in Wessex, from the 400 responses received, 96% of participants had a good experience of taking part in research. It also showed that 98% of research participants surveyed had all the information that they needed in relation to the study.

The NIHR have released a recent report that shares the results of the Research Participant Experience Survey 2018-19, which was also conducted across the other 14 Clinical Research Network areas in England. You can take a look at the report here.

Setting up NHS / HSC research in the UK– upcoming changes

The UK Local Information Pack

A ‘UK Local Information Pack‘ will be introduced on the 5 June 2019 to support the set-up of NHS / HSC research in the UK.

The ‘UK Local Information Pack’ is the set of documents that NHS / HSC organisations use to formally start preparing to deliver the study. You can find more information here, including what comprises the pack. All researchers wishing to set-up their study at an NHS/HSC site from 5 June, will need to be aware of this change.

The Organisation Information Document

Researchers and research teams may be aware of a document called the ‘Statement of Activities’ – this is essentially a document that allows the sponsor to make clear to the research site, what activities will be undertaken locally. The document can also act as the agreement between the sponsor and site. Researchers setting up their study before 5 June should continue to use this document.

From 5 June the Statement of Activities will be replaced by a document called the ‘Organisation Information Document‘. For non-commercially sponsored studies, that are not clinical trials or clinical investigations, the ‘Organisation Information Document’ should be used as the agreement between sponsor and participating NHS / HSC organisation.

A new delegation log template

Another feature of the UK Local Information Pack is the inclusion of a delegation log template, which is intended to be used at participating NHS / HSC organisations. This will allow NHS/HSC organisations to locally record who will be working on the study and who is authorised to undertake study tasks.

Schedule of Events or Schedule and Events Cost Attribution Tool (SoECAT)

For non-commercially sponsored studies studies an IRAS Schedule of Events or a SoECAT will be a part of the IRAS Form submission and is used in the UK Local Information Pack as a way of providing clarity to participating NHS / HSC organisations on the cost attributions associated with a study.

Further help and guidance

Guidance on the use of the UK Local Information Pack has now been published in the Site Specific page of IRAS Help to help applicants get ready for the change.

If you are making an IRAS Form submission or planning to set up research in an NHS / HSC organisation from 5 June 2019 please read the transition guidance so that you prepare the correct materials.

If you have any queries regarding any of the information provided above, or would like some guidance with regard to implementing your research in a healthcare setting – please get in touch with BU’s Research Ethics team.

You can also take a look at the Clinical Governance blog for documents, links and training opportunities.

Article published in Physiological Reports

 

The article titled “The effects of 8 weeks of inspiratory muscle training on the balance of healthy older adults: a randomized, double-blind, placebo-controlled study” has been published by Physiological Reports.

 

It is the first research to describe the effects of inspiratory muscle training (i.e. breathing exercises that improve the strength of inspiratory muscles) on static and dynamic balance (measured with the clinical tool mini-BEST) and functional mobility (such as Timed Up and Go and 5 sit to stand tasks) with community dwellers older adults (aged 65+).

The research is part of Francesco Ferraro PhD journey. Journey guided with the supervision of Professor Alison McConnell, Dr James Gavin and Tom Wainwright

The article is now fully available as open access here

https://doi.org/10.14814/phy2.14076

Abstract

To examine the effects of 8‐week unsupervised, home‐based inspiratory muscle training (IMT) on the balance and physical performance of healthy older adults. Fifty‐nine participants (74 ± 6 years) were assigned randomly in a double‐blinded fashion to either IMT or sham‐IMT, using a pressure threshold loading device. The IMT group performed 30‐breath twice daily at ~50% of maximal inspiratory pressure (MIP). The sham‐IMT group performed 60‐breaths once daily at ~15% MIP; training was home‐based and unsupervised, with adherence self‐reported through training diaries. Respiratory outcomes were assessed pre‐ and postintervention, including forced vital capacity, forced expiratory volume, peak inspiratory flow rate (PIFR), MIP, and inspiratory peak power. Balance and physical performance outcomes were measured using the shortened version of the Balance Evaluation System test (mini‐BEST), Biodex® postural stability test, timed up and go, five sit‐to‐stand, isometric “sit‐up” and Biering–Sørensen tests. Between‐group effects were examined using two‐way repeated measures ANOVA, with Bonferroni correction. After 8‐week, the IMT group demonstrated greater improvements (P ≤ 0.05) in: PIFR (IMT = 0.9 ± 0.3 L sec−1; sham‐IMT = 0.3 L sec−1); mini‐BEST (IMT = 3.7 ± 1.3; sham‐IMT = 0.5 ± 0.9) and Biering–Sørensen (IMT = 62.9 ± 6.4 sec; sham‐IMT = 24.3 ± 1.4 sec) tests. The authors concluded that twice daily unsupervised, home‐based IMT is feasible and enhances inspiratory muscle function and balance for community‐dwelling older adults.

Floods and PTSD in India

Cover of NJE Yesterday the Nepal Journal of Epidemiology published its latest issue which included the paper on ‘Post-Traumatic Stress Disorder among the Flood Affected Population in Indian Subcontinent’ [1].  This Short Communication is co-authored by Prof. Edwin van Teijlingen and two members of the Visiting Faculty in our Faculty of Health & Social Sciences, namely: Prof. Padam Simkhada and Dr. Brijesh Sathian.  The Nepal Journal of Epidemiology is an Open Access journal hence this paper is freely available for anybody with internet access to read.

  Reference:

  1. Asim, M., Mekkodathil, A., Sathian, B., Elayedath, R., N, R., Simkhada, P., & van Teijlingen, E. (2019). Post-Traumatic Stress Disorder among the Flood Affected Population in Indian Subcontinent. Nepal Journal of Epidemiology, 9(1), 755-758. https://doi.org/10.3126/nje.v9i1.24003

Paper in top 30 most cited Journal Advanced Nursing articles

BU’s Dr. Bibha Simkhada’s paper ‘Factors affecting the utilisation of antenatal care in developing countries: a systematic review of the literature’ [1] is currently the 27th most cited paper in the Journal of Advanced Nursing.  This is great achievement considering that the journal has published nearly ten thousand articles since its inception (to be precise 9,847).  The Journal of Advanced Nursing (published by Wiley) is one of the prestigious journals in the nursing field.  This extremely well-cited paper was part of Bibha’s Ph.D. study at the University of Aberdeen.  Dr. Bibha Simkhada is Lecturer in Adult Nursing in the  Department of Nursing and Clinical Sciences.  One of her co-authors also works at BU, Prof. Edwin van Teijlingen and a second co-author, Prof. Padam Simkhada from Liverpool John Moores University is Visiting Professor in the Faculty of Health & Social Sciences.  The third co-author Dr. Maureen Porter retired a few years ago.

 

 

Reference:

  1. Simkhada, B., van Teijlingen E., Porter, M., Simkhada, P. (2008) Factors affecting the utilisation of antenatal care in developing countries: a systematic review of the literature, Journal of Advanced Nursing 61(3): 244-260.

Top ten cited paper in MIDWIFERY

Looking at the SCOPUS data for 5 May 2019 on the International Day of the Midwife showed that the theoretical paper ‘Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care’ [1] is in the top ten mosted quoted articles in Midwifery.  Now in its 35th year, Midwifery is an international  journal published by Elsevier.  Since its inception in 1985 it has published 2,626 papers, and our paper ”Risk, Theory, Social & Medical Models’ has now been cited by 108 papers, making it the eighth most cited article.

Professor Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

 

Reference:

  1. MacKenzie Bryers H., van Teijlingen, E. (2010) Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care, Midwifery 26(5): 488-496.