Tagged / Health

Good Clinical Practice refresher – Monday 12th November

Are you currently undertaking research within the NHS and your Good Clinical Practice (GCP) training is due to expire? Or has it expired recently?

GCP certification lasts for two years, so if your training is due to expire, has expired, or you want to validate your learning, then take advantage of the upcoming refresher half day session, taking place at Poole Hospital on Monday 12th November, 9am – 12:30pm.

Spaces are still remaining, so if you’d like to enrol, get in touch with Research Ethics or the Wessex Clinical Research Network.

Failing to publish data from clinical trials presents risk to human health

A recent inquiry into research integrity was made earlier this year by the Science and Technology Committee, which revealed that nearly half of clinical trials fail to publish their results.

This lack of publishing has been deemed a risk to human health and a contributory factor in research wastage.

The article gives examples of a number of studies that are yet to be published, and how this activity ‘threaten(s) research integrity, and in some cases, endanger(s) human life’. The full article can be found here.

The University has administrative access to the ClinicalTrials.gov system – get in touch with us  if you are conducting clinical research, to ensure that you have access.

Nepal paper by Lesley Milne (CMMPH)

Congratulations to Lesley Milne, senior lecturer in midwifery, on the acceptance of her latest paper on maternity care in Nepal.  This new paper ‘Gender inequalities and childbearing: A qualitative study of two maternity units in Nepal’ will appear soon in the Open Access publication: Journal of Asian Midwives [1].   This is the second publication from a qualitative research study undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff [2].

The study received financial support from Wellbeing of Women and the RCM (Royal College of Midwives) as Lesley won their first International Fellowship Award.   The study was a collaboration led by Lesley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) with two of FHSS’s Visiting Faculty, namely Prof. Padam Simkhada who is based at Liverpool John Moores University and Jillian Ireland, Professional Midwifery Advocate based at Poole NHS Hospitals Foundation Trust.

Well done!

Profs. Vanora Hundley & Edwin van Teijlingen

 

 

 

References

  1. Milne, L., Ireland, J., van Teijlingen, E., Hundley, V., Simkhada, P.P. (2018) Gender inequalities and childbearing: A qualitative study of two maternity units in Nepal, Journal of Asian Midwives (accepted).
  2. Milne, L., van Teijlingen, E., Hundley, V., Simkhada, P., Ireland, J. (2015) Staff perspectives of barriers to women accessing birthing services in Nepal: A qualitative study BMC Pregnancy & Childbirth 15:142 www.biomedcentral.com/1471-2393/15/142 .

FHSS student awarded Chiropractor of the Year 2018-19

Congratulations to Amy Miller!   At the British Chiropractic Council’s annual conference 13-14th October, Bournemouth University PhD student Amy Miller was awarded the British Chiropractic Association’s award of ‘Chiropractor of the Year 2018-19’ for her contributions to research and engagement. 

Amy is based in the Faculty of Health & Social Sciences  (FHSS).  Her PhD is investigating an inter-professional student-led breastfeeding clinic for student learning, and breastfeeding outcomes and experiences.  Amy is supervised by Associate Professor Sue Way, Senior Lecturer in Midwifery Dr. Alison Taylor and Prof. Edwin van Teijlingen all based in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH). The British Chiropractic Association’s award for Chiropractor of the Year recognises individuals who have made a significant contribution to the profession.

 

 

SAIL meet in Hunstanton

Last week saw the bi-annual meeting of the Stay Active and Independent for Longer (SAIL) Research Team. Research colleagues from Belgium, the Netherlands and France travelled to Hunstanton, Norfolk to meet with UK partners from Norfolk County Council, University of East Anglia and Bournemouth University. The project is in 4 phases: Explore, Design and Develop, Test and Evaluate. October 2018 will see the SAIL project move into the third phase: Test. The visit to Hunstanton provided an opportunity to see at first hand the challenges which face the area in terms of supporting an aging population now and in the future. The Mayor of Hunstanton hosted an evening reception in the Town Hall to welcome the SAIL Research Team and to learn more about the progress which is being made.

Prof Ann Hemingway & Prof Adele Ladkin  meeting the Mayor of Hunstanton with Charlotte Watts, a project partner from Norfolk County Council.

Good luck today to our DEALTS 2 finalists for the 9th National Dementia Care Awards!

The Dementia Education And Learning Through Simulation 2 (DEALTS 2) programme has been shortlisted for the 9th National Dementia Care Awards 2018 in the Best Dementia Training Initiative category, which recognises the vital role of effective training in dementia care. Today is the judging day and the award will be made to an individual or organisation that can demonstrate the value of a training initiative which has been successfully implemented.

“I was over the moon when I found out DEALTS 2 had been shortlisted, it is a real honour to be a finalist in the 2018 competition,” says Dr Michelle Heward, 1/4 of the DEALTS 2 research team. “We had been nominated by a colleague from another university who completed an application.”

The DEALTS 2 programme is a national simulation-based dementia education programme for hospital staff with regular contact with people with dementia. The programme is an innovative, low cost, high impact training toolkit which aims to facilitate staff to consider experiences from the point of view of a person living with dementia, enabling staff to see beyond the diagnosis and see the person.

These resources can be adapted to be relevant in different settings and have been designed using low key simulation scenarios, which will allow staff to make positive changes to how they care and support people with dementia. The training also integrates theory into practice introducing the Humanising Values Framework (HVF) a philosophical lens developed at BU that identifies potentially humanising and dehumanising care and support. The HVF enables trainers to support staff morals as well as improve the care of people with dementia.

“The team has worked hard to deliver 13 train-the-trainer sessions nationally across England in 2017 with 196 trainers attending. The toolkit has been developed iteratively to encapsulate feedback from dementia specialists, trainers and informal carers,” says Dr Heward.

Click here to find out more about the DEALTS 2 programme, or get in touch with Dr Michelle Heward here. The DEALTS team includes Professor Jane Murphy, Dr Michele Board and Ashley Spriggs.

Congratulations to Dr. Alison Taylor

Congratulations to Dr. Alison Taylor whose PhD paper ‘The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers‘ has just appeared online [1].  This paper, in Women and Birth (published by Elsevier), was co-authored with her PhD supervisors Prof. Emerita Jo Alexander, Prof. Kath Ryan (University of Reading) and Prof. Edwin van Teijlingen.

The paper highlights that despite breastfeeding providing maximum health benefits to mother and baby, many women in the United Kingdom do not breastfeed, or do so briefly.  Alison’s study explored in a novel way the everyday experiences of first-time breastfeeding mothers in the early weeks following birth.  Five UK mothers were given a camcorder to capture their real-time experiences in a video diary, until they perceived their infant feeding was established. This meant that data were collected at different hours of the day by new mothers without a researcher being present.  Using a multidimensional approach to analysis, we examined how five mothers interacted with the camcorder as they shared their emotions, feelings, thoughts and actions in real-time. In total mothers recorded 294 video clips, 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. The paper concludes that frequent opportunities to relieve tension by talking to “someone” without interruption, judgement or advice can be therapeutic and that more research is needed into how the video diary method can be integrated into standard postnatal care to provide benefits for a wider population.

Alison is Senior Lecturer in Midwifery and a member of the Centre for Midwifery, Maternatal & Perinal Health.

 

 

Reference:

  1. Taylor, A.M., van Teijlingen, E., Alexander, J. & Ryan, K. The therapeutic role of video diaries: A qualitative study involving breastfeeding mothers, Women Birth (2018), (online first)  https://doi.org/10.1016/j.wombi.2018.08.160

Wellbeing in Nepal – Libraries week

Edwin van Teijlingen, Professor of Reproductive Health Research, will talk about wellbeing in Nepal. Professor van Teijlingen has done over a decade of field research in Nepal, especially on community-based projects on maternal health.

Edwin has extensive experience in public and reproductive health and has collaborated in large-scale evaluations of community-based public-health interventions.

Most publications by Professor van Teijlingen can be found on BURO, Bournemouth University’s repository.

Thursday 11 October, 3.30pm – 4.30pm, EB306, Executive Business Centre, Lansdowne Campus

International Conference on Migration Health (Rome)

Two days ago Bournemouth University Visiting Professor Padam Simkhada presented our paper ‘Problems faced by Nepalese female migrants workers in the Gulf Countries: A quantitative survey’ at the International Conference on Migration Health in Rome, Italy [1].  The study reports on the health and other problems experienced by Nepali women migrants at their work place during foreign employment in Gulf Countries.  The paper is building on earlier research with the charity Pourakhi in Kathmandu which helps women who return from working abroad in trouble.  The first paper was publish earlier this year in the journal BMC International Health & Human Rights [2].  

The conference presentation was co-authored with BU’s Dr. Pramod Regmi and Prof. Edwin van Teijlingen, Ms. Manju Gurung from Pourakhi, Ms. Samjhana Bhujel from Green Tara Nepal, and Padam Simkhada, who is professor in the Public Health Institute at Liverpool John Moores University.

 

References:

  1. Simkhada, P., van Teijlingen, E., Bhujel, S, Gurung, M., Regmi, P. Problems faced by Nepalese female migrants workers in the Gulf Countries: A quantitative survey’ [Abstract: 238] presented at Internat. Conf. Migration Health, Rome, 1-3 Oct. 2018, http://istmsite.membershipsoftware.org/files/Documents/Activities/Meetings/Migration/FOR%20WEBSITE%20-%20ORAL%20accepted%20abstracts%20-%20session-bookmark.pdf
  2. Simkhada, P.P., van Teijlingen, E.R., Gurung, M., Wasti, S. (2018) A survey of health problems of Nepalese female migrants workers in the Middle-East and Malaysia, BMC International Health & Human Rights 18(4): 1-7. http://rdcu.be/E3Ro

Ouch! Missing reference

One of the first rules of drafting a scientific paper is that one cites the key literature in the respective field.  So as someone who teaches people how to write and publish in this week’s experience of getting a paper rejected was not great, if not disheartening!   Earlier this week we submitted a research paper to the Journal of Travel Medicine on a study of the health and well-being of female migrant workers in Nepal.  This is high quality journal in which we have published before, including one paper on migrants’ health [1-3]. 

Two days later the journal editor emailed us to say: “”We feel that the scope of your paper would not justify a full original article in the Journal of Travel Medicine”, which is, in our opinion, a fair judgement.  My co-authors and I between us have over 300 papers published and most have been rejected or at least we have been asked for a resubmission, so nothing new here. What was more upsetting than the rejection itself was the additional comment.  The editor added:

The authors should ideally include the two following references:

……(first reference omitted)   …. +

Identifying the gaps in Nepalese migrant workers’ health and well-being: a review of the literature.

Simkhada PP, Regmi PR, van Teijlingen E, Aryal N. J Travel Med. 2017 Jul 1;24(4). doi: 10.1093/jtm/tax021. Review.

 

We agree with the editor that we should have included the two listed key papers. Crucially, it is more than a little mistake to have missed the second paper since we wrote it ourselves.  There are many lessons to be learnt from this: (a) check you have covered the key literature in your paper, either in the Background section and/or the Discussion; (b) don’t underestimate the importance of your own work; (c) you’re never too old to make mistakes (and to learn from them); (d) be thankful for good editors and reviewers; (e) do what you advise others to do; (f) etc. ………………

 

In shame,

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1. Hind, C., Bond, C.M., Lee, A., van Teijlingen E. (2008) Needs assessment study for community pharmacy travel medicine services, Journal of Travel Medicine 15(5): 328-334.
  2. Bhatta, P., Simkhada, P., van Teijlingen E., Maybin, S. (2009) A questionnaire study of VSO volunteers: Health risk & problems encountered. Journal of Travel Medicine 16(5): 332-337.
  3. Simkhada, P.P., Regmi, P.R., van Teijlingen, E., Aryal, N. (2017) Identifying the gaps in Nepalese migrant workers’ health and well-being: A review of the literature, Journal of Travel Medicine 24 (4): 1-9.

Congratulations on timely editorial in Nepal

Congratulations to FHSS academics Dr. Pramod Regmi and Dr. Nirmal Ayral who published an editorial yesterday in a scientific journal in Nepal.  The paper ‘Experts warn Nepal Government not to reduce local Public Health spending’ [1] was co-authored by Dr. Bibha Simkhada who has just been offered a post as Lecturer in Nursing in the Department of Nursing & Clinical Sciences, she shall be starting with us on November 1st.  Further co-authors include FHSS Visiting Professor Padam Simkhada and Dr . Sujan Marahatta, the journal’s editor.  He is based at Manmohan Memorial Institute of Health Sciences (MMIHS) in Kathmandu, Nepal.  Bournemouth University has a long-standing research collaboration with MMIHS.

The editorial warns about the risks of losing the focus on public health and its wider national and global perspective in the recently changed political arena of Nepal.  Since 2015 Nepal has moved from a central state to a federal republic, whereby the seven new Provinces have gained much more power and control in the decentralisation process.  Moreover the first local elections for two decades in 2017 meant a lot of new and inexperienced local politicians were voted in.  Many of these local people had little prior experience of political processes, governing health systems, the notion of priority setting, running sub-committees of elected representatives, political decision-making at local level, etc.  The paper argues that Public Health can easily disappear of the radar.  The untrained newly elected representatives with no political experience are most likely to be drawn into proposing and supporting popular measures including developing new buildings, black-top roads, hospitals, etc., rather than measures that increase the local or regional budget for teachers, Continuous Professional Development (CPD) for community health workers, and preventative public health measures in general.  Buildings and roads are immediate demonstration to voters that politicians have done something useful, reducing maternal mortality by 2.6% or employing two additional health workers doesn’t give politicians neither the same publicity, nor do such policies have immediate signs of success, and hence are unlikely to be vote winners.

The Journal of Manmohan Memorial Institute of Health Sciences is part of the Open Access publishing of Nepal Journals OnLine (NepJOL) supported by INASP.  The editorial also illustrates the kind of work conducted in Bournemouth University’s Integrative Wellbeing Research Centre (iWell).

 

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

 

Reference:

Simkhada, P., Teijlingen van, E., Simkhada, B., Regmi, P., Aryal, N., Marahatta, S.B. (2018) Experts warn Nepal Government not to reduce local Public Health spending, Journal of Manmohan Memorial Institute of Health Sciences, 4(1): 1-3.

New BU publication on maternity care & culture in Afghanistan

Congratulations to Dr. Rachel Arnold on the acceptance by Social Science & Medicine (published by Elsevier) of the second paper based on her PhD on maternity care in Afghanistan [1].  This interesting ethnography explores the experiences, motivations and constraints of healthcare providers in a large public Afghan maternity hospital. Arnold and colleagues identify barriers and facilitators in the delivery of care. Under the surface of this maternity hospital, social norms were in conflict with the principles of biomedicine. Contested areas included the control of knowledge, equity and the primary goal of work. The institutional culture was further complicated by pressure from powerful elites. These unseen values and pressures explain much of the disconnection between policy and implementation, education and the everyday behaviours of healthcare providers.

Improving the quality of care and equity in Afghan public maternity hospitals will require political will from all stakeholders to acknowledge these issues and find culturally attuned ways to address them.  The authors argue that this notion of parallel and competing world-views on healthcare has relevance beyond Afghanistan.   The paper co-authored by (a) Prof. Kath Ryan, Professor of Social Pharmacy at the University of Reading and Visiting Professor in FHSS, and BU’s Professors Immy Holloway and Edwin van Teijlingen.

 

References:

  1. Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: An ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40. doi: 10.1016/j.socscimed.2018.09.010.

 

Dr Gavin or: how I stopped worrying and learned to love research

A lesson on patience

It apparently took J.D. Salinger 10 years to write his first novel, The Catcher in the Rye. J.K. Rowling spent about 6 years writing and re-writing Harry Potter and the Philosopher’s Stone (I suspect publisher pressure accelerated things thereafter). As an early career researcher, I feel that since graduating from my doctorate and becoming independent, I can be less patient and eager for instant results – a feeling encouraged by social media and continuous metricisation.

My own current project, inspiratory muscle training for care home residents at risk of falling, can’t be compared to great achievements like those novels. But it is my ambition to undertake my own research project as principal investigator – and so I intend to savour the experience (i.e. be task oriented), rather than just chasing the outputs (i.e. being outcome oriented). I have learned to value iterative research designs, in that, the initial study’s outcomes inform the subsequent study’s methodology, and so on. However, this method presents its own uncertainties, as the researcher has to relinquish their control over the study.

Several lessons on managing myself

That said, I am beginning to see the need to set regular targets to keep the momentum on a project like this going. Taking my research beyond the controlled ‘safety’ of the physiology laboratory (satisfying internal validity), into a brave new world of the care home setting (satisfying external validity), requires working with research ‘end users’, be it: service managers, staff or residents. I’m finding the process: i) slow, care providers have additional administrative requirements, ii) essential, in laying trusted foundations for a long-term project, and iii) rewarding, by implementing research into the real world and establishing impact from the outset.

Since being awarded ACORN funding, my summer has been spent: writing for ethical approval, satisfying HR admin, recruiting care home partners, revising protocols, creating Plan B, writing Plan B ethical approval, piloting testing, revising participant selection criteria, and being trained by my PhD student (a lesson in humility, if nothing else). Even supported by an industrious research assistant this has felt a slow journey, with weekly peaks and troughs. I have even begun an 8 week period of inspiratory muscle training myself, to understand how care home residents can improve, feel challenged, and require further support. This has been equally useful to highlight practicalities – my challenges have been fitting 30 breaths, morning and night, into my daily routine; in contrast care residents’ challenges are likely to relate to effort, guidance, and motivation for training.

 

 

 

 

 

Research is an intellectual and logistical marathon

My initial participant selection criteria excluded all people with: dementia, COPD and respiratory difficulties, and cardiovascular diseases. My journey has presented three worries thus far: i) the funding expenditure deadline, ii) recruiting care homes and, iii) the selection criteria. In academia, the deadlines, targets and metrics are omnipresent, arguably more so since the increase in tuition fees.

Following the joy of being awarded research funding, comes the deadlines of expenditure (simple, if it were not for standard processes – ethical clearance, securing HR contracts, recruitment, and piloting) and the deliverables. I’m highly grateful of the ongoing support I receive, however I strongly believe that HE institutions must be realistic when financing projects and staff. Research is a slow process; outcomes cannot always be constrained to exact dates, as much as quality research cannot be established in rushed expenditure.

Mostly recently my challenge has been in recruiting care homes, particularly due to my selection criteria. This presents the methodological conflict between internal validity (i.e. the controlled laboratory) and external validity (i.e. the unpredictable care environment). Should I maintain my exclusion criteria, even though the majority of care home residents have dementia and/or COPD? Or relax the criteria to reflect the real environment and achieve recruitment? The former would make for more publishable data; the latter would support a Research Council funding bid (ah, I nearly forgot…must submit one of those by April 2019). Again, tempus fugit.

Self-experimentation

In this this social media age, time can appear condensed; two days can seem like an age, an afternoon of no replies, an epoch. A study in the 2017 Altmetric Top 100 provides compelling evidence that regular Smartphone use impairs cognitive performance by re-orienting attention. I’ve ‘disconnected’ from using a Smartphone and Facebook; this works for me. Regardless, I still have to exercise discipline in unnecessary email checking and now time-block my diary for: education, research or practice. I seriously recommend, as an academic, experiment on yourself. J.B.S. Haldane was a notable and prolific example of a self-experimenting physiologist. Yet whether it’s inspiratory muscle training or reducing Smartphone use, experiment on yourself – assess how you respond, identify influential variables and intervene if you wish.

 

 

 

 

How my ACORN grows

The simple truth is I don’t have a study finish date. The logic is if I am flexible on time, and put lots of my own effort in, then I will ultimately be able to generate both output and impact. There’s the psychological advantage too: by not having a finish date, I also stop the project becoming ‘work’. Pressures, missed opportunities, worrying others are publishing – these would stop research being fun. Academic success is not proportional to effort alone, however developing partnerships beyond academia is.

Being an academic is great – relative freedom, interesting colleagues, working with students, and contributing to societal value. Personally I’m not sure I’ll ever stop worrying, nevertheless, I have learnt to expect challenge on a near daily basis. This is notably relevant for the early career researcher looking to develop into an independent researcher, capable of sustaining their own work. Academia will always have a mountain to climb. I learnt to relax, stop worrying and love research by:

  1. Indulging in ‘quiet time’ – think, talk and share ideas
  2. Accepting failure
  3. Avoiding perfectionism
  4. Prioritising – day by day, week by week, time-block based on what tasks arise
  5. Avoiding distraction – e.g. social media detox / only read emails after late morning

Dr James Gavin

Dept. Sport & Physical Activity

Faculty of Management

Email jgavin@bournemouth.ac.uk

Phone 012029 66303

The link between loneliness and the rising number of elderly people suffering from malnutrition

Home Instead is launching the Stay Nourished initiative in consultation with Professor Jane Murphy from BU’s Ageing & Dementia Research Centre.

See full article below:

https://www.express.co.uk/life-style/life/1000975/one-million-pensioners-summer-eating-every-meal-alone?platform=hootsuite

 

Congratulations to FHSS Visiting Faculty

Congratulations to two members of Bournemouth University’s Visiting Faculty Minesh Khashu and Jillian Ireland on the publication of their paper ‘Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father co-parenting ‘ which has been accepted this week by the Journal of Neonatal Nursing. [1]  Prof. Minesh Khashu is the lead Consultant Neonatologist and Jillian Ireland is Professional Midwifery Advocate and both are based at Poole Hospital NHS Foundation Trust.

This position paper has been co-authored by a wide-range of international experts from The Family Initiative (based in London), Edith Cowan University in Australia, McGill University in Canada, Northwestern University in the United States of America, the University of Toulouse in France, Luleå University of Technology in Sweden, Lillebaelt Hospital in Denmark, the Scientific Institute IRCCS Eugenio Medea in Italy, the University of Melbourne in Australia and Bournemouth University.

This is second paper in this field by these BU Visiting Faculty members after the 2016 publication of a literature review. [2]

 

Congratulations!

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health

 

 

References:

  1. Fisher, D., Khashu, M., Adama, E., Feeley, N., Garfield, C., Ireland, J., Koliouli, F., Lindberg, B., Noergaard, B., Provenzi, L., Thomson-Salo, F., van Teijlingen, E. (2018) Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father co-parenting Journal of Neonatal Nursing (accepted).
  2. Ireland, J., Khashu, M., Cescutti-Butler, L., van Teijlingen, E., Hewitt-Taylor, J. (2016) Experiences of fathers with babies admitted to neonatal care units: A review of the literature, Journal of Neonatal Nursing 22(4): 171–176.

New BU publication disability & pregnancy

Two days ago the Open Access journal BMC Pregnancy & Childbirth published an important article on women with disabilities and their experiences with the maternity services when pregnant [1].  The new paper Dignity and respect during pregnancy and childbirth: a survey of the experience of disabled women’ has been co-authored by BU’s Dr. Jenny Hall (Centre for Excellence in Learning/CEL) and Prof. Vanora Hundley (Centre for Midwifery, Maternal & Perinatal Health/CMMPH) in collaboration with Dr. Bethan Collins (formerly of BU and now based at the University of Liverpool) and BU Visiting Faculty Jillian Ireland (Poole NHS Foundation Trust). The project was partially funded by the charity Birthrights and Bournemouth University.

Women’s experiences of dignity and respect in childbirth revealed that a significant proportion of women felt their rights were poorly respected and that they were treated less favourably because of their disability. The authors argue that this suggests that there is a need to look more closely at individualised care. It was also evident that more consideration is required to improve attitudes of maternity care providers to disability and services need to adapt to provide reasonable adjustments to accommodate disability, including improving continuity of carer.

 

Congratulations!

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health

 

Reference:

  1. Jenny Hall, Vanora Hundley, Bethan Collins & Jillian Ireland (2018) Dignity and respect during pregnancy and childbirth: a survey of the experience of disabled women, BMC Pregnancy & Childbirth, 18:328