Tagged / Health

New BU multidisciplinary media & health paper out today!

media childbirth

Today saw the publication “Is it realistic?” the portrayal of pregnancy and childbirth in the media, a paper which is truly interdisciplinary, both in terms of its authorship as well as its topics[1]. The lead-author, Dr. Ann Luce is based in the Faculty of Media & Communication, whilst her BU co-authors Dr. Catherine Angell, Prof. Vanora Hundley, Prof. Edwin van Teijlingen and Dr. Marylin Cash are all associated with the Faculty of Health & Social Sciences. Prof. Helen Cheyne, the only non-BU co-author, is based at the University of Stirling.

The paper is a scoping review to assess the influence media have on pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful.  Although many claim that the portrayal of childbirth has a negative effect on society, there is little research evidence to support this claim. It has been suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void through the increasing anticipation of negative outcomes. However the impact that has on normal birth has not been explored.  Our paper highlighted three key themes: (a) the medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event.  The key conclusions are the media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.

BMC cover media

BMC Pregnancy and Childbirth is an Open Access journal so our paper is freely available to researchers, journalists, childbirth activists as well as pregnant women anywhere in the world.  This paper builds on a growing number of academic papers published by staff in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the role the media play in health and midwifery, both in the UK [2-3] and in Nepal [4-6].

 

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1.  Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., Angell, C., (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media BMC Pregnancy & Childbirth 16: 40
  2. Hundley, V., Duff, E., Dewberry, J., Luce, A., van Teijlingen, E. (2014) Fear in childbirth: are the media responsible? MIDIRS Midwifery Digest 24(4): 444-447.
  3. Hundley, V., Luce, A., van Teijlingen, E. (2015) Do midwives need to be more media savvy? MIDIRS Midwifery Digest 25(1):5-10.
  4. Devkota, S., Simkhada, P., van Teijlingen, E., Rai, L.D. (2012) Media use for Health Promotion: Communicating Childhood Immunisation Messages to Parents. Journal of Health Promotion 4(1): 1-9.
  5. Devkota, S., Simkhada, P., van Teijlingen, E., Rai, L.D. (2013) Childhood Immunisation in Nepal: Parents’ knowledge, attitudes and behaviour & implications for Health Policy. Health Science Journal 7(4):370-383.
  6. Devkota, S., Maharjan, H.M., van Teijlingen, E. (2015) Media and Health. In: Wasti, S.P., Simkhada, P.P. & van Teijlingen, E. (Eds.) The Dynamics of Health in Nepal, Kathmandu, Nepal: Social Science Baha & Himal Books: 169-184.

First BU paper Prof. McConnell

Alison McConnell 2016FHSS Professor Alison McConnell just published her latest paper ‘Inspiratory muscle training improves breathing pattern during exercise in COPD patients’  with her international co-authors from Belgium and Thailand.  The paper concludes that the addition of inspiratory muscle training to a pulmonary rehabilitation programme in COPD (chronic obstructive pulmonary disease) patients with inspiratory muscle weakness resulted in a deeper and slower breathing pattern during exercise. Patients could achieve significantly higher peak work rate and exercise ventilation without increasing dyspnoea sensation.

Prof. McConnell is also author of Breathe Strong, Perform Better as well as Respiratory Muscle Training: Theory & Practice.

Congratultions,

Prof. Edwin van Teijlingen

CMMPH

 

Big Data in Health and Care – ‘Using data to gain new insights’

Data-science-history

Date: Tuesday 19 April

Location: St. Mary’s Stadium – Britannia Road Southampton, Hampshire SO14 5FP GB – View Map

Time: 9:00am – 5:00pm

About the event:

Big Data in healthcare is being used to cure disease, improve quality of life, avoid preventable deaths and more importantly plan primary prevention strategies. With the UK population increasing and all of us living longer, through initiatives such as the Vanguards, models of care are rapidly changing, and many of the decisions behind those changes are being driven by data.

This Big Data conference, chaired by Richard Samuel, (Fareham and Gosport, South-Eastern Hants CEO) will provide an overview of Big Data from experts within the field, as well as practical examples of how Big Data is being used to improve the way that we deliver services. A Big Data expo will be accessible throughout the day and in the afternoon a variety of plenary sessions will gather feedback from participants to help shape future actions.

To register: Click here

If you have any questions or queries regarding the event or any specific access needs please do not hesitate to contact Katie Cheeseman – Digital Health Programme Manager katie.cheeseman@wessexahsn.net                                                                                     

 

New NHS article by BU Visiting Faculty Minesh Khashu

FileLaptopImageDataManagement-1024x1024Minesh Khashu (BU Visiting Faculty and clinician in Poole Hospital) and Jeremy Scrivens published their third instalment of a series of online papers on the NHS.  This contribution is called ‘Can We Heal an Ailing Healthcare System? Part 3’.  They deep dive into this idea of transformation through a strengths-based approach.   They consider how we can build an NHS Social Movement by bringing the whole system together to inquire into and extend NHS’s Positive Core.  The blog (online paper) can be accessed here!

For more information you can also follow the two authors on Twitter: Minesh Khashu(@mkrettiwt) & Jeremy Scrivens (@jeremyscrivens)

 

 

Prof. Edwin van Teijlingen

CMMPH

 

New paper by Dr. Sarah Collard in Psychology of Sport & Exercise

Collard + Marlow 2016Dr. Sarah Collard (based in FHSS) had her article “It’s such a vicious cycle”: Narrative accounts of the sportsperson with epilepsy accepted in the scientific journal Psychology of Sport and Exercise. [1]  The paper, co-authored with Caroline Marlow, addresses the issues of the psychosocial barriers and benefits of exercising for the sportsperson/people with epilepsy (SWE). Her qualitative research presents the narratives of SWE over time and as a result, offers a deeper understanding of the psychosocial impact of exercising with epilepsy.

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

Collard, S.S., Marlow, C. (2016) “It’s such a vicious cycle”: Narrative accounts of the sportsperson with epilepsy, Psychology of Sport and Exercise 24: 56-64.

  http://www.sciencedirect.com/science/article/pii/S1469029216300073

Presentation by PhD student Preeti Mahato Jan 27th.

On Wednesday Jan. 27th CMMPH PhD student Preeti Mahato will present her PhD research ideas under the title “Addressing quality of care and equity of services available at birthing centres to improve maternal and neonatal health in western Nepal.”  Her presentation will be held at the Lansdowne Campus at 13.00 in room 301 in Royal London House.

IMG_6459Preeti’s research focuses on birthing centres in western Nepal; and quality and equity of service available at these facilities. In Nepal, birthing centres act as first contact point for the women seeking maternity services especially the basic obstetric care. The focus of this presentation will be to talk about the first review article Preeti Mahato wrote for the ‘Journal of Asian Midwives’ entitled “Birthing centres in Nepal: Recent development, obstacles and opportunities”. The article has been accepted for publication in June 2016 and focuses on introducing birthing centres, their current state of operation under the health system of Nepal, barriers they are facing and what could be done to improve their present state. The quality of care issue available at birthing centre is emphasised, since the number of these facilities are increasing however there is a growing trend to bypass and uptake services at hospitals. Despite barriers to utilisation of services at birthing centres, they can play an important role in increasing institutional delivery rate and proportion of births benefiting from a skilled birth attendant.IMG_6591

The second part of presentation will provide a brief summary on what Preeti has done since writing a review article, as she has worked on a systematic review on quality of basic obstetric care facilities in low and middle income countries.

Preeti Mahato has worked in the field of public health in Nepal for three years after completing her Master of Public Health. She has an interest in sexual and reproductive health, women’s health and maternal and child health. Working as a public health officer she was involved in maternal and neonatal health that developed her interest in pursuing a doctorate related to maternal and neonatal health. Part of her work in Nepal also included monitoring and supervision of birthing centres in rural areas of Nepal and that is how she became motivated to start a PhD at BU.

 

Prof. Edwin van Teijlingen

CMMPH

New CMMPH international midwifery publication

Congratulations to Professor Vanora Hundley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the publication of her latest international paper ‘How do midwives in Slovenia view their professional status?’ [1]. slovenia midwifery 2015

The paper explores Slovenian midwives’ views of their professional status, linkng this to the participants’ educational background. Most participants did not consider midwifery to be a profession in its ow right. Midwives with secondary education were more likely to consider practical skills to be important than theoretical midwifery knowledge. In general Slovenian midwives did not feel enabled to practise autonomously causing them several ethical dilemmas. All participants with midwifery secondary school education thought that obstetrics jeopardises midwifery scope of practice, but only half of the B.Sc. participants thought this. One-fifth of all participants estimated that midwifery is also threatened by nursing. The respondents reported feeling a lack of control over their professional activity and policy making; however the majority of midwives claimed that they were willing to take on more responsibility for independent practice. The authors conclude that Slovenian midwifery cannot be considered to be a profession yet. It faces several hindrances, due to its historical development.

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

Mivšek, P., Pahor, M., Hlebec, V., Hundley, V. (2015) How do midwives in Slovenia view their professional status? Midwifery 31(12):1193-201

Latest BU Nursing publication

Scammel J Clin Nurse 2016Congratulations to Janet Scammell, Vanessa Heaslip and Emma Crowley in FHSS on their new publication which appeared at the very end of 2015.  Their most recent paper is the first systematic review of service user involvement in non-mental health specific preregistration  nurse education.  The paper ‘Service user involvement in preregistration general nurse education: a systematic review’ is published in the current issue of the Journal of Clinical Nursing. [1]

Well done!

Prof. Edwin van Teijlingen

CMMPH

Reference:

  1. Scammell, J., Heaslip, V., Crowley, E. (2015) ‘Service user involvement in preregistration general nurse education: a systematic review’ Journal of Clinical Nursing 25:53-69.

Mental health & maternity care in Nepal: THET-funded training

group work NawalparasiIMG_6649

A few days I posted a short report of our first session as part of the THET-funded project ‘Mental Health Training for Community-based Maternity Providers in Nepal’, see this previous post here.  Yesterday we completed the final third day training of the first session of this BU-led project.  Over three days we had 70 ANMs (Auxiliary Nurse Midwives) in attendance, which we think is (nearly) all such staff based in all birthing centres in the district (=province).  The three days were the same, i.e. each session was repeated twice so each day one third of the ANMs could attend, and two-third could be at work in the birthing centre ensuring women could deliver safely.

logo THETAs part of this project we send UK volunteers (health and/or education) experts to Nepal to offer high quality training in areas where it is most needed.  Further detail on this BU-led THET project can be found in our scientific paper Mental health issues in pregnant women in Nepal  published in the Nepal Journal of Epidemiology available through Open Access.  Mental illness is still very much a taboo topic in Nepal as it has often a serious stigma attached to it.  Moreover, the relatively short training of ANMs is often fairly basic and the national curriculum does not cover mental health issues in any detail.  This joint project between Bournemouth University, Liverpool John Mooores University, Tribhuvan University and the local charity Green Tata Nepal addresses issues about mental health in general and in pregnant women and new mothers in particular.  Tribhuvan University is the oldest university in Nepal and one of the ten largest universities in the world (based on student numbers).  The project is multi-disciplinary involving midwives, (mental health) nurses, and doctors as well as global health researchers, educationalists and sociologists.

 

Prof. Edwin van Teijlingen

CMMPH

 

 

New Public Health paper on Christmas Eve

Douglas 2015 Men healthOur latest paper and the last one for 2015, published the day before Christmas.  The paper ‘Implementing Health Policy: Lessons from the Scottish Well Men’s Policy Initiative’ appeared in AIMS Public Health [1].  The paper draws on evaluation research led by Dr. Flora Douglas (University of Aberdeen).  This was a set of evaluations of the Well Men’s Health projects which were part of an initiative running in many health regions (or health boards as they are called in Scotland).

 

The focus of this particular paper centres around the fact that little is known about how health professionals translate government health policy into action [2]. Our paper examines that process using the  Scottish Well Men’s Services policy initiative as a ‘real world’ case study [1]. These Well Men’s Services were launched by the Scottish Government to address men’s health inequalities. Our analysis aimed to develop a deeper understanding of policy implementation as it naturally occurred.  We used an analytical framework that was developed to reflect the ‘rational planning’ principles health professionals are commonly encouraged to use for implementation purposes.

Our analysis revealed four key themes: (1) ambiguity regarding the policy problem and means of intervention; (2) behavioral framing of the policy problem and intervention; (3) uncertainty about the policy evidence base and outcomes, and; (4) a focus on intervention as outcome. This study found that mechanistic planning heuristics (as a means of supporting implementation) fails to grapple with the indeterminate nature of population health problems. A new approach to planning and implementing public health interventions is required that recognises the complex and political nature of health problems; the inevitability of imperfect and contested evidence regarding intervention, and, future associated uncertainties.

 

The paper is published in an Open Access journal, so it is easily and freely available to public health professionals, policy-makers and health workers across the globe.

Prof. Edwin van Teijlingen 

CMMPH

 

Reference:

  1. Douglas, F., van Teijlingen, E., Smith, W.C.S., Moffat, M. (2015) Implementing Health Policy: Lessons from the Scottish Well Men’s Policy Initiative, AIMS Public Health 2 (4): 887-905. http://www.aimspress.com/article/10.3934/publichealth.2015.4.887/fulltext.html
  2. Killoran, A., Kelly, M. (2004) Towards an evidence-based approach to tackling health inequalities: The English experience. Health Education Journal;63: 7-14.

Mixed methods: not without its downside?

Prof Edwin van Teijlingen

Conducting mixed-methods research has become very popular over the past decade especially in the health research field.1-4 This development ties in with the growth in inter-disciplinary and multi-disciplinary research. Many grant applications, PhD project and the resulting papers especially in the health field apply a mixed-methods approach, where in the past a single approach would have dominated.   This interest in combining methods seems to be the case even in the more traditional quantitative field of clinical effectiveness and randomised controlled trials. Whilst I find this development encouraging as a mixed-methods social scientist, it also makes me wonder whether the applicants putting forward a mixed-methods project have thought about the disadvantages or at least the opportunity costs of using such approach.

A mixed-methods approach is ‘simply’ combining two or more research methods to address a research question, i.e. what the label suggests. It is often perceived as the combining of qualitative with quantitative methods, but it can technically also be a mix of quantitative methods or a combination of qualitative methods. The advantage of a mixed-methods approach is that the different methods in the mix address different aspects of the research question and that combining these methods offers a synergetic effect. So what are the possible limitations of or barriers to mixed-methods research?

First, using a mixed-methods approach means you need an understanding of two different philosophies and how to bring the findings of these two different methods together.4-6   One requires expertise in two different research approaches, either as individual or in the team as well as someone who can do the combining of the findings. For the latter you really need someone in the team who understand the pragmatic approach commonly used in mixed-methods approaches. Otherwise there is a great risk that the original mixed-methods study will be analysed and reported as two or more separate papers each based on data from one of the methods applied in the mixed-methods study.

Secondly, you can spend your money only once, hence there are opportunity costs. Thus if the maximum grant is £200,000 or £300,000 you can’t spend the full amount on the designing a large-scale quantitative study/survey, as you need to spend a proportion of your money and your attention and time on your qualitative study.

Thirdly, and related the above, both quantitative and qualitative methods have ‘rules’ about sampling and sample-size.5 Just because you have two methods this does not mean you can necessarily do a study with a smaller sample. The sample size calculations will still say you need at least xxx participants. Similarly, although perhaps not so rigidly you need a certain number of interviews or focus groups to do you qualitative study appropriately.

Fourthly, a common mistake seems to be to add a bit of qualitative research to a larger quantitative study, perhaps a bit tokenistic.7 Often it is so obvious in a grant application that the qualitative research is an add-on, an afterthought perhaps from a reviewer in the previous failed grant application.

Finally, not all mixed-methods studies are the same, in fact each mixed-methods study is more or less unique in the way in the way it mixes and matched individual research methods.3 So although mixed-methods may be the best way to address a particular research question, your particular proposed mixed of quantitative and qualitative research might not be the most appropriate to answer the overall research question.8

As with all research methods and research proposals my recommendation is if in doubt go and find an expert for advice.6 If necessary get an expert on your team of researchers to strengthen your application.

 

Professor Edwin van Teijlingen

CMMPH

 

References:

  1.  Barbour, R.S. (1999) The case of combining qualitative and quantitative approaches in health services research. Journal of Health Services Research Policy, 4(1): 39-43.
  2. Simkhada, P., van Teijlingen, E., Wasti, S.P., Sathian, B. (2014) Mixed-methods approaches in health research in Nepal, Nepal Journal of Epidemiology 4(5): 415-416.
  3. Plano Clark, V.L., Anderson, N., Wertz, J.A., Zhou, Y., Schumacher, K., Miaskowski, C. (2015) Conceptualizing Longitudinal Mixed Methods Designs: A Methodological Review of Health Sciences Research, Journal of Mixed Methods Research, 9: 297-319.
  4. MacKenzie Bryers, H., van Teijlingen, E. Pitchforth, E. (2014) Advocating mixed-methods approaches in health research, Nepal Journal of Epidemiology 4(5): 417-422. http://www.nepjol.info/index.php/NJE/article/view/12018/9768
  5. Bryman, A. (1988) Quality and Quantity in Social Research, London: Routledge
  6. Bazeley, P. (2003) Teaching mixed methods. Qualitative Research Journal, 4: 117-126.
  7. Maxwell, J.A. (2016) Expanding the History and Range of Mixed Methods Research, Journal of Mixed Methods Research, 10: 12-27.
  8. Brannen, J. (2005) Mixing methods: The entry of qualitative & quantitative approaches into the research process. International Journal of Social Research Methodology 8(3): 173-85.