

Latest research and knowledge exchange news at Bournemouth University
Professors Vanora Hundley and Edwin van Teijlingen just completed their ERASMUS Plus exchange with Manmohan Memorial Institute of Health Sciences (MMIHS) in Nepal. This was a very successful collaboration with colleagues in Nepal, despite the various turns of fate that were sent to challenge us. Indeed, the Profs toiled with the idea of giving this BU Research Blog the heading ‘The show must go on’ or ‘One man down….’ or even the far less punchy ‘The irony of doing a workshop by ZOOM in Nepal from a hotel 200 meters across the road’! In the end we decided that excellent collaboration requires resilience and a wee bit of ingenuity.
The trip to Nepal was marred by many little hiccups. It started at Heathrow where the airline insisted that they complete a now obsolete form about COVID-19 for the Government of Nepal, otherwise they would not let us on the flight. Arguing that Edwin had been to Nepal in April, and that no one then had asked for that particular piece of paper was fruitless. A quick online completion solved that first hurdle. The next hurdle was the flight leaving Heathrow over two hours late, which in turn meant missing the connection in Doha. Fortunately, the airline booked our academics on a replacement flight which left only hours after the original onwards flight had been scheduled to leave for Kathmandu. ingenuity. The trip to Nepal was marred by many little hiccups. It started at Heathrow where the airline insisted that they complete a now obsolete form about COVID-19 for the Government of Nepal, otherwise they would not let us on the flight. Arguing that Edwin had been to Nepal in April, and that no one then had asked for that particular piece of paper was fruitless. A quick online completion solved that first hurdle. The next hurdle was the flight leaving Heathrow over two hours late, which in turn meant missing the connection in Doha. Fortunately, the airline booked our academics on a replacement flight which left only hours after the original onwards flight had been scheduled to leave for Kathmandu.
The first five days in Kathmandu went well, apart from the to be expected tummy problems that go with monsoon in all low-income countries in South Asia. The teaching at MMIHS mainly focused on methodological issues. Our scheduled teaching sessions focused on the first-year MSc Nursing students (Vanora) and the first-year MSc Public Health students at MMIHS (Edwin).
In addition, with extra funding from GCRF (Global Challenges Research Fund), Bournemouth University and MMIHS supported by the local charity Green Tara Nepal planned ran a one-day research workshop in Kathmandu. This GCRF- funded ‘Systematic Review on Dementia Research Workshop’ was very well attended. Although the workshop budgeted for 30 people the attendance register shows that nearly double (n=59) the number of people attended at least part of the workshop. However, running the workshop was not without is problems. Two-days before the workshop Prof. van Teijlingen first had a positive COVID-19 lateral flow test followed by a positive PCR test. This put the burden of running the show very much on Prof. Vanora Hundley with Edwin being called in through Zoom. This is where the potential ‘irony’ title comes in. The irony of doing a workshop by ZOOM in Nepal ….. not from halfway across the globe but from a local hotel 200 meters across the road from MMIHS! The hotel’s internet connection was not as good as most of us have grown used to in Dorset, which added to the difficulty of running the workshop smoothly.
Despite all these challenges, the result was a very successful workshop that will continue to build our collaboration with colleagues in MMIHS and more widely across Nepal.
Finally, to end the story of hiccups, MMIHS forgot to inform the hotel that Edwin would be staying four extra nights. On the day he was originally scheduled to leave Nepal he received a phone call from reception asking what time he was checking out. When he said he thought extra nights had been booked for him, there was no reply. A little later he was told he could get another night, but he would have to move to another floor, and it would be for one night only, since all 91 room of the hotel were booked for the weekend for a big Asian wedding party. Luckily MMIHS found him another hotel a bit more outside the city centre for the remaining three nights.
We are incredibly grateful for the support of colleagues and friends in Nepal and at home in the UK, which helped smooth out some of the more interesting challenges.
Lessons learnt:
· Be ready to change and adapt to the needs of the situation.
· Strong relationships will help you deal with the unexpected.
· Keep positive when things get tough.
In the words of Steve Maraboli “Life doesn’t get easier or more forgiving, we get stronger and more resilient.”
Earlier this spring Dr. Pramod Regmi, Senior Lecturer in International Health in the Department of Nursing Sciences, traveled to MMIHS as part of this exchange. His visit in April 2022 included running the ‘Migration and Health Research Capacity Building Workshop for Early Career Researchers’ in Kathmandu. Bournemouth University organised this two-day event jointly with the University of Huddersfield, MMIHS, and the charity Green Tara Nepal.
Two current Faculty of Health & Social Sciences Ph.D. students are also benefittng from being involved in this exchange. Yagya Adhikari returned back to the UK a week or so ago whilst Sulochana Dhakal-Rai will be arriving in Kathmandu tomorrow. Both will use this ERASMUS+ opportunity to developed aspects of their Ph.D. thesis.
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Congratulations to Dr. Rachel Arnold in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the publication today of her paper ‘Why use Appreciative Inquiry? Lessons learned during COVID-19 in a UK maternity service‘ [1]. This methodological paper is co-authored with Dr. Clare Gordon who holds a has joint clinical academic post at UCLan and Lancashire Teaching Hospitals NHS Trust, with a focus on developing clinically focused stroke research, education and improvement.
Clare is also a former BU Ph.D. student. Further co-authors from CMMPH are Professors Sue Way and Edwin van Teijlingen. The final co-author, Dr. Preeti Mahato, finished her post in CMMPH two days ago to start her Lectureship in Global Health at Royal Holloway (part of the University of London).
The paper highlights that selecting the most appropriate research method is an important decision in any study. It affects the type of study questions that can be answered. In addition, the research method will have an impact on the participants – how much of their time it takes, whether the questions seem important to them and whether there is any benefit in taking part. This is especially important when conducting research with staff in health services. This article is a reflection on the process of using Appreciative Inquiry (AI) in a study that explored staff well-being in a UK maternity unit. The authors discuss our experience of using AI,the strengths and limitations of this approach, and conclude with points to consider if you are thinking about using AI. Although a study team was actively involved in decisions, this paper is largely based on reflections by dr. Arnold, the researcher conducting the field work in the maternity services.
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The second presentation will focus of the Nepal Federal Health System Project, our major collaborative project examining the consequences for the health system of Nepal’s move to a federal government structure in 2015. This is a joint project led by the University of Sheffield with Bournemouth University, the University of Huddersfield, and two institutions in Nepal: Manmohan Memorial Institute of Health Sciences MMIHS) and PHASE Nepal. This interdisciplinary study is funded by the UK Health Systems Research Initiative [Grant ref.
MR/T023554/1].
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternity & Perinatal Health (CMMPH)
Congratulations to Charlotte Clayton, PhD student in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) on the publication of an article based on her PhD study. The paper ‘The public health role of case-loading midwives in advancing health equity in childbearing women and babies living in socially deprived areas in England: The Mi-CARE Study protocol’ is co-authored with her supervisors Prof. Ann Hemingway, Dr. Mel Hughes and Dr. Stella Rawnson [1].
This paper in the European Journal of Midwifery is Open Access, and hence freely available to everybody with an internet access. Charlotte is doing the Clinical Academic Doctoral (CAD) programme at Bournemouth University. The CAD programme provides midwives with bespoke research training, which includes conducting a piece of independent research whilst also remaining in clinical practice. The CAD programme is part of the NIHR Wessex Integrated Academic Clinical Training Pathway and in her PhD study supported by BU and University Hospital Southampton (UHS), where Charlotte works as a midwife). Charlotte use the Twitter handle: @femmidwife.
Well done!
Prof. Edwin van Teijlingen
CMMPH
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Congratulations to FHSS PhD students Aniebiet Ekong and Nurudeen Adesina on the acceptance of their paper by MIDIRS Midwifery Digest [1]. This methodological paper reflects on their data collection approaches as part of their PhD involving African pregnant women in the UK.
This paper provides a snapshot of some of the challenges encountered during the recruitment of pregnant Black African women living in the UK for their research. Though there are several strategies documented to access/invite/recruit these ‘hard-to-reach population’ these recruitment strategies however were found to be unsuitable to properly engage members of this community. Furthermore, ethical guidelines around informed consent and gatekeeping seem to impede the successful engagement of the members of this community. It is believed that an insight into the experience and perceptions of ethnic minorities researchers will enhance pragmatic strategies that will increase future participation and retention of Black African women across different areas of health and social care research. This paper is co-authored with their BU PhD supervisors: Dr Jaqui-Hewitt Taylor, Dr Juliet Wood, Dr Pramod Regmi and Dr Fotini Tsofliou.
Well done !
Pramod Regmi
Congratulations to Bournemouth University’s PhD student Sulochana Dhakal-Rai on the publication today of the latest paper from her research thesis. This latest paper ‘Factors contributing to rising cesarean section rates in South Asian countries: A systematic review‘ has been published in the Asian Journal of Medical Sciences [1].
The paper is part of her PhD study of the rising CS rate in Nepal. This systematic review is co-authored with her BU PhD supervisors, Dr. Juliet Wood, Dr. Pramod Regmi and Prof. Edwin van Teijlingen as well as her Nepal-based supervisors Dr. Ganesh Dangel (FHSS Visiting Faculty) and Dr. Keshar Bahadur Dhakal. This is the sixth paper from Sulochana’s interesting and highly topical PhD thesis. The previous five were published in 2018, 2019 and 2021 [2-6].
Congratulations!
Prof. Edwin van Teijlingen
CMMPH
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In 2018 BU researchers Dr. Jenny Hall and Prof. Vanora Hundley in the Centre for Midwifery, Maternal & Perinal Health (CMMPH) published a paper on disabled women and maternity care. This scientific paper was co-authored with Ms. Jillian Ireland, Professional Midwifery Advocate in University Hospitals Dorset NHS Foundation Trust and BU Visiting Faculty, and Dr. Bethan Collins at the University of Liverpool (and former BU staff member). Their paper ‘Dignity and respect during pregnancy and childbirth: a survey of the experience of disabled women’ appeared in the Open Access journal BMC Pregnancy & Childbirth and was commissioned by the charity Birthrights. The study shows that disabled women are generally not receiving the individualised care and support they that they need to make choices about their maternity care. At the time of publication this BU paper was picked up by various media, including in South Africa.
The study resulted in change in St Mary’s Maternity Hospital in Poole (as part of maternity care provision by University Hospitals Dorset NHS Foundation Trust). One of the innovations at Poole Maternity Hospital was supporting a woman to give birth in hospital with her assistance dog by her side to help ease her anxiety.
This story was picked up by several newspapers including the local Bournemouth Echo under the heading ‘Dog to accompany Poole dog handler as she gives birth‘, and by several national newspapers last week when the The Guardian published ‘UK woman has baby in hospital with ‘birth dog’ by her side‘, The Times printed ‘Baby safely delivered, with a little help from woman’s best friend‘, whilst the online news website Big World Tale used the headline: ‘Woman, 24, gives birth in hospital with a DOG as ‘medical aid”.
Universities are always on the look out for impact generated by its research. This seems a clear example of joint research between BU and University Hospitals Dorset NHS Foundation Trust staff resulting in innovations in practice.
Congratulations to all involved!
Prof. Edwin van Teijlingen
CMMPH
Congratulations to BU PhD student Nurudeen Adesina on the publication of his systematic review. Nurudeen together with Huseyin Dogan in the Department of Computing & Informatics, Sue Green in the Nursing for Long-term Health Centre, and Fotini Tsofliou in Centre for Midwifery, Maternal & Perinatal Health (CMMPH) appeared in print just before Christmas with their paper ‘Effectiveness and Usability of Digital Tools to Support Dietary Self-Management of Gestational Diabetes Mellitus: A Systematic Review‘ [1].
This new paper highlights that advice on dietary intake is an essential first line intervention for the management of gestational diabetes mellitus (GDM). Digital tools such as web-based and smartphone apps have been suggested to provide a novel way of providing information on diet for optimal glucose regulation in women with GDM. This systematic review explored the effectiveness and usability of digital tools designed to support dietary self-management of GDM. A systematic search of Medline, Embase,
Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Scopus using key search terms identified 1476 papers reporting research studies, of which 16 met the specified inclusion criteria. The quality of the included studies was assessed using the ErasmusAGE Quality Score or the Mixed Methods Appraisal Tool (MMAT) version 2018. The findings show that the adoption of digital tools may be an effective approach to support self-management relating to healthy diet, health behaviour, and adherence to therapy in women with GDM as a usable intervention. However, the four authors argue that there is a lack of evidence concerning the effectiveness of tools to support the dietary management of GDM. Consideration for ethnic specific dietary advice and evidence-based frameworks in the development of effective digital tools for dietary management of GDM should be considered as these aspects have been limited in the studies reviewed.
Reference:
Adesina, N.; Dogan, H.; Green, S.; Tsofliou, F. Effectiveness and Usability of Digital Tools to Support Dietary Self-Management of Gestational Diabetes Mellitus: A Systematic Review. Nutrients 2022, 14, 10. https://doi.org/10.3390/nu14010010
Recently I completed a game of Happy Families, to be more precise I added a paper with my fourth family member to a ‘collection’. I got the idea from Prof. Jonathan Parker and Prof. Sara Ashencaen Crabtree (both based in the Department of Social Sciences & Social Work) who published a paper with their children a few years ago [1]. When Jonathan told me about this achievement I had already published two dozen of scientific and practitioners’ papers with my partner Jilly Ireland, Professional Midwifery Advocate in University Hospitals Dorset NHS Foundation Trust and FHSS Visiting Faculty (for example 2-5).
Two years ago, Dr. Preeti Mahato (in the Centre for Midwifery, Maternal & Perinatal Health) and I published a paper with my middle son about ‘Vaping and e-cigarettes: A public health warning or a health promotion tool?’ [6]. The following year, Prof. Hamid Bouchachia (Faculty of Science & Technology) and I co-authored a paper with my oldest son on AI and health in Nepal [7], followed by a paper this year on academic publishing with FHSS’s Dr. Shovita Dhakal Adhikari (Department of Social Sciences & Social Work , Dr. Nirmal Aryal (CMMPH) and Dr. Pramod Regmi (Department of Nursing Sciences [8]. And to complete the four family members in the Happy Families set, I published a paper late last month with my daughter under the title ‘ Understanding health education, health promotion and public health’ [9].
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Today Sunday 21st November was a midwifery dominated day today. This lunchtime a interdisciplinary team from CMMPH (Centre for Midwifery, Maternal & Perinatal Health) at BU and the University of Exeter submitted a research proposal to the ICM (International Confederation of Midwives) on Midwife-Led Birthing Centres in Low- and Middle-Income Countries. As a personal observation: whoever thought that setting the submission deadline for a Sunday was a good idea has no respect for researchers’ work-life balance!
This afternoon many of us attended the March with Midwives vigils which were held nationwide in the UK to highlight issues with midwifery staffing and working conditions. The March with Midwives vigil took place in 50 towns and cities, as a vigil to make the general public and politicians aware about the maternity crisis. In Poole Park it attracted over fifty people.
This wonderful session reminded me of my draft chapter I wrote for my PhD thesis three decades ago. My thesis A social or medical model of childbirth? : comparing the arguments in Grampian (Scotland) and the Netherlands at the University of Aberdeen was supervised by Dr. Peter McCaffery. Peter wisely said to me: “You really needed to write this chapter to make sense of the history of midwifery in your head, but it does not really fit the thesis.” He added: “You have too many words already. You know that it is not going in?” The material of this history chapter was not lost as I used loads of text from it it in the introduction section for a textbook [1]. The section ‘History of Midwifery: Introduction’ became part of our edited volume Midwifery and the Medicalization of Childbirth: Comparative Perspectives (Nova Science Publishers, Inc., Huntington, New York, USA) [2].
It is a message I occasionally repeat to my own PhD students. Under the circumstances I may fing myself saying things like “This is something you had to get of your chest, or you had to write it to make sense of it, but as it stands do you think it fits your argument?” Or more subtly in a supervision meeting, tell us: “What does this section add to your overall story in the thesis?”
Prof. Edwin van Teijlingen
CMMPH
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Congratulations to Faculty of Health & Social Sciences (FHSS) staff and students on their latest publication in the international journal Midwifery (published by Elsevier). FHSS Professors Carol Clark and Vanora Hundley, undergraduate student researcher Guste Kalanaviciute and CMMPH PhD student Vanessa Bartholomew and Professor Helen Cheyne from the University of Stirling recently had the following paper accepted: ‘Exploring pain characteristics in nulliparous women; a precursor to developing support for women in the latent phase of labour’ [1].
Reference:
Clark C, Kalanaviciute G, Bartholomew V, Cheyne H, Hundley VA (2021) Exploring pain characteristics in nulliparous women; a precursor to developing support for women in the latent phase of labour. Midwifery (in press)
Prof. Vanora Hundley in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) has been appointed to the Chief Midwifery Officer’s (CMidO) National Research Strategy Board. The key aim of this National Research Strategy Board is to ensure the Chief Midwifery Officer for England and the maternity transformation programme team have access to advice and expertise to support and develop its strategic plan for research. Prof. Hundley will help identify research gaps and priorities relating to maternity and newborn care. The first meeting was held in mid-September and chaired by Prof. Jane Sandall, Head of Midwifery and Maternity Research.
The second prestigious appointment for Prof. Hundley is to Tommy’s Scientific Advisory Group. Tommy’s is a pregnancy charity “working to make the UK the safest place in the world to give birth”. The charity funds pioneering research to understand how to prevent complications and loss, as well as enabling specialist care for people at their clinics, research centres and across the NHS. In addition, the charity provides expert, midwife-led advice for parents before, during and after pregnancy, working together towards safer, healthier pregnancies. As a member of the Scientific Advisory Group, Prof. Hundley will review the strategy, plans and outputs from Tommy’s Research Centres.
Congratulations!
Profs. Sue Way & Edwin van Teijlingen
CMMPH
Yesterday we had the pleasure of running an Academic Writing Workshop for academics and postgraduate students in the Department of Health & Physical Education based at the Sanothimi campus of Tribhuvan University. Tribhuvan University is the oldest and largest university of Nepal. We base these training session on our various publications on academic publishing, [1-14] and we used the opportunity to advertise our forthcoming textbook on the matter [15].
Prof. Padam Simkhada, Professor of Global Health and Associate Dean International at the School of Human and Health Sciences at the University of Huddersfield and FHSS Visiting Professor.
&
Prof. Edwin van Teijlingen, Centre for Midwifery, Maternal & Perinatal Health (CMMPH)
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Last night I misread a call from BMC Pregnancy & Childbirth. To be fair the email included two different request to contribute to two different kinds of blog posts with different set of instructions. Of course, I managed not to simply to swap these instructions around, but mix them up properly. The result is the text below that does not fit either of the two calls, I think.
My adopted question explains the title ‘Health is not a vacuum’. The short overview of the blog I drafted focused on all the papers I have published in this journal over a fifteen-year period from 2006-2021 [1-11]. Not surprising for a sociologist of health & illness, my argument is that there are nearly always issues wider than SDG 3 ‘Good health and well-being’ in the way health care/service or health policy factors affects maternity care and midwifery. Social, cultural and economic factors affect the way maternity services ares provided, used and perceived. SDG 5 ‘Gender equality’ springs to mind first, but also important is SDG 4 ‘Quality education’, especially of girls, and SDG 1 ‘No poverty’, of course strongly linked with SDG 10 ‘Reduced inequalities’.
Gender is highlighted or at least part of the argument in many of our papers in low- and middle income countries [2,3,5, 7,10,11], but also in a high-income context [1,6]. Education, both health education and education more generally, for example education levels of maternity service users, appears in several papers [1,6,8-11] whilst poverty is a key factors in several papers based on our work in Nepal [2,3,5,6,11]. Several of our papers address issues wider than health that are not strictly speaking SDG, such as paper on cultural differences in postnatal quality of life among German-speaking women living either side of the Swiss-German border [4], and of course, our paper on media and childbirth [6].
Last, but not least, all papers published in BMC Pregnancy & Childbirth are Open Access and freely available online!
Prof. Edwin van Teijlingen
CMMPH (Centre for Midwifery, Maternal & Perinatal Health)
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The term ‘pilot studies’ refers to mini versions of a full-scale study (also called ‘feasibility’ studies), as well as the specific pre-testing of a particular research instrument such as a questionnaire or interview schedule. Pilot studies are a crucial element of good study design. Conducting a pilot study does not guarantee success in the main study, but it does increase the likelihood of success. Pilot studies fulfill a range of important functions and can provide valuable insights for other researchers. There is a need for more discussion among researchers of both the process and outcomes of pilot studies.
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