Tagged / Prof. Edwin van Teijlingen

New NHS article by BU Visiting Faculty Minesh Khashu

open access, Publishing

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

 

A series of co-incidents

BU research, international, Publishing, Uncategorized

Over 25 years ago during my PhD research comparing the organisation of midwifery and maternity care in the Netherlands and the Northeast of Scotland I wrote a chapter comparing the history of maternity care in the two countries.  I needed to write this not, as I thought at the time, to improve my thesis, but for myself to help me as a sociologist to help understand these historical developments.

In the process of researching the history of midwifery in the Netherlands I found a commemorative book by Drenth (1998) celebrating the centenary of the Dutch midwifery organisation. In this book is a footnote stating that the first chair of the KNOV (Royal Dutch Organisation of Midwives), Ms Francijntje de Kadt, lived and worked in the town of Vlaardingen in the late 19th to early 20th century (Drenth 1998). This note caught my eyes as I am born and bred in Vlaardingen.

Francijntje de Kadtlaan in Vlaardingen, the Netherlands

Francijntje de Kadtlaan in Vlaardingen, the Netherlands

After a bit more searching and a visit to the archives of the town of Vlaardingen I managed to dig up a little more about Francijntje de Kadt, but not an awful lot. During a family visit to the Netherlands I visited the archives of Vlaardingen to see what information they had about her. The archivist immediately recognised the name of Francijntje de Kadt, since genealogists keep finding her name as the midwife listed on their ancestors’ birth certificates. However, the archivist did not know that Francijntje de Kadt had been the first chair of the Dutch Mmidwifery organisation from its establishment in 1898 till 1926. At that point I decided to apply for a small travel grant in the History of Medicine from the Wellcome Trust. That application was successful, awarding a travel grant of £ 1,050 in 2001. My research in various archives in the Netherlands resulted in two papers (in Dutch) about Francijntje de Kadt, one in a local history journal (van Teijlingen 2003a) and one in the Dutch midwifery journal (2003b) and one about the collapse in 1921 of the midwives’ first pension fund (van Teijlingen 2002). This was for a while the end of my career as an amateur historian due to my busy day job as a health researcher and MSc coordinator at the University of Aberdeen.

Many years later (2010) I ended up talking to the burgomaster of Vlaardingen at the reception organised by the town to celebrate the fact that my father had been awarded the Dutch equivalent of an OBE. Over a drink I asked the burgomaster what the process was for suggesting a new street name in Vlaardingen. He suggested I write to the Street Name Committee with a justification why Francijntje de Kadt deserved a street name. With my recommendation I sent this committee my two Dutch publications. A few months later the secretary to the Street Name Committee wrote to say that my proposal had been accepted and that her name would be given to a street in a new development of the former local hospital grounds.

Then in mid-2015 a Dutch historian Eva Moraal came to Vlaardingen with her partner on a day trip and they ended up walking through the Francijntje de Kadtlaan. She read the subscript on the street sign (see photo) and thought ‘This woman need to have an encyclopaedia entry!’ A few days later she emailed me at Bournemouth University for further information on the live, work and achievements of Francijntje de Kadt to help her write a piece for the encyclopaedia. Two months ago Eva Moraal (2015) published her very nice contribution on Francijntje de Kadt.

So what started as a small historical study as an introduction chapter of a PhD thesis in Medical Sociology ended up with a ‘forgotten’ national midwifery leader having a street named after her in the town she spent most of her working live and her own entry in the encyclopaedia, Digitaal Vrouwenlexicon van Nederland (in Dutch: Online Women’s Lexicon of the Netherlands). What is even more interesting that this otherwise chronologically logical story is based on three major co-incidents: first, spotting a footnote in commemorative book about Vlaardingen. If Francijntje de Kadt had lived and worked anywhere else in the Netherlands other than my birthplace I would not have paid much attention. Secondly, speaking to the burgomaster of Vlaardingen and having a conversation in which street names cropped up, and thirdly, Eva Moraal who just happened to walk through the Francijntje de Kadtlaan, reading the street sign, and thinking this is an historical figure who needs better recognition.

 

Prof. Edwin van Teijlingen

CMMPH

 

References:

Drenth, P. (1998) 1898-1998. Honderd jaar vroedvrouwen verenigd, Bilthoven: KNOV.

Moraal, E. (2015) Kadt, Francijntje de, in: Digitaal Vrouwenlexicon van Nederland. URL: http://resources.huygens.knaw.nl/vrouwenlexicon/lemmata/data/Kadt

van Teijlingen, E. (2002) Ondergang eerste pensioenfonds voor vroedvrouwen (in Dutch: Decline of the first pension fund for midwives), Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), 27(12): 684.

van Teijlingen, E.R. (2003a) Berichten – Francijntje de Kadt (1858-1929), Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), 28(12): 630-633.

van Teijlingen, E.R. (2003b) Francijntje de Kadt (1858-1929). Vroedvrouw te Vlaardingen en eerste voorzitter van de Nederlandsche vroedvrouwenvereeniging, Tijd-schrift (in Dutch: Time-Magazine) 88: 14-23.

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

Publishing, Research news, writing

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

Editorial by Dr. Way in top journal highlights midwifery education

Fusion, international, Publishing

Way editorial 2016The forthcoming editorial in Midwifery (Elsevier) by FHSS’s Dr Susan Way highlights the importance of midwifery education and its educators.[1]  This editorial makes reference to the recent series on midwifery in The Lancet.[2]  Of course, midwifery plays a vital role in improving the quality of care of women and infants globally. Dr. Way reminds us that consistent, high-quality midwifery care has a vital role to play in the reduction of maternal and newborn mortality. Outcomes are enhanced when care is led by midwives who are educated, licensed, regulated, integrated in the health system, and working in interdisciplinary teams, with ready access to specialised care when needed.

Midwifery one of the leading academic journals globally in the field of midwifery and maternity care.  Dr.Way is based in the Centre for Midwifery, Maternal & Perinatal Health in FHSS at the Lansdowne Campus.

 

Congratulations!

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1. Way, S. (2015) Consistent, quality midwifery care: How midwifery education and the role of the midwife teacher are important contributions to the Lancet Series, Midwifery (online first) see: http://www.midwiferyjournal.com/article/S0266-6138(16)00021-8/abstract
  2. Renfrew, M.J., McFadden, A., Bastos, M.H. et al. (2014) Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. the Lancet. 384:1129–1145.

Presentation by PhD student Preeti Mahato Jan 27th.

international, PG research, Research news, student research, Uncategorized

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

Latest BU Nursing publication

BU research, Centre for Excellence in Learning, Uncategorized, writing

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

BU research, international, open access, Research news, Uncategorized

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

BU research, Publishing, Research communication, Research news, Uncategorized, writing

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?

BU research, REF Subjects, Research communication, Research news, Uncategorized

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.