Tagged / public health

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.

Management of male obesity: The qualitative evidence (BMJ Open)

BMJ Open 2015Yesterday BMJ Open published our latest article on the weight management in obese men, under the title A qualitative evidence synthesis on the management of male obesity.[1]  To the best of our knowledge, this is the first synthesis of qualitative studies investigating men’s perceptions and experiences of weight management services.  The interdisciplinary study was conducted between the three research centres at the University of Aberdeen, namely the Health Services Research Unit (HSRU), the Health Economics Research Unit (HERU) and the Rowett Institute of Health & Nutrition, the University of Stirling’s NMAHP Research Unit, the University of Edinburgh’s Scottish Collaboration for Public Health Research & Policy (SCPHRP) and Bournemouth University.

Studies published between 1990 and 2012 reporting qualitative research with obese men, or obese men in contrast to obese women and lifestyle or drug weight management were included. The studies included men aged 16 years or over, with no upper age limit, with a mean or median body mass index of 30 kg/m2 in all settings. In total 22 studies were identified.

Health concerns and the perception that certain programmes had ‘worked’ for other men were the key factors that motivated men to engage with weight management programmes. Barriers to engagement and adherence with programmes included: men not problematizing their weight until labelled ‘obese’; a lack of support for new food choices by friends and family, and reluctance to undertake extreme dieting. Retaining some autonomy over what is eaten; flexibility about treats and alcohol, and a focus on physical activity were attractive features of programmes. Group interventions, humour and social support facilitated attendance and adherence. Men were motivated to attend programmes in settings that were convenient, non-threatening and congruent with their masculine identities, but men were seldom involved in programme design.

The paper concluded that men’s perspectives and preferences within the wider context of family, work and pleasure should be sought when designing weight management services. Qualitative research is needed with men to inform all aspects of intervention design, including the setting, optimal recruitment processes and strategies to minimise attrition.  This paper grew out of the larger ROMEO study which was published in our full HTA (Health Technology Assessment) report, which is also freely available on line, click here! [2]

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., Stewart, F., Robertson, C., Boyers, D., Avenell, A. (2015) A qualitative evidence synthesis on the management of male obesity. BMJ Open 5: e008372. doi:10.1136/bmjopen-2015-008372 http://bmjopen.bmj.com/content/5/10/e008372.full.pdf+html
  2. Robertson, C., Archibald, D., Avenell, A., Douglas, F., Hoddinott, P., van Teijlingen, E., Boyers, D., Stewart, F., Boachie, C., Fioratou, E., Wilkins, D., Street, T., Carroll, P., Fowler, C. (2014) Systematic reviews of & integrated report on the quantitative, qualitative & economic evidence base for the management of obesity in men. Health Technology Assessment 18(35): 1-424.  http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/118180/FullReport-hta18350.pdf

Paper ahead of its time?

Presentation1Sometimes my co-authors and I wonder why a particular paper get more cited after a few years of publication.  Is is because the paper and the research were are ahead of their time?  Or is there simply a lag time between publication and other researchers publishing in the field finding your paper (or stumbling upon it perhaps)?

Take for example the following paper published in 2006 when I was still based in the Department of Public Health at the University of Aberdeen: Promoting physical activity in primary care settings: Health visitors’ and practice nurses’ views and experiences in  the Journal of Advanced Nursing.[1]

 

Published in 2006 our paper was first cited in Scopus in 2007 (just once),three time in the following year (2008), five times in 2009 and then just a few times per year until this year. In 2015 we have six citations already and the year is not even finished.

We really wonder what lies behind that increased popularity of this 2006 paper.

citations JAN

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

  1. Douglas, F., van Teijlingen E.R., Torrance, N., Fearn, P., Kerr, A., Meloni, S. (2006) Promoting physical activity in primary care settings: Health visitors’ and practice nurses’ views and experiences Journal of Advanced Nursing, 55(2): 159-168.

Fusion Investment Fund: Neuroscience has found that emotions are a primary factor in learning to change behaviour: A project to apply and study these findings in many areas of practice (for example, public health, sports science, youth work, neurological rehabilitation, special education, and potentially many others).

 

We were very fortunate to receive Fusion funding for our collaboration between colleagues and students in Health and Social Sciences, Sports Science, and a variety of external practice partners. Essentially the funding will enable us to obtain psychophysiological recording equipment to be used to measure emotional responses in a wide variety of learning and training settings. Below is a screenshot of a typical recording from this kind of equipment.

 

Image-1

 

Huge progress has been made over the last couple of decades in our understanding of emotion and feelings. A compelling conclusion from this enormous body of work is the primacy of emotion in how we operate in the world. Darwin knew this, as did Freud, but many still cling to the notion of the achievements of homo sapiens (“wise man”!) as founded on cognition and rational thinking. For them, feelings are a vestigial remnant of our evolutionary past, not dissimilar to the appendix – no longer having any purpose, and also potentially a threat to our well being.

Affective neuroscience completely opposes this so-called rational approach: emotions and feelings guided our survival in our evolutionary past, but the big news is that they still do! Accumulations of theory and research from fields such as affective neuroscience, positive psychology, and health psychology support this simple but crucial switch in emphasis. Some everyday practice reveals the primacy of emotion, for example emotionally skilled doctors tend to bring about better health outcomes for their patients, children are taught to pay attention to their ‘uh oh’ signs (involuntary emotional responses of sweaty palms and heart beating faster) to keep them safe. So emotions are not the redundant and fickle “appendix” of our behavioural systems, but in fact are their driving force.

Despite an array of pragmatic findings about the way emotions and feelings work, this largely ‘pure’ body of neuroscience has not been directly applied to any particular field of practice. This project aims to correct that omission. The applications of affective science to how we learn and change our behaviour are potentially enormous, as the physiological emotional measures offer a straightforward ‘window’ into the person’s emotional responses.

The Fusion funding enables us to build on one of the applications, through running a study developing a previous pilot. This will be based on a form of training using natural horsemanship that has been demonstrated to be very successful in behaviour change for young offenders and young people who do not engage with school. This is an example of what it looks like (thanks to TheHorseCourse for the picture):

 

TheHorseCourse picture

 

The equipment, and experience gained through carrying out the initial study, will also allow for projects with other practice partners to go ahead, for example, work with people with acquired brain injuries, and children with profound learning disabilities. If any of this interests you, please get in touch with Sid Carter or Emma Kavanagh, and we’d be glad to tell you more.

 

New paper on obesity research

Colleagues associated with the Health Economics Research Unit (HERU), Health Services Research Unit (HSRU) and the Rowett Institute of Nutrition and Health (all based at the University of Aberdeen), the Nursing, Midwifery & Allied Health Professional Research Unit (University of Stirling), the Scottish Collaboration for Public Health Research & Policy (SCPHRP) based at the University of Edinburgh and the Centre for Midwifery, Maternal and Perinatal Health (CMMPH) at Bournemouth University published their latest paper on obesity research.  The paper ‘A systematic review of the cost-effectiveness of non-surgical obesity interventions in men’ is published in the journal: Obesity Research & Clinical Practice.  This systematic review summarises the literature reporting the cost-effectiveness of non-surgical weight-management interventions for men. Studies were quality assessed against a checklist for appraising decision modelling studies.  This research is part of the larger ROMEO study.

 

Prof. Edwin van Teijlingen

Faculty of Health & Social Sciences

 

Reference:

Boyers, D., Avenell, A., Stewart, F., Robertson, C., Archibald, D., Douglas, F., Hoddinott, P., van Teijlingen, E., A systematic review of the cost-effectiveness of non-surgical obesity interventions in men, Obesity Research & Clinical Practice (online first)

Congratulations to HSC student Mr. Jib Acharya

HSC PhD student Jib Acharya presented the preliminary results of his thesis research in a poster presentation entitled “A Comparative Study on Nutritional Problems in Preschool Aged Children of Nepal”

The poster was accepted at the 3rd World Congress of Public Health Nutrition Conference in Gran Canaria,  Spain, 2014.

Mr. Acharya’s poster was displayed as a traditional paper poster but also a digital poster on television screens around the conference.  The thesis work is supervised in the School of Health & Social Care by Dr. Jane Murphy, Dr. Martin Hind and Prof. Edwin van Teijlingen.  The attendance of this conference was made possible due to the support of a Santander award.

Congratulations

Prof. Edwin van Teijlingen

CMMPH

Congratulations to Dr. William Haydock

 

Congratulations to William Haydock, researcher in HSC, for his recently published paper in Capital & Class 38 (3): 583-600

The paper “‘20 tins of Stella for a fiver’: The making of class through Labour and Coalition government alcohol policy” is available from: http://cnc.sagepub.com/content/38/3/583.abstract

 

Prof. Edwin van Teijlingen

CMMPH

Changing diet and exercise, offering men-only groups, and humour may be the recipe for tackling male obesity

Fewer men join weight loss programmes but are more likely than women to stick with them, according to analysis of international obesity studies by researchers from the Universities of Aberdeen, Bournemouth and Stirling.

Men also prefer the use of simple ‘business-like’ language, welcome humour used sensitively, and benefit from the moral support of other men in strategies to tackle obesity. The researchers suggest that obese men might be helped better if weight loss programmes were specifically designed for men.

Researchers from the Universities of Aberdeen, Bournemouth and Stirling analysed evidence from around the world, gathered from weight loss trials and studies that have also taken men’s views. The team particularly investigated what would make services more appealing for men.

From their systematic review (see: http://www.journalslibrary.nihr.ac.uk/__data/assets/pdf_file/0019/118180/FullReport-hta18350.pdf ) of the evidence on obesity management published by the NHS National Institute for Health Research Health Technology Assessment Programme, researchers also found:

 

  • Cutting calories together with exercise and following advice on changing behaviour are the best way for obese men to shed pounds. This can also help reduce the risk of type 2 diabetes and can help improve erectile dysfunction for some men.
  • Obese men who eat less lose more weight than those who take more exercise but don’t eat less.
  • In the long term, one calorie-reducing diet has not yet been found to better than another for weight loss for men.
  • Middle-aged men are motivated to lose weight once they perceive they have a health problem they want to tackle.
  • A desire to improve personal appearance without looking too thin is also a motivator for weight loss in men.
  • Men are likely to prefer weight-loss programmes delivered by the NHS rather than those run commercially.
  • Group-based weight management programmes run only for men provide moral support.
  • Obesity interventions in sports clubs, such as football clubs, have been very effective, with low dropout rates and very positive responses from men.

 

Chief investigator Professor Alison Avenell, based at the University of Aberdeen, said: “More men than women are overweight or obese in the UK, but men are less likely to see their weight as a problem and engage with weight-loss services, even though obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. This could be because dieting and weight-loss programmes are perceived as being feminine activities.”

“We looked at the outcomes of obesity management trials and interventions as well as interviews with men in order to find out more about how to design services and inform health policy. While more research is needed into the effectiveness of new approaches to engage men with weight-loss, our findings suggest that men should be offered the opportunity to attend weight loss programmes that are different to programmes which are mainly attended by women.”

 

Dr Flora Douglas, from the Rowett Institute of Nutrition and Health, said: “Men prefer more factual information on how to lose weight and more emphasis on physical activity in weight loss programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings.   Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice helped men.  Programmes which were situated in a sporting venue, where participants had a strong sense of affiliation, showed low drop-out rates and high satisfaction.”

University of Stirling Professor Pat Hoddinott said: “Men are much less likely to enrol in commercial weight loss schemes. Some men preferred weight loss programmes delivered in an NHS context. The difference between weight loss for men from NHS and commercial programmes is presently unclear”.

 

Professor Edwin van Teijlingen from Bournemouth University added: “This research project has benefited throughout from the input and insights offered by the Men’s Health Forum in Ireland, the Men’s Health Forum Scotland and the Men’s Health Forum England and Wales.”

This project was funded by the National Institute for Health Research, Health Technology Assessment Programme (NIHR HTA Project 09/127/01; Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men http://www.nets.nihr.ac.uk/projects/hta/0912701).  The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Department of Health.

 

Prof. Edwin van Teijlingen

CMMPH

 

Comment on BU Blog leads to academic publication

Authorship differs between disciplines

Paper by Hundley et al. published 2013

Last year Prof. Matthew Bennett1 raised some interesting issues about academic authorship on this award-winning BU Blog.  Authorship is an issue that many academic colleague see as challenging.   On September 27th, 2012 two of us replied to this blog by adding some of our own observations on the web. Having penned our online comments we discussed the issue with BU Visiting Faculty Dr. Padam Simkhada Senior Lecturer in International Health at ScHARR, University of Sheffield (www.shef.ac.uk/scharr/sections/ph/staff/profiles/padamsimkhada).  Between the three of us we came to the conclusion that the issue of academic authorship can be very confusing as well as tricky.

 

We discussed a wide-range of issues around academic authorship, including who should be an author and who should not be so, the order of authors, and that there are different conventions between different academic disciplines.  Being academic we rapidly came to the conclusion that there was a paper in this.  We drafted our ideas, searched the literature for other discussions on authorship, general guidelines on authorship, etc.   We wrote the paper and submitted it to the academic journal Health Renaissance; an Open-Access journal, which is freely available world-wide.  The editor liked it and published our paper ‘Academic authorship: who, why and in what order?’ this month as a guest editorial. 3

 

 

We would like to highlight that there are two separate messages in the publication of this paper.  The first message is about academic scholarship; some of our colleagues may find the content of this paper is a useful guide in deciding authorship order, or at least in helping to open the debate about who should be included as co-author and who is not eligible.  The second message is more about academic citizenship, namely that messages on the BU Blog and even comments in reply to other people’s messages may contain useful information to the wider academic community and should be taken further.  Our message here is don’t see the BU Blog as an end point, see it as a stepping stone to the wider academic world!

 

Prof. Edwin van Teijlingen*, Prof. Vanora Hundley* & Dr. Padam Simkhada**

* Centre for Midwifery, Maternal & Perinatal Health, HSC, Bournemouth University

** ScHARR, The University of Sheffield

 

References:

1.      Bennett, M. (2012) What’s in a list?, BU Research Blog, http://blogs.bournemouth.ac.uk/research/2012/09/27/whats-in-a-list/?utm_source=digest&utm_medium=email&utm_campaign=daily

 

2.      Hundley, V., van Teijlingen, E. (2012) Response to What’s in a list?, http://blogs.bournemouth.ac.uk/research/2012/09/27/whats-in-a-list/#comment-17234

 

3.      Hundley, V., van Teijlingen,      E., Simkhada, P. (2013) Academic authorship: who, why and in what order? Health Renaissance 11      (2):98-101  www.healthrenaissance.org.np/uploads/Download/vol-11-2/Page_99_101_Editorial.pdf

Publish empirical or experimental data early whilst letting theory mature?

My colleagues and I have written several papers to help budding researchers about the process of writing and publishing academic papers (Hundley, & van Teijlingen 2002; van Teijlingen 2004; Pitchforth et al. 2005; van Teijlingen et al. 2012; Simkhada et al. 2013). For all researchers – students and staff alike publishing research findings is important as new insights will add to the existing knowledge base, advance the academic discipline and, in the case of applied research, perhaps improve something in the lives of others such as, well-being, the economy or the environment. Apart from this general/altruistic drive to add to knowledge, the advice academics give our postgraduate students is: to get your study published as soon as possible. The two main reasons for publishing early are: (a) getting into print to potentially help your careers; and (b) staking once claim as an authority in the field and/or publishing your findings before someone else does.
As always there are exceptions to the rule. As academics we agree that trying to get into print early is a good personal strategy for an early researcher or a postgraduate student especially for those working with empirical or experimental data. However, occasionally it is better to wait and give the underlying idea in the paper time to develop and mature. The kind of paper that often improves with time is one based on theory. Let me share a personal example: a theoretical paper from my PhD (awarded by the University of Aberdeen in 1994). This paper started life as a theory chapter in my PhD thesis (van Teijlingen 1994). This chapter on models of maternity care was not the strongest part of my thesis and it took me another decade of fine-tuning to get it into a state worth publishing. The paper ‘A Critical Analysis of the Medical Model as used in the Study of Pregnancy and Childbirth’ was finally published in Sociological Research Online, the original online-only Sociology journal in the world (van Teijlingen 2005). The wait was worthwhile as the paper is today (May 2013), eight year after publication, the seventh ‘most viewed articles during the past eight weeks’ in the journal (see: http://www.socresonline.org.uk/stats/top20.html).
In conclusion, it is generally sound advice to new researchers and postgraduate students to publish early. Occasionally though, waiting and giving your paper time to improve through discussion with colleagues, presenting the ideas at conferences and on blogs may lead to a better final product.
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health
School of Health & Social Care

References
Hundley, V., van Teijlingen E. (2002) How to decide where to send an article for publication? Nursing Standard 16(36): 21.
van Teijlingen (1994) A social or medical comparison of childbirth? : comparing the arguments in Grampian (Scotland) and the Netherlands (PhD thesis), Aberdeen: University of Aberdeen. Available online in the British Library (search for: uk.bl.ethos.387237 ).
Teijlingen van, E. (2004) Why I can’t get any academic writing done, Medical Sociology News 30 (3): 62-6.
van Teijlingen, E. (2005) A Critical Analysis of the Medical Model as used in the Study of Pregnancy and Childbirth, Sociological Research Online 10(2) Freely available online at: www.socresonline.org.uk/10/2/teijlingen.html.
Pitchforth, E., Porter, M., Teijlingen van, E.R., Forrest Keenan, K. (2005) Writing up and presenting qualitative research in family planning and reproductive health care, Journal of Family Planning & Reproductive Health Care 31 (2): 132-135.
Teijlingen van, E., Simkhada. P.P., Simkhada, B., Ireland, J. (2012) The long and winding road to publication, Nepal Journal Epidemiology 2(4): 213-215. http://nepjol.info/index.php/NJE/article/view/7093
Simkhada, P., van Teijlingen, E., Hundley, V. (2013) Writing an academic paper for publication, Health Renaissance 11 (1): 1-5. www.healthrenaissance.org.np/uploads/Pp_1_5_Guest_Editorial.pdf

Public Health: Knowledge into Action

1 day conference  – 26th June 2012

Jointly hosted by BU and the NHS

Public health is at a crossroads … moving back into local authorities where it began with the appointment of the first medical officers for health.  This move presents opportunities to improve health and wellbeing by taking a more integrated approach. The purpose of this one day conference was to discuss these opportunities and identify action that can be taken to improve health and wellbeing using the best available evidence.  The event was very successful and well attended and included local public health practitioners, local councillors and BU staff.

For further information please contact: Ann Hemingway, Public Health Academic at Bournemouth University – ahemingway@bournemouth.ac.uk or Lindley Owen Consultant in Public Health NHS Bournemouth and Poole – Lindley.Owen@bp-pct.nhs.uk

Presentations

BU student identifies Legionella pneumophila in windscreen washer fluid

Matthew Palmer [one of the BU students on the MSc Public Health programme within HSC] has just published part of his dissertation as a letter to the editor of the European Journal of Epidemiology. Matthew is reporting and confirming, for the first time, the identification of the microorganism (Legionella pneumophila) in water obtained from the windscreen washer fluid of a car without added screenwash.

Legionellosis or Legionnaires’ disease is a severe bacterial pneumonia caused by Legionella pneumophila acquired through droplet inhalation. Its public health significance lies primarily in the potential for large outbreaks of the disease such as the 1976 outbreak at an American Legionnaires’ conference in Philadelphia from which the disease derives its name. According to the Health Protection Agency there are, on average, 237 cases a year in England and Wales.

This is the first time that Legionella pneumophila has been identified in windscreen washer fluid and the first time that screenwash has been shown to be effective against its growth. With this in mind, we felt that Matthew should waste no time in getting this into the literature by starting publishing his findings. We envisage that there will be a fair amount of interest in Matthew’s discovery, especially within the public health world.

Matthew is currently working as a senior health protection practitioner at the Health Protection Agency and he has been doing his MSc degree at BU on part-time basis under the supervision of Professor Ahmed Khattab, Vanessa Heaslip and the MSc Public Health team.

You can access Matthew’s paper via this link: http://www.springerlink.com/content/u024qt22g77820t7/

Read more about Legionnaires’ Disease on the NHS website: http://www.nhs.uk/conditions/legionnaires-disease/Pages/Introduction.aspx

Prof Ahmed Khattab, HSC

Research into public health and tourism strategies

Watch this excellent short video from BU’s Dr Heather Hartwell (School of Tourism and School of Health and Social Care) who describes unique research facilitating strategic direction for public health, in alignment with tourism strategies, aimed at creating conversation and collaboration

To see other BU videos on YouTube go to the BU YouTube page.

 

httpv://www.youtube.com/watch?v=Hv8DM9zKU1c