Tagged / publishing

British Academy Writing Workshop in Nepal: Call for participants

Awarded & submitted bids, conferences, international, Publishing, Training, Women's Academic Network, writing

We are inviting expressions of interest for Nepal-based academic with an interest in gender and development issue to participate in our Writing Workshop: “Promoting Publishing in the field of Gender and Development in Nepal”.  Bournemouth University is leading two separate three-day workshops for early career researchers (ECRs) working across various universities in Nepal to encourage and support them to publish in peer reviewed journals in the field of social sciences, in Kathmandu (from  17-19 August 2022), and in Pokhara (from  21-23 August 2022).  The funding for these exciting workshop is provided by the British Academy.

There will be a mixture of presentations, group discussion and other interactive exercises, and independent writing exercises. The workshop involves practical sessions to help attendees to make their research idea clear and compelling to reviewers, and finalise their papers for publications. One-to-one sessions with our expert advisers will allow attendees to work through different aspects of their own research papers, methods and ideas.

 

How to apply: If you are an ECR based in Nepal and have some idea (or/and data) to work towards publication in gender and development, then please send us:

  1. A short CV – 3 pages maximum;
  2. An abstract or summary of the proposed paper you wish to develop through the writing workshop- (300 words maximum) by 30thJune 2022.

Female ECRs are highly encouraged to apply. Please use Subject British Academy Writing Workshop 2022 and email to sdhakaladhikari@bournemouth.ac.uk,  with a copy to both: pregmi@bournemouth.ac.uk and rashmi.rajkarnikar@cdec.tu.edu.np . The faciliators will inform you about your selection for the workshop by the middle of July 2022.  Selected participants will be asked to to submit their first rough draft by 3rd August, so that this can be discussed further during the workshop (17-19 August 2022).

The Writing Workshop facilitators are three BU scholars, Dr Shovita Dhakal Adhikari, in the Department of Social Sciences & Social Work, Dr. Pramod Regmi in the Department of Nursing Sciences, and Prof. Edwin van Teijlingen in the Department of Midwifery & Health Science in collaboration with Dr. Rashmee Rajkarnikar, at Nepal’s oldest and largest university, namely Tribhuvan University.

 

Another CMMPH COVID-19 publication on fathers

innovation, international, Knowledge Transfer, Publishing, writing

Congratulations to Centre for Midwifery, Maternal & Perinatal Health (CMMPH) Visiting Faculty members Prof. Minesh Khashu and Ms. Jillian Ireland on the acceptance of their paper “COVID-19 restrictions and psychological well-being of fathers with infants admitted to NICU (neonatal intensive care units)—an exploratory cross-sectional study” has been accepted by Acta Paediatrica [1]. Acta Paediatrica

These authors, both employed by University Hospitals Dorset NHS Foundation Trust, are part of an international team of researchers studying the role of fathers in maternity care.  The first author on the paper, Dr. Esther Adama is Lecturer in the School of Nursing and Midwifery at Edith Cowan University in Australia. Previous papers produced by some members of this team were both published in the Journal of Neonatal Nursing [2-3].

Congratulations to my colleagues!

Prof. Edwin van Teijlingen

 

 

References:

  1. Adama E.A., Koliouli F., Provenzi L., Feeley N., van Teijlingen E., Ireland J., Thomson-Salo F., Khashu M and FINESSE Group (2022) COVID-19 restrictions and psychological well-being of fathers with infants admitted to NICU—an exploratory cross-sectional study, Acta Paediatrica (accepted).
  2. Fisher, D., Khashu, M., Adama, E., Feeley, N., Garfield, C., Ireland, J., Koliouli F., Lindberg, B., Noergaard, B., Provenzi, L., Thomson-Salo, F., van Teijlingen, E. (2018) Fathers in neonatal units: Improving infant health by supporting the baby-father bond & mother-father co-parenting, Journal of Neonatal Nursing 24(6): 306-312 https://doi.org/10.1016/j.jnn.2018.08.007
  3. Ireland, J., Khashu, M., Cescutti-Butler, L., van Teijlingen, E., Hewitt-Taylor, J. (2016) Experiences of fathers with babies admitted to neonatal care units: A review of literature, Journal of Neonatal Nursing 22(4): 171–176

Another research league table

international, Publishing

This week Research.com, a prominent academic platform, published its 2022 Edition of the Ranking of Top 1000 Scientists in the area of Social Sciences and Humanities.  Professor Edwin van Teijlingen, in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), is listed as number 234 in United Kingdom ranking as well as number 1238 in the Social Sciences and Humanities world ranking.

 

Congratulations to Dr. Rachel Arnold on her latest paper

NHS, open access, Publishing, writing

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.

 

Reference:

Arnold, R., Gordon, C., van Teijlingen, E., Way, S., Mahato, P. (2022). Why use Appreciative Inquiry? Lessons learned during COVID-19 in a UK maternity service. European Journal of Midwifery, 6(May), 1-7. https://doi.org/10.18332/ejm/147444

Two new academic papers on COVID-19 research

international, Publishing, writing

This month CMMPH has two new research papers focusing on COVID-19.   The first one published in World Medical & Health Policy reports on a quantitative study of the availability of hand-washing facilities in households across Nepal [1].  This study used secondary data from Nepal Demographic Health Survey (NDHS) 2016 to assess the association between households’ wealth status to handwashing stations. The findings reported a statistically significant association between age of the household head, residence place, ecological zone, province, wealth status, having of mosquito net, having a radio, and TV at respondents’ household to fixed hand-washing stations at their households.

The second paper published three days ago in Vaccines is a qualitative study of of interviews with Nepali immigrants living in the UK and their attitudes towards COVD-19 vaccination [2].  Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the UK. This study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and (i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK.   This Vaccine paper includes two FHSS Visiting Faculty as co-authors: Prof. Padam Simkhada and Dr. Bibha Simkhada.

 

Prof. Edwin van Teijlingen

 

 

 

 

 

References:

  1. Sharma, M., Adhikari, R., van Teijlingen, E. (2022) Handwashing station in Nepal: Role of wealth status in establishing a handwashing station, World Medical & Health Policy Accepted
  2. Simkhada, P., Tamang, P., Timilsina, L., Simkhada, B., Bissell, P., van Teijlingen, E., Sah, S.K., Wasti, S.P. (2022) Factors Influencing COVID-19 Vaccine Uptake among Nepali in the UK: A Qualitative Study, Vaccine 10(5), 780;https://doi.org/10.3390/vaccines10050780

Paramedic science book launch this Friday

Centre for Excellence in Learning, Publishing, Training, writing

Coming Friday the Faculty of Health & Social Sciences has the pleasure of hosting the official launch of a new Mental Health Care in Paramedic Practice written by BU’s Dr. Ursula Rolfe and Mr. David Partlow, Somerset County Council Adult Social Care Strategic Manager.  The launch will take place in the Bournemouth Gateway Building at noon on May 6th in room BGB 302.

Mental Health Care in Paramedic Practice is the first guide written specifically to support paramedics in understanding a range of different mental health conditions in their practice.  This new book provides essential information on recognising and managing a range of conditions.  It offers case studies written by paramedics with first-hand experience of managing mental health issues, and includes a section on legal changes and policy descriptions as well as on the importance of interprofessional working. One of the online reviewers declared that this is an important read for Emergency Medical Service staff.

Congratulations!

Prof. Edwin van Teijlingen

Centre for Midwifery, Maternal & Perinatal Health (CMMPH)

 

Reference:

Rolfe, U., Partlow, D.  (eds.) (2022) Mental Health Care in Paramedic Practice, Class Publishing  [ISBN: 9781859599242]

Publish with Six PLOS journals for FREE

BU Challenges, open access, Publishing

Starting 1 April 2022, all BU corresponding authors will no longer need to pay the Article Processing Charge (APC) for publishing with PLOS Computational Biology, PLOS Digital Health, PLOS Genetics, PLOS Neglected Tropical Diseases, PLOS ONE and PLOS Pathogens, due to the JISC PLOS flat fee agreement that Bournemouth University has signed up to.

In order to benefit from this agreement, it is important that you properly self-identify during the submission process to be recognised as eligible for this agreement.

1.

2.

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If you wish to find out more about this publishing deal, you can visit this FAQ – and ensure that you expand the PLOS Institutional Partnerships menu and select PLOS Flat Fee Agreements –

For all related enquiries, please email OpenAccess@bournemouth.ac.uk 

 

Summit of Health & Population Scientists in Nepal 2022

international, Publishing, writing

Today say the start of the Eight National Summit of Health & Population Scientists in Nepal.  Bournemouth University is involved in two presentation.  The first will be one by University of Huddersfield PhD student Tamang Pasang, and her supervisors Prof. Padam Simkhada (FHSS Visiting Faculty), Dr. Bibha Simkhada (former BU Lecturer in Nursing and current FHSS Visiting Faculty) and Prof. Edwin van Teijlingen.  Pasang will be talking about her thesis fieldwork: ‘Impact of Federalisation in Maintaining Quality of Maternal and Neonatal Care in Nepalese Health System’.

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)

 

 

Latest BU publication on academic writing

Guidance, international, open access, Publishing, writing

Today the Nepal Journal of Epidemiology published our latest paper on academic writing, under the title ‘The Art of the Editorial’. [1]  This editorial highlights the importance of writing and publishing editorials in scientific journal.  Writing editorials seems sometimes to be a dying art.  This is perhaps due to more and more online journals not publishing regular issues, but adding papers online as and when they have been reviewed, revised and accepted. This paper is co-authered by Bournemouth University’s Professors Vanora Hundley and Edwin van Teijlingen, two of their four co-authors are also BU Visiting Faculty: Prof. Padam Simkhada based at the University of Huddersfield and Dr. Brijesh Sathian based in the Geriatric Medicine Department, Rumailah Hospital, Hamad Medical Corporation in Qatar.  This paper is an Open Access publication.

This paper on the art of writing editorials follows on from a series of papers on a wide-range of aspects of academic writing and publishing by FHSS (Faculty of Health & Social Sciences) authors [2-18].  FHSS co-authors on aspects of academic writing include: Dr. Orlanda Harvey [2], Dr. Pramod Regmi [2-3,4,16], Prof. Vanora Hundley [1,3,5,6,12-14], Dr. Nirmal Aryal [3-4], and Dr. Shovita Dhakal Adhihari [4,16], Dr. Preeti Mahato [3,16].

 

References:

  1. van Teijlingen, E., Hundley, V, Sathian, B., Simkhada, P., Robinson, J., Banerjee, I. (2022) The Art of the Editorial Nepal J Epidemiol, 12(1): 1135–38.
  2. Harvey, O., van Teijlingen, A., Regmi, P.R., Ireland, J., Rijal, A., van Teijlingen, E.R. (2022) Co-authors, colleagues, and contributors: Complexities in collaboration and sharing lessons on academic writing Health Prospect 21(1):1-3.
  3. Wasti, S.P., van Teijlingen, E., Simkhada, P., Hundley, V. with Shreesh, K. (2022) Writing and Publishing Academic Work, Kathmandu, Nepal: Himal Books
  4. van Teijlingen, E.R., Dhakal Adhikari, S., Regmi, P.R., van Teijlingen, A., Aryal, N., Panday, S. (2021). Publishing, identifiers & metrics: Playing the numbers game. Health Prospect, 20(1). https://doi.org/10.3126/hprospect.v20i1.37391
  5. Simkhada, P., van Teijlingen E., Hundley, V., Simkhada, BD. (2013) Writing an Abstract for a Scientific Conference, Kathmandu Univ Med J 11(3): 262-65. http://www.kumj.com.np/issue/43/262-265.pdf
  6. van Teijlingen, E, Hundley, V. (2002) Getting your paper to the right journal: a case study of an academic paper, J Advanced Nurs 37(6): 506-11.
  7. Pitchforth, E, Porter M, Teijlingen van E, Keenan Forrest, K. (2005) Writing up & presenting qualitative research in family planning & reproductive health care, J Fam Plann Reprod Health Care 31(2): 132-135.
  8. van Teijlingen, E, Simkhada, PP, Rizyal A (2012) Submitting a paper to an academic peer-reviewed journal, where to start? (Guest Editorial) Health Renaissance 10(1): 1-4.
  9. van Teijlingen, E, Simkhada. PP, Simkhada, B, Ireland J. (2012) The long & winding road to publication, Nepal J Epidemiol 2(4): 213-215 http://nepjol.info/index.php/NJE/article/view/7093/6388
  10. 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
  11. 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
  12. van Teijlingen, E., Ireland, J., Hundley, V., Simkhada, P., Sathian, B. (2014) Finding the right title for your article: Advice for academic authors, Nepal J Epidemiol 4(1): 344-347.
  13. van Teijlingen E., Hundley, V., Bick, D. (2014) Who should be an author on your academic paper? Midwifery 30: 385-386.
  14. Hall, J., Hundley, V., van Teijlingen, E. (2015) The journal editor: friend or foe? Women & Birth 28(2): e26-e29.
  15. Sathian, B., Simkhada, P., van Teijlingen, E., Roy, B, Banerjee, I. (2016) Grant writing for innovative medical research: Time to rethink. Med Sci 4(3):332-33.
  16. Adhikari, S. D., van Teijlingen, E. R., Regmi, P. R., Mahato, P., Simkhada, B., & Simkhada, P. P. (2020). The Presentation of Academic Self in The Digital Age: The Role of Electronic Databases. International J Soc Sci Management, 7(1), 38-41. https://doi.org/10.3126/ijssm.v7i1.27405
  17. Pradhan, AK, van Teijlingen, ER. (2017) Predatory publishing: a great concern for authors, Med Sci 5(4): 43.
  18. van Teijlingen, E (2004), Why I can’t get any academic writing done, Medical Sociol News 30(3): 62-63. britsoc.co.uk/media/26334/MSN_Nov_2004.pd

Social Work Research cited in national newspaper

international, PG research, Publishing, writing

Congratulations to Dr. Orlanda Harvey who was cited last week in The Daily Telegraph in an article with the underlying question whether Vladimir Putin is experiencing so-called “roid rage” from steroid treatment.  This theory has been suggested by by Western intelligence services.  Orlanda’s PhD study at Bournemouth University focused on men using anabolic androgenic steroids for non-medical use.  She published several academic papers on the topic [1-3].

References:

  1. Harvey, O., Parrish, M., van Teijlingen, E, Trenoweth, S. (2021) Libido as a reason to use non-prescribed Anabolic Androgenic Steroids, Drugs: Education, Prevention & Policy (online first). https://doi.org/10.1080/09687637.2021.1882940
  2. Harvey, O., Parrish, M., van Teijlingen, E., Trenoweth, S. (2020) Support for non-prescribed Anabolic Androgenic Steroids users: A qualitative exploration of their needs Drugs: Education, Prevention & Policy 27:5, 377-386. doi 10.1080/09687637.2019.1705763
  3. Harvey, O., Keen, S., Parrish, M., van Teijlingen, E. (2019) Support for people who use Anabolic Androgenic Steroids: A Systematic Literature Review into what they want and what they access. BMC Public Health 19: 1024 https://doi.org/10.1186/s12889-019-7288-x https://rdcu.be/bMFon

Speaking to a journalist

international, Publishing, Research Ethics, Research Integritiy, writing

In late 2021 I was contacted by an Indonesian science journalist, Dyna Rochmyaningsih, who was investigating the ethics around international studies on human population genetics to build expand genomic libraries of people in the Global South.  She highlights that “these international studies, often led by Western scientists, have contributed to a more global understanding of ancient patterns of human migration and evolution. But on some occasions, they’ve also sidestepped local regulatory agencies in the developing world, and ventured into murky research ethics terrain as a result”.   The reason for contacting me was because we had published several papers here at Bournemouth University about the need for applying for ethical approval for research in developing countries [1-3].  I had a long Skype conversation with her about the various perspectives on the matter she was investigating.

Today she emailed me that her piece ‘Opinion: Genomics’ Ethical Gray Areas Are Harming the Developing World. A recent controversy in the Philippines illustrates the pitfalls and pressure points of international genomics research‘ has been published online.  In the email she made a really nice comment: “It was nice talking to you even though you might see that I disagree at some of your points. However, the discussion gave me insights that there is a wide disagreement on what considers ethical research.”  I think that is what science should be all about, disagreements, discussions, disputes, etc. and, at the same time, learning from these disputes and gaining greater insight.

 

Prof. Edwin van Teijlingen

CMMPH

 

References:

  1. van Teijlingen E.R., Simkhada P.P. (2012)    Ethical approval in developing countries is not optional. Journal of Medical Ethics 38(7):428-30. doi: 10.1136/medethics-2011-100123. Epub 2012 Feb 16.PMID: 22345548 
  2. van Teijlingen, E., Simkhada, P. (2015). Failure to Apply for Ethical Approval for Health Studies in Low-Income Countries. Nepal Journal of Epidemiology, 5(3), 511–515. https://doi.org/10.3126/nje.v5i3.13609

  3. Regmi, P. R., Aryal, N., Kurmi, O., Pant, P. R., van Teijlingen, E., & Wasti, S. P. (2017). Informed Consent in Health Research: Challenges and Barriers in Low-and Middle-Income Countries with Specific Reference to Nepal. Developing World Bioethics, 17(2), 84–89. https://doi.org/10.1111/dewb.12123

Rejection is the norm

In academic life rejection is the norm, for both journal articles and grant applications, the average academic is more likely to fail than to succeed at any time.  This can also be true, although to a lesser extent, for applications to present at academic conferences.  At the time of writing this blog (12 February 2022), I have 299 published papers listed on the databases SCOPUS.  Of these nearly 300 papers only two papers ever were accepted on first submission as submitted.  Most papers went through one or two rounds revision in the light of comments and critique offered by reviewers, and sometimes also additional feedback from the journal’s editor.

After rejection by the first journal, your paper needs to be rewritten before submitting it to another journal.  Obviously, this process of rewriting and resubmitting takes time as different journals have different styles, lay-outs, sub-headings, audiences, and often peculiar ways of referencing.  I would guess more than half of my papers have been through the review process of at least two journals.  Quite a few of my published papers were accepted by the third or even fourth journal to which we had submitted them.  Persistence is the name of the game.   Some paper fell by the wayside often after second submission, if especially if review process had been time-consuming and the reviewers very critical and demanding too many changes.

Peer review can be very good and constructive but also brutal and destructive.  Blind peer-review is a fair process as it means the quality of the paper is all that counts in getting accepted.  I have had the pleasure of being co-author on papers rejected by journals for which I was: the book review editor at the time (Sociological Research Online), on the journal’s editorial board at the time of submission (e.g. Midwifery, Nepal Journal of Epidemiology), one of journal’s Associate Editors (BMC Pregnancy & Childbirth) and, to top it all, on which I was one of the two editors (Asian Journal of Midwives).   

Grant applications in the UK have a one in eight to one in ten chance of success.  Most of our successful grant applications have been resubmissions, with attempts to improve the application each time in the light of reviewers’ comments.  For example, our successful application to THET (Tropical Health & Education Trust) resulted in the funded project ‘Mental Health Training for Rural Community-based Maternity Care Workers in Nepal‘ [1], led by Bournemouth University (see picture).  This THET project was organised by Tribhuvan University in collaboration with Bournemouth University and Liverpool John Moores University (LJMU).  However, I was only successful during our second submission.  Our first submission was rejected the year before with feedback that our partner organisation in Nepal was deemed to be too small.  In the resubmission we changed to work with colleagues at Tribhuvan University, the oldest and largest university in Nepal. Apart from some further, but minor changes, this was really the main change between the rejected and the successful application.

 

 

 

 

 

 

 

 

The situation for conferences is slightly better, the success rate for an application to present a paper or poster are higher. This is partly because conference organisers realise that most academics are unlikely to get funding from their institution unless they present something.  Conferences are often themed and submitted abstracts are peer-reviewed.  This makes in important to write a clear abstract, focusing in on the conference theme.[1]  In the past I have had the honour of being rejected to present a paper at a BSA Medical Sociology Conference, whist I was on the organising committee.

Prof. Edwin van Teijlingen

CMMPH

References

  1. Simkhada, P., van Teijlingen E., Hundley, V., Simkhada, BD. (2013) Writing an Abstract for a Scientific Conference, Kathmandu University Medical Journal 11(3): 262-65. http://www.kumj.com.np/issue/43/262-265.pdf

 

 

 

Hard to reach or hard to engage?

international, PG research, Publishing, student research, writing

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

  1. Ekong, A., Adesina, N., Regmi, P., Tsofliou, F., Wood, J. and Taylor, J., 2022. Barriers and Facilitators to the recruitment of Black African women for research in the UK: Hard to engage and not hard to reach. MIDIRS Midwifery Digest (accepted).