• Impact of nutrition interventions for reduction of maternal anemia in low and middle income countries - an evidence summary

      Panchal, Pooja; Menon, Kavitha; Ravalia, Anal; Rana, Ritu; Puthussery, Shuby; Gauri, Vaze (Karger, 2019-12-31)
    • Health impact assessment in Nigeria: an initiative whose time has come

      Chilaka, Marcus A.; Ndioho, Ibiangake; ; University of Bedfordshire; University of Salford (PAGEpress, 2020-03-19)
      Health Impact Assessment (HIA) is increasingly applied in many developed countries as a tool for advancing healthy public policy. This research was carried out to obtain a HIA situation report for Nigeria and to assess ways of enhancing the use of HIA to promote healthy public policy. Semi structured questionnaires were administered both online and by hand to health and nonhealth professionals in Nigeria. Inferential statistics was used in the analysis of the 510 responses that were received. Only 29% of the respondents had ever heard about HIA; similarly, only 19.3% of those who were aware of HIA had received any form of HIA training. However, 93.2% of respondents were convinced that HIA would be beneficial to the Nigerian health system. Using the approach of SWOT Analysis to discuss the findings, this research concludes that the time has now come, and the right conditions are in place, for the integration of Health Impact Assessment into public policy in Nigeria. Raising awareness and political commitment are the two major strategies to help drive this agenda forward.
    • Designing an experimental and a reference robot to test and evaluate the impact of cultural competence in socially assistive robotics

      Recchiuto, Carmine Tommaso; Papadopoulos, Chris; Hill, Tetiana; Castro, Nina; Bruno, Barbara; Papadopoulos, Irena; Sgorbissa, Antonio; University of Genova; University of Bedfordshire; Advinia Healthcare; et al. (IEEE, 2020-01-13)
      The article focusses on the work performed in preparation for an experimental trial aimed at evaluating the impact of a culturally competent robot for care home assistance. Indeed, it has been estabilished that the user's cultural identity plays an important role during the interaction with a robotic system and cultural competence may be one of the key elements for increasing capabilities of socially assistive robots. Specifically, the paper describes part of the work carried out for the definition and implementation of two different robotic systems for the care of older adults: a culturally competent robot, that shows its awareness of the user's cultural identity, and a reference robot, non culturally competent, but with the same functionalities of the former. The design of both robots is here described in detail, together with the key elements that make a socially assistive robot culturally competent, which should be absent in the non-culturally competent counterpart. Examples of the experimental phase of the CARESSES project, with a fictional user are reported, giving a hint of the validness of the proposed approach.
    • Do predictors of mental health differ between home and international students studying in the UK?

      Pedder-Jones, Catrin; Lodder, Annemarie; Papadopoulos, Chris (Emerald, 2019-04-08)
      Purpose Previous research has found that international students can experience poor mental health, low levels of life satisfaction, self-esteem and high levels of loneliness when studying in a foreign country. No study has directly compared these between international and home students studying in the UK. The paper aims to discuss these issues. Design/methodology/approach A total of 247 students completed an online survey at the University of Bedfordshire. Findings The hypothesis that international students experience higher loneliness, lower self-esteem, lower life satisfaction and poorer general mental health than home students was rejected. Home students had significantly lower self-esteem, life satisfaction and general mental health scores. Black ethnicity and home student status significantly predicted general mental health and self-esteem in regression analyses. The predictive utility of home student status was maintained when other variables were controlled for in regression models. Originality/value This research suggests that the UK universities should ensure that both home and international students are adequately supported for their mental health.
    • The development of a stigma support intervention to improve the mental health of family carers of autistic children: suggestions from the autism community

      Lodder, Annemarie; Papadopoulos, Chris; Randhawa, Gurch (Akadémiai Kiadó, 2019-06-03)
      Parents and family carers of autistic children report poorer mental health than any other parents. Stigma surrounding autism plays a significant role in the mental health of family carers of autistic children, often leaving families feeling isolated. Yet there are currently no interventions available to support families with stigma. In order to guide the design and development of an intervention to improve the psychological well-being of parents and carers of autistic children by addressing the stigma they may experience, we surveyed the autism community (n = 112) about their views and suggestions to make such intervention more successful. The thematic analysis of the qualitative responses revealed that respondents wished for public awareness to be raised and suggested that education would be the key to this. Respondents also – recommended that parental self-esteem and self-compassion skills should be increased and that they would benefit from ‘ready-made’
    • Impact of Covid-19 on the experiences of parents and family carers of autistic children and young people in the UK

      Pavlopoulou, Georgia; Wood, Rebecca; Papadopoulos, Chris; UCL Institute of Education; University of East London; University of Bedfordshire (UCL Institute of Education, 2020-07-01)
      A new study led by the Institute of Education at University College London, in collaboration with the University of East London and the University of Bedfordshire, has shed light on the experiences of the parents and carers of autistic children and young people during lockdown in the UK. The findings reveal that many families feel let down by the government and that they have had to face the lockdown tackling new struggles, often with significantly reduced support. However, parents and carers also experienced a number of positives, providing important lessons for support and health services and education providers in the future.
    • An economic–business approach to clinical risk management

      Comite, Ubaldo; Dong, Kechen; Li, Rita Yi Man; Crabbe, M. James C.; Shao, Xue-Feng; Yue, Xiao-Guang; University Giustino Fortunato; University of South Australia; Hong Kong Shue Yan University; Oxford University; et al. (MDPI, 2020-06-23)
      This paper introduces risk factors in the field of healthcare and discusses the clinical risks, identification, risk management methods, and tools as well as the analysis of specific situations. Based on documentary analysis, an ecient and coherent methodological choice of an informative and non-interpretative approach, it relies on “unobtrusive” and “non-reactive” information sources, such that the research results are not influenced by the research process itself. To ensure objective and systematical analysis, our research involved three macro-phases: (a) the first involved a skimming (a superficial examination) of the documents collected; (b) the second reading (a thorough examination) allowed a selection of useful information; (c) the third phase involved classification and evaluation of the collected data. This iterative process combined the elements of content and thematic analysis that categorised the information into di erent categories which were related to the central issues for research purposes. Finally, from the perspective of safety analysis and risk management, we suggest that comprehensive control and operation should be conducted in a holistic way, including patient safety, cost consumption, and organizational responsibility. An organizational strategy that revolves around a constant and gradual risk management process is an important factor in clinical governance which focuses on the safety of patients, operators, and organizations.
    • Mapping transitional care pathways among young people discharged from adolescent forensic medium secure units in England

      Livanou, Maria; Singh, Swaran P.; Liapi, Fani; Furtado, Vivek; ; Kingston University; University of Warwick; Birmingham and Solihull Mental Health NHS Foundation Trust; Birmingham and Solihull Mental Health NHS Foundation Trust; University of Bedfordshire (SAGE, 2019-11-10)
      This study tracked young offenders transitioning from national adolescent forensic medium secure units to adult services in the UK within a six-month period. We used a mapping exercise to identify eligible participants moving during the study period from all national adolescent forensic medium secure units in England. Young people older than 17.5 years or those who had turned 18 years (transition boundary) and had been referred to adult and community services were included. Of the 34 patients identified, 53% moved to forensic adult inpatient services. Psychosis was the most prevalent symptom among males (29%), and emerging personality disorder symptomatology was commonly reported among females (18%) followed by learning disability (24%). The mean time for transition to adult mental-health services and community settings was eight months. There were no shared transition or discharge policies, and only two hospitals had discharge guidelines. The findings highlight the need for consistency between policy and practice among services along with the development of individualised care pathways. Future qualitative research is needed to understand and reflect on young people's and carers' experiences to improve transition service delivery.
    • Factors in implementation of clinical commissioning policy in improving health and wellbeing and/or reducing health inequalities in the English NHS: a systematic review of the evidence

      Regmi, Krishna; Mudyarabikwa, Oliver; University of Bedfordshire; Coventry University (Research Square, 2020-06-25)
      This is a preprint. Preprints are preliminary reports that have not undergone peer review. They should not be considered conclusive, used to inform clinical practice, or referenced by the media as validated information. Objective: This study aimed to identify and synthesise the factors in implementing clinical commissioning policy in improving health and/or reducing health inequalities in the English NHS. Methods: Systematic review was conducted. We searched Medline, EMBASE, CINAHL, Allied & Complementary Medicine, DH-DATA, Global Health and CINAHL for primary studies that assessed the enablers and barriers, and reported in accordance with PRISMA statement. Methodological quality was appraised using JBI Critical Appraisal tools and Mixed Methods Appraisal Tool [MMAT] to assess the methodological qualities, and synthesised performing thematic analysis. Two reviewers independently screened the papers and extracted data. Results: We included six primary studies (including a total of 1155 participants) in the final review. The studies reported two broad categories, under four separate themes: agenda of health inequalities not fully addressed; poor evidence for reducing health inequalities; reform through restructuring of organisations, and strategic approaches. Conclusion: This study provides useful factors – enablers and barriers – to implement and deliver clinical commissioning policy in improving health and wellbeing. These factors could be assessed in future to develop objective measures and interventions to establish the link between commissioning and health inequalities improving equitable access, health outcomes and effective partnerships.
    • A collaborative brief engagement with medically unexplained sexual and other persistent physical symptoms: a realist service evaluation

      Penman, Jean; Cook, Erica Jane; Randhawa, Gurch; University of Bedfordshire (Taylor & Francis, 2019-12-10)
      Attempts to secure improved outcomes with persistent medically unexplained physical symptoms (MUS/PPS) are in their early stages of development and effective implementation in the United Kingdom remains inconsistent. There are scant systematically examined process and outcome studies in this field published in peer reviewed journals. Moreover, persistent sexual symptoms no longer appear in listed examples of MUS/PPS in the professional literature and consequently few studies can be found on 'what works' for improved outcomes with this group of sufferers. A systematic evaluation of an NHS Community Psychosexual Counselling Service delivered within an Integrated Contraception and Sexual Health Service for adults with persistent sexual dysfunction is summarised. The findings from the synthesis of evaluated research, professional guidance and a particular practice, at clinic cohort and embedded case levels, revealed common themes of engagement across the therapy divides when addressing “medically unexplained” physical symptoms. This supports future research in this area and calls for the inclusion of persistent sexual symptoms. The extracted themes from the therapy process may be used as tools to enhance skills of engagement with unresolved PPS in similar settings in which the individual seeks help to achieve improved outcomes.
    • Factors impacting social distancing measures for preventing coronavirus disease 2019 [COVID-19]: a systematic review

      Regmi, Krishna; Lwin, Cho Mar (Research Square, 2020-06-23)
      This is a preprint. Preprints are preliminary reports that have not undergone peer review. They should not be considered conclusive, used to inform clinical practice, or referenced by the media as validated information. Background: Social distancing measures (SDMs) protect the health of the public from coronavirus 2019 (COVID-19) infection. However, the impact of SDMs has been inconsistent and unclear. This study aims to review the factors impacting SDMs (e.g. isolation, quarantine) for reducing the transmission of COVID-19. Methods: A systematic review was conducted. We searched MEDLINE, EMBASE, Allied & Complementary Medicine, COVID-19 Research and WHO database on COVID-19 for primary studies assessing the enablers and barriers associated with SDMs, and reported in accordance with PRISMA statement. We used JBI Critical Appraisal Checklist for the cross-sectional survey and Qualitative Research to assess the methodological qualities and synthesised performing thematic analysis. Two reviewers independently screened the papers and extracted data. Results: A total of 1235 citations were identified, of which 16 were found to be relevant. The studies reported in two broad categories, under seven separate themes: positive impact of SDMs, effective public health interventions, positive change in people’s behaviour, worries and concerns about COVID-19, roles of mass media, physical and psychological impacts, and ethnicity/age associated with COVID-19. Conclusion: The identified evidence signals that SDMs are generally effective for preventing or reducing transmission. There is a scope and need to find the best methods and approaches at the primary healthcare level in terms of developing objective measures and interventions to establish the link between different factors and SDMs and reducing transmission of COVID-19 trend effectively, efficiently and equitably.
    • Impact of social distancing measures for preventing coronavirus disease 2019 [COVID-19]: a systematic review and meta-analysis protocol

      Regmi, Krishna; Lwin, Cho Mar (medRxiv, 2020-06-16)
      This article is a preprint and has not been peer-reviewed. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice. Introduction: Social distancing measures (SDMs) protect public health from the outbreak of coronavirus disease 2019 (COVID-19). However, the impact of SDMs has been inconsistent and unclear. This study aims to assess the effects of SDMs (e.g. isolation, quarantine) for reducing the transmission of COVID-19. Methods and analysis: We will conduct a systematic review meta-analysis research of both randomised controlled trials and non-randomised controlled trials. We will search MEDLINE, EMBASE, Allied & Complementary Medicine, COVID-19 Research and WHO database on COVID-19 for primary studies assessing the enablers and barriers associated with SDMs, and will be reported in accordance with PRISMA statement. The PRISMA-P checklist will be used while preparing this protocol. We will use Joanna Briggs Institute guidelines (JBI Critical Appraisal Checklists) to assess the methodological qualities and synthesised performing thematic analysis. Two reviewers will independently screen the papers and extracted data. If sufficient data are available, the random-effects model for meta-analysis will be performed to measure the effect size of SDMs or the strengths of relationships. To assess the heterogeneity of effects, I2 together with the observed effects (Q-value, with degrees of freedom) will be used to provide the true effects in the analysis. Ethics and dissemination: Ethics approval and consent will not be required for this systematic review of the literature as it does not involve human participation. We will be able to disseminate the study findings using the following strategies: we will be publishing at least one paper in peer-reviewed journals, and an abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the World Health Organization.
    • Children, organ donation, and Islam: a report of an engagement day of Islamic scholars, young Muslims and pediatric transplant and donation professionals

      Aktas, Mikail; Randhawa, Gurch; Brierley, Joe; ; University of Newcastle; University of Bedfordshire; Great Ormond St Hospital for Sick Children (Wiley, 2020-03-02)
      Meeting report
    • The CARESSES study protocol: testing and evaluating culturally competent socially assistive robots among older adults residing in long term care homes through a controlled experimental trial

      Papadopoulos, Chris; Hill, Tetiana; Battistuzzi, Linda; Castro, Nina; Nigath, Abiha; Randhawa, Gurch; Merton, Len; Kanoria, Sanjeev; Kamide, Hiroko; Chong, Nak Young; et al. (BMC (part of Springer Nature), 2020-03-20)
      This article describes the design of an intervention study that focuses on whether and to what degree culturally competent social robots can improve health and well-being related outcomes among older adults residing long-term care homes. The trial forms the final stage of the international, multidisciplinary CARESSES project aimed at designing, developing and evaluating culturally competent robots that can assist older people according to the culture of the individual they are supporting. The importance of cultural competence has been demonstrated in previous nursing literature to be key towards improving health outcomes among patients. = 15 each). Participants were allocated to either the experimental group, control group 1 or control group 2 (all n = 15). Those allocated to the experimental group or control group 1 received a Pepper robot programmed with the CARESSES culturally competent artificial intelligence (experimental group) or a limited version of this software (control group 1) for 18 h across 2 weeks. Participants in control group 2 did not receive a robot and continued to receive care as usual. Participants could also nominate their informal carer(s) to participate. Quantitative data collection occurred at baseline, after 1 week of use, and after 2 weeks of use with the latter time-point also including qualitative semi-structured interviews that explored their experience and perceptions further. Quantitative outcomes of interest included perceptions of robotic cultural competence, health-related quality of life, loneliness, user satisfaction, attitudes towards robots and caregiver burden. This trial adds to the current preliminary and limited pool of evidence regarding the benefits of socially assistive robots for older adults which to date indicates considerable potential for improving outcomes. It is the first to assess whether and to what extent cultural competence carries importance in generating improvements to well-being.
    • Protecting and testing-more to be learned from Ebola

      Maytum, Robin; (BMJ Publishing Group: BMJ, 2020-04-24)
    • A theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers: an acceptability and feasibility experimental study using mixed methods

      Lim, Rosemary; Courtenay, Molly; Deslandes, Rhian; Farriday, Rebecca; Gillespie, David; Hodson, Karen; Reid, Nicholas; Thomas, Neil; Chater, Angel M.; ; et al. (BMJ, 2019-08-18)
      Introduction: Nurse and pharmacist independent prescribers manage patients with respiratory tract infections and are responsible for around 8% of all primary care antibiotic prescriptions. A range of factors influence the prescribing behaviour of these professionals, however, there are no interventions available specifically to support appropriate antibiotic prescribing behaviour by these groups. The aims of this paper are to describe (1) the development of an intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers and (2) an acceptability and feasibility study designed to test its implementation with these prescribers. METHOD AND ANALYSIS: Development of intervention: a three-stage, eight-step method was used to identify relevant determinants of behaviour change and intervention components based on the Behaviour Change Wheel. The intervention is an online resource comprising underpinning knowledge and an interactive animation with a variety of open and closed questions to assess understanding. Acceptability and feasibility of intervention: nurse and pharmacist prescribers (n=12-15) will use the intervention. Evaluation includes semi-structured interviews to capture information about how the user reacts to the design, delivery and content of the intervention and influences on understanding and engagement, and a pre-post survey to assess participants' perceptions of the impact of the intervention on knowledge, confidence and usefulness in terms of application to practice. Taking an initial inductive approach, data from interview transcripts will be coded and then analysed to derive themes. These themes will then be deductively mapped to the Capability, Opportunity, Motivation-Behaviour model. Descriptive statistics will be used to analyse the survey data, and trends identified.
    • Capturing debriefing and enhancing reflection within simulated clinical learning environments

      Wareing, Mark; England, Jacqueline A.; Mathew, David; Ball, Carla; Willetts, Amanda; Kemp, Jane; Clifford, Kelly; Thompson, Andrea; Dove, Ian; Adams, Louise; et al. (National Association of Educators in Practice, 2020-05-05)
      This article presents findings from an evaluation of a new A3-size learner notes sheet designed for use by healthcare students engaging in clinical simulation and clinical skills sessions. The notes sheet consists of an adapted form of the SBAR (situation, background, assessment, response) tool, whilst capturing post-simulation oral debriefing provided by a facilitator. Additionally, the Driscoll (2007) model is used to provide students with an opportunity to reflect on their engagement in clinical simulation. Two cohorts of students, who engaged in separate simulation sessions, completed the A3 sheet. The study featured 33 midwifery and 21 operating department practitioner (ODP) students undertaking a simulation. Documentary analysis was undertaken to identify the depth of reflective writing of both groups of students. Midwifery student participants reflected on their experiences of simulation at a slightly deeper level than their ODP counterparts. All students adhered to the structure of the notes sheet when receiving their briefing from the facilitator and when asked to write their reflective accounts. This study has sought to explore an under-researched area of clinical simulation: the extent to which healthcare students can utilise reflection when engaging with a clinical scenario within a simulated learning environment.
    • SOLACE: a psychosocial stigma protection intervention to improve the mental health of parents of autistic children: a feasibility randomised controlled trial

      Lodder, Annemarie; Papadopoulos, Chris; Randhawa, Gurch (Springer, 2020-04-23)
      This study presents findings from a feasibility trial, testing an 8-week psychosocial stigma protection intervention (SOLACE) designed to improve the mental health of parents of autistic children. Seventeen parents were stratified then randomly assigned to either SOLACE (n = 9) or control group (n = 8). Retention and adherence rates were excellent with minimal missing data suggesting SOLACE had good acceptability and feasibility. Quantitative analysis revealed that mental health scores had significantly improved for those who took part in SOLACE compared to no significant changes for control group participants. In addition, changes in secondary outcome measures (e.g. stigma, self-esteem and self-compassion) were in favour of SOLACE. Focus group interviews revealed that SOLACE was acceptable to parents. Results suggest that a full randomised controlled trial is warranted.
    • Qualitative investigation of the flipped classroom teaching approach as an alternative to the traditional lecture

      Abdulaziz Almanasef, M.; Chater, Angel M.; Portlock, Jane (International Pharmaceutical Federation (FIP), 2020-04-25)
    • British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing careers

      Quereshi, Irtiza; Ali, Nasreen; Randhawa, Gurch; University of Bedfordshire (Wiley, 2020-04-06)
      To ascertain British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing education and careers. There is a shortage of men from Black, Asian and Minority Ethnic groups in the National Health Service nursing workforce. There is a dearth of evidence on the views of British south Asian men on this subject. A qualitative interpretative intersectional approach was used to carry out one to one interviews (n=5) with British South Asian male nurses using a semi-structured topic guide. Interviews took place between July 2018 and February 2019, across England. A Framework Analysis approach was used to analyse the interview transcripts. The main themes emerging as barriers were: poor pay and conditions, negative immediate, extended family, community views and a lack of knowledge and awareness of the nursing profession. The main themes emerging as enablers were: personal circumstances (including role models) and ethnicity (including the role of religion and masculinity). Findings suggest that the intersection between ethnicity and gender presents as an important enabler, as well as inhibitor, for British South Asian men. Nursing careers and salient barriers exist at a systemic level and include institutional racism. Review policies and practice on unconscious bias and institutional racism in the recruitment, retention and progression of British South Asian men. Provide continuous professional development including mentoring support to help career progression for these men. Develop culturally specific interventions to reduce the stigma associated with the nursing profession in the British South Asian community. Consider places of worship as venues for delivery of these interventions when promoting nursing. AIM BACKGROUND METHODS RESULTS CONCLUSION IMPLICATIONS FOR NURSING MANAGEMENT