School of Nursing and Midwifery
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Item Open Access 2021 Report of the Evaluation of the Work.Live.Leicestershire Programme(De Montfort University, 2021-01-31) Blair, Krista; McGill, George; Gkiontsi, Dimitra; de Vries, Kay; Brown, Jayne; Clayton, David; Coleby, Dawn; Dunn, Andrew; Oviasu, Osaretin; Padley, WendyThe Work.Live.Leicestershire (WiLL) programme provided help to economically inactive or unemployed people in Leicestershire to move into job search, training, or employment. The programme aimed to help people into work or learning by improving their health and wellbeing, social engagement, and skills and work experience, and by supporting people as they volunteered, job searched or started a business. The programme was open to residents of rural Leicestershire who were economically inactive or unemployed, and targeted the areas of Hinckley and Bosworth, North West Leicestershire, Melton, and Harborough. As of November 2020, the programme had registered details of 535 participants1 (263 men and 266 women) across all age groups. 152 participants were 24 or under, and 158 participants were 51 or over. Of the participants registered, some will have just joined the programme, some will be part way through the programme, and some will have left the programme at various points after their initial engagement with WiLL. This report discusses findings from the second year of De Montfort University’s evaluation, focussing on programme results and how the programme supported people to address barriers to moving into work or learning. The programme is ongoing, and this report draws on data from both participants who had left the programme and those whose support was in progress.Item Open Access Access to Leisure for disabled children from minority ethnic communities(2011) Raghavan, Raghu; Pawson, N.Item Metadata only Alcohol issues and South Asian / African Caribbean communities: Improving education, research and service development (Final report #28)(AERC (Alcohol Education & Research Council), 2006) Johnson, Mark, 1948 Mar. 16-; Menzies-Banton, P.; Dhillon, H.; Subhra, V.; Hough, J.Item Metadata only Alcohol Services and the needs of Black and Minority Ethnic Groups (Alcohol Insight 29)(AERC: Alcohol Education and Research Council, 2006-10) Johnson, Mark, 1948 Mar. 16-; Menzies-Banton, P.; Dhillon, H.; Subhra, V.; Hough, J.Item Open Access Are digital interventions for smoking cessation in pregnancy effective? A systematic review and meta-analysis(Taylor and Francis, 2018-06-18) Griffiths, Sarah Ellen; Parsons, Joanne; Fulton, Emily Anne; Naughton, Felix; Tombor, Ildiko; Brown, Katherine ElizabethSmoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. The aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation and (4) the association between the total number of BCTs delivered and smoking cessation. Systematic searches of 9 databases resulted in the inclusion of 12 published articles (n = 2970). The primary meta-analysis produced a sample-weighted odds ratio (OR) of 1.44 (95% CI 1.04–2.00, p = .03) in favour of digital interventions compared with comparison groups. Computer-based (OR = 3.06, 95% CI 1.28–7.33) and text-message interventions (OR = 1.59, 95% CI 1.07–2.38) were the most effective digital platform. Moderator analyses revealed seven BCTs associated with smoking cessation: information about antecedents; action planning; problem solving; goal setting (behaviour); review behaviour goals; social support (unspecified); and pros and cons. A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects. This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy.Item Metadata only Asylum seekers in dispersal – healthcare issues(Home Office, 2003-02) Johnson, Mark, 1948 Mar. 16-Item Open Access Authors Reply to "Induction of labour and emergency caesarean section in English maternity services: examining outcomes is needed before recommending changes in practice".(Wiley, 2022-12-27) Gurol-Urganci, Ipek; Jardine, Jennifer; Harris, Tina; Khalil, Asma; van der Meulen, JanWe thank Anna Seijmonsbergen-Schermers and colleagues for their interest in our paper in which we describe that there is considerable between-hospital variation in the use of induction of labour and emergency caesarean section in singleton term births that took place in the English National Health Service between April 2015 and March 2017.1 More importantly, we also show that hospitals with a higher rate of induction had slightly lower risks of adverse perinatal outcomes, whilst a similar association was not found for emergency caesarean section. In our paper, we suggest that the between-hospital variation observed in the induction of labour and emergency caesarean section rates may reflect differences in the ‘practice style’ of hospitals providing maternity services. Admittedly at the risk of over-interpreting our results, we conclude that a more proactive practice style with an increased use of induction of labour, rather than an increased use of caesarean section in emergency situations, seems to be linked to safer childbirth. Seijmonsbergen-Schermers and colleagues raise two issues. First, they argue that the range of outcome measures we use, i.e., antenatal and intrapartum stillbirth, neonatal unit admission, and mechanical ventilation, is too narrow. They argue that perinatal mortality should have been used instead of stillbirth, because induction of labour may in some cases only change the timing of birth without preventing a baby dying in utero or at a later stage. We could not agree more. Indeed, the ideal study would have used perinatal mortality. However, it is important to note that in our paper we also show associations of induction of labour with better postnatal outcomes, e.g., lower neonatal admission and mechanical ventilation, which are fully in line with the associations that we report for stillbirth. Second, Seijmonsbergen-Schermers and colleagues contrast our results with a population-based follow-up study they carried out using linked data reporting a range of outcomes in healthy women giving birth to a singleton term baby with and without induction of labour between 2000 and 2016 in New South Wales, Australia.2 They conclude that their results show that induction of labour for non-medical reasons was associated with more adverse perinatal outcomes. Here, we need to point out the fundamental difference between this study and the one that we report in our paper: we answer a different question with a different study design. We compare outcomes in hospitals with higher and lower rates of induction and emergency caesarean section; Our study does not directly compare a group of women who had induction of labour with a group of women who did not. Therefore, the studies are not directly comparable. Our study design, comparing perinatal outcomes according to hospital-level intervention rates, is likely to be less strongly affected by confounding by clinical indication than the population-based follow-up study by Seijmonsbergen-Schermers. Most importantly, we wholeheartedly support Seijmonsbergen-Schermers’ final plea: projects aiming to get a better understanding of how we can make childbirth safer should include a range of measures and indicators, ideally covering both maternal and neonatal outcomes beyond the intrapartum period.3 References 1. Seijmonsbergen-Schermers A, Peters LL, Downe S, Dahlen H, de Jonge A. Induction of labour and emergency caesarean section in English maternity services: Examining outcomes is needed be fore recommending changes in practice. BJOG. 2022. https://doi. org/10.1111/1471-0528.17359 2. Gurol-Urganci I, Jardine J, Carroll F, et al. Use of induction of labour and emergency caesarean section and perinatal outcomes in English maternity services: a national hospital-level study. BJOG. Vol 129, 11:1899-1906 3. Dahlen HG, Thornton C, Downe S, et al. Intrapartum interventions and outcomes for women and children following induction of labour at term in uncomplicated pregnancies: a 16-year population-based linked data study. BMJ Open. 2021;11(6):e047040. 4. NMPA Project Team. National Maternity and Perinatal Audit: Clinical Report 2022. Based on births in NHS maternity services in England and Wales between 1 April 2018 and 31 March 2019. London: RCOG;2022.Item Metadata only Item Open Access A COST-EFFECTIVENESS EVALUATION OF A SERVICE USER AND CARER CO-DELIVERED TRAINING PROGRAMME FOR MENTAL HEALTH PROFESSIONALS TO ENHANCE INVOLVEMENT IN CARE PLANNING(2019-07-02) Hinsliff-Smith, K.; Davies, L.; Camacho, E.; Bee, P.; Brooks, H.; Callaghan, P.; Grundy, A.; Meade, O.; Rogers, A.; Rushton, K.; Bower, P.; Lovell, K.; Shields, G.E.; Carter, L.A.; Fraser, C.Item Metadata only Custody nursing: A forensic innovation for England(2000-08-01) Rutty, JaneItem Metadata only Item Metadata only Developments in custody nursing.(2009-06-10) Rutty, JaneItem Open Access Engaging in research with care homes(NIHR-ARC, 2023-02-10) Hinsliff-Smith, K.; Devi, Reena; Chadborn, Neil; Horne, Jane; Gordon, AdamCare homes are a key part of health and social care provision within the UK, and research is needed to help develop solutions to challenges faced in practice. Care homes might want to get involved in research but might not know where to start, and likewise, researchers might not know how best to engage care homes in their work. A team of academics with first-hand experience of conducting research and working with care homes have produced a tool, with public and patient input, to help care homes get more involved in research, and researchers wanting to involve care homes in research. The tool is freely available and is a 2-sided infographic hand out which aims to help guide discussions about engaging in research from the perspectives of both the research community and the care homes.Item Metadata only English hospitals under report SSIs(BMJ, 2013) Tanner, Judith; Padley, Wendy; Kiernan, Martin; Leaper, David; Baggott, Rob; Norrie, PeterWe thank Lamagini and colleagues for their interest in our paper. These authors from the HPA claim that we are misinformed and lacking in understanding. Yet, our criticisms are the same as those expressed by the Public Accounts Committee and the DH Advisory Committee on HCAIs. Even the European Centers for Disease Control says the English SSI surveillance system ‘lags’ behind the rest of Europe. The SSI surveillance data published by the HPA does not include post discharge surveillance (save for readmission data in the mandatory scheme) which account up to 80% of SSIs. This results in the ‘true’ scale of SSIs being hugely under reported. As length of stay after surgery continues to fall this becomes ever more important. An SSI surveillance system which does not include post discharge surveillance is akin to describing the size of iceberg by measuring only the part seen above the water.Item Metadata only Evaluation of CYGNET parent training programme(2008) Raghavan, Raghu; Raghavan, S.Item Open Access An exploration of infant feeding experiences of women in Lincolnshire in the early postnatal period(University of Nottingham, 2012-12) Spencer, R.; Hinsliff-Smith, K.; Walsh, D.Executive Summary Breastfeeding initiation and maintenance rates within Lincolnshire remain lower than the average for the East Midlands and England. Rates of initiation of breastfeeding at birth in 2010/2011 were 72% in Lincolnshire, compared to an initiation rate in England of 74%. The percentage of babies still being either partially or exclusively breastfed at 6 – 8 weeks dropped to 39% in Lincolnshire in comparison to 46% in England (NHS Lincolnshire, 2011). The purpose of this qualitative research was to gain an understanding of primigravid women‟s breastfeeding experience in the first 6 – 8 week postpartum period. Whilst valuable audit data is held on infant feeding methods in Lincolnshire, this research focuses on offering insights into the experiences of new mothers in order to better understand their feeding experiences and decisions, with a view to understanding differences in rates. The objectives of the study were: PRIMARY OBJECTIVE To describe women‟s experiences of breastfeeding SECONDARY OBJECTIVES To determine women‟s perceptions of breastfeeding To identify the factors that influence breastfeeding duration and cessation. The study used phenomenological principles to understand the lived experiences of the women. The study focused on women who were living in the county of Lincolnshire. Ethical approval was granted by the University of Nottingham and the National Research Ethics Committee. Two methods of data collection were used: Personal diaries 48 primigravid women over 34 weeks gestation were invited to complete detailed daily diaries of their infant feeding experiences in the 6 to 8 week postnatal period. 22 diaries were completed, a response rate of 46%. In-depth interviews A sub-sample of 13 women participated in a face-to-face interview which explored their infant feeding experiences and factors that affected their decision to continue or to discontinue breastfeeding. Data analysis utilised phenomenological principles that proceeded from coding to category development to themes.Item Metadata only Factors influencing utilisation of ‘free-standing’ and ‘alongside’ midwifery units for low-risk births in England: a mixed-methods study(National Institute for Health Research, 2020-03-02) Walsh, Denis; Spiby, Helen; McCourt, Christine; Coleby, Dawn; Grigg, Celia; Bishop, Simon; Scanlon, Miranda; Culley, Lorraine; Wilkinson, jane; Pacanowski, Lynne; Thornton, JimAbstract Background Midwifery-led units (MUs) are recommended for ‘low-risk’ births by the National Institute for Health and Care Excellence but according to the National Audit Office were not available in one-quarter of trusts in England in 2013 and, when available, were used by only a minority of the low-risk women for whom they should be suitable. This study explores why. Objectives To map the provision of MUs in England and explore barriers to and facilitators of their development and use; and to ascertain stakeholder views of interventions to address these barriers and facilitators. Design Mixed methods – first, MU access and utilisation across England was mapped; second, local media coverage of the closure of free-standing midwifery units (FMUs) were analysed; third, case studies were undertaken in six sites to explore the barriers and facilitators that have an impact on the development of MUs; and, fourth, by convening a stakeholder workshop, interventions to address the barriers and facilitators were discussed. Setting English NHS maternity services. Participants All trusts with maternity services. Interventions Establishing MUs. Main outcome measures Numbers and types of MUs and utilisation of MUs. Results Births in MUs across England have nearly tripled since 2011, to 15% of all births. However, this increase has occurred almost exclusively in alongside units, numbers of which have doubled. Births in FMUs have stayed the same and these units are more susceptible to closure. One-quarter of trusts in England have no MUs; in those that do, nearly all MUs are underutilised. The study findings indicate that most trust managers, senior midwifery managers and obstetricians do not regard their MU provision as being as important as their obstetric-led unit provision and therefore it does not get embedded as an equal and parallel component in the trust’s overall maternity package of care. The analysis illuminates how provision and utilisation are influenced by a complex range of factors, including the medicalisation of childbirth, financial constraints and institutional norms protecting the status quo. Limitations When undertaking the case studies, we were unable to achieve representativeness across social class in the women’s focus groups and struggled to recruit finance directors for individual interviews. This may affect the transferability of our findings. Conclusions Although there has been an increase in the numbers and utilisation of MUs since 2011, significant obstacles remain to MUs reaching their full potential, especially FMUs. This includes the capacity and willingness of providers to address women’s information needs. If these remain unaddressed at commissioner and provider level, childbearing women’s access to MUs will continue to be restricted. Future work Work is needed on optimum approaches to improve decision-makers’ understanding and use of clinical and economic evidence in service design. Increasing women’s access to information about MUs requires further studies of professionals’ understanding and communication of evidence. The role of FMUs in the context of rural populations needs further evaluation to take into account user and community impact.Item Metadata only Forensic Nursing(2006-03-19) Rutty, Jane; Lynch, VirginiaItem Metadata only Forensic Nursing: The role of the nurse in death investigation.(2001-06) Rutty, JaneItem Metadata only From Silence 2 Voice. Global Research in Health Sciences(The University of Nottingham, 2019-09-20) Hinsliff-Smith, K.
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