Perhaps the central policy question for those of us studying education is: how can we raise levels of attainment? For long, the focus was almost solely on cognitive skills, but a line of recent research has looked at the interaction between such skills and non-cognitive factors (also called psychological traits), motivations, and culture in generating higher student achievement. Continue reading
This week sees the launch of the James Lind Alliance Advanced Heart Failure Priority Setting Partnership Survey to gather research ideas from those living or working with advanced heart failure. Continue reading
The appeal of collaborating with a government agency, or an organisation funded by one, seems obvious. It provides researchers with much needed resources and information, while also offering practitioners and policymakers a way of generating the evidence needed to design better programmes. Continue reading
Photo Credit: Christopher Gross/Released
Dr Fiona Lithander, Senior Research Associate, NIHR Bristol Biomedical Research Centre.
Fiona explains how a new questionnaire could be used to increase healthy food and drink options in hospital retail outlets
At the National Institute for Health Research (NIHR), Bristol Biomedical Research Centre we are interested in the role the NHS plays in promoting good nutrition and health in children. Recent reports have shown a quarter of children in the UK are overweight or obese; a worrying statistic in itself, and the problem doesn’t appear to be getting any better.
NICE guidelines say that retail outlets in hospitals such as shops, cafes, restaurants and vending machines should offer healthy food and drink options, and that these options should be prominently displayed. They also say that nutritional information about the foods on their menus should be available. These guidelines do not refer to foods served to patients, although patients may have access to foods and drinks for sale onsite.
At NIHR Bristol Biomedical Research Centre we developed a new questionnaire to help NHS Trusts assess how healthy their food and drink options are. This differs from other questionnaires in that it allows Trusts to compare their findings with the NICE guidelines. Trusts can use this questionnaire to measure how healthy prepared foods for sale are, and can make changes accordingly. These changes may involve, replacing sugary drinks with sugar-free options such as water, and replacing chocolate bars with more healthy options such as unsalted nuts.
Using this questionnaire, we measured how healthy the foods and drinks were in two Trusts, and how closely they followed NICE guidelines. Our findings showed a lack of healthy food and drink options for sale in vending machines. Nutritional information on menus was minimal, and there was limited promotion and advertising of healthy foods and drinks. Since the findings were published, both of the Trusts have made improvements.
Our plan is to further develop the questionnaire in conjunction with the NICE guidelines, so that it can be used more widely in NHS Trusts and in local authority settings, such as leisure centres. Making it easier for parents to direct their children to healthier choices should be a central element of our healthcare system.
Disclaimer: This study was supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
This blog was originally published by the National Institute for Health and Care Excellence (NICE)
In a systematic review published this month, we identified 153 communication skills training interventions for generalists in end of life care. In randomised controlled trials, training improved showing empathy and discussing emotions in simulated interactions (i.e. with actor patients) but evidence of effect on clinician behaviours during real patient interactions, and on patient-reported outcomes, was inconclusive.
The global increase in the proportion of older people and length of life means providing end of life care is now increasingly the responsibility of generalist as well as specialist palliative care providers. But many clinicians find communicating about end of life issues challenging: how do you best discuss imminent mortality, limited treatment options, what to expect when you’re dying, or a patient’s preferences for end of life care?
When this communication is done poorly, or not done at all, patients are confused and less satisfied with their care, experience inadequate symptom relief, and have worse quality of life. Staff who feel insufficiently trained in communication skills are more likely to provide depersonalised care and suffer from burnout.
While research in clinical communication has grown in recent years, there is little consensus on optimal training strategies and the most effective teaching methods. Continue reading
Administrative data: it’s one of those phrases that can generate much excitement among economists and some other social scientists, but will never make for scintillating party conversation in any other setting.
However, the possibilities and limits on the use of administrative data for research can have a big impact on the policymaking process and raise tricky ethical questions, so it is important that the conversation is as broad as it can possibly be.
What is administrative data?
Administrative data is collected by the government for a non-research purpose.
For example, as part of my doctoral research I analyse national insurance data on jobs, wages and commuting distances in Germany.
Whenever someone starts or leaves a job, starts to claim unemployment benefits, is assigned to a jobseekers’ training programme or goes on parental or sick leave, this leaves a paper trail.
Economists in particular are very interested in this information: Many of us still subscribe to the traditional credo “Believe what people do, not what they say”. Continue reading
“I have a problem with gambling. There’s not enough of it.”
That was the admission from billionaire Steve Wynn, a major figure in the casino industry, speaking at a recent gambling research conference in (where else?) Las Vegas. And sure, it made for a good quote. But it’s also a rather glib dismissal of a serious issue that affects many thousands of people across the world.
The UK certainly has a problem with gambling. At least it has since 2007, when laws were changed to allow for huge growth in gambling opportunities and exposure. It has been hard to ignore the subsequent explosion in industry advertising, which increased by around 500% between 2007 and 2013. By contrast, you may have missed the increased numbers of high intensity electronic gambling machines, called Fixed-Odds Betting Terminals (FOBTs), which now occupy the high street (within betting shops) and allow punters to wager up to £100 every 20 seconds.
Yet Britain doesn’t have much insight into its problem with gambling. Compared to most other addictive behaviours, involving drugs or alcohol for example, gambling is largely ignored by health services and public health agencies. This is partly because gambling is a hidden concern. It does not manifest with physical warning signs. Indicators are usually visible in extreme cases only, and generally following major life crises such as extreme debt or relationship breakdown. Continue reading
In 2005 a seminal article by John Ioannidis argued that various biases in how science is conducted, such as the use of small sample sizes and emphasising on novel, eye-catching findings, conspire to reduce the likelihood that a piece of published research is in fact correct. Since then, there has been growing interest in what has become known as the reproducibility crisis, stimulated in part by growing empirical evidence that many published research findings cannot be replicated. For example, in 2011 scientists from the pharmaceutical company Bayer reported that they were only able to replicate ~20-25% of results published in academic journals. Interest in the question of what proportion of published research findings are actually true, and whether we can do better, has grown – in 2015 the Academy of Medical Sciences in the UK held a symposium on the topic, while the House of Commons Science and Technology Committee is currently undertaking an inquiry on these issues. Continue reading
Last month I led an ESRC Funded Thinking Futures Event on Migration and Belonging at the St Werburgh’s Community Centre, Bristol. The event was attended by twenty-six people who had experience of applying for British citizenship or had personal stories to share about migration. Storytelling gives a direct voice to research participants and this was the theme of the event. Artist Sam Church who is a graphic artist simultaneously sketched the stories which were being shared. Continue reading