Tag Archives: health

Rouen blood transfusion 1954

Women at the forefront of the NHS

The traditional role of women in the medical profession was often seen as one of caring and not necessarily a role that required technical, pharmaceutical or even medical skills. Research at Huddersfield has revealed a new dimension to the type of work women occupied in the NHS during the mid-20th century.

While researching his book on hospitals in Leeds and Sheffield, Professor Doyle discovered documentary material showing mid-20th century women carrying out analysis in the pathology lab, taking charge of radiography and handling other high-tech procedures.

“Care to cure”

2 million volt X-ray Generator, Sheffield
2 million volt X-ray Generator, Sheffield

As the 20th century develops there has been a shift in culture in the medical profession from “care to cure” using new technologies, medication and pharmaceuticals. This focus has often seen men and the male doctor leading this area. This research reveals that in the early days of the NHS, women were just as likely to be found in labs and x-ray departments as at the bedside adopting a caring role.

A brochure issued in 1952 by the Sheffield Regional Hospital Board, reports on the previous five years of its activities – therefore covering the transformation to the NHS in 1948. It has a sequence of photographs showing women – some in nursing uniforms, some in lab coats – taking control of most aspects of hospital life.

This brochure demonstrates that during this time women were using microscopes, manipulating a huge two million volt X-ray machine, operating an iron lung, taking charge of the chest clinic and correcting children’s eyesight in the orthoptic department. Few men are to be seen. Most doctors would have been male, but there were actually very few doctors in hospitals at this period.

Professor Doyle has also accumulated evidence from overseas as well as the UK.  For example, a 1950s blood transfusion centre in Rouen, France, was entirely run by women.

Reappraising the role and status of women

Chest Clinic, Sheffield
Chest Clinic, Sheffield

Professor Doyle now believes there is an opportunity for health historians to reappraise the roles and status of women in early 20th century hospitals and he hopes to carry out further research.  Meanwhile, he has written a blog that includes the text and pictures of the 1952 Sheffield booklet.

He acknowledges that men did begin to exert predominance in healthcare technology and began to take over the narrative of the medicalization of healthcare.

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Protecting the children of Tanzania and Zanzibar

In 2011, UNICEF commissioned an extensive study of violence against children in Tanzania mainland and Zanzibar revealing alarmingly high levels of physical, emotional and sexual violence against children. In 2014 The Centre for Applied Childhood Youth and Family Research at the University of Huddersfield was commissioned by UNICEF Tanzania to undertake a follow up study exploring the role of Knowledge Attitudes and Practices that give rise to violence against children.

Expertise at Huddersfield

The Centre for Applied Childhood Youth and Family Research has an established international reputation in research concerning violence and abuse against children as well as participatory action research with children and communities.

Developing a deeper understanding to inform policy and programming

The aim of the study was to gain a better understanding of the drivers of violence against children and the possibilities for developing a protective environment for children. The overall purpose of the research is to inform policy and programme development whilst at the same time build capacity at a local level through community engagement.

International collaboration

The study was undertaken between October 2014 and December 2015 in 10 regions across mainland Tanzania and Zanzibar and involved a collaboration with Mzumbe University in Tanzania. A team of 10 researchers from Mzumbe University and 20 community researchers from each of the 10 regions were trained by University of Huddersfield staff to undertake the field work.

Community action research

The research was conducted in two phases. The first phase involved focus groups with children, parents, community leaders and professionals in each region. The second phase involved a community action research process involving a total of 60 research workshops. Action research is a different sort of research. Instead of collecting data, action research involves a process of ‘learning for change’ in which participants critically reflect on their own values and practices in order to consider possibilities for change. In this research, issues and questions emerging from the focus groups were explored further in a participatory appraisal process to map attitudes and practices in the community. Parents and community leaders then engaged in critical reflection and dialogue in response to findings, with a view to exploring possibilities for developing a protective environment for children.

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[Image caption: Adults involved in participatory appraisal of values and practices relating to violence against children]

Giving children and young people a voice

In parallel to the adult community action research groups, participatory research with children and young people aged 11-18 years was undertaken in each area. The voices of children are often overlooked in Tanzania, so in this study emphasis was placed on ensuring children and young people had an opportunity to share their views and experiences of violence.

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[Image caption: Young people working together to map violence in their community]

Policy and programme development

UNICEF along with other NGOs (non-governmental organisations) is working with the government in Tanzania mainland and Zanzibar to improve child protection. In January 2016 two national workshops were facilitated by the University of Huddersfield during which national stakeholders engaged with the findings from the study and discussed implications for policy and programme development. Findings from this study will feed into the next 10 year strategy to reduce violence against children in Tanzania. At the same time emphasis was placed on building capacity at a local level by engaging community members and local stakeholders as research partners and agents of change. Their role is to activate learning and development at a local level to respond to violence against children.

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[Image caption: National stakeholders engaging with research findings]

Future research

A subsequent proposal has been submitted to the Oak Foundation for a study of Healthy Relationships in Adolescence, which is a participatory action research project with young people to develop preventative strategies in response to sexual abuse and exploitation.

This project consolidates the reputation of the Centre for Applied Childhood Youth and Family Research for high quality research in the field of child abuse and exploitation.

For further information contact the project leader:

Professor Barry Percy-Smith
Email: b.percy-smith@hud.ac.uk

Felicity Astin

Developing nurses to deliver the best cardiovascular care

With a growing and ageing population and an increase in lifestyle-related conditions such as obesity and diabetes the challenge facing the health service in Europe is immense.

Cardiovascular disease such as coronary disease and stroke continues to be a significant global health burden and the leading cause of mortality worldwide.

Nurse education

The European Society of Cardiology (ESC) which includes the Council on Cardiovascular Nursing and Allied Professions (CCNAP) has an international membership of over 50,000 members from 56 countries. The Society has a vision to decrease the burden of cardiovascular disease in Europe.

As the largest sector of the health professional workforce nurses have a significant contribution to make. However, the provision of nurse education in Europe is variable. Research has revealed that the level of nurse education, together with the nurse-to-patient ratio, has an impact on 30-day in-patient mortality rates. Hospitals with a greater number of their workforce educated to Bachelor level have lower 30-day in-patient mortality, compared to those with less (Aitken et al, 2014).

Core curriculum

Felicity Astin

An educational initiative led by Professor Felicity Astin (pictured above) at the University of Huddersfield, together with colleagues, has made a significant contribution towards the streamlining of cardiovascular nurse education in Europe. A core curriculum has been developed, on behalf of CCNAP, that can be used as a learning framework to guide nurse education in cardiovascular care.

A grass roots approach was taken when developing the curriculum with the emphasis being on the decentralisation of decision making. This approach supports the autonomy and shared responsibility of each individual country.

There are eight key themes of the core curriculum. These themes are transferable across different levels of clinical practice and settings and can be used as a learning framework to guide nurse education.

Diagram of Core Curriculum
Diagram of Core Curriculum

Focus on ‘care’ not ‘cure’

A significant proportion of illnesses are preventable and by shifting the focus from ‘cure’ to ‘care’ the aim is to help people to self-manage their health.

The core curriculum moves the emphasis away from the biomedical approach to care delivery and strengthening the person and family centred perspective. Key components include effective communication, learning and teaching skills, the ability to facilitate patient autonomy and the provision of individualised care in a respectful manner – all of which were identified as key markers of quality care by in-patients in a large scale survey of over 68,000 patients in Europe (Jenkinson et al, 2002).

The curriculum also emphasises the importance of health literacy – the ability and opportunity that an individual has to access, read and understand high quality health information – which has the potential to enhance health promotion, wellbeing and reduce health inequalities. The educational provision of cardiovascular nurses needs to reflect the changing healthcare needs of our global population.

Equality of nurse education

The development of a core curriculum contributes to the advancement of cardiovascular nursing education across Europe. Currently educational programmes for nurses differ across European countries with an increasing need to provide nurses in Europe with access to Bachelor level education.

The next step is to identify advanced and specialist curricula. Other specialist groups, such as the Heart Failure Association within the European Society of Cardiology are currently developing such material. The content within the core curriculum will link with the specialist content to progress and advance cardiovascular nurse education.

The core curriculum is being used to inform similar educational developments in Australia and will be presented as part of a keynote session at the World Heart Federation meeting in Mexico in June 2016.

For further information contact:

Professor Felicity Astin
Email: f.astin@hud.ac.uk