Dr. Ravindra Pathirathna joined the School of Health and Social Care and CaHRU in March 2017 as its first visiting international research fellow. Ravindra graduated in medicine from the University of Peradeniya and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the field of medical administration where he gained his master’s and MD.
He has worked for 14 years as a medical officer in emergency medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy provincial director of the health department in the central province of Sri Lanka. His main interests are in operational management, system development and quality improvement in health care.
Ravindra has published several research papers, for example in the Journal of Medical Administration in Sri Lanka, mainly in the area of health systems. These include: a study testing a new model of evaluation of health policy; interventional research using total quality principles and systems theory in inter-hospital patient transports; and workload assessment in health care administrative staff. He has also published in the fields of: cost evaluation of healthcare training; managerial approaches to waiting time reduction in clinical settings; interventions to improve clinical facility management; an epidemiological study on dengue in different climatic conditions and an evaluation of care in older people. He is a member of several academic associations in Sri Lanka including the College of Medical Administration of Sri Lanka.
During his visiting fellowship he will be studying the prehospital emergency system in the UK, mainly focusing on policy and operational background, ambulance service quality and clinical performance improvement. His main objective is to identify and develop an appropriate prehospital care model for a developing country such as Sri Lanka.
By Dr Ravindra Pathirathna
Joseph Akanuwe recently joined CaHRU as a research assistant working on quality improvement and implementation science projects in primary and prehospital care.
Joseph has a nursing and public health background. After qualifying as a registered general nurse (RGN) he worked within primary and secondary care settings as a staff nurse and a casualty and emergency unit manager in Ghana. He went completed his Bachelor’s degree in Nursing and Psychology and a Master’s in Public Health (MPH) at the University of Ghana. Returning to his former Nurses Training College, he worked as a lecturer before moving to the UK.
In the UK, Joseph has worked as a staff nurse (RN) in the Dartford and Gravesend NHS Trust from 2004 to 2006, and as a renal nurse (specialising in renal haemodialysis) at the Sheffield Teaching Hospitals NHS Foundation Trust. While working as a renal nurse in Sheffield, Joseph studied at the University of Sheffield, achieving a Master of Medical Science (MMedSci) degress specialising in the management of long term health conditions, and a Master of Philosophy (MPhil) with training in public health research. His MPhil thesis explored the impact of the UK Quality and Outcomes Framework (QOF) on the quality of diabetes care and health care inequalities in primary care settings in England. Joseph is completing his doctoral studies at the University of Lincoln exploring the perspectives of service users and practitioners on the use of QCancer, a novel cancer risk assessment tool, for early detection of cancer in primary care settings.
Joseph is a Practitioner Member of the UK Faculty of Public Health (FPH), a member of the European Public Health Association, a registered member of the UK Nurses and Midwifery Council (NMC) and an Associate Fellow of the Higher Education Academy (AFHEA). He also contributes to the teaching of the health promotion module, as part of the Health and Social Care and Nursing programmes at the University of Lincoln.
Members of the CaHRU team recently attended the College of Social Science Research Showcase at the University of Lincoln on 4 July 2016. The event aimed to present the work being undertaken across the College of Social Science. The day started with registration and a poster-viewing session. Posters portrayed research from a variety of areas, ranging from animal and comparative psychology, “Dogs and humans respond to emotionally competent stimuli by producing different facial actions” (Catia Correia Caeiro, Dr Kun Guo, Prof Daniel Mills) to other topics from the Schools of Psychology, Health & Social Care and Sport & Exercise Science.
The rest of the day included presentations from across the College of Social Science, with Dr Jo Middlemass (pictured right) giving the first presentation of the day on her innovative work on the EU funded CHROMED project (Clinical Trials for Elderly Patients with Multiple Diseases), entitled “Perceptions and experiences of tele-monitoring in older patients with multi-morbidity- a qualitative study”. Other CaHRU members also gave excellent presentations including Mohammed Iqbal (“A non-randomised control study to investigate the effectiveness of a novel pain assessment tool for use by ambulance clinicians: improving prehospital pain management”), Dr Zahid Asghar (“Exploratory Cross-Sectional Study of Factors Associated with Transport to Hospital in Patients with Suspected Convulsions presenting to Ambulance Services”), Joseph Akanuwe ( pictured left “Exploring service user and practitioner perspectives of QCancer use in primary care consultations”), Viet-Hai Phung (“Delivering ambulance service care that meets the needs of EU Accession migrants in Lincolnshire”), Fiona Togher (“The use of cognitive interviews to enhance the quality of a Patient Reported Experience Measure (PREM) for use in NHS ambulance services”), Dr Stephanie Armstrong (“Network exploring the Ethics of Ambulance based clinical Trials (NEAT)”), and Despina Laparidou (“Challenges for carers of people with dementia and their support needs from health and social care providers: a qualitative study”). Overall, the event was an excellent opportunity for all researchers to present their work and ‘showcase’ the wonderful projects taking place within CaHRU.
A quick break for a final session of poster viewing was followed by the keynote speaker, Prof Martin Tovee from the School of Psychology, giving an excellent talk on “Body Image, Eating Disorders and the Media”. The day was brought to its close with a reception, where delegates had the opportunity to further discuss the presentations given earlier and share thought-provoking ideas.
By Despina Laparidou
As part of the CaHRU Improvement Science and Research Methods seminar series, Fiona Togher presented a fascinating seminar on the use of cognitive interviews on 28 June 2016. Fiona eloquently described how cognitive interviews can and indeed should be used as an integral part of questionnaire design. She explained how some of the potential problems found in data collected by questionnaires can be directly apportioned to participants understanding and perception of the questions along with issues of memory retrieval and the response process. Traditional field testing of questionnaires does not highlight these issues as this type of testing will only analyse whether a participant answers a question or not. It does not assess the thought process behind the participant’s decision to answer the question in that way.
Cognitive interviews are an in-depth question by question discussion with typical participants designed to assess their comprehension, retrieval, judgement and response process. From this it is possible to determine the suitability and relevance of questions to the target audience, thereby producing clear questionnaires that will themselves produce more robust data. Fiona was able to show practical application of this technique through her own experiences whilst developing a Patient Reported Experience Measure (PREM) for use in Ambulance Services in England. Her personal experience of using cognitive interviews and relaxed and engaging presentation style made this an interesting, informative and enjoyable seminar.
Fiona recommended the following book as a good starting place for understanding this method: Willis, G. B. (2004) Cognitive Interviewing: A Tool for Improving Questionnaire Design Sage Publications, Inc. There is also a follow on book: Willis, G.B. (2015) Analysis of the Cognitive Interview in Questionnaire Design (Understanding Qualitative Research) OUP, USA. The next Improvement Science and Methods seminar will take place on 13th September, 2016 where Prof Chris Bridle, director of the Lincoln Institute for Health, will be discussing accumulative evidence synthesis.
By Dr Stephanie Armstrong
Members of the CaHRU team together with colleagues from East Midlands Ambulance Service NHS Trust attended the 999 EMS Research Forum conference, ‘Making it happen: delivering research in pre-hospital care’ at the Assembly Rooms in Newcastle on 1 March 2016. The event was organised by the 999 EMS Forum in collaboration with North East Ambulance Service NHS Trust and Newcastle University.
The conference was opened by Yvonne Ormston, Chief Executive of North East Ambulance Service and introduced by Prof Helen Snooks, Professor of Health Services Research at Swansea University and chair of the EMS 999 Research Forum. The opening keynote was given by Dr Simon Woods of Newcastle University on ‘Ethics and consent in pre-hospital research’. This was followed by a number of oral presentations from the highest scoring abstracts submitted to the conference. This included a presentation by Dr Mohammad Iqbal, research associate at East Midlands Ambulance Service NHS Trust and research fellow at CaHRU, who presented his doctoral study, ‘Non randomised control study of the effectiveness of a novel pain assessment tool for use by paramedics’. After the oral presentations there was a further keynote from Dr Chris Price of Newcastle University on ‘Delivering safe pre-hospital research: a stroke perspective’.
Poster sessions included a presentation from Fiona Togher, graduate research assistant at CaHRU on her doctoral research, ‘Refining questionnaire items in a Patient Reported Experience Measure (PREM) designed for users of NHS ambulance services: Question Appraisal Study’. The afternoon session included a workshop given by Prof Niro Siriwardena and Dr Adele Langlois supported by Dr Stephanie Armstrong, on ‘Ethics and consent in pre-hospital research’, which form part of the Network exploring Ethics of Ambulance Trials funded by the Wellcome Trust. The workshop was well attended and generated ideas on consent, confidentiality, and privacy in relation to ambulance trials as well as ideas on future research.
The final keynote was given by Dutch researcher, and acute physician, Dr Prabath Nanayakkara on his ‘Research in the pre-hospital management of sepsis: opportunities and challenges’. The conference was closed by Prof Siriwardena, with prizes presented to the best research, best poster, research most likely to affect practice and best use of data, and thanks given to the organisers for an excellent and memorable event.