at the Faculty of Health, Psychology & Social Care ISSue 02 | SPRING 2015

Research Matters

The University forWorld-Class Professionals

Inside this issue

Do tough people sing the blues?

Professor Peter Clough

Challenging stigma: social work and substance use

Professor Sarah Galvini

Getting the message: Raising awareness of AAC for children

with communication disabilitiesDr Janice Murray

Cold Water Immersion: Physiological or Psychological

benefit for athletes?

Nora Alshoweir

Living life to the full: safeguarding health and wellbeing

services across the lifespan

Professor Josie Tetley

What Next? Integrating

former drug users back into

the workforce

Dr Sheila Wilson

The Cost of Patient Care: Equity in resource allocation for

our health service

Dr Francis Fatoye

For many former substance misuse service users, overcoming alcohol and drug addiction can mark the start of a long road ahead. When treatment finishes, they may be left wondering ‘what next?’ as they try to get their life back on track and can often face a series of struggles. One such obstacle is how they integrate into the workforce after weeks, months or even years away.

So to help ease the transition, research from an MMU student

is being transferred directly into the NHS to help former service

users rebuild for the future.

Substance misuse specialist Dr Sheila Wilson works for the

Greater Manchester West Mental Health NHS Foundation Trust

and has been helping former drug users trying to make the

transition into employment, a theme that shaped her MSc and

PhD studies.

She developed a model that sought to tap into former drug users’

experiences of dealing with addiction by helping them to become

volunteers and later employees in the substance misuse field,

and at the same time helping them to build a new life and feed

back into the service that had once provided support.

“Most ex-user narratives already ‘end’ at the point where

treatment ends, leaving much to discover regarding what

happens next,” said Dr Wilson.

“Understanding the next transition stage is valuable in enhancing

recovery and treatment outcomes, and determining how best to

recruit, induct, train, supervise and support ex-user drug workers

in gaining paid employment within the substance misuse field.”

Participants told their story through a ‘process map’ (pictured)

to develop participant-structured narratives, with former service

users plotting key events chronologically while telling their story.

This invaluable insight allowed Dr Wilson to develop three

key stages of change from drug user to employee: transition,

disclosure and professional identity. The narratives explored many

barriers – such as lack of prior work or educational achievement,

negative staff attitudes and previous convictions – and

opportunities, which can include positive role models, support,

training, volunteering and employment.

She adds: “Many of the study’s recommendations are already

being adopted: disclosure training on volunteer programmes is

enabling ex-users to balance being a role model with selective

disclosure to safeguard their own and clients’ wellbeing while

optimising disclosure effectiveness.

“This is just one example of how the research is already

positively influencing ex-users’ experience in making the

transition to drug worker status in the substance misuse field.

Further developments include a range of positive behaviours and

strategies to help to them as they transition.”

As Associate Dean for Research, I am delighted to introduce our research in the faculty of Health, Psychology and Social Care.

The faculty is engaged in internationally recognised, innovative

research in Health and Social Change, embracing the disciplines

of Psychology, Physiotherapy, Nursing, Speech and Language

Pathology, Social Work, and Social Care.

Our research is coordinated by two Faculty Research Centres:

• the Health Research Centre: Disability, Ageing and Wellbeing,

which comprises four Research Groups:

– Ageing and Long Term Conditions

– Applied Psychology and Wellbeing

– Disability and Participation

– Health Services and Outcomes

• the Research Centre for Social Change: Community Wellbeing,

which comprises three Research Groups:

– Community and Critical Psychology

– Safeguarding and Critical Professional Practice

– Substance Use and Addictive Behaviours

In REF 2014, we made highly successful cross-faculty

submissions to UoA22 (Social Work and Social Policy) and UoA3

(Allied Health Professions, Dentistry, Nursing and Pharmacy);

61% and 73% (respectively) of our research was designated

‘world leading’ or ‘internationally excellent.’

For more about MMU’s REF performance, including our

internationally excellent impact case studies, see

http://www2.mmu.ac.uk/research/ref/

Strongly established and widely published in the field, our

two Research Centres and our faculty partner, the Centre for

Knowledge Exchange, bring together an impressive array of

research and knowledge exchange activity within MMU and

across our extensive regional, national and international networks.

We reflect the demands placed on policy makers, employers

and public services in the 21st century, through our integrated

approach both to research and to the issues affecting individuals,

communities and populations. We are involved in a wide range of

research projects in health, psychology and social care; you can

read about some exciting examples in this magazine.

We offer postgraduate supervision at Masters and Doctoral

level. We currently have over 80 doctoral students, including full

and part time students from the UK and a wide range of other

countries. See the opposite page for an exciting account of the

work of one of our recent Doctoral graduates, Dr Sheila Wilson.

For further information on postgraduate research degrees,

see the MMU website http://www2.mmu.ac.uk/research/

researchdegrees/.

We welcome opportunities for collaborative research and

applications from prospective postgraduate research students.

Contact details can be found on the back of this issue of

Research Matters.

I hope you will enjoy reading about the work some of our

researchers in the faculty of Health, Psychology & Social Care.

Professor Juliet Goldbart Associate Dean: Research

Welcome from Professor Juliet Goldbart

What Next? Integrating former drug users back into the workforceDr Sheila Wilson

Drug unit detox

Full-time support worker

18 months

Promoted senior support worker

3 years

Peer support group 3 months

Sessional worker 6 weeks

Completed Level 3 substance misuse practitioner course

Take over running the group

Volunteer on the detox unit 10 months

Community drug worker

For many former substance misuse service users, overcoming alcohol and drug addiction can mark the start of a long road ahead. When treatment finishes, they may be left wondering ‘what next?’ as they try to get their life back on track and can often face a series of struggles. One such obstacle is how they integrate into the workforce after weeks, months or even years away.

So to help ease the transition, research from an MMU student

is being transferred directly into the NHS to help former service

users rebuild for the future.

Substance misuse specialist Dr Sheila Wilson works for the

Greater Manchester West Mental Health NHS Foundation Trust

and has been helping former drug users trying to make the

transition into employment, a theme that shaped her MSc and

PhD studies.

She developed a model that sought to tap into former drug users’

experiences of dealing with addiction by helping them to become

volunteers and later employees in the substance misuse field,

and at the same time helping them to build a new life and feed

back into the service that had once provided support.

“Most ex-user narratives already ‘end’ at the point where

treatment ends, leaving much to discover regarding what

happens next,” said Dr Wilson.

“Understanding the next transition stage is valuable in enhancing

recovery and treatment outcomes, and determining how best to

recruit, induct, train, supervise and support ex-user drug workers

in gaining paid employment within the substance misuse field.”

Participants told their story through a ‘process map’ (pictured)

to develop participant-structured narratives, with former service

users plotting key events chronologically while telling their story.

This invaluable insight allowed Dr Wilson to develop three

key stages of change from drug user to employee: transition,

disclosure and professional identity. The narratives explored many

barriers – such as lack of prior work or educational achievement,

negative staff attitudes and previous convictions – and

opportunities, which can include positive role models, support,

training, volunteering and employment.

She adds: “Many of the study’s recommendations are already

being adopted: disclosure training on volunteer programmes is

enabling ex-users to balance being a role model with selective

disclosure to safeguard their own and clients’ wellbeing while

optimising disclosure effectiveness.

“This is just one example of how the research is already

positively influencing ex-users’ experience in making the

transition to drug worker status in the substance misuse field.

Further developments include a range of positive behaviours and

strategies to help to them as they transition.”

As Associate Dean for Research, I am delighted to introduce our research in the faculty of Health, Psychology and Social Care.

The faculty is engaged in internationally recognised, innovative

research in Health and Social Change, embracing the disciplines

of Psychology, Physiotherapy, Nursing, Speech and Language

Pathology, Social Work, and Social Care.

Our research is coordinated by two Faculty Research Centres:

• the Health Research Centre: Disability, Ageing and Wellbeing,

which comprises four Research Groups:

– Ageing and Long Term Conditions

– Applied Psychology and Wellbeing

– Disability and Participation

– Health Services and Outcomes

• the Research Centre for Social Change: Community Wellbeing,

which comprises three Research Groups:

– Community and Critical Psychology

– Safeguarding and Critical Professional Practice

– Substance Use and Addictive Behaviours

In REF 2014, we made highly successful cross-faculty

submissions to UoA22 (Social Work and Social Policy) and UoA3

(Allied Health Professions, Dentistry, Nursing and Pharmacy);

61% and 73% (respectively) of our research was designated

‘world leading’ or ‘internationally excellent.’

For more about MMU’s REF performance, including our

internationally excellent impact case studies, see

http://www2.mmu.ac.uk/research/ref/

Strongly established and widely published in the field, our

two Research Centres and our faculty partner, the Centre for

Knowledge Exchange, bring together an impressive array of

research and knowledge exchange activity within MMU and

across our extensive regional, national and international networks.

We reflect the demands placed on policy makers, employers

and public services in the 21st century, through our integrated

approach both to research and to the issues affecting individuals,

communities and populations. We are involved in a wide range of

research projects in health, psychology and social care; you can

read about some exciting examples in this magazine.

We offer postgraduate supervision at Masters and Doctoral

level. We currently have over 80 doctoral students, including full

and part time students from the UK and a wide range of other

countries. See the opposite page for an exciting account of the

work of one of our recent Doctoral graduates, Dr Sheila Wilson.

For further information on postgraduate research degrees,

see the MMU website http://www2.mmu.ac.uk/research/

researchdegrees/.

We welcome opportunities for collaborative research and

applications from prospective postgraduate research students.

Contact details can be found on the back of this issue of

Research Matters.

I hope you will enjoy reading about the work some of our

researchers in the faculty of Health, Psychology & Social Care.

Professor Juliet Goldbart Associate Dean: Research

Welcome from Professor Juliet Goldbart

What Next? Integrating former drug users back into the workforceDr Sheila Wilson

Drug unit detox

Full-time support worker

18 months

Promoted senior support worker

3 years

Peer support group 3 months

Sessional worker 6 weeks

Completed Level 3 substance misuse practitioner course

Take over running the group

Volunteer on the detox unit 10 months

Community drug worker

Currently in the UK, you have a statutory right to access a wheelchair if you cannot walk, or a hearing aid if you have a hearing impediment. However, if you have a communication disability, you do not have the same right to access similar support services or receive a communication aid.

During the last 10 years, momentum has gathered around the

need for a better understanding of Augmentative and Alternative

Communication (AAC) aided by the prominence of public users

such as Professor Stephen Hawking and stand-up comedian

Lee Ridley. But progress is still needed, according to Dr Janice

Murray.

Dr Murray is a Reader in Community Rehabilitation at

Manchester Metropolitan University, with a background in

speech and language therapy, specialising in AAC. Her research

focuses on creating better prospects for people who use aided

communication.

Her research impact includes the creation of the website www.

aacknowledge.org.uk, which provides summaries of research

evidence, practice strategies and case stories to inform a range

of stakeholders including professionals, parents, suppliers

and users of AAC technology. She is the Chair of Council for

the International Society for Augmentative and Alternative

Communication (ISAAC).

Dr Murray’s current work centres on children who, from birth,

have difficulties communicating. The project, titled ‘Becoming

an Aided Communicator’ led by Stephen von Tetzchner from

the University of Oslo, brings together experts from 16 different

countries including Germany, Australia and the USA.

The research was inspired by the tension created by current

communication aid technologies: a need to make devices simple

enough to use but at the same time not restricting language and

communication development. Such devices can include graphic

symbol systems that use symbols together with the word or

phrase it stands for and voice output communication aids, similar

to what is used by Professor Hawking.

The project seeks to map language development in children who

use aided communication. This will inform future assessment

protocols and system recommendations, making the experience

more relevant to the child with communication difficulties.

Dr Murray says: “A lot of evidence in the research literature

suggests that children who use aided communication to speak

and have no other learning difficulty do

not acquire the language and the literacy

skills of which they should be capable.

This suggests that there is something that

we have not got quite right in supporting

their language and communication

development. Long-term, this impacts

on their opportunities and prospects in

society.”

The current practice for assessing a

child’s need for aided communication

involves matching their skills against the

knowledge of typical language acquisition

development, which Dr Murray suggests

is unfair because ‘these children are not

learning to communicate in a typical way’.

Much of the crucial and fast-paced

language development for children

takes place in the first three years of

their lives, a stage when children with

communication difficulties and their

parents often struggle to come to terms

with the issues and struggle to find out

how they can access help.

Instead of focusing on how language

develops in all children, this research

charts how language is learned

by children who already use aided

communication and have been doing so

for two years. The project has tested

the patterns of learning in 100 children

between the ages of 5 and 15.

Dr Murray explains: “What we did as a

group was create unique and novel tasks

with the view of looking at the children’s

ability to understand language, and

also their expressive communication or

speaking skills. In this way we mapped

what was a typical speech and language

response in aided communicators.”

The evidence is currently being brought

together in a book to encourage

practitioners to use it. The hope is

that it becomes a reference text for

professionals assessing children who

may benefit from aided communication.

Overall, the goal with the research

is to increase the independence and

quality of life for those who use aided

communication, but also to help raise

awareness across society of these very

skilled and strategic children who get

their message across in a very different

but effective way.

One example of its success follows

Dr Murray’s research over 10 years when

she worked with a school to promote

the benefits of aided communication.

A young boy who had cerebral palsy, a

condition that left him without speech,

enrolled in the school.

After some tests, Dr Murray found

he was extremely bright for his age

and provided him with a speaking

communication aid which she installed

with a language representation system

developed with teenagers in mind.

Within one month, the child learned

to use the system by being able to

locate all the right vocabulary so that he

could create sentences and contribute

to a conversation in the same way as

any naturally speaking child. After two

months, the staff saw the communication

aid as his actual voice, no longer

automatically separating the child and the

machine. “He did in two months what

I had been trying to do over a 10-year

period of time. They finally got it, it was

fabulous,” she said.

Two years later the same child

successfully entered mainstream school.

Dr Murray believes the importance of this

is the overall acceptance and inclusion of

those who use aided communication in a

mainstream educational setting.

She added: “If we can get more kids

out into the mainstream setting, then I

think what we are trying to work towards

will be understood more and people will

get it. We all take being able to talk and

communicate for granted, here these kids

have to work so hard to just be normal.”

Dr Murray’s long-term aim is to develop

more thorough and coherent aided

communication systems for children,

providing them with greater prospects

in terms of employment and other

opportunities within society.

Getting the message: Raising awareness of AAC for children with communication disabilitiesDr Janice Murray

“The goal with the research is to increase the independence and quality of life for those who use aided communication, but also to help raise awareness across society.”

Currently in the UK, you have a statutory right to access a wheelchair if you cannot walk, or a hearing aid if you have a hearing impediment. However, if you have a communication disability, you do not have the same right to access similar support services or receive a communication aid.

During the last 10 years, momentum has gathered around the

need for a better understanding of Augmentative and Alternative

Communication (AAC) aided by the prominence of public users

such as Professor Stephen Hawking and stand-up comedian

Lee Ridley. But progress is still needed, according to Dr Janice

Murray.

Dr Murray is a Reader in Community Rehabilitation at

Manchester Metropolitan University, with a background in

speech and language therapy, specialising in AAC. Her research

focuses on creating better prospects for people who use aided

communication.

Her research impact includes the creation of the website www.

aacknowledge.org.uk, which provides summaries of research

evidence, practice strategies and case stories to inform a range

of stakeholders including professionals, parents, suppliers

and users of AAC technology. She is the Chair of Council for

the International Society for Augmentative and Alternative

Communication (ISAAC).

Dr Murray’s current work centres on children who, from birth,

have difficulties communicating. The project, titled ‘Becoming

an Aided Communicator’ led by Stephen von Tetzchner from

the University of Oslo, brings together experts from 16 different

countries including Germany, Australia and the USA.

The research was inspired by the tension created by current

communication aid technologies: a need to make devices simple

enough to use but at the same time not restricting language and

communication development. Such devices can include graphic

symbol systems that use symbols together with the word or

phrase it stands for and voice output communication aids, similar

to what is used by Professor Hawking.

The project seeks to map language development in children who

use aided communication. This will inform future assessment

protocols and system recommendations, making the experience

more relevant to the child with communication difficulties.

Dr Murray says: “A lot of evidence in the research literature

suggests that children who use aided communication to speak

and have no other learning difficulty do

not acquire the language and the literacy

skills of which they should be capable.

This suggests that there is something that

we have not got quite right in supporting

their language and communication

development. Long-term, this impacts

on their opportunities and prospects in

society.”

The current practice for assessing a

child’s need for aided communication

involves matching their skills against the

knowledge of typical language acquisition

development, which Dr Murray suggests

is unfair because ‘these children are not

learning to communicate in a typical way’.

Much of the crucial and fast-paced

language development for children

takes place in the first three years of

their lives, a stage when children with

communication difficulties and their

parents often struggle to come to terms

with the issues and struggle to find out

how they can access help.

Instead of focusing on how language

develops in all children, this research

charts how language is learned

by children who already use aided

communication and have been doing so

for two years. The project has tested

the patterns of learning in 100 children

between the ages of 5 and 15.

Dr Murray explains: “What we did as a

group was create unique and novel tasks

with the view of looking at the children’s

ability to understand language, and

also their expressive communication or

speaking skills. In this way we mapped

what was a typical speech and language

response in aided communicators.”

The evidence is currently being brought

together in a book to encourage

practitioners to use it. The hope is

that it becomes a reference text for

professionals assessing children who

may benefit from aided communication.

Overall, the goal with the research

is to increase the independence and

quality of life for those who use aided

communication, but also to help raise

awareness across society of these very

skilled and strategic children who get

their message across in a very different

but effective way.

One example of its success follows

Dr Murray’s research over 10 years when

she worked with a school to promote

the benefits of aided communication.

A young boy who had cerebral palsy, a

condition that left him without speech,

enrolled in the school.

After some tests, Dr Murray found

he was extremely bright for his age

and provided him with a speaking

communication aid which she installed

with a language representation system

developed with teenagers in mind.

Within one month, the child learned

to use the system by being able to

locate all the right vocabulary so that he

could create sentences and contribute

to a conversation in the same way as

any naturally speaking child. After two

months, the staff saw the communication

aid as his actual voice, no longer

automatically separating the child and the

machine. “He did in two months what

I had been trying to do over a 10-year

period of time. They finally got it, it was

fabulous,” she said.

Two years later the same child

successfully entered mainstream school.

Dr Murray believes the importance of this

is the overall acceptance and inclusion of

those who use aided communication in a

mainstream educational setting.

She added: “If we can get more kids

out into the mainstream setting, then I

think what we are trying to work towards

will be understood more and people will

get it. We all take being able to talk and

communicate for granted, here these kids

have to work so hard to just be normal.”

Dr Murray’s long-term aim is to develop

more thorough and coherent aided

communication systems for children,

providing them with greater prospects

in terms of employment and other

opportunities within society.

Getting the message: Raising awareness of AAC for children with communication disabilitiesDr Janice Murray

“The goal with the research is to increase the independence and quality of life for those who use aided communication, but also to help raise awareness across society.”

Students at Manchester Metropolitan University (MMU) may now have the edge over other graduates after the arrival of Professor Peter Clough. Having spent most of his academic career at The University of Hull in a variety of roles including Associate Dean, Professor Clough joined MMU in February 2014 as the Chair of Applied Psychology. His main focus is the area of mental toughness and the expertise he has gained over the years is being used to enhance student performance and employability.

Professor Clough has spent the last 15 years researching Mental

Toughness, initially as a sports and occupational psychologist,

developing his 4 ‘C’ model and the mental toughness

questionnaire MTQ48. However, he is now more interested in

the subtleties of the subject with a particular focus on sensitivity

and how sensitive people cope with the world.

“Mental toughness is often seen as a macho concept and we

talked a lot when we were developing it, about what to call it, and

mental toughness seems to be more honest. You can call it lots

of stuff but that’s what it is,” he explained.

With schools now using more exams rather than coursework,

the pressure placed on people in education can be debilitating,

especially if they are both introverted and sensitive. Also, with

most managerial positions within companies filled with people

who score highly on the MTQ48 questionnaire, it becomes

increasingly difficult for the more sensitive to succeed.

“Our mental toughness model developed out of sport, into

business and now most of its focus is in education. We have a

book out currently looking at mental toughness in education, the

reason that it’s interesting is because there is so much wasted

talent,” he said.

“Every time there is an assessment the more sensitive

people get ’taken out’, whilst the mentally tough people just

keep ‘ploughing on’. If you can’t deal with the pressures of

assessment in school, then you don’t do well.”

With students from traditionally working-class backgrounds

often under-performing in schools, the question of whether we

can develop toughness is becoming very pertinent. This may

allow disadvantaged children to achieve better results at school

and ultimately enjoy greater success in a working environment.

Professor Clough says that helping people

to achieve their potential is the socially

responsible thing to do; however, he

is philosophical about the benefits of

making everyone mentally tough and

believes we need to maintain and support

sensitive people in society.

“We’re interested in working in areas of

deprivation to try to help people get an

education - generally the only way out

of poverty is sport, music or education.

Throughout history, especially recently,

there have always been people that have

prospered in harsh conditions so that’s

where you start. Can we identify what

they do? Or: can we develop people to be

like that? And finally, the third and most

interesting question is: should we?”

He builds on that further by saying: “Can

mentally tough people sing the blues?

Sensitive people bring a lot to the party,

unfortunately they’re often not in a

position of power.”

Professor Clough is pleased to have

joined MMU, enjoying the eclectic mix

within the Psychology department. They

are applying his research to help MMU

students by introducing them to a range

of toughening techniques.

With regards to his own research he

says: “People who are drawn to mental

toughness training are often mentally

tough, it’s the sensitive people who

might need it that don’t come forward,

We don’t want to fundamentally change

them, we just want to give them a range

of options.”

He adds: “We try to give them tools and

techniques. Let’s say they can’t reach

the top shelf, we don’t make them taller

rather we give them something to step

on - that’s what we’re trying to do.” He

makes it clear that individual differences

obviously play a major role, and that the

Psychology department now encourages

students to take the mental toughness

questionnaire and the individual student’s

support is tailored to her or his needs

based on their results.

Regarding what he considers as success,

he believes that it should be what works

for you. He says it should not necessarily

be earning lots of money, it is doing

what you need to do. Professor Clough

explained: “That is mental toughness,

making your own decisions and not

from group pressure. It’s reaching

your full potential.” Professor Clough

hopes his future research will better

explain the cognitive underpinnings of

mental toughness and the explanation

of the mental toughness advantage. He

added: “There is definitely an advantage

but the question is why? What is it

that these people are doing that gives

the advantage? Is it cognitive? Is it

physiological? Or is it psychological?”

With his upcoming research, we may find

out the answer.

Do tough people sing the blues?Professor Peter Clough

Control

Confidence CommitmentMentalToughness

Challenge

Students at Manchester Metropolitan University (MMU) may now have the edge over other graduates after the arrival of Professor Peter Clough. Having spent most of his academic career at The University of Hull in a variety of roles including Associate Dean, Professor Clough joined MMU in February 2014 as the Chair of Applied Psychology. His main focus is the area of mental toughness and the expertise he has gained over the years is being used to enhance student performance and employability.

Professor Clough has spent the last 15 years researching Mental

Toughness, initially as a sports and occupational psychologist,

developing his 4 ‘C’ model and the mental toughness

questionnaire MTQ48. However, he is now more interested in

the subtleties of the subject with a particular focus on sensitivity

and how sensitive people cope with the world.

“Mental toughness is often seen as a macho concept and we

talked a lot when we were developing it, about what to call it, and

mental toughness seems to be more honest. You can call it lots

of stuff but that’s what it is,” he explained.

With schools now using more exams rather than coursework,

the pressure placed on people in education can be debilitating,

especially if they are both introverted and sensitive. Also, with

most managerial positions within companies filled with people

who score highly on the MTQ48 questionnaire, it becomes

increasingly difficult for the more sensitive to succeed.

“Our mental toughness model developed out of sport, into

business and now most of its focus is in education. We have a

book out currently looking at mental toughness in education, the

reason that it’s interesting is because there is so much wasted

talent,” he said.

“Every time there is an assessment the more sensitive

people get ’taken out’, whilst the mentally tough people just

keep ‘ploughing on’. If you can’t deal with the pressures of

assessment in school, then you don’t do well.”

With students from traditionally working-class backgrounds

often under-performing in schools, the question of whether we

can develop toughness is becoming very pertinent. This may

allow disadvantaged children to achieve better results at school

and ultimately enjoy greater success in a working environment.

Professor Clough says that helping people

to achieve their potential is the socially

responsible thing to do; however, he

is philosophical about the benefits of

making everyone mentally tough and

believes we need to maintain and support

sensitive people in society.

“We’re interested in working in areas of

deprivation to try to help people get an

education - generally the only way out

of poverty is sport, music or education.

Throughout history, especially recently,

there have always been people that have

prospered in harsh conditions so that’s

where you start. Can we identify what

they do? Or: can we develop people to be

like that? And finally, the third and most

interesting question is: should we?”

He builds on that further by saying: “Can

mentally tough people sing the blues?

Sensitive people bring a lot to the party,

unfortunately they’re often not in a

position of power.”

Professor Clough is pleased to have

joined MMU, enjoying the eclectic mix

within the Psychology department. They

are applying his research to help MMU

students by introducing them to a range

of toughening techniques.

With regards to his own research he

says: “People who are drawn to mental

toughness training are often mentally

tough, it’s the sensitive people who

might need it that don’t come forward,

We don’t want to fundamentally change

them, we just want to give them a range

of options.”

He adds: “We try to give them tools and

techniques. Let’s say they can’t reach

the top shelf, we don’t make them taller

rather we give them something to step

on - that’s what we’re trying to do.” He

makes it clear that individual differences

obviously play a major role, and that the

Psychology department now encourages

students to take the mental toughness

questionnaire and the individual student’s

support is tailored to her or his needs

based on their results.

Regarding what he considers as success,

he believes that it should be what works

for you. He says it should not necessarily

be earning lots of money, it is doing

what you need to do. Professor Clough

explained: “That is mental toughness,

making your own decisions and not

from group pressure. It’s reaching

your full potential.” Professor Clough

hopes his future research will better

explain the cognitive underpinnings of

mental toughness and the explanation

of the mental toughness advantage. He

added: “There is definitely an advantage

but the question is why? What is it

that these people are doing that gives

the advantage? Is it cognitive? Is it

physiological? Or is it psychological?”

With his upcoming research, we may find

out the answer.

Do tough people sing the blues?Professor Peter Clough

Control

Confidence CommitmentMentalToughness

Challenge

With cold water immersion (CWI) prevalent in sport, in particular with elite athletes, Nora Alshoweir has made it her mission to find out the benefits of the treatment, building on existing knowledge in the field to help athletes’ recovery, including those new to sport from her own country, Saudi Arabia.

Miss Alshoweir’s career has spanned 19 years, starting out as

a staff therapist before working her way up to the Head of the

Physiotherapy department at a military hospital. She initially

completed her Masters at MMU in 2008 before becoming part of

the medical team that travelled with the Saudi Royal Family. She

has since returned to the University and is currently finishing the

fourth and final year of her PhD, before returning home hopefully

to break down barriers and pioneer research into the effects of

CWI on Saudi women.

Miss Alshoweir’s research is focusing on how to alleviate the

soreness athletes feel due to intensive training or competitive

performance. Her intention is to help athletes understand how to

operate at a higher level for longer. CWI, usually following intense

exercise, is where the athlete is submerged into an ice bath for a

set period of time.

In her research, Miss Alshoweir carried out a three-phased study.

She said: “In phase one, active volunteers were immersed

into cold water once for 15 minutes and we measured their

physiological response for two days.”

She continued: “For phase two we used elite athletes and gave

them an exercise that caused a response called delayed onset

muscle soreness. We then separated them into two groups:

one had the CWI for 15 minutes and the other received passive

treatment, in which we had them sitting for the same duration.

Cold Water Immersion: Physiological or Psychological benefit for athletes?Nora Alshoweir

Afterwards we tested the athletes’

muscle strength and pain levels over

three days.

“Phase three was connected with phase

two; it was about the athletes’ perception

of their strength and pain. They were

interviewed on their expectations prior

to the study and their experience post-

CWI. We wanted to extract information

such as how did they feel physically

and emotionally. Did they feel it was

beneficial?”

Miss Alshoweir believes that, up to now,

the results showed that CWI provides

a benefit to the athletes; however, this

was not an obvious physiological benefit

but rather a psychological one. The

athletes believed that they were aware

of a reduction in pain and an increase in

muscle strength, she added, “From our

measurements we saw that there is no

physical benefit in regards to strength,

and yet overall the participants reported

their belief that they felt stronger

afterwards and reported subjectively that

they felt less pain.

However, Miss Alshoweir believes that

there needs to be more research into the

subject, suggesting that we need more

studies that test other sports to allow

the results to be generalised across all

sporting disciplines. She also believes

that most of the previous research into

the subject has focused on males and

that in the future more studies need to

look at the effect on females saying, “If

you want to establish a treatment base

then it needs to be suitable for all.”

Miss Alshoweir will submit her PhD in

July, and following that she intends to do

a similar study in Saudi Arabia to see if

there are any cross-cultural differences.

Initially she will be focusing on the

Saudi males so that she can compare

her current results, which are based on

British males, to see what the similarities

and differences are. Following on from

that she hopes to research the effects on

Saudi women, as it is only recently that

they have been allowed to participate in

competitive sport.

“Active volunteers were immersed into cold water once for 15 minutes and we measured their physiological response for two days.”

With cold water immersion (CWI) prevalent in sport, in particular with elite athletes, Nora Alshoweir has made it her mission to find out the benefits of the treatment, building on existing knowledge in the field to help athletes’ recovery, including those new to sport from her own country, Saudi Arabia.

Miss Alshoweir’s career has spanned 19 years, starting out as

a staff therapist before working her way up to the Head of the

Physiotherapy department at a military hospital. She initially

completed her Masters at MMU in 2008 before becoming part of

the medical team that travelled with the Saudi Royal Family. She

has since returned to the University and is currently finishing the

fourth and final year of her PhD, before returning home hopefully

to break down barriers and pioneer research into the effects of

CWI on Saudi women.

Miss Alshoweir’s research is focusing on how to alleviate the

soreness athletes feel due to intensive training or competitive

performance. Her intention is to help athletes understand how to

operate at a higher level for longer. CWI, usually following intense

exercise, is where the athlete is submerged into an ice bath for a

set period of time.

In her research, Miss Alshoweir carried out a three-phased study.

She said: “In phase one, active volunteers were immersed

into cold water once for 15 minutes and we measured their

physiological response for two days.”

She continued: “For phase two we used elite athletes and gave

them an exercise that caused a response called delayed onset

muscle soreness. We then separated them into two groups:

one had the CWI for 15 minutes and the other received passive

treatment, in which we had them sitting for the same duration.

Cold Water Immersion: Physiological or Psychological benefit for athletes?Nora Alshoweir

Afterwards we tested the athletes’

muscle strength and pain levels over

three days.

“Phase three was connected with phase

two; it was about the athletes’ perception

of their strength and pain. They were

interviewed on their expectations prior

to the study and their experience post-

CWI. We wanted to extract information

such as how did they feel physically

and emotionally. Did they feel it was

beneficial?”

Miss Alshoweir believes that, up to now,

the results showed that CWI provides

a benefit to the athletes; however, this

was not an obvious physiological benefit

but rather a psychological one. The

athletes believed that they were aware

of a reduction in pain and an increase in

muscle strength, she added, “From our

measurements we saw that there is no

physical benefit in regards to strength,

and yet overall the participants reported

their belief that they felt stronger

afterwards and reported subjectively that

they felt less pain.

However, Miss Alshoweir believes that

there needs to be more research into the

subject, suggesting that we need more

studies that test other sports to allow

the results to be generalised across all

sporting disciplines. She also believes

that most of the previous research into

the subject has focused on males and

that in the future more studies need to

look at the effect on females saying, “If

you want to establish a treatment base

then it needs to be suitable for all.”

Miss Alshoweir will submit her PhD in

July, and following that she intends to do

a similar study in Saudi Arabia to see if

there are any cross-cultural differences.

Initially she will be focusing on the

Saudi males so that she can compare

her current results, which are based on

British males, to see what the similarities

and differences are. Following on from

that she hopes to research the effects on

Saudi women, as it is only recently that

they have been allowed to participate in

competitive sport.

“Active volunteers were immersed into cold water once for 15 minutes and we measured their physiological response for two days.”

As we age, we change, but that doesn’t mean our health and wellbeing has to. Time may march on but fresh ideas and thinking are helping to debunk the myth that our quality of life drops as the years advance.

Industry-informing nursing research at Manchester Metropolitan

University is helping to address the issues we face as we age,

equipping society with the tools to tend to the physical and

emotional needs of older people.

There are currently 10 million people over 65 in the UK and that

number is projected to double by 2050. However, stakeholders

ranging from government to care providers are creating new

ways to help older people to keep living life to the full. The

Department of Nursing at MMU is playing its part by developing

new strategies for living with dementia, raising awareness of

glaucoma among nurses and highlighting the barriers to sexual

activity in older couples.

Josie Tetley, Professor of Nursing, draws on 28 years’ experience

as a qualified nurse, lecturing for 20 of those, to tackle the

questions raised by ageing and the questions faced by the next

generation of nurses.

“I wanted to try to make a difference in terms of how nurses

more broadly think about working with older people,” she says.

“That’s because working with older people can be seen as a

negative career option but it isn’t: it’s extremely fulfilling because

you’re having a direct impact on the wellbeing of a large group.

“An ageing society is not something to be feared and we can adapt

to safeguard our health and wellbeing as we age. Research is

leading the way in making progress, not only to meet the demands

of the next 50 years, but also to embrace and overcome them. ”

Professor Tetley is currently working with colleagues Professor

Janet Marsden and Donna Davenport on a project that is exploring

nurses’ knowledge and awareness of glaucoma management in

care homes. The project is funded by the International Glaucoma

Organisation and the Royal College of Nursing.

The research was initiated by the concern that nurses working

in care homes may not have access to the evidence-based

knowledge needed to manage this condition.

“Unfortunately, care homes tend to get cut off from some of the

mainstream education opportunities because the nurses are not

employed by the NHS,” said Professor Tetley.

“They often don’t get access to seminars or study days. So it was

vital that we understood how much was known by nurses and

what information they need so that older people’s glaucoma can

be effectively managed within care homes.”

This desire to improve the understanding of the ageing process

and issues that can arise from it grounds much of her other

research. Professor Tetley, in collaboration with Dr David Lee at

the University of Manchester, is currently working on a project for

the English Longitude of Ageing (E.LSA) focusing on the sexual

relations and activities of older people in later life, an under-

researched topic she says.

The project, which surveyed 7,000 people, is unique in that it

focuses on the sexual activity of couples rather than in older

people as individuals, a trend seen in most previous studies. The

survey also created an invaluable qualitative data set that she is

helping to analyse.

Findings from a previous study suggest that many older people

feel they are not being given the bigger picture by the health

professionals they visit. Although they may be told they have

diabetes or high blood pressure, it is not made clear how the

health conditions or the medications prescribed might affect

sexual health and wellbeing.

Initial findings from the work have been presented at the British

Society of Gerontology and at a joint seminar organised by MMU,

the Association of Education and Ageing and the Manchester

Institute and Centre for Ageing.

Looking to the future, she is turning her attention to dementia

with MMU’s Dr Jenny Fisher and Open University colleagues

after securing a successful funding bid from the Alzheimer’s

Society. The project starts later in 2015

and will evaluate an intensive home

support service for people living with

dementia.

Prior to joining MMU, Professor Tetley

had undertaken European work exploring

older people’s attitudes to engaging with

new and existing technologies. As part of

the ‘OPT-IN’ project, the team provided

spaces and places where older people

could engage informally with a range of

technological devices.

“We wanted to move away from the idea

that older people have to go to formal

classes to learn how to use technology,”

she explained.

The project also involved taking older

participants to Germany and The

Netherlands to meet their peers to see

how they use different technology.

Professor Tetley believes that by seeing

others playing and engaging with new

technologies and game consoles - such

as iPads and Nintendo Wiis - participants

become more confident to try things

themselves. For example, it inspired one

person to buy an iPad and others to open

the Nintendo Wii they had been given to

use at an Age UK centre.

Professor Tetley keenly emphasises that

service user and carer participation is at

the heart of most of her research, and

she works closely with members of the

Faculty service users and carer group. As

a result of her active engagement with

service users and carers in research, she

has been invited to be a member of the

People in Research North West working

group. This work is supported by NIHR’s

Research Design Service North West.

Professor Tetley said: “I am looking

forward to working with People in

Research North West and I hope that I

can help them build on the excellent work

that they have already undertaken in our

region and increase the outreach of the

group.

“It has been an exciting time moving

to Manchester Metropolitan University

and I look forward to leading more

ageing focused research that can make a

difference to the lives of older people and

those who support them.”

Living life to the full: safeguarding health and wellbeing services across the lifespanProfessor Josie Tetley

“An ageing society is not something to be feared and we can adapt to safeguard our health and wellbeing as we age. Research is leading the way in making progress, not only to meet the demands of the next 50 years, but also to embrace and overcome them.”

As we age, we change, but that doesn’t mean our health and wellbeing has to. Time may march on but fresh ideas and thinking are helping to debunk the myth that our quality of life drops as the years advance.

Industry-informing nursing research at Manchester Metropolitan

University is helping to address the issues we face as we age,

equipping society with the tools to tend to the physical and

emotional needs of older people.

There are currently 10 million people over 65 in the UK and that

number is projected to double by 2050. However, stakeholders

ranging from government to care providers are creating new

ways to help older people to keep living life to the full. The

Department of Nursing at MMU is playing its part by developing

new strategies for living with dementia, raising awareness of

glaucoma among nurses and highlighting the barriers to sexual

activity in older couples.

Josie Tetley, Professor of Nursing, draws on 28 years’ experience

as a qualified nurse, lecturing for 20 of those, to tackle the

questions raised by ageing and the questions faced by the next

generation of nurses.

“I wanted to try to make a difference in terms of how nurses

more broadly think about working with older people,” she says.

“That’s because working with older people can be seen as a

negative career option but it isn’t: it’s extremely fulfilling because

you’re having a direct impact on the wellbeing of a large group.

“An ageing society is not something to be feared and we can adapt

to safeguard our health and wellbeing as we age. Research is

leading the way in making progress, not only to meet the demands

of the next 50 years, but also to embrace and overcome them. ”

Professor Tetley is currently working with colleagues Professor

Janet Marsden and Donna Davenport on a project that is exploring

nurses’ knowledge and awareness of glaucoma management in

care homes. The project is funded by the International Glaucoma

Organisation and the Royal College of Nursing.

The research was initiated by the concern that nurses working

in care homes may not have access to the evidence-based

knowledge needed to manage this condition.

“Unfortunately, care homes tend to get cut off from some of the

mainstream education opportunities because the nurses are not

employed by the NHS,” said Professor Tetley.

“They often don’t get access to seminars or study days. So it was

vital that we understood how much was known by nurses and

what information they need so that older people’s glaucoma can

be effectively managed within care homes.”

This desire to improve the understanding of the ageing process

and issues that can arise from it grounds much of her other

research. Professor Tetley, in collaboration with Dr David Lee at

the University of Manchester, is currently working on a project for

the English Longitude of Ageing (E.LSA) focusing on the sexual

relations and activities of older people in later life, an under-

researched topic she says.

The project, which surveyed 7,000 people, is unique in that it

focuses on the sexual activity of couples rather than in older

people as individuals, a trend seen in most previous studies. The

survey also created an invaluable qualitative data set that she is

helping to analyse.

Findings from a previous study suggest that many older people

feel they are not being given the bigger picture by the health

professionals they visit. Although they may be told they have

diabetes or high blood pressure, it is not made clear how the

health conditions or the medications prescribed might affect

sexual health and wellbeing.

Initial findings from the work have been presented at the British

Society of Gerontology and at a joint seminar organised by MMU,

the Association of Education and Ageing and the Manchester

Institute and Centre for Ageing.

Looking to the future, she is turning her attention to dementia

with MMU’s Dr Jenny Fisher and Open University colleagues

after securing a successful funding bid from the Alzheimer’s

Society. The project starts later in 2015

and will evaluate an intensive home

support service for people living with

dementia.

Prior to joining MMU, Professor Tetley

had undertaken European work exploring

older people’s attitudes to engaging with

new and existing technologies. As part of

the ‘OPT-IN’ project, the team provided

spaces and places where older people

could engage informally with a range of

technological devices.

“We wanted to move away from the idea

that older people have to go to formal

classes to learn how to use technology,”

she explained.

The project also involved taking older

participants to Germany and The

Netherlands to meet their peers to see

how they use different technology.

Professor Tetley believes that by seeing

others playing and engaging with new

technologies and game consoles - such

as iPads and Nintendo Wiis - participants

become more confident to try things

themselves. For example, it inspired one

person to buy an iPad and others to open

the Nintendo Wii they had been given to

use at an Age UK centre.

Professor Tetley keenly emphasises that

service user and carer participation is at

the heart of most of her research, and

she works closely with members of the

Faculty service users and carer group. As

a result of her active engagement with

service users and carers in research, she

has been invited to be a member of the

People in Research North West working

group. This work is supported by NIHR’s

Research Design Service North West.

Professor Tetley said: “I am looking

forward to working with People in

Research North West and I hope that I

can help them build on the excellent work

that they have already undertaken in our

region and increase the outreach of the

group.

“It has been an exciting time moving

to Manchester Metropolitan University

and I look forward to leading more

ageing focused research that can make a

difference to the lives of older people and

those who support them.”

Living life to the full: safeguarding health and wellbeing services across the lifespanProfessor Josie Tetley

“An ageing society is not something to be feared and we can adapt to safeguard our health and wellbeing as we age. Research is leading the way in making progress, not only to meet the demands of the next 50 years, but also to embrace and overcome them.”

The healthcare system is faced with a puzzle: there is rising demand for services but budget pressures mean there are limited resources to meet this. Trying to strike this balance between cost and services – and its resulting effect on people – has spawned the discipline of health economics. Now, this young branch of economics is poised to become even more essential to healthcare.

Since 2012, the Government has sought to heighten the role

of those who actually provide care, through the Health and

Social Care Act. They moved to give care practitioners more

of an influence in deciding what treatment to provide for their

patients when Clinical Commissioning Groups replaced Primary

Care Trusts. This could create a dilemma for many healthcare

professionals: on the one hand wanting to offer their patients the

best treatment but also needing to assess the treatment’s cost-

effectiveness on the other.

One researcher trying to tackle this conundrum is Dr Francis

Fatoye, who joined MMU in 2006 and is now a Reader in

Physiotherapy, a profession he practised for many years

previously. His research interests are neuromusculoskeletal

conditions, health outcomes and health economics, including

economic evaluations. He has also become a pioneer for the

teaching and understanding of health economics.

But the focus on cost-effectiveness that surrounds health

economics is not something wholly money-related: the term ‘cost’

widens to include personal and emotional implications as well.

As part of his MSc in Health Economics and Health Policy,

Dr Fatoye looked at the impact of stroke rehabilitation on the

caregivers. The role of the caregiver and the impact on them is

not typically taken into account when assessing the effectiveness

of treatment, yet this can have big implications for resource use

by caregivers.

If a person’s caregiver, typically a close friend or family member,

has to take time off work then that can impact on not only

their economic situation, but also on their personal wellbeing.

Caregivers may no longer be able to carry out everyday tasks or

hobbies which they previously enjoyed

and this can also impact negatively on

their mood. Dr Fatoye believes this

should all be taken into consideration

when assessing the cost-effectiveness

of a treatment, admitting that relying

on caregivers might be ‘cheap for

government or healthcare providers but it

is not cheap for individual family members

or society’.

Dr Fatoye’s understanding of health

economics has also helped him in his

research on an international scale. “My

knowledge of health economics has

helped me understand how health care

systems work, not just in the UK, but all

over the world,” he adds.

He is currently working in

collaboration with Isfahan University

of Medical Sciences, in Iran, on

neuromusculoskeletal disorders. The

research focuses on the biomechanical

consequences associated with

musculoskeletal disorders, evaluating the

outcomes of interventions for patients

with these conditions.

Dr Fatoye believes the teaching of health

economics is crucial to the future of

providing the right care for patients but

it is also important for MMU. This belief

has seen health economics incorporated

into teaching on the MSc in Professional

Practice Development this year.

It has provided an avenue that has

enabled the University to stand apart and

nurture new partnerships. A collaboration

is being formed between multi-national

pharmaceutical company Astellas

Pharma Europe and the Faculty of Health,

Psychology and Social Care, with the

goal of creating a centre of excellence

in relation to health economics and

outcomes research. It is hoped that in

the long term there will be better, more

efficient care for patients.

Dr Fatoye believes that health economics

is not only focused on the expense

of a treatment, but also on assessing

the benefits associated with such

interventions. There is a need for equity

in resource allocation in healthcare and

fair access to health services, as it would

not be right to allocate vast amounts of

money to one sector and neglect another.

He says: “When people see health

economics they think it is only about cost

saving. It is not only about cost saving, it

is about providing the right information for

the right decision to be made. We need to

look at everything in totality.”

Although all healthcare practitioners want

the best care for their patients, weighing

up the cost effectiveness of treatment

becomes more central to care in the

current budgetary climate. This in itself

increases the importance of the current

and future teaching of health economics.

Dr Fatoye believes that if health

economics is embedded more thoroughly

into teaching and healthcare research, the

moral dilemmas that resonate become

less prominent. In turn, it does not then

have to be viewed as a negative part

of practice but as an essential part of

providing the very best treatment for

every patient.

The Cost of Patient Care: Equity in resource allocation for our health serviceDr Francis Fatoye

“Health economics is not only about cost saving, it is about providing the right information for the right decision to be made.”

The healthcare system is faced with a puzzle: there is rising demand for services but budget pressures mean there are limited resources to meet this. Trying to strike this balance between cost and services – and its resulting effect on people – has spawned the discipline of health economics. Now, this young branch of economics is poised to become even more essential to healthcare.

Since 2012, the Government has sought to heighten the role

of those who actually provide care, through the Health and

Social Care Act. They moved to give care practitioners more

of an influence in deciding what treatment to provide for their

patients when Clinical Commissioning Groups replaced Primary

Care Trusts. This could create a dilemma for many healthcare

professionals: on the one hand wanting to offer their patients the

best treatment but also needing to assess the treatment’s cost-

effectiveness on the other.

One researcher trying to tackle this conundrum is Dr Francis

Fatoye, who joined MMU in 2006 and is now a Reader in

Physiotherapy, a profession he practised for many years

previously. His research interests are neuromusculoskeletal

conditions, health outcomes and health economics, including

economic evaluations. He has also become a pioneer for the

teaching and understanding of health economics.

But the focus on cost-effectiveness that surrounds health

economics is not something wholly money-related: the term ‘cost’

widens to include personal and emotional implications as well.

As part of his MSc in Health Economics and Health Policy,

Dr Fatoye looked at the impact of stroke rehabilitation on the

caregivers. The role of the caregiver and the impact on them is

not typically taken into account when assessing the effectiveness

of treatment, yet this can have big implications for resource use

by caregivers.

If a person’s caregiver, typically a close friend or family member,

has to take time off work then that can impact on not only

their economic situation, but also on their personal wellbeing.

Caregivers may no longer be able to carry out everyday tasks or

hobbies which they previously enjoyed

and this can also impact negatively on

their mood. Dr Fatoye believes this

should all be taken into consideration

when assessing the cost-effectiveness

of a treatment, admitting that relying

on caregivers might be ‘cheap for

government or healthcare providers but it

is not cheap for individual family members

or society’.

Dr Fatoye’s understanding of health

economics has also helped him in his

research on an international scale. “My

knowledge of health economics has

helped me understand how health care

systems work, not just in the UK, but all

over the world,” he adds.

He is currently working in

collaboration with Isfahan University

of Medical Sciences, in Iran, on

neuromusculoskeletal disorders. The

research focuses on the biomechanical

consequences associated with

musculoskeletal disorders, evaluating the

outcomes of interventions for patients

with these conditions.

Dr Fatoye believes the teaching of health

economics is crucial to the future of

providing the right care for patients but

it is also important for MMU. This belief

has seen health economics incorporated

into teaching on the MSc in Professional

Practice Development this year.

It has provided an avenue that has

enabled the University to stand apart and

nurture new partnerships. A collaboration

is being formed between multi-national

pharmaceutical company Astellas

Pharma Europe and the Faculty of Health,

Psychology and Social Care, with the

goal of creating a centre of excellence

in relation to health economics and

outcomes research. It is hoped that in

the long term there will be better, more

efficient care for patients.

Dr Fatoye believes that health economics

is not only focused on the expense

of a treatment, but also on assessing

the benefits associated with such

interventions. There is a need for equity

in resource allocation in healthcare and

fair access to health services, as it would

not be right to allocate vast amounts of

money to one sector and neglect another.

He says: “When people see health

economics they think it is only about cost

saving. It is not only about cost saving, it

is about providing the right information for

the right decision to be made. We need to

look at everything in totality.”

Although all healthcare practitioners want

the best care for their patients, weighing

up the cost effectiveness of treatment

becomes more central to care in the

current budgetary climate. This in itself

increases the importance of the current

and future teaching of health economics.

Dr Fatoye believes that if health

economics is embedded more thoroughly

into teaching and healthcare research, the

moral dilemmas that resonate become

less prominent. In turn, it does not then

have to be viewed as a negative part

of practice but as an essential part of

providing the very best treatment for

every patient.

The Cost of Patient Care: Equity in resource allocation for our health serviceDr Francis Fatoye

“Health economics is not only about cost saving, it is about providing the right information for the right decision to be made.”

A leading researcher into problematic substance use and domestic violence has joined Manchester Metropolitan University after leaving the University of Bedfordshire (UoB). Professor Galvani was the Assistant Director of the Tilda Goldberg Centre for Social Work and Social Care at UoB for the past six years, and brings with her a wealth of expertise in research, as well as a passion for helping others.

Professor Galvani started along her path by volunteering for

‘Crisis at Christmas’ (now Crisis) before moving to the USA to

continue her work with homeless people, people experiencing

mental distress, and those with alcohol and other drug problems.

On her return to the UK, she trained to be a social worker and

maintains her registration to this day. Whilst in the USA she

became involved in work at street-based needle exchanges,

which further opened her eyes to the damage that problematic

substance use can cause.

She says: “My voluntary work with homeless people with

alcohol or other drug problems triggered both a practice and

academic interest. It led me into social work practice in terms of

wanting to provide support and advocate on their behalf, because

people with alcohol and other drug problems in particular are

often very marginalised.”

The shame and stigma felt by people with problematic

substance use can be a barrier to early intervention as the

problem is often hidden until it reaches crisis point. Professor

Galvani believes that there is no single cause of problematic

substance use, rather there is often a host of overlapping

issues that may be social, psychological and emotional.

However, she feels strongly that there is a particular lack

of acknowledgement about the social contributors and

consequences of problematic use.

“If you talk to people who provide drug and alcohol services, the

instances of abuse of different kinds - including childhood sexual

exploitation as well as domestic violence and abuse - is there,

alongside mental health problems, relationship difficulties, and

often physical health problems.”

She continued: “One thing that has happened policy-wise

is that people with alcohol and/or drug problems have been

seen as either sick and needing treatment or as criminals and

needing punishment.”

Her passion for highlighting the social causes and consequences

of substance use has informed her research career. In particular,

her research and curriculum development work has focused

on plugging gaps in social work training. Professor Galvani

believes that social workers are ideally placed for working with

the complexities of the issue; however, due to it being framed

as a criminal justice or treatment issue, there is a distinct lack

of education for social workers on the subject. In 2011, she

carried out the ‘National Survey of Social Workers: Experiences

of Working with Substance Use’ and found that approximately

a third of graduates had never experienced any training in this

field. A further third had received two days or less for what

is a significant part of many social workers’ jobs. Social care

professionals fared even worse.

Professor Galvani says: “What we need is a three-pronged attack

really, because we need the new workforce to have training in it,

we need to plug the gaps of the social workers in practice that

haven’t had much or any training, so that needs to be done by

employers or in-house training. But also we need to ramp up a

focus on substance use within the more formal post-qualifying

education where it can be tailored to particular areas of specialist

practice.”

Her research also encompasses

exploratory work with people who are not

the focus of mainstream research around

substance use. She recently completed

an exploratory study; Alcohol, other Drugs

and Sight Loss: A Scoping Study, funded

by the Thomas Pocklington Trust (TPT),

who support people with sight loss, and

Alcohol Research UK. The study was

motivated by practitioner reports of the

increasing number of people presenting to

services who have both alcohol and sight

loss problems, and a concern about how

best to support people with both issues.

“Once we started talking it raised bigger

questions, like what is the relationship

between substance use and sight loss?

Is there a medical relationship, a causal

relationship, or are they two separate

things that just happen to co-exist?

Maybe alcohol and other drugs are coping

mechanisms? The importance of doing

that work was that it emerged from the

ground up, from frontline practice. It’s

about services saying what can we do

better, what can we do differently?”

Related to the substance use and sight

loss research, Professor Galvani is

currently developing practice guidelines

for professionals funded by TPT to

help sight loss and substance use

professionals support people who

are struggling with both issues. This

application of research to practice, and

education, is at the core of Professor

Galvani’s work.

She has also recently conducted an

ethnographic study exploring substance

use within a Punjabi Sikh community to

inform service development in the region.

Professor Galvani now has a number of

other projects on the horizon, including

work on child-to-parent violence, alcohol

and older people, and end-of-life care

for people with alcohol and other drug

problems.

However, she is also continuing to focus

on social work and social care, clarifying

social workers’ roles and capabilities for

working with substance use, whatever

their area of specialist practice. In March

she launched the first ever national

guidance for social workers Alcohol

and other Drug Use: The Roles and

Capabilities of Social Workers.

Funded by Public Health England, the

document was developed alongside

a working group with representation

from The College of Social Work, the

British Association of Social Work, the

Associations of Directors of Adults’

and Children’s Services and Public

Health.“Importantly,” she states, “we have

a large group of social work practitioners

involved in its development too.”

The applied nature of her research is

clearly a priority for Professor Galvani.

She said: “As academics we have certain

targets to meet in terms of research

income and outputs in particular, such

as writing for peer-reviewed journals.

What I’m very conscious of as someone

who is interested in applied research

is that we need to be disseminating to

the practitioners as well as the other

audiences. I think that’s the challenge

we have at the moment with the current

ways of assessing what we do.”

Challenging stigma: social work and substance useProfessor Sarah Galvani

“We need to ramp up a focus on substance use within the more formal post-qualifying education where it can be tailored to particular areas of specialist practice.”

A leading researcher into problematic substance use and domestic violence has joined Manchester Metropolitan University after leaving the University of Bedfordshire (UoB). Professor Galvani was the Assistant Director of the Tilda Goldberg Centre for Social Work and Social Care at UoB for the past six years, and brings with her a wealth of expertise in research, as well as a passion for helping others.

Professor Galvani started along her path by volunteering for

‘Crisis at Christmas’ (now Crisis) before moving to the USA to

continue her work with homeless people, people experiencing

mental distress, and those with alcohol and other drug problems.

On her return to the UK, she trained to be a social worker and

maintains her registration to this day. Whilst in the USA she

became involved in work at street-based needle exchanges,

which further opened her eyes to the damage that problematic

substance use can cause.

She says: “My voluntary work with homeless people with

alcohol or other drug problems triggered both a practice and

academic interest. It led me into social work practice in terms of

wanting to provide support and advocate on their behalf, because

people with alcohol and other drug problems in particular are

often very marginalised.”

The shame and stigma felt by people with problematic

substance use can be a barrier to early intervention as the

problem is often hidden until it reaches crisis point. Professor

Galvani believes that there is no single cause of problematic

substance use, rather there is often a host of overlapping

issues that may be social, psychological and emotional.

However, she feels strongly that there is a particular lack

of acknowledgement about the social contributors and

consequences of problematic use.

“If you talk to people who provide drug and alcohol services, the

instances of abuse of different kinds - including childhood sexual

exploitation as well as domestic violence and abuse - is there,

alongside mental health problems, relationship difficulties, and

often physical health problems.”

She continued: “One thing that has happened policy-wise

is that people with alcohol and/or drug problems have been

seen as either sick and needing treatment or as criminals and

needing punishment.”

Her passion for highlighting the social causes and consequences

of substance use has informed her research career. In particular,

her research and curriculum development work has focused

on plugging gaps in social work training. Professor Galvani

believes that social workers are ideally placed for working with

the complexities of the issue; however, due to it being framed

as a criminal justice or treatment issue, there is a distinct lack

of education for social workers on the subject. In 2011, she

carried out the ‘National Survey of Social Workers: Experiences

of Working with Substance Use’ and found that approximately

a third of graduates had never experienced any training in this

field. A further third had received two days or less for what

is a significant part of many social workers’ jobs. Social care

professionals fared even worse.

Professor Galvani says: “What we need is a three-pronged attack

really, because we need the new workforce to have training in it,

we need to plug the gaps of the social workers in practice that

haven’t had much or any training, so that needs to be done by

employers or in-house training. But also we need to ramp up a

focus on substance use within the more formal post-qualifying

education where it can be tailored to particular areas of specialist

practice.”

Her research also encompasses

exploratory work with people who are not

the focus of mainstream research around

substance use. She recently completed

an exploratory study; Alcohol, other Drugs

and Sight Loss: A Scoping Study, funded

by the Thomas Pocklington Trust (TPT),

who support people with sight loss, and

Alcohol Research UK. The study was

motivated by practitioner reports of the

increasing number of people presenting to

services who have both alcohol and sight

loss problems, and a concern about how

best to support people with both issues.

“Once we started talking it raised bigger

questions, like what is the relationship

between substance use and sight loss?

Is there a medical relationship, a causal

relationship, or are they two separate

things that just happen to co-exist?

Maybe alcohol and other drugs are coping

mechanisms? The importance of doing

that work was that it emerged from the

ground up, from frontline practice. It’s

about services saying what can we do

better, what can we do differently?”

Related to the substance use and sight

loss research, Professor Galvani is

currently developing practice guidelines

for professionals funded by TPT to

help sight loss and substance use

professionals support people who

are struggling with both issues. This

application of research to practice, and

education, is at the core of Professor

Galvani’s work.

She has also recently conducted an

ethnographic study exploring substance

use within a Punjabi Sikh community to

inform service development in the region.

Professor Galvani now has a number of

other projects on the horizon, including

work on child-to-parent violence, alcohol

and older people, and end-of-life care

for people with alcohol and other drug

problems.

However, she is also continuing to focus

on social work and social care, clarifying

social workers’ roles and capabilities for

working with substance use, whatever

their area of specialist practice. In March

she launched the first ever national

guidance for social workers Alcohol

and other Drug Use: The Roles and

Capabilities of Social Workers.

Funded by Public Health England, the

document was developed alongside

a working group with representation

from The College of Social Work, the

British Association of Social Work, the

Associations of Directors of Adults’

and Children’s Services and Public

Health.“Importantly,” she states, “we have

a large group of social work practitioners

involved in its development too.”

The applied nature of her research is

clearly a priority for Professor Galvani.

She said: “As academics we have certain

targets to meet in terms of research

income and outputs in particular, such

as writing for peer-reviewed journals.

What I’m very conscious of as someone

who is interested in applied research

is that we need to be disseminating to

the practitioners as well as the other

audiences. I think that’s the challenge

we have at the moment with the current

ways of assessing what we do.”

Challenging stigma: social work and substance useProfessor Sarah Galvani

“We need to ramp up a focus on substance use within the more formal post-qualifying education where it can be tailored to particular areas of specialist practice.”

This publication is available in alternative formats. Telephone: 0161 247 2996

For more information on our current research projects, research opportunities within the faculty or general enquiries, please contact us:

Professor Juliet Goldbart Associate Dean for Research, j.goldbart@mmu.ac.uk

For any general enquiries about research in the Faculty please contact hpscresearchdegrees@mmu.ac.uk