Professor Sharon Brownie explains her research on nursing in LMICs Nurses are the largest part of the health care workforce an millions more will be needed in LMIC if high quality care is to be available to everyone. Research that addresses the consequences of the shortage of nurses but also helps generate ideas on solutions is important and should be conducted in partnership with the nursing profession.

Global Health

Nursing research in a global context

Researcher Jalemba Aluvaala tells us about his work concerning newborn care in LMICs. Care for even the sickest newborns in many countries is limited by the resources available but there are some key interventions that can save lives. Delivering these interventions requires doctors and nurses to work together and often it is the continuous care provided by the nursing team together with families that is critical. Despite this a number of babies die and understanding risks is important to help provide information to families, to help plan care and should help us design better systems of care.

The treatment and outcomes of care for sick newborns

Jacob McKnight tells us about the challenges faced by nurses caring for newborns in Kenya. Caring for sick newborns in a poorly resourced hospital is a very challenging job. Yet this is not the only challenge many nurses face as they juggle supporting families and lives in a busy city. Some nurses have developed ways to cope in these difficult circumstances but for many the relentless pressure may cause them harm while upholding the ideals of nursing may seem impossible.

Under pressure, the challenges of neonatal nursing

David Gathara tells us about his work leading nursing research Sick newborns require large amounts of nursing time, so what happens when nurses have to care for too many babies? By making direct observations of the care that is given this important new research identified how much care is missed. More care is missed when nurses have more babies to care for showing the direct consequences of health care worker shortages.

Quantifying nursing care done (or left undone)

Social Scientist Jacinta Nzinga tell us about her research on the care of sick newborns. To really understand the work of nurses in very busy wards where care for sick newborns is provided, you have to be there. Using detailed observations, day, night and weekends, linked to narrative interviews, the routines, compromises and coping strategies that characterise the delivery of hospital care for newborns are brought to light providing critical information to understand why care is missed and to guide improvement efforts.

Understanding nurses' work to care for sick newborns

Professor Mike English tells us about the research project Health Services that Deliver for Newborns. Basic hospital care may be key to saving newborn lives. Professor Mike English, University of Oxford, outlines a multidisciplinary project engaging policy-makers and practitioners in Kenya. This project demonstrated poor coverage of Nairobi's 4.25 million population if a sick newborn baby needs quality hospital care. Using novel research approaches the team also identified how severe shortages of nurses contribute to poor quality of care for patients and negatively affect nurses themselves.

Health services that deliver for newborns.

Professor Tran Hien, founder member of our OUCRU unit in Vietnam tells us about the development of this very successful Clinical Research Unit. Although incidence of malaria has decreased in Vietnam, the burden of infectious diseases remains high and weighs heavily on the health care system. Clinical research aims to allow investments to go further: findings in the laboratory, tested in clinical trials and then applied to the community, help improve diagnosis and management.

Infectious diseases in the tropics

Professor Ronald Geskus from our OUCRU unit in Ho Chi Minh City, Vietnam, tells us about the contribution of biostatisticians to complex clinical research. The role of biostatisticians in clinical research is to contribute to trial design, by calculating sample size for example, and to help draw correct conclusions from the data, discriminating important information from noise. They are instrumental in the translation of a practical problem into a statistical model, and the translation of the result into practice.

Sophisticated biostatistics for complex clinical research

Dr Audrey Dubot-Peres from our LOMWRU unit in Laos and IRD (Institut de Recherche pour le Développement, Marseille, France) tells us about her research on viral infections in Laos. Infections such as dengue and Japanese encephalitis are important problems in Laos but confirmed data are lacking, particularly from outside the capital Vientiane. Rapid diagnostic tests that can be kept at tropical room temperature help better diagnosis and treatment, and also inform policy to implement vaccination programmes.

Viral infections in Laos

Dr Juan Carrique-Mas from OUCRU, our Clinical Research Unit in Ho Chi Minh City, Vietnam, tell us about his research in the development of antimicrobial resistance in small-scale poultry production. Many households in Vietnam raise animals for food production, particularly chickens, using large amounts of antimicrobials with no veterinary support, and those antimicrobials find their way into the food chain. The ViParc project conducts intervention trials similar to human clinical trials, to help farmers reduce the level of antimicrobials used when raising chickens.

Antimicrobial resistance in poultry production

Dr Tri Wangrangsimakul from our MORU unit and based in Chiangrai, northern Thailand, tells us about his research on scrub typhus. Scrub typhus is an infection caused by Orientia tsutsugamushi, a bacteria transmitted by the bite of an infected chigger mite. Characterised by a variety of symptoms and a high mortality rate, scrub typhus is an underfunded, neglected tropical disease not even listed by the WHO. Better diagnostic tests and optimised treatments are being developed since no vaccine is currently available.

Scrub typhus in northern Thailand

Professor Rogier van Doorn, director of our OUCRU unit in Hanoi, Vietnam, tells us about his research on antimicrobial resistance and avian influenza. Antibiotics are widely used in Vietnam, leading to widespread antimicrobial resistance. Monitoring antibiotic use helps inform the government to change treatment guidelines and implement antibiotic stewardship programmes. This may also prevent the transmission of resistant bacteria outside the country.

Research at OUCRU Hanoi

Professor Heiman Wertheim from our OUCRU unit in Hanoi, Vietnam, tells us about his research on drug resistant infections in low and middle-income countries. Drug resistant infections are a global crisis and we cannot focus on our own country only. Clinical trials in low and middle income countries where the burden is highest, as well as work with local communities and engagement with policy makers help influence public health policies.

Clinical research in low and middle-income countries

Professor Guy Thwaites, director of our OUCRU unit in Vietnam, tells us about his research on tuberculosis meningitis. Tuberculosis meningitis affects a fractions of TB patients but causes high levels of mortality and morbidity. A recent trial at OUCRU showed that aspirin can greatly improve outcomes. Such trial is typical of the work done in our Vietnam units, where all the research is focussed on improving the outcome for patients directly.

Tuberculosis meningitis

Dr Motiur Rahman from our OUCRU unit in Ho Chi Minh City, Vietnam, tells us about his responsibilities in laboratory management. OUCRU laboratories provide support to the unit's extensive clinical research programme, from level 2 laboratory to SAPO 4 laboratory for high-risk pathogens responsible for zoonotic infections. Early diagnosis and detection of antimicrobial resistance help prescribe the right medicine in time, contributing to better patient management.

OUCRU laboratory management

Translational research in NDM has a truly worldwide impact, with scientists and clinicians investigating epidemiology, treatment, and prevention of disease on a global scale. Our podcasts on Global Health illuminate this work, and discuss research conducted in Oxford and around the world to better understand and manage emerging and endemic diseases.

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