Jonathan Shepherd
Jonathan P Shepherd
Research and its Impact
Cryosurgery
Shepherd's research career began as a research fellow in the Nuffield Department of Surgery at
Epstein Barr Virus and jaw tumours
During a UK government Overseas Development Administration (Now DfID) secondment as a surgeon to the Ahmadu Bello University, Kaduna, Nigeria, he studied links between Epstein Barr Virus (EBV) and the jaw tumour prevalent in sub Saharan Africa, ameloblastoma. This research was inspired by the work of Denis Burkett who had found a causal link between this virus and lymphoma. Shepherd found no links with ameloblastoma apart from in immunocompromised patients.[5] After returning to his substantive surgical training post in Leeds in 1981 he donated the remaining serum samples from his research in Nigeria to Harald zur Hausen for his ongoing research on Human Papilloma Virus – work which would win zur Hausen the Nobel Prize for Physiology or Medicine.
Violence
Shepherd's surgical experiences in West Yorkshire (1980–3) brought about an interest in behavioural science and epidemiology. He observed that the miners' strikes in the Yorkshire Coalfield led to more people being injured in violence, and that a few pubs seemed to be the locations of hugely disproportionate numbers of violent incidents.
Following his appointment as senior lecturer and consultant oral and
Two new research groups
After appointment as professor of oral and maxillofacial surgery and head of the department of oral surgery, medicine and pathology at the
Clinical decisions and the first NICE guidance
Shepherd established the Clinical Decisions Research Group expressly to investigate decisions about
Violence research since 1991
Prompted by his PhD and subsequent confirmation that police ascertain, at most, only 50% of violence which results in
Psychological impact of violence
Working with Jonathan Bisson, Shepherd, studied
Risk factors for violence
Glassware
Having discovered that many people are injured in violence where glasses are used as weapons and that glass fragmentation rather than whole glasses were the problem, Shepherd set about finding out which glass types were most frequently involved, and how they stood up to laboratory impact testing. A national survey showed that straight sided pint glasses (noniks) were used in three-quarters of these incidents
Violence not known to the police
Shepherd's discovery that the police were unaware of 50–75% of violence which results in hospital treatment – a finding since replicated in every Western country where this overlap has been studied – prompted him to hypothesise that emergency departments are sources of unique information which could be used to prevent violence more effectively than is possible using police intelligence alone. To test this idea, in 1996 he convened the Cardiff Violence Prevention Group (now Board). This group was a prototype Community Safety Partnership and was replicated by law across Britain in 1998.
First, methods of collection in emergency departments of data on precise violence location, weapon, time and day and assailants were compared; electronic data capture by receptionists (termed registrars in the United States) proved most effective and sustainable.
By 2007, violent incidents in Cardiff had declined by 40%.
This "Cardiff Model" was first implemented elsewhere in the UK in the late 1990s, starting in south east England, Merseyside and in Glasgow. In 2008, it was included in the UK government's alcohol strategy and in 2010 it was included in the new coalition government's programme.[30] By 2014 more than 60% of emergency departments were collecting and sharing Cardiff Model data and in 2016 this became mandatory in England. In 2017, the data were included in the new Emergency Care Data Set.[31] The Model has been endorsed by the World Health Organization,[32] adopted by the Centers for Disease Control and Prevention (CDC) for implementation in the United States,[33] and implemented in cities in the United States, Australia, South Africa and the Netherlands.[34][35]
Shepherd summarised the public health effectiveness of policing and criminal justice systems in an article in the Lancet.[36]
Childhood risk factors
After discovering a distinctive pattern of illness and injury among people injured in violence, Shepherd coined the term DATES Syndrome (Drug Abuse, Assault, Trauma and Elective Surgery).[37] He then led a series of studies with the Cambridge criminologist David Farrington of links between offending and health, using data from the longitudinal Cambridge Study of Delinquent Development (CSDD). Discoveries from this research include relatively good health among young offenders until their mid-20s; strong links between childhood impulsivity, adolescent offending and injury; and that early death and disability by age 48 which they discovered, is linked with conviction between ages 10–18 and antisocial behaviour at age 8–10.[38]
Alcohol
Shepherd's finding that consumption of more than eight units of alcohol in a drinking session substantially increased the risk of injury in violence prompted him and his colleagues to investigate links between alcohol prices and violence, and the effectiveness of brief motivational advice to reduce risky consumption. Of all the drivers of injury in violence they studied, low alcohol price was found to be the most powerful.[39] In six randomised trials, Shepherd and his colleagues found that this advice was effective for at least a year when it was given to alcohol abusers on probation, in trauma clinics and in primary care, but not effective when it was given to offenders in magistrates' courts or to patients in emergency departments – when offenders' and patients' thoughts were dominated by their conviction or injuries or clouded by their intoxication.[40]
To incorporate this effective advice into national health services, Shepherd, collaborating with Welsh Government, led two knowledge transfer projects. With Craig and Sarah Jones, he developed brief advice training courses, local collaborations across Wales, a training team, and social media support under the new "Brief Advice works, Have a Word!" brand.[41] By 2017, 18,000 practitioners had been trained, the Have a Word package sold to Public Health England, and the scheme implemented in the armed forces by the Ministry of Defence.[42]
Research on evidence and public services
Shepherd's study of controlled trials across public services showed that there had been an exponential increase of these rigorous evaluations in healthcare, but not in other sectors such as education and policing.[43] Shepherd concluded that this disparity reflected a lack of organisations which publish evidence-based guidelines, such as the National Institute for Health and Care Excellence, in these other sectors and that these organisations should be replicated in other public services and a mechanism created for sectors to learn from each other about evidence.[43]
He campaigned for these changes through Sir Adrian Smith at the UK Department for Business and Skills and Sir Michael Bichard, director of the Institute for Government. As a result, the Institute for Government ran a conference where these proposals found favour. This was the genesis of the new "What Works Centres" (NICE equivalents across six service sectors) and the "What Works Council" supported by the Cabinet Office and the Economic and Social Research Council.[44]
Next, supported by the Cabinet Office What Works team, Shepherd investigated what he first defined as the "evidence ecosystem", in which evidence first has to be generated, then synthesised, and then adopted and used in practice and policy. This needs to be a dynamic process Shepherd concluded – evidence demand is needed as well as supply.[45] The report's recommendations for a research funding scheme for policing, for a social policy trials unit and for a professional body for teachers were adopted in the form of the new Police Knowledge Fund, the Government Trials advisory Panel and the Chartered College of Teaching.[45]
Shepherd also proposed a national College of Policing – a medical Royal College equivalent.[46] This concept was adopted by the Home Office and the new college launched in 2013. Shepherd also proposed and worked for a similar standard setting institution for probation.[47] The Probation Institute was launched by the president of the Supreme Court, Lord Neuberger, at an event hosted by Shepherd at the Royal College of Surgeons in 2014.[48]
Shepherd was nominated by the Royal College of Surgeons to explain to teachers' leaders the value and functions of a medical Royal College and how these might be applied to form a standard setting professional body for teachers and teaching. After serving on the Commission which produced a blueprint for a new College of Teaching[49] and Shepherd's appointment as a founder College trustee, the new Chartered College was founded in 2016.[50]
To improve effectiveness and cost benefit of public services on the basis of reliable evidence, Shepherd also convened two evidence summits, at the Royal College of Surgeons in 2012, and at the Institution of Civil Engineers in 2013.[51][52]
Shepherd wrote The Declaration on Evidence which was agreed by the UK medical Royal Colleges, the College of Policing and the Chartered College of Teaching - institutions with a major influence on the professional lives of over a million practitioners. This declaration was signed by the leaders of these bodies at the Royal Society in November 2017 at an event hosted by Shepherd and the Alliance for Useful Evidence and chaired by the former Cabinet Secretary Lord O'Donnell.[53][54]
Realising the need for incentives for public health academics to translate their research into practice, Shepherd initiated and sourced funding for a new professorship which he titled the Bazalgette Chair for Research Translation in honour of Sir Joseph Bazalgette who famously engineered the sewers which helped eradicate cholera in 19th Century London and in other cities. The, now annual, Bazalgette professorship was first awarded by the Faculty of Public Health in 2019.[55] Prompted by the rapid, perplexing expansion across sectors of evidence production, synthesis and translation into guidance, and the economic impact of the COVID-19 pandemic, Shepherd wrote the 2020 report Evidence and Guidance for Better Public Services.[56] Summarised in the science journal Nature[57] and in Civil Service World,[58] report recommendations include standardisation and proportionate regulation of the evidence ecosystem.
Other research and impact
Cycle helmet design
Working with Michael Harrison, Shepherd mapped head and face injuries sustained by cyclists,
Coulthard exhibited the prototype at the 2002 UK Motor Show. This new design was instrumental in bringing about a new generation of helmet designs, especially in mountain and other sports cycling disciplines.
Honours and awards
Shepherd was elected a
References
- ^ "Violence Prevention Group, Cardiff Community Safety Partnership". who.int. Archived from the original on 7 June 2012. Retrieved 11 August 2017.
- ^ "Professor Jonathan Shepherd". Cardiff University. Retrieved 11 August 2017.
- ^ "Letter of Commendation for Professor Shepherd".
- PMID 6713945.
- PMID 3028597.
- S2CID 37249332.
- ^ Shepherd, J P (1990). "Personal Violence: the relevance of Symonds' model of psychological response and loss theory. British Journal of Social Work 20:309–332".
- PMID 2282423.
- ^ Shepherd, J P (1990). "Violent Crime in Bristol: an Accident and Emergency Department Perspective. British Journal of Criminology 30:289–305".
- S2CID 274287.
- S2CID 26609695.
- S2CID 274287.
- PMID 10581815.
- S2CID 13653203.
- PMID 10744290.
- PMID 14702229.
- PMID 22893799.
- ^ Shepherd, J P; Bisson, J (2012). "Managing the impact of violence on mental health, including among witnesses and those affected by homicide. London. Royal College of Psychiatrists" (PDF).
- PMID 2342047.
- PMID 8263994.
- PMID 10728540.
- ^ Mirrlees-Black, C; Budd, T; Partridge, S. "The 2000 British Crime Survey. London: HMSO, 2001 (Sub-analysis: Janson K. 2006)" (PDF).
- PMID 10819383.
- PMID 16373796.
- S2CID 72620088.
- PMID 24048916.
- ^ "Queen's Speech December 2019".
- ISSN 0261-3077. Retrieved 20 December 2017.
- ^ a b "Award for drink-violence project". BBC News. 18 November 2009. Retrieved 20 December 2017.
- ^ "Health ministers set 'standard' to cut violence". Cardiff University News. 25 September 2014. Retrieved 18 October 2017.
- ^ "Accident and Emergency Departments: Crimes of Violence:Written question – 62157". UK Parliament. Retrieved 18 October 2017.
- ^ "Cardiff Model for violence prevention". apps.who.int. Retrieved 18 October 2017.
- ^ "The Cardiff Model Toolkit |Violence Prevention|Injury Center|CDC". 29 January 2021.
- ^ "About us". Cardiff University Violence Research Group. Retrieved 18 October 2017.
- ^ "Cardiff celebrates 20 years of violence reduction". Cardiff University News. Retrieved 18 October 2017.
- S2CID 41113355.
- PMID 7769600.
- PMID 19493916.
- S2CID 10809058.
- .
- ^ Jordan, P; Shepherd, J P (2013). "Tackling Alcohol Misuse Through Screening and Brief Interventions: A Knowledge Transfer Partnership. Final Report. Welsh Government, Public Health Wales" (PDF).
- ^ "Violence Research: Have a Word". Cardiff University. Retrieved 18 October 2017.
- ^ .
- ^ "Whats Works Council".
- ^ a b Shepherd, J P (2014). "How to achieve more effective services: the evidence ecosystem. Cabinet Office, What Works Network, Cardiff University. How to achieve more effective services: the evidence ecosystem".
- ^ Shepherd, J P (2008). "Police professionalism: the view from surgery. Police Professional;127:4 September: 13" (PDF). Archived from the original (PDF) on 27 March 2019. Retrieved 27 March 2019.
- ^ Shepherd, JP (2013). "probation howard league" (PDF).
- ^ "Probation Institute launch - full text of speeches". Probation Institute. Archived from the original on 1 December 2017. Retrieved 28 November 2017.
- ^ Pope, C; Bell, D; Bousted, M; Coles, J; Davies, G; Gronn, P; Husbands, C; McCabe, B; Peacock, A; Shepherd, J; Smith, D; Steers, J (2014). "A new member-driven College of Teaching: A Blueprint. London. Prince's Teaching Institute. Blueprint for a new member-driven College of Teaching" (PDF). Archived from the original (PDF) on 27 March 2019. Retrieved 27 March 2019.
- ^ "The Chartered College of Teaching". chartered.college. Retrieved 28 November 2017.
- .
- ^ Shepherd, J P (2013). "Report of the Summit: Professions and Evidence-Informed Practice. Professions Summit. Alliance for Useful Evidence".
- ^ "Surgeon's 'Magna Carta' puts hard evidence at heart of decision making".
- ^ "Medics, teachers and police organisations sign up to adopt".
- ^ "FPH launches Bazalgette Professorship – Champion of Evidence Award". 25 January 2019.
- ^ "Shepherd JP (2020). Evidence and Guidance for Better Public Services: Making the most of the Evidence Ecosystem. Cardiff University" (PDF).
- S2CID 230784451.
- ^ "66 Smith B (2020). Academic whose research led to What Works Network calls for independent review. Civil Service World, 14 September". 13 September 2020.
- PMID 10230200.
- PMID 9253912.
- ^ a b c "Jonathan Shepherd". People. Retrieved 20 December 2017.
- ^ "Home office Science Advisory Council".
- ^ "Award for tackling drink violence". BBC News. 29 December 2007. Retrieved 20 December 2017.
- ISSN 1353-8047.
- ^ "Violence Prevention Group, Cardiff Community Safety Partnership". World Health Organization. Archived from the original on 7 June 2012. Retrieved 20 December 2017.
- ^ "Student News" (PDF). Wisdom. Autumn 2014. p. 13.
- ^ Wales, The Learned Society of. "Jonathan Shepherd". The Learned Society of Wales. Retrieved 31 August 2023.
External links
- Faculty page at Cardiff University
- Cardiff celebrates 20 years of violence reduction, Cardiff University News