Predicting breastfeeding in women living in areas of economic hardship : explanatory role of the theory of planned behaviour

This study employed the theory of planned behaviour (TPB) and additional variables (descriptive norm, moral norm, self-identity) to investigate the factors underlying breastfeeding intention and subsequent breastfeeding at four time points (during hospital stay, at hospital discharge, 10 days postpartum and 6 weeks postpartum) in a sample of women selected from defined areas of economic hardship (N = 248). A model containing the TPB, additional variables and demographic factors provided a good prediction of both intention (R-2 = 0.72; attitude, perceived behavioural control, moral norm and self-identity significant predictors) and behaviour - breastfeeding at birth (88.6% correctly classified; household deprivation, intention, attitude significant), at discharge from hospital (87.3% correctly classified; intention, attitude significant), 10 days after discharge (83.1% correctly classified; education, intention, attitude, descriptive norm significant) and 6 weeks after discharge (78.0% correctly classified; age, household deprivation, ethnicity, moral norm significant). Implications for interventions are discussed, such as the potential usefulness of targeting descriptive norms, moral norms and perceived behavioural control (PBC) when attempting to increase breastfeeding uptake

IRREVERSIBILITY ANALYSIS IN Al2O3-WATER NANOFLUID FLOW WITH VARIABLE PROPERTY

The present numerical work deals with the optimization of the micro-channel heat sink using irreversibility analysis. The nanofluid of Al2O3-water with the different nanoparticles concentration and the temperature-dependent property is chosen as a coolant. The flow is considered as fully developed, steady, and laminar in the constant cross-section of circular channels. Navier-Stokes and energy equations are solved for a single-phase flow with total mass flow rate and heat flow rate as constant. The objective functions related to the frictional and heat transfer irreversibilities are framed to assess the performance of the micro-channel heat sink. The optimum channel diameter corresponding to the optimum number of channels is determined at the lowest total irreversibility for both constant property solution and variable property solution. Designed optimum diameter is observed maximum for 2.5% Al2O3-water nanofluid with μ(T) variation followed by 1% Al2O3-water nanofluid with μ(T) variation, 2.5% Al2O3-water nanofluid with constant property solution, and 1% Al2O3-water nanofluid with constant property solution

Pakistani Muslim women birthing in Northern England: Exploration of experiences and context.

This study examines Pakistani Muslim women's experiences of labour and maternity services against a backdrop of the National Health Service and the history of Black people in Britain. It sets out to develop an understanding of how Pakistani women see their relationships with midwives and to address the paucity of available research about their intrapartum experiences. The study also aims to contribute to the development of responsive and sensitive midwifery care, and midwifery knowledge and theory.An interpretive ethnographic approach was adopted to obtain narratives from twenty-seven participants: thirteen primigravidae Pakistani Muslim women, nine interpreters and five midwives. The primary method of data collection was conversational qualitative interviews, although a small number of participant observations of women's labours were conducted. Content analysis was utilised for data analysis.The findings of this study reveal that many Pakistani Muslim women generally reported a positive experience of their encounters with maternity services. They valued western obstetric and midwifery services, believing that the midwives and doctors know best; they were grateful for the care they received. The study revealed that adequate and timely information, constructive relationships with the midwives, and support during labour were some of the key factors that shaped women's experiences of labour. Whilst some women expressed satisfaction in these areas, others voiced concern about the variable levels of availability of information, and consequently women laboured without, knowledge of the available methods of pain relief and processes of care during labour. The findings show that Pakistani women value emotional support in labour. A minority of these women were supported by their husbands or female relatives, and some received support from midwives. However for many, when support from midwives was not forthcoming, 'Allah' was the only available source of support. Other key factors highlighted were communication and linguistic barriers, and the role of perceived stereotypes and discrimination, which shaped the context in which women birthed as well as underpinning women's experience of maternity services. The study highlighted that whilst women's ability to speak English played a role in developing relationships with midwives, a lot depended on the attitudes and behaviours of the midwives, and the way they responded to the women. Resources such as interpreters, which may have assisted in overcoming some of the communication barriers, were found to be lacking.The study showed that midwives were the orchestrators of women's labouring experiences, manifesting 'power' in terms of influencing or controlling women, birthing events, processes and resources. Many women appeared to be passive recipients of care; they did not exercise choice and control over the care they received, and the majority did not perceive that they were able to work in partnership with the midwives.These findings are discussed in the context of the way in which service delivery is organised. In addition, the findings are very timely in view of the NHS Plan and the NSF's commitment to women having informed choice and individualised care

Experience of and access to maternity care in the UK by immigrant women: a narrative synthesis systematic review

© 2019 Author(s). One in four births in the UK is to foreign-born women. In 2016, the figure was 28.2%, the highest figure on record, with maternal and perinatal mortality also disproportionately higher for some immigrant women. Our objective was to examine issues of access and experience of maternity care by immigrant women based on a systematic review and narrative synthesis of empirical research. Review methods: A research librarian designed the search strategies (retrieving literature published from 1990 to end June 2017). We retrieved 45 954 citations and used a screening tool to identify relevance. We searched for grey literature reported in databases/websites. We contacted stakeholders with expertise to identify additional research. Results: We identified 40 studies for inclusion: 22 qualitative, 8 quantitative and 10 mixed methods. Immigrant women, particularly asylum-seekers, often booked and accessed antenatal care later than the recommended first 10 weeks. Primary factors included limited English language proficiency, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Maternity care experiences were both positive and negative. Women with positive perceptions described healthcare professionals as caring, confidential and openly communicative in meeting their medical, emotional, psychological and social needs. Those with negative views perceived health professionals as rude, discriminatory and insensitive to their cultural and social needs. These women therefore avoided continuously utilising maternity care. We found few interventions focused on improving maternity care, and the effectiveness of existing interventions have not been scientifically evaluated. Conclusions: The experiences of immigrant women in accessing and using maternity care services were both positive and negative. Further education and training of health professionals in meeting the challenges of a super-diverse population may enhance quality of care, and the perceptions and experiences of maternity care by immigrant women

Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review

Limited evidence suggests experiences of immigrant women accessing and using UK maternity services were mixed but largely poor, and there were few rigorously evaluated interventions focused on improving care

Promoting ethical behaviour and preventing wrongdoing in organisations: A rapid evidence assessment

This Rapid Evidence Assessment (REA), based on 57 studies carried out in policing and other professions, aimed to identify interventions, mechanisms and levers that might encourage ethical behaviour and prevent wrongdoing in organisations. Taken together, the evidence raises a number of possibilities for organisations for action, though no readymade single solution was identified. The importance of strong and effective leadership – such as leaders being open, acting as role models, and also being ‘firm’ in terms of setting and enforcing standards – was highlighted as encouraging ethical behaviour, as well as being an essential ingredient for the successful implementation of interventions. Promising interventions tended to be broadly preventive or remedial in their approach, rather than focused on apprehending and disciplining those responsible for wrongdoing