Home is Where the Heart is: A Comparative Analysis of Home Birth Outcomes and Perceptions in the Developed World

Home birth rates are increasing throughout the developed world, which necessitates a discussion regarding the outcomes and perceptions of home birth in developed countries. Home birth outcomes and perceptions are widely varied, and many have noted that there exists a relationship between a nation’s acceptance and integration of home birth into the standard model of maternity care and the nation’s home birth outcomes. This paper discusses a sample of developed countries, namely the United States, Canada, the United Kingdom, and the Netherlands, and seeks to identify the relationship between a nation’s home birth outcomes and its home birth perceptions. It was found that some countries, such as the United States, are reluctant to integrate home birth into the standard model of maternity care, and also have poor home birth outcomes. Countries like the Netherlands, by contrast, have created a standard maternity system that embraces and supports home birth. Home birth outcomes in these countries are exceptional. However, it was also found that no matter where a woman lives, the home birth is associated with fewer medical interventions, high rates of physiologic birth, and a strong sense of empowerment and autonomy. By comparing and contrasting home birth outcomes and perceptions in nations around the globe, our understanding of this growing phenomenon improves drastically and it becomes possible to create safer, better-integrated home birth systems.Bachelor of Scienc

Running a successful network to support methodologists and guideline developers: sharing experiences from UK evidence synthesis networks

Running a successful network to support methodologists and guideline developers: sharing experiences from UK evidence synthesis networks Facilitators: Judith Thornton (NICE); Ruaraidh Hill (University of Liverpool), Emma McFarlane (NICE), Li Chia Chen (University of Manchester) BACKGROUND AND INTRODUCTION We established the ‘North West Evidence Synthesis Network’ (NWESN) to bring together guideline developers, health researchers and policy makers from across our region in order to share knowledge and expertise and raise awareness of methodological developments. Several other UK networks have been initiated including the ‘Liverpool Evidence Synthesis Network’ (LivEN). Feedback from members has been positive with both personal and institutional benefits. Other networks include: • Health Research Methodology and Implementation (HeRMI) • Bangor Evidence Synthesis Hub (BESH) • Peninsula Systematic Review discussion group (PenSR) OBJECTIVES • To advocate the role of networks • To discuss the practicalities to establishing/running networks • To explore what guideline developers needs from networks DESCRIPTION OF THE WORKSHOP Short presentations to compare and contrast the remit, structure and function of different networks. Group discussions to explore: • What guideline developers want from networks • Challenges to establishing/running networks and strategies to overcome these. • Future directions for networking • How networks can be better connected Group feedback and conclusions TARGET GROUPS All staff involved in evidence synthesis and guideline development. IMPLICATIONS FOR GUIDELINE DEVELOPERS Our presentation at the Global Evidence Summit 2017 demonstrated the benefits of membership of the NWESN. Implications for guideline developers included general education and updating on new methods; a key benefit is the opportunity to share skills, information and support across researchers and institutions. CONCLUSIONS The workshop intends to raise awareness of the benefits of networks and what they can offer methodologists and guideline developers. We hope to encourage more people to connect with and establish methodological networks

#50+ fashion Instagram influencers: cognitive age and aesthetic digital labours

This paper demonstrates how #50+ fashion Instagram influencers contribute to the social construction of cognitive age through their aesthetic digital labours.Non-participative netnography in the form of visual and textual analysis of over 300 Instagram posts including images, captions and comments.Findings reveal how outfit selection, background choices and bodily poses redefine expressions of look age through forms of aesthetic labour. Post construction, hashtag and emoji usage illustrates how influencers refrain from directly posting about the fashion brands that they endorse. Instead, image and personality work visually attracts followers to politically charged posts which directly impact upon the social and cultural contexts where influencers are active. This ties into present day wider societal discourses.50+ fashion influencers have high spending power. Fashion brands should refrain from using #brand and collaborate in more subtle ways and concentrate on challenging the negativity of the old age cliché.Advances theory on the social construction of age in fashion studies by combining cognitive age with aesthetic labour to identify the characteristics of the social phenomenon of the 50+ Instagram influencer. Applies principles from critical visual analysis to digital context thereby advancing the qualitative netnographic toolkit

Patient and public attitudes to and awareness of clinical practice guidelines : a systematic review with thematic and narrative syntheses

Article Accepted Date: 15 July 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Acknowledgements The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 258583 (DECIDE project). The Health Services Research Unit, Aberdeen University, is funded by the Chief Scientist Office of the Scottish Government Health Directorates. The authors accept full responsibility for this paper and the views expressed in it are those of the authors and do not necessarily reflect those of the Chief Scientist Office. NS receives funding through a Knowledge Translation Fellowship from the Canadian Institutes of Health Research. No funding bodies had a role in the manuscript. We would like to thank Healthcare Improvement Scotland and the University of Dundee for support, including access to literature. We would also like to thank Lorna Thompson (Healthcare Improvement Scotland), for her help with the protocol for this review.Peer reviewedPublisher PD

IL-4 Mediated Resistance of BALB/c Mice to Visceral Leishmaniasis Is Independent of IL-4Rα Signaling via T Cells

Previous studies infecting global IL-4Rα-/-, IL-4-/-, and IL-13-/-mice on a BALB/c background with the visceralizing parasite Leishmania donovani have shown that the T helper 2 cytokines, IL-4, and IL-13, play influential but not completely overlapping roles in controlling primary infection. Subsequently, using macrophage/neutrophil-specific IL-4Rα deficient BALB/c mice, we demonstrated that macrophage/neutrophil unresponsiveness to IL-4 and IL-13 did not have a detrimental effect during L. donovani infection. Here we expand on these findings and show that CD4+ T cell-(Lckcre), as well as pan T cell-(iLckcre) specific IL-4Rα deficient mice, on a BALB/c background, unlike global IL-4Rα deficient mice, are also not adversely affected in terms of resistance to primary infection with L. donovani. Our analysis suggested only a transient and tissue specific impact on disease course due to lack of IL-4Rα on T cells, limited to a reduced hepatic parasite burden at day 30 post-infection. Consequently, the protective role(s) demonstrated for IL-4 and IL-13 during L. donovani infection are mediated by IL-4Rα-responsive cell(s) other than macrophages, neutrophils and T cells

Pre-analytical and analytical variables that influence urinary volatile organic compound measurements

There has been rapidly accelerating interest in the utilization of volatile organic compounds (VOCs) as non-invasive methods for rapid point-of-care medical diagnostics. There is widespread variation in analytical methods and protocols, with little understanding of the effects of sample storage on VOC profiles. This study aimed to determine the effects on VOC profiles of different storage times, at room temperature, prior to freezing, of sealed urine samples from healthy individuals. Analysis using Field Asymmetric Ion Motility Spectrometry (FAIMS) determined the alterations in VOC and total ion count profiles as a result of increasing room temperature storage times. Results indicated that increasing exposure time to room temperature prior to freezing had a threefold effect. Firstly, increased urinary VOC profile variability, with a plateau phase between 12 and 48 hours, before further degradation. Secondly, an increase in total ion count with time exposed to room temperature. Finally, a deterioration in VOCs with each sample run during the analysis process. This provides new insight into the effect of storage of urine samples for VOC analysis using FAIMS technology. Results of this study provide a recommendation for a 12-hour maximum duration at room temperature prior to storage

Minimal Gluten Exposure Alters Urinary Volatile Organic Compounds in Stable Coeliac Disease

Coeliac disease (CD) patients are distinguishable from healthy individuals via urinary volatile organic compounds (VOCs) analysis. We exposed 20 stable CD patients on gluten-free diet (GFDs) to a 14-day, 3 g/day gluten challenge (GCh), and assessed urinary VOC changes. A control cohort of 20 patients continued on GFD. Urine samples from Days 0, 7, 14, 28 and 56 were analysed using Lonestar FAIMS and Markes Gas Chromatography−Time of Flight−Mass Spectrometer (GC-TOF-MS). VOC signatures on D (day) 7−56 were compared with D0. Statistical analysis was performed using R. In GCh patients, FAIMS revealed significant VOC differences for all time points compared to D0. GC-TOF-MS revealed significant changes at D7 and D14 only. In control samples, FAIMS revealed significant differences at D7 only. GC-TOF-MS detected no significant differences. Chemical analysis via GC-MS-TOF revealed 12 chemicals with significantly altered intensities at D7 vs. D0 for GCh patients. The alterations persisted for six chemicals at D14 and one (N-methyltaurine) remained altered after D14. This low-dose, short-duration challenge was well tolerated. FAIMS and GC-TOF-MS detected VOC signature changes in CD patients when undergoing a minimal GCh. These findings suggest urinary VOCs could have a role in monitoring dietary compliance in CD patients

Patients, health information, and guidelines:a focus-group study

Background. Evidence-based clinical guidelines could support shared decision-making and help patients to participate actively in their care. However, it is not well known how patients view guidelines as a source of health information. This qualitative study aimed to assess what patients know about guidelines, and what they think of their presentation formats. Research question. What is the role of guidelines as health information for patients and how could the implementation of evidence-based information for patients be improved? Methods. A qualitative study with focus groups that were built around a semi-structured topic guide. Focus groups were audiotaped and transcribed and analysed using a phenomenographic approach. Results. Five focus groups were carried out in 2012 with a total of 23 participants. Patients searched for health information from the Internet or consulted health professionals or their personal networks. The concepts of guidelines included instructions or standards for health professionals, information given by a health professional to the patient, and material to protect and promote the interests of patients. Some patients did not have a concept for guidelines. Patients felt that health information was abundant and its quality sometimes difficult to assess. They respected conciseness, clarity, clear structure, and specialists or well-known organizations as authors of health information. Patients would like health professionals to deliver and clarify written materials to them or point out to them the relevant Internet sites. Conclusions. The concept of guidelines was not well known among our interviewees; however, they expressed an interest in having more communication on health information, both written information and clarifications with their health professionals

Dealing with alcohol-related harm and the night-time economy

Alcohol-related problems are a major cause of social disorder and illness in Australia. In particular, problems associated with the night-time economies of urban and regional centres cause substantial community concern and are a considerable drain on police, community and health resources. The estimated cost of alcohol to the community is $15.3 billion, including costs associated with crime, violence, patient treatment, loss of productivity and premature deaths in 2004&ndash;05 (Collins 2008). Alcohol has also been identified as a factor in around three quarters of assaults and incidents of offensive behaviour on the street (Buss 1995). Previous research has identified several issues that contribute to the levels of short-term harm associated with risky drinking. These include: excessive consumption at licensed premises, consumption in public areas and lack of transport and security in entertainment precincts (Homel et al. 1992; Graham &amp; Homel 2008).Drinking in licensed venues is another predictor of harm and public disorder. More than half of offences occurring on the street have been associated with licensed premises in Australia (Buss 1995). A complex range of factors increase risky drinking and associated harms on licensed premises including: aspects of patron mix; levels of comfort, boredom, and intoxication; promotions that cause mass intoxication; and the behaviour of security/bouncers (Homel et al. 1992). Violence has also been shown to be perpetuated by poor venue management, lax police surveillance, lack of transport options for patrons, and inappropriate bureaucratic controls and legislation (Homel et al. 1992). This project aims to provide evidence-based knowledge regarding the implementation and impact of innovative local initiatives directed at alcohol-related harms.<br /