Decline and fall:a biological, developmental, and psycholinguistic account of deliberative language processes and ageing

Background: This paper reviews the role of deliberative processes in language: those language processes that require central resources, in contrast to the automatic processes of lexicalisation, word retrieval, and parsing. 10 Aims: We describe types of deliberative processing, and show how these processes underpin high-level processes that feature strongly in language. We focus on metalin- guistic processing, strategic processing, inhibition, and planning. We relate them to frontal-lobe function and the development of the fronto-striate loop. We then focus on the role of deliberative processes in normal and pathological development and ageing, 15 and show how these processes are particularly susceptible to deterioration with age. In particular, many of the commonly observed language impairments encountered in ageing result from a decline in deliberative processing skills rather than in automatic language processes. Main Contribution: We argue that central processing plays a larger and more important 20 role in language processing and acquisition than is often credited. Conclusions: Deliberative language processes permeate language use across the lifespan. They are particularly prone to age-related loss. We conclude by discussing implications for therapy

Lotions and Lubricants

First paragraph: Few studies have been published by midwives regarding the lotions and lubricants used in vaginal examination and procedures in labour and in the immediate postnatal period. In this article I review published research and present the findings of my own research conducted in 1993. Although seven years ago it describes a range of practices which are as relevant today as they were then

Ageing makes us dyslexic

Background: The effects of typical ageing on spoken language are well known: word production is disproportionately affected while syntactic processing is relatively well preserved. Little is known, however, about how ageing affects reading.Aims: What effect does ageing have on written language processing? In particular, how does it affect our ability to read words? How does it affect phonological awareness (our ability to manipulate the sounds of our language)?Methods & Procedures: We tested 14 people with Parkinson's disease (PD), 14 typically ageing adults (TAA), and 14 healthy younger adults on a range of background neuropsychological tests and tests of phonological awareness. We then carried out an oral naming experiment where we manipulated consistency, and a nonword repetition task where we manipulated the word-likeness of the nonwords.Outcomes & Results: We find that normal ageing causes individuals to become mildly phonologically dyslexic in that people have difficulty pronouncing nonwords. People with Parkinson's disease perform particularly poorly on language tasks involving oral naming and metalinguistic processing. We also find that ageing causes difficulty in repeating nonwords. We show that these problems are associated with a more general difficulty in processing phonological information, supporting the idea that language difficulties, including poorer reading in older age, can result from a general phonological deficit.Conclusions: We suggest that neurally this age-induced dyslexia is associated with frontal deterioration (and perhaps deterioration in other regions) and cognitively to the loss of executive processes that enable us to manipulate spoken and written language. We discuss implications for therapy and treatment

An early process evaluation of the public law outline in family courts

Context Local authorities with serious allegations of significant harm or likely significant harm to a child which cannot be resolved with a parent may apply to the court to place the child under local authority care or supervision, under Section 31 of the Children Act 1989. Care proceedings resulting from such applications can be very lengthy. The Public Law Outline (PLO) was introduced by the Judiciary and Ministry of Justice as a tool for the management of care proceeding cases (Ministry of Justice 2008). The aims of this study were to describe and evaluate the process of implementation of the Public Law Outline (PLO) in two tiers of the family justice system (magistrates’ Family Proceedings Courts and county court Care Centres). The PLO was initially trialled in ten areas in England and Wales from June 2007, and rolled out nationally on the 1st April 2008, together with the issue of statutory guidance for local authorities issued by the Department for Children, Schools and Families (DCSF 2008), and the Welsh Assembly Government (WAG 2008)

Prioritising research and dissemination: a Delphi study of NHS Highland midwives

 This paper reports on a Delphi study undertaken by a health librarian and two midwifery professionals, to determine the research priorities of midwives working in NHS Highland. Six important topics were identified: workforce issues, second stage of labour, obesity in pregnancy, women's expectations of pregnancy and of childbirth, place of birth, and breastfeeding. Related evidence was examined to identify topics where dissemination of existing evidence was needed. The study dealt both with the practice of midwifery in general and with the information needs of local midwives in particular. The Delphi technique was found to be a useful method to determine research priorities but it was not without its limitations

Evaluating the impact of nursing and midwifery sensitive clinical quality indicators on practice

This narrative literature review aimed to examine the literature that identified clinical quality indicators (CQIs) in nursing and midwifery and that also measured the impact of nursing and midwifery practice on CQI implementation and outcome. Specifically, the review objectives were to: (a) examine the evidence that reviewed how quality indicators are being used to influence care delivered by nursing and midwifery practitioners, and (b) from the evidence reviewed, identify the quality indicators that are most readily applied to nursing and midwifery practice in NHS Highland. Nurse and midwifery sensitive CQIs are quantitative measures which reflect professional care standards that monitor and evaluate particular aspects of care for which nurses and midwives have key responsibility. This narrative literature review considered the nurse and midwifery CQIs that have been implemented in NHS Scotland and identified themes from these indicators which reflect the nurse or midwives' distinct professional contribution to CQI outcomes. Additionally, factors have been identified that have been shown to support successful implementation of nurse and midwife sensitive CQIs into clinical practice

Exploring women's experiences, views and understanding of vaginal examinations during intrapartum care:A meta-ethnographic synthesis

Objective: To conduct a systematic review exploring women’s experiences, views and understanding of any vaginal examinations during intrapartum care, in any care setting and by any healthcare professional. Intrapartum vaginal examination is deemed both an essential assessment tool and routine intervention during labour. It is an intervention that can cause significant distress, embarrassment, and pain for women, as well as reinforce outdated gender roles. In view of its widespread and frequently reported excessive use, it is important to understand women’s views on vaginal examination to inform further research and current practice.Design: A systematic search and meta-ethnography synthesis informed by Noblit and Hare (1988) and the eMERGe guidance (France et al. 2019) was undertaken. Nine electronic databases were searched systematically using predefined search terms in August 2021, and again in March 2023. Studies meeting the following criteria: English language, qualitative and mixed-method studies, published from 2000 onwards, and relevant to the topic, were eligible for quality appraisal and inclusion.Findings: Six studies met the inclusion criteria. Three from Turkey, one from Palestine, one from HongKong and one from New Zealand. One disconfirming study was identified. Following both a reciprocal and refutational synthesis, four 3rd order constructs were formed, titled: Suffering the examination, Challenging the power dynamic, Cervical-centric labour culture embedded in societal expectations, and Context of care. Finally, a line of argument was arrived at, which brought together and summarised the 3rd orde rconstructs.Key conclusions and implications of practice: The dominant biomedical discourse of vaginal examination and cervical dilatation as central to the birthing process does not align with midwifery philosophy or women’s embodied experience. Women experience examinations as painful and distressing but tolerate them as they view them as necessary and unavoidable. Factors such as context of care setting, environment, privacy, midwifery care, particularly in a continuity of carer model, have considerable positive affect on women’s experience of examinations. Further research into women’s experiences of vaginal examination in different care models as well as research into less invasive intrapartum assessment tools that promote physiological processes is urgently require