Exercise and physical activity in asylum seekers in Northern England; using the theoretical domains framework to identify barriers and facilitators

Background Many asylum seekers have complex mental health needs which can be exacerbated by the challenging circumstances in which they live and difficulties accessing health services. Regular moderate physical activity can improve mental health and would be a useful strategy to achieve this. Evidence suggests there are barriers to engaging black and minority ethnic groups in physical activity, but there is little research around asylum seekers to address the key barriers and facilitators in this group. Methods A two stage qualitative study used semi-structured interviews underpinned by the Theoretical Domains Framework. The interviews were conducted in voluntary sector groups in four towns/ cities in Northern England. Purposive sampling recruited 36 asylum seekers from 18 different countries. Interviews were audio recorded, transcribed verbatim and subject to framework analysis. Stage two involved a nominal group technique with five key stakeholders including asylum seekers and those that work with them. They followed a four stage process to rank and reach consensus on the key barrier to undertaking physical activity/ exercise that could be addressed locally through a future intervention. Results A number of barriers and facilitators were identified including a lack of understanding of the term physical activity and recommended levels but knowledge of the health benefits of physical activity/ exercise and the motivation to increase levels having engaged with activities back home. Living as an asylum seeker was considered a barrier due to the stress, poverty and temporary nature of living in an unfamiliar place. The outcome of the nominal group technique was that a lack of knowledge of facilities in the local area was the prevailing barrier that could be addressed. Conclusions Public health practitioners could develop interventions which capitalise on the motivation and knowledge of asylum seekers to encourage an increase in physical activity which may in turn reduce the breadth and depth of mental health needs of this group

Capturing Skill State in Curriculum Learning for Human Skill Acquisition

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Peer volunteering; an innovative approach to striving towards achieving normal childbirth in asylum seeking and refugee women.

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Striving for excellence in maternity care: The Maternity Stream of the City of Sanctuary.

yesAsylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women

Asylum seekers and refugees: A cross European perspective

yesIn this chapter we explore issues of psychosocial resilience and risk related to asylum seeking and refugee women during the perinatal period, drawing on experiences from three diverse European countries; the United Kingdom (UK), Malta and the Netherlands. First we define the terms asylum seekers and refugees to allow us to focus on the issues that pertain specifically to women experiencing this form of migration. We also note the prevalence of migration in contemporary society. We explore recent research on asylum seeking and refugee women in the perinatal period to identify; the barriers women face in accessing care in their reception countries and their experiences of perinatal care. Through this work, the challenges faced by healthcare professionals to provide culturally appropriate and high quality care to these women who face a range of psychosocial challenges are also highlighted. We suggest possible ways to address some of these challenges including how health professionals can actively build on the resilience of asylum seeking and refugee women to improve their perinatal experiences. We conclude by focusing on the implications of these findings; drawing on examples of good practice from the UK, Netherland and Malta to provide recommendations for practice and service development

Is It Rational to Assume that Infants Imitate Rationally? A Theoretical Analysis and Critique

It has been suggested that preverbal infants evaluate the efficiency of others' actions (by applying a principle of rational action) and that they imitate others' actions rationally. The present contribution presents a conceptual analysis of the claim that preverbal infants imitate rationally. It shows that this ability rests on at least three assumptions: that infants are able to perceive others' action capabilities, that infants reason about and conceptually represent their own bodies, and that infants are able to think counterfactually. It is argued that none of these three abilities is in place during infancy. Furthermore, it is shown that the idea of a principle of rational action suffers from two fallacies. As a consequence, is it suggested that it is not rational to assume that infants imitate rationally. Copyright (C) 2012 S. Karger AG, Base

Inflammatory myofibroblastic pseudotumour of the liver in association with gall stones - a rare case report and brief review

Inflammatory myofibroblastic pseudotumours of the liver are rare tumour-like lesions that can mimic malignant liver neoplasms. The symptoms and radiological findings of this rare tumour can pose diagnostic difficulties. We describe a 69-year-old gentleman who was admitted to our department with symptoms suggestive of acute cholecystitis. Ultrasonography and computed tomography of the liver raised the possibility of metastatic liver disease. A core biopsy of the liver was performed to confirm the diagnosis of liver metastasis. Unexpectedly it showed no evidence of malignancy but instead revealed an inflammatory myofibroblastic pseudotumour of the liver. This case report highlights the diagnostic dilemma that arose due to the similarity of appearances between the two pathological entities on imaging and this stresses the need for accurate histological diagnosis so as to avoid unnecessary surgical intervention. To the best of our knowledge, only a minority of cases are reported in the literature associating a hepatic inflammatory myofibroblastic pseudotumour with gall stones

Infants in Control: Rapid Anticipation of Action Outcomes in a Gaze-Contingent Paradigm

Infants' poor motor abilities limit their interaction with their environment and render studying infant cognition notoriously difficult. Exceptions are eye movements, which reach high accuracy early, but generally do not allow manipulation of the physical environment. In this study, real-time eye tracking is used to put 6- and 8-month-old infants in direct control of their visual surroundings to study the fundamental problem of discovery of agency, i.e. the ability to infer that certain sensory events are caused by one's own actions. We demonstrate that infants quickly learn to perform eye movements to trigger the appearance of new stimuli and that they anticipate the consequences of their actions in as few as 3 trials. Our findings show that infants can rapidly discover new ways of controlling their environment. We suggest that gaze-contingent paradigms offer effective new ways for studying many aspects of infant learning and cognition in an interactive fashion and provide new opportunities for behavioral training and treatment in infants

Hospital postnatal discharge and sepsis advice: Perspectives of women and midwifery students

Background: Women are discharged home from hospital increasingly early, but there is little evidence examining the postnatal hospital discharge process and how this may impact on the health of women and babies. In particular, there is little on sepsis prevention advice, despite it being the biggest direct cause of maternal mortality. Aim: To explore the perceptions of women and senior student midwives related to the postnatal hospital discharge process and maternal sepsis prevention advice. Methods: Three focus group interviews were undertaken, involving 9 senior student midwives and 14 women attending paid or specialist classes for vulnerable migrant women. Findings: All participants believed that the postnatal hospital discharge process was inadequate, rushed and inconsistent. Sepsis advice was patchy and the condition underplayed. Conclusions: Cost effective, time-efficient and innovative ways to impart vital information are required to support the postnatal hospital discharge process