A qualitative meta-synthesis: public health nurses role in the identification and management of perinatal mental health problems

Aim: To report findings of a systematic review and meta-synthesis of qualitative studies exploring public health nurses’ perceptions and experiences of identifying and managing women with perinatal mental health (PMH) problems. Background: Public health nurses play a key role in supporting women who experience PMH problems and several qualitative studies have explored their role. Design: Systematic review and meta-synthesis. Data sources: A comprehensive search was developed and multiple databases were searched from 2000–2015. Review methods: Studies that employed qualitative methods to explore experiences of public health nurses in identifying and managing women with PMH problems were included. Two reviewers independently assessed the methodological quality of studies. Themes, concepts and interpretations were extracted and synthesized using the process of thematic analysis. Results: Fifteen papers including 14 unique qualitative studies were included. Two overarching themes were identified: ‘conceptualization and detection of PMH problems’ and ‘barriers and facilitators to management’. The former of these comprised several subthemes including the use of formal screening tools vs. clinical intuition and challenges encountered in detection. The latter theme, barriers to management included availability of referral pathways and time. In terms of facilitators, training, public health nursing interventions, support groups and referral pathways were identified as factors that optimize management. Conclusions: Public health nurses use a variety of methods to identify women with PMH problems. However, several support structures are needed to optimize management including access to appropriate referral pathways, support groups and relationship continuity

Midwives’ perceptions and experiences of caring for women who experience perinatal mental health problems: an integrative review

Background Perinatal mental health is an important public health issue and consideration must be given to care provision for effective support and care of women in the perinatal period. Aim To synthesise primary research on midwives’ perceived role in Perinatal Mental Health (PMH). Design Integrative review. Methods Whittemore and Knafl's (2005) framework was employed. A systematic search of the literature was completed. Studies were included if they met the following criteria: primary qualitative, quantitative and mixed methods research studies published in peer reviewed journals between January 2006 to February 2016, where the population of interest were midwives and the outcomes of interest were their perceived role in the management of women with PMH problems. The methodological quality of studies was assessed using the relevant CASP (Critical Appraisal Skills Programmes) criteria for quantitative and qualitative research studies. Data extraction, quality assessment and thematic analysis were conducted. Findings A total of 3323 articles were retrieved and 22 papers were included in the review (15 quantitative, 6 qualitative and one mixed method study). The quality of the studies included was good overall. Two overarching themes emerged relating to personal and professional engagement. Within personal engagement four sub themes are presented: knowledge, skills, decision making and attitude. Within professional engagement four themes are presented: continuous professional development, organisation of care, referral, and support. Conclusions and implications for practice The findings indicate midwives require continuous professional development opportunities that address knowledge, attitudes to PMH, communication and assessment skills. However educational and training support in the absence of appropriate referral pathways and support systems will have little benefit

Survey of midwives' perinatal mental health knowledge, confidence, attitudes and learning needs

BackgroundMidwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.AimsThe aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.DesignA cross-sectional survey design.MethodsThe study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.FindingsMidwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.ConclusionMidwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format

Evaluation of a Pilot School-Based Physical ActivityClustered Randomised Controlled Trial—ActiveSchools: Skelmersdale

Schools are key environments in which physical activity (PA) can be promoted. Various strategies and opportunities should be used to engage children in PA within schools. The aim of this study was to evaluate the effectiveness of the multi-component Active Schools: Skelmersdale (AS:Sk) pilot intervention on children’s PA and sedentary time (ST). The AS:Sk intervention was implemented for eight weeks in four schools with three control schools continuing normal practice. It consisted of eight components: active breaks, bounce at the bell, ‘Born To Move’ videos, Daily Mile or 100 Mile Club, playground activity challenge cards, physical education teacher training, newsletters, and activity homework. Child-level measures were collected at baseline and follow-up, including objectively measured PA. After accounting for confounding variables, the intervention had a significant effect on school day ST which was significantly less for the intervention children by 9 min per day compared to the control group. The AS:Sk pilot intervention was effective in reducing school day ST but significant changes in PA were negligible. To increase the efficacy of the current and future school-based interventions, authors should focus on implementation and process evaluations to better understand how schools are implementing intervention components

Rechargeable aluminum–selenium batteries with high capacity

Rechargeable aluminum (Al) batteries are emerging as a promising post lithium-ion battery technology. Herein, we demonstrate a conceptually new design of rechargeable aluminum-selenium (Al-Se) batteries by understanding the selenium chemistry and controlling the electrode reaction. The Al-Se battery consists of a composite cathode including selenium nanowires and mesoporous carbon (CMK-3) nanorods, an Al metal anode and chloroaluminate ionic liquid electrolyte. The working mechanism of the Al-Se battery is the reversible redox reaction of the SeCl/Se pair confined in the mesopores of CMK-3 nanorods. Al-Se batteries deliver a high reversible capacity of 178 mA h g (by Se mass), high discharge voltages (mainly above 1.5 V), and good cycling/rate performances

Developing sensitive detection nanotechnology to better identify insulin in serum

Text, tables and figures describing methods and materials used in experimental process to quantify insulin in seru

The acceptability and feasibility of a novel peer-led schoolbased physical activity intervention for adolescent girls: The girls' peer activity (G-PACT) project

Meeting abstract presented at 7th International Society for Physical Activity and Health Congress, London, England, 15-17 October, 2018.Introduction: This study assessed the feasibility and acceptability of a novel peer-led physical activity (PA) intervention for adolescent girls aged 13-14 years. Methods: The intervention employed a three-tier peer-led model under- pinned by Social Cognitive Theory (SCT) and Self-Determination Theory (SDT). The 8-week intervention was delivered in three schools and involved 233 participants. Each school recruited 12-16 girls to become PA-leaders, who received leadership training delivered by undergraduate PA students, who subsequently acted as their intervention mentors and role models. The PA-leaders were encouraged to support their school peers to engage in more PA. Two of the schools provided organised after- school PA opportunities which the PA-leaders actively promoted. The acceptability, practicality, engagement, and perceived success of the intervention was investigated using focus groups and interviews. Qualitative analysis adopted deductive and inductive methods, using SCT and SDT as thematic frameworks, and then exploring additional emergent themes. Results: The intervention was perceived as feasible and acceptable between mentors (n = 6) and leaders (n = 47). However, the relationship between leaders and their peers (n = 196) suggested uncertainty in delivery and engagement Disparity was reported from the peers in how much and what information was conveyed to them by their PA-leaders. Conclusions: This intervention was reported to be feasible and acceptable among mentors and PA-leaders. Teachers were supportive of the intervention and the intervention demonstrates innovation incorporating undergraduate students as mentors and role models to adolescent girls. Further research is needed to clarify the roles and responsibilities for the PA-leaders.External funding details: This research was funded by Edge Hill University

How can UK public health initiatives support each other to improve the maintenance of physical activity? Evidence from a cross-sectional survey of runners who move from Couch-to-5k to parkrun

Physical activity improves physical and mental well-being and reduces mortality risk. However, only a quarter of adults globally meet recommended physical activity levels for health. Two common initiatives in the UK are Couch-to-5k (an app-assisted 9-week walk/run programme) and parkrun (a free, weekly, timed 5-km walk/run). It is not known how these initiatives are linked, how Couch-to-5k parkrunners compare to parkrunners, and the extent to which this influences their parkrun performance. The aims were to compare the characteristics and motives and to compare physical activity levels, parkrun performance and the impact of parkrun between Couch-to-5k parkrunners and parkrunners. Three thousand two hundred and ninety six Couch-to-5k parkrunners were compared to 55,923 parkrunners to explore age, sex, ethnicity, employment status, neighbourhood deprivation, motives, physical activity levels, parkrun performance and the impact of parkrun. Couch-to-5k parkrunners were slightly older, more likely to be female and work part-time, but similar in ethnicity, and neighbourhood deprivation compared with other parkrunners. Couch-to-5k parkrunners had different motives for participation and reported high levels of physical activity at registration, which remained to the point of survey completion. This group had slower parkrun times but, when registered for a year, completed a similar number of runs (11) per year. Larger proportions of Couch-to-5k parkrunners perceived positive impacts compared with other parkrunners and 65% of Couch-to-5k parkrunners reported improvements to their lifestyle. parkrun appears to be an effective pathway for those on the Couch-to-5k programme, and the promising positive association between the two initiatives may be effective in assisting previously inactive participants to take part in weekly physical activity

An XMM-Newton Observation of Abell 2597

We report on a 120 ks XMM-Newton observation of the galaxy cluster Abell 2597. Results from both the European Photon Imaging Camera (EPIC) and the Reflection Grating Spectrometer (RGS) are presented. From EPIC we obtain radial profiles of temperature, density and abundance, and use these to derive cooling time and entropy. We illustrate corrections to these profiles for projection and point spread function (PSF) effects. At the spatial resolution available to XMM-Newton, the temperature declines by around a factor of two in the central 150 kpc or so in radius, and the abundance increases from about one-fifth to over one-half solar. The cooling time is less than 10 Gyr inside a radius of 130 kpc. EPIC fits to the central region are consistent with a cooling flow of around 100 solar masses per year. Broad-band fits to the RGS spectra extracted from the central 2 arcmin are also consistent with a cooling flow of the same magnitude; with a preferred low-temperature cut-off of essentially zero. The data appear to suggest (albeit at low significance levels below formal detection limits) the presence of the important thermometer lines from Fe XVII at 15, 17 Angstrom rest wavelength, characteristic of gas at temperatures ~ 0.3 keV. The measured flux in each line is converted to a mass deposition estimate by comparison with a classical cooling flow model, and once again values at the level of 100 solar masses per year are obtained. These mass deposition rates, whilst lower than those of previous generations of X-ray observatories, are consistent with those obtained from UV data for this object. This raises the possibility of a classical cooling flow, at the level of around 100 solar masses per year, cooling from 4 keV by more than two orders of magnitude in temperature.Comment: 16 pages, 18 figures. Accepted for publication in MNRA

Polysomnographic evaluation of obstructive sleep apnea syndrome in children, before and after adenotonsillectomy

Introduction: In the last years the Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) has much interested because it has not been completed established. Many criteria defined for OSAS in adults and children are different. We know that patient's clinical story is not sufficient for the diagnosis of OSAHS. In childhood, the most common cause of OSAHS is adenotonsillar hypertrophy, clinically characterised by snoring, apnea episodes, restless sleep, mouth breathing and daytime somnolence. Aim: This study has the purpose of comprovating, by objective way, the OSAS improving in children who underwent adenotonsillectomy. Study design: Clinical prospective. Material and method: For that, 23 children, among 2 and 13 years old, with adenotonsillar hypertrophy, were analysed. After endoscopy and polysomnography, they were submitted to adenotonsillectomy. Results: The polysomnography was repeated 2 months after surgery. The polysomnographic findings were compared through statistic study. Conclusion: All the patients had an important improve after adenotonsillectomy. Only two children (8.69%) persisted with light OSAHS, but they had moderate and important OSAHS before. We concluded that OSAHS is a precise indication for adenotonsillectomy in children.Introdução: Nos últimos anos a Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono (SAHOS) tem despertado muito interesse por tratar-se de uma condição não totalmente estabelecida. Muitos critérios usados para definir SAHOS em adultos e crianças são diferentes entre si. Em 1995 Sabe-se que a história clínica do paciente não era suficiente para estabelecer o diagnóstico de SAHOS. Na criança a causa mais comum de SAOS é a hipertrofia adenoamigdaliana, normalmente caracterizada clinicamente pela presença de roncos noturnos, episódios de apnéia, sono agitado, respiração bucal e hipersonolência diurna4. Objetivo: Este estudo tem o intuito de comprovar de forma objetiva a melhora da SAHOS em crianças submetidas a adenoamigdalectomia. Forma de estudo: Clínico prospectivo. Material e método: Para isso, foram avaliadas 23 crianças entre 2 e 13 anos (1999-2001), com hipertrofia adenoamigdaliana, que após nasofibroscopia e polissonografia foram submetidas a cirurgia de adenoamigdalectomia. A polissonografia foi repetida após 2 meses de pós-operatório. Foi então realizado estudo estatístico dos dados obtidos na polissonografia pré- e pós-operatória. Resultado: Observamos que todos os pacientes tiveram melhora importante após adenoamigdalectomia. Duas crianças (8,69%) persistiram com SAOS leve, que anteriormente eram de grau moderado e acentuado. Conclusão: Concluímos assim que SAOS é uma indicação precisa para cirurgia de adenoamigdalectomia em crianças.UNIFESP-EPM Disciplina de Otorrinolaringologia PediátricaUNIFESP, EPM, Disciplina de Otorrinolaringologia PediátricaSciEL