Weight-management in children living with asthma:a qualitative study of the experiences of paediatric healthcare professionals

OBJECTIVE: Weight loss has been found to improve the symptoms of asthma in children who are overweight. However, many paediatric weight management programmes do not address the challenges associated with living with asthma. The aim of this study was to explore the views and experiences of paediatric healthcare professionals concerning weight management advice and support offered to families of children living with asthma. METHODS: In-depth individual interviews with 10 healthcare professionals who work with a paediatric asthma population (n = 4 Respiratory Consultants, 3 Respiratory Nurses, 3 General Paediatricians). Data were analysed using a Framework approach. RESULTS: Healthcare professionals highlighted that families' perceptions of weight, their approach to physical activity and nutrition, the family's social context and perceptions of asthma and asthma treatment all influence weight management in children living with asthma. Initiating weight management conversations and referring to weight management support were perceived as challenging. It was thought that tailoring weight management to the needs of children living with asthma and locating support within the community were important to the success of a family-centred intervention. CONCLUSIONS: The results highlight the added complexity of responding to excessive weight in a paediatric population with asthma. Training and referral guidance for healthcare professionals may help overcome weight management support challenges. Addressing family beliefs about the factors influencing paediatric asthma and exploring families' motivations for behaviour change may enhance engagement with weight management

A systematic review of contemporary competency-based education and training for pharmacy practitioners and students

BackgroundThe use of competency-based education (CBE) worldwide is increasing and has been advocated for by key reports in health professional education. Recent developments, including the first global competency framework for pharmacists published by the International Pharmaceutical Federation (FIP) in 2012, can help facilitate CBE adoption. However, adopting CBE is complex and involves various features and stages of development.ObjectiveThis systematic review examines pharmacy education and training to identify features of CBE-related approaches currently in use worldwide to develop a picture of contemporary CBE-related activity in pharmacy for the purpose of guiding future development.MethodScopus, Web of Science, Medline, Embase, and ERIC electronic databases were searched to identify relevant literature. Studies associated with CBE or training of pharmacy practitioners and related postgraduate or undergraduate students were included. Studies were limited to those published in English from 2010 to 2021. Two authors performed the screening and selection of studies, and a 3rd author resolved any discrepancies. The review followed PRSIMA guidelines and was registered with PROSPERO under CRD42022296424. The findings were analysed using an inductive approach and presented descriptively.ResultsTwenty-eight studies were included in the review, all of which originate from high-income countries, spanning a range of educational levels and research designs. A total of 20 features and 21 supporting components were identified and categorised, connected to those previously identified in the closely linked medical literature, and categorised into 6 overarching themes: design, teaching and learning, feedback and assessment, faculty, resources, and internal and external factors. A collective understanding of the concept of competency, in combination with a shared vision between education, regulation, and practice, underpins successful application of the CBE approach.ConclusionsThis review summarises common features of CBE across the globe which can be used to guide further developments in pharmacy education. Mutual consensus on the design and delivery of CBE features ensures that the intended learning outcomes are in alignment with the learner's experience and congruent with the realities of pharmacy practice

Parental feeding, child eating and physical activity:Differences in children living with and without asthma

This study aimed to establish the differences in parental attitudes toward feeding and activity, as well as child eating and activity levels, between families of children living with and without asthma. Parents of children and young people aged between 10 and 16 years living both with asthma (n = 310) and without asthma (n = 311) completed measures for parental feeding, parental attitudes toward child exercise, child eating, child activity level and asthma control. Children living with asthma had a significantly higher BMIz (BMI standardised for weight and age) score, were significantly more likely to emotionally overeat and desired to drink more than their peers without asthma. Parents of children with asthma reported greater use of food to regulate emotions, restriction of food for weight control, monitoring of child activity, pressure to exercise and control over child activity. When asthma symptoms were controlled, parental restriction of food for weight management predicted greater child BMIz scores, and higher child activity predicted lower child BMIz scores. These relationships were not found to be significant for children with inadequately controlled asthma. Differences in parental attitudes toward feeding and exercise, and child eating and exercise behaviors, between families may help to explain the increased obesity risk for children with asthma

“He’s not fat, he just has asthma”:A qualitative study exploring weight management in families living with pediatric asthma

Objective: Children and young people living with asthma have an increased risk of overweight/obesity, leading to increased severity of asthma symptoms. Weight management has been recommended to improve asthma symptoms, however, there is limited understanding of how this is experienced or how children and young people with asthma and their families wish to be supported. The aim of this study was to explore parents and children/young people’s views and experiences of managing weight while living with asthma, and to identify acceptable strategies for support. Methods: A qualitative methodological approach was taken to facilitate rich understanding of families’ insights into weight management while living with asthma. In-depth interviews were conducted with nine families living with pediatric asthma (n = 9 parents, 9 young people). Data were analyzed using a Framework approach. Results: Findings indicated that family engagement with weight management behaviors was primarily influenced by perceptions of risk regarding asthma outcomes and beliefs about asthma control. Families also reported weight management engagement to be influenced by perceptions of the food environment, perceptions of the exercise environment (e.g. weather, anticipated social outcomes) and the availability of weight management support. Participants sought tailored support which gave consideration to the asthma-obesity interaction. It was suggested that this would help reduce perceptions of weight stigma in consultations, thereby supporting behavioral changes. Conclusions: Individualized weight management plans that consider families concerns about asthma-related risk are needed to manage weight in children and young people living with asthma

The experiences of student nurses in a pandemic : a qualitative study

© 2021 The Author(s). Published by Elsevier Ltd. his is an open access article under the CC BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/4.0/Aim/objective: To record and learn from the experiences of students working on clinical placement in a pandemic. Background: In March of 2020, final and second year student nurses in England were given the option to join the Covid-19 pandemic work-force, paid as high-level health care assistants. Methods/design: Using qualitative methods and rapid analysis techniques, this study gathered the unique experiences of 16 final year students, from all fields of nursing at a University in the East of England, who chose to complete their final extended placement in a diverse range of clinical placements at the height of the first wave of the pandemic. Data was collected between July and September 2020. Results: Five key themes were identified across our data: rationale for undertaking the extended placement, role tensions, caring for patients and their families, the impact on teaching and learning, and personal health and wellbeing. Conclusions: While our participants reported largely positive experiences including a perceived heightened preparedness for qualification, their experiences provide important insights for nurse educators for the education and support of future students going into similar situations, in particular relating to welfare and support, preparation for placement, resilience, e-learning and learning on the front line.Peer reviewedFinal Published versio

Evaluating the usefulness of a wordless picture book for adults with intellectual disabilities about the COVID ‐19 vaccination programme using co‐production: The CAREVIS study

© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Aim: To explore the usefulness of a co‐designed wordless book showing processes of receiving COVID‐19 vaccines designed by, and for, adults with intellectual disabilities. Methods: A qualitative evaluation of the resource using mixed methods. Semi‐structured interviews were conducted with people with intellectual disabilities, carers and health professionals about resource content, and use. This was analysed thematically. A survey was circulated to intellectual disabilities networks to understand resource need, use, sharing and content. Results: Understanding the COVID‐19 vaccine was a process, not a single event using one resource. A visual resource had a place in facilitating conversations about vaccines between people with intellectual disabilities and carers. Differing perspectives were expressed regarding personal needs, existing awareness of vaccine programmes and communication preferences. Changes were suggested to improve the suggested storyline and relevance around COVID‐19 restrictions changing. Conclusion: A visual resource may help conversations about the COVID‐19 vaccine for people with intellectual disabilities.Peer reviewe

Pregnancy prevention and contraceptive preferences of online sex workers in the UK

Objectives: The internet has changed the organisation of sex work. The risk of sexually transmitted infections has frequently been a research focus, but less is known about sex workers’ use of contraception for pregnancy prevention. The aim of this research was to gain a better understanding of contraceptive preferences and provider interactions of online sex workers. Methods: Data were obtained from a multi-methods study of sex workers in the UK who advertise on the internet and have sexual contact with clients, particularly in the Birmingham and Solihull areas. The study comprised an online survey among 67 participants and eight qualitative interviews. Results: Reported high rates of condom use with clients led to sex workers considering pregnancy prevention to be a personal rather than an occupational issue. Disclosure of sex working to health professionals is often seen as unnecessary and/or undesirable due to concerns about stigma. A clear distinction between contraceptive needs for commercial and non-commercial partners was evident. Conclusion: Service providers need to take account of both personal and commercial needs during contraceptive consultations and avoid making assumptions based on homogeneous understandings of sex work. Encouraging disclosure of sex work to facilitate appropriate discussions may need new approaches to combat privacy and stigma concerns

Synthesis and structure of Mu-33, a new layered aluminophosphate

Mu-33, a new layered aluminophosphate with an Al/P ratio of 0.66, was obtained from a quasi non-aqueous synthesis in which tert-butylformamide (tBF) was the main solvent and only limited amounts of water were present. During the synthesis, tBF decomposed and the resulting protonated tert-butylamine is occluded in the as-synthesized material. The approximate structure was determined from data collected on a microcrystal (200 × 25 × 5 μm3) at the European Synchrotron Radiation Facility (ESRF) in Grenoble, but the quality of these data did not allow satisfactory refinement. Therefore the structure was refined using high-resolution powder diffraction data, also collected at the ESRF. The structure (P21/c, a = 9.8922(6) Å, b = 26.180(2) Å, c = 16.729(1) Å and β = 90.4(1)°) consists of anionic aluminophosphate layers that can be described as a six-ring honeycomb of alternating corner-sharing AlO4 and PO4 tetrahedra with additional P-atoms above and below the honeycomb layer bridging between Al-atoms. The tert-butylammonium ions and water molecules located in the interlayer spacing interact via hydrogen-bonds with the terminal oxygens of the P-atoms. The characterization of this new aluminophosphate by 13C, 31P, 1H–31P heteronuclear correlation (HETCOR) and 27Al 3QMAS solid state NMR spectroscopy is also reported

Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely

Experiences of student nurses during the first wave of the pandemic : a qualitative study

Background : In March 2020 in response to the first wave of the Covid-19 pandemic, student nurses in England in the final year of their degree could choose to work on the frontline for their final extended clinical placement, paid as band 4 health care assistants (Swift et al, 2020). 16 students across all fields of nursing from an East of England University who chose to go on extended placement were interviewed between July and September 2020. Aims : The aim of this study was to understand and learn from their experiences, and to inform and enhance approaches to student education and experience. Methods : We used a qualitative approach and rapid analysis techniques, underpinned by thematic analysis. Rapid research is used to facilitate cost-effective and timely results in rapidly changing situations (Beebe, 2001) providing immediate insights in areas in which little is known (Johnson and Vindrola-Padros, 2017). Results : Five themes were identified from the interview data: rationale for undertaking the extended placement, role tensions, caring for patients and their families, the impact on teaching and learning and personal health and wellbeing. Discussion : In an unprecedented global emergency, students put themselves and their families at risk, motivated by wanting to be useful in the pandemic, to finish their nursing degree, and the financial incentive. They had largely positive experiences, in particular, a heightened preparedness for qualification. However, they faced challenges including balancing clinical commitments with learning needs in environments in which usual levels of support and supervision were often lacking, and expectations around their role required clarity. Conclusion : Our participants experienced huge emotional, educational and personal challenges, which they overcame with their own personal strength and resilience, and support from the University and their friends and families. Their experiences provide important insights into education and support of students for the future