The Identification and Support of Child Victims of Trafficking in Scotland: A Child Protection Model

In February 2013 an earlier version of this paper was presented to a stakeholder group, proposing a child-rights approach to the identification and protection of child victims of trafficking in Scotland; an approach that sought to prioritise the protection of children being a higher policy and practice importance than immigration control.  This updated paper, taking account of recent developments, proposes a model of child protection focused practice for child victims of trafficking in Scotland, underpinned by multiagency practice experience and research developed over the last 10 years. The proposal seeks to locate child trafficking practice firmly within existing devolved powers and legislation; any decisions regarding immigration control and residency remain firmly within the powers of the UK Government. This proposal does not necessitate any legislative changes and can be accommodated in existing child protection policy and practice in Scotland

Effect of selected plant species within biodiverse pasture on in vitro fatty acid biohydrogenation and tissue fatty acid composition of lamb

The effect of botanical diversity on supply of polyunsaturated fatty acids (PUFA) to ruminants in vitro, and the fatty acid (FA) composition of muscle in lambs was investigated. Six plant species, commonly grown as part of UK herbal ley mixtures (Trifolium pratense, Lotus corniculatus, Achillea millefolium, Centaurea nigra, Plantago lanceolata and Prunella vulgaris), were assessed for FA profile, and in vitro biohydrogenation of constituent PUFA, to estimate intestinal supply of PUFA available for absorption by ruminants. Modelling the in vitro data suggested that L. Corniculatus and P. Vulgaris had the greatest potential to increase 18:3 n-3 supply to ruminants, having the highest amounts escaping in vitro biohydrogenation . Biodiverse pastures were established using the six selected species, under-sown in a perennial ryegrass-based sward. Lambs were grazed (~50 days) on biodiverse or control pastures and the effects on the FA composition of m. longissimus thoracis (lean and subcutaneous fat) and m. semimembranosus (lean) were determined. Biodiverse pasture increased 18:2 n-6 and 18:3 n-3 contents of m. semimembranosus (+14.8 and +7.2 mg/100g tissue respectively) and the subcutaneous fat of m. l. thoracis (+158 and +166 mg/100g tissue respectively) relative to feeding a perennial ryegrass pasture. However, there was no effect on total concentrations of saturated FA in the tissues studied. It was concluded that enhancing biodiversity had a positive impact on muscle FA profile reflected by increased levels of total PUFA

Effects of replacing maize silage with lucerne silage and lucerne silage chop length on rumen function and milk fatty acid composition

The objective of this study was to investigate whether higher lucerne (medicago sativa; alfalfa) silage inclusion rate and longer lucerne chop length improves rumen function through increased provision of physically effective fiber, when included in a maize and lucerne silage-based total mixed ration. Diets were formulated to contain a 50:50 forage:concentrate ratio (dry matter [DM] basis) and be isonitrogenous and contain equal levels of neutral detergent fiber (320 g/kg). The forage portion of the offered diets was comprised of maize and lucerne silage DM in proportions (w/w) of either 25:75 (high lucerne; HL) or 75:25 (low lucerne; LL). Second cut lucerne was harvested and conserved as silage at either a long (L) or a short (S) chop length (geometric mean particle lengths of 9.0 and 14.3 mm, respectively). These variables were combined in a 2 x 2 factorial arrangement to give four treatments (HLL, HLS, LLL, LLS) which were fed in a 4 x 4 Latin square design study to four rumen-cannulated, multiparous, Holstein dairy cows in mid-lactation. Effects on dry matter intake (DMI), chewing behaviour, rumen volatile fatty acid (VFA) concentration, rumen pH, rumen and fecal particle size, milk production and milk fatty acid (FA) profile were measured. Longer chop length increased rumination times/kg DMI (+2.8 min/kg) relative to the S chop length, with HLL diets resulting in the most rumination chews. Rumen concentrations of total VFA, acetate, and n-valerate were higher for the HLS diet than the other three diets, while rumen propionate concentration was lowest for the HLL diet. Physically effective fiber (particles >4 mm) percentage in the rumen mat was increased when L chop length was fed regardless of lucerne inclusion rate. No effect of treatment was observed for milk yield although milk protein concentration was increased by L for the LL diet (+1.6 g/kg) and decreased by L for the HLL diet (-1.4 g/kg). Milk fat concentrations of total cis-18:1 (+3.7 g/100g FA) and 18:3 n-3 (+0.2 g/100g FA) were greater with HL. In conclusion, longer lucerne silage chop length increased time spent ruminating per kg DMI, but had no effect on rumen pH in the present study. Increasing dietary lucerne inclusion rate had no effects on rumination activity or rumen pH, but decreased the ratio of n-6:n-3 polyunsaturated fatty acid concentrations in milk fat

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

Abstract Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the Assets-based infant feeding help Before and After birth (ABA) randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers co-constructed a genogram at the first antenatal meeting for the intervention group, and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted.Discussion/Conclusion The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended

Asynchronous video messaging promotes family involvement and mitigates separation in neonatal care

From BMJ via Jisc Publications RouterVoR closed-deposited 2020-09-16; AM deposited OA 2020-12-01.Objective: To evaluate the parent and staff experience of a secure video messaging service as a component of neonatal care. Design: Multicentre evaluation incorporating quantitative and qualitative items. Setting: Level II and level III UK neonatal units. Population: Families of neonatal inpatients and neonatal staff. Intervention: Use of a secure, cloud-based asynchronous video messaging service to send short messages from neonatal staff to families. Evaluation undertaken July–November 2019. Main outcome measures: Parental experience, including anxiety, involvement in care, relationships between parents and staff, and breastmilk expression. Results: In pre-implementation surveys (n=41), families reported high levels of stress and anxiety and were receptive to use of the service. In post-implementation surveys (n=42), 88% perceived a benefit of the service on their neonatal experience. Families rated a positive impact of the service on anxiety, sleep, family involvement and relationships with staff. Qualitative responses indicated enhanced emotional closeness, increased involvement in care and a positive effect on breastmilk expression. Seventy-seven post-implementation staff surveys were also collected. Staff rated the service as easy to use, with minimal impact on workload. Seventy-one percent (n=55) felt the service had a positive impact on relationships with families. Staff identified the need to manage parental expectations in relation to the number of videos that could be sent. Conclusions: Asynchronous video messaging improves parental experience, emotional closeness to their baby and builds supportive relationships between families and staff. Asynchronous video supports models of family integrated care and can mitigate family separation, which could be particularly relevant during the COVID-19 pandemic.https://doi.org/10.1136/archdischild-2020-319353106pubpub

Building social capital through breastfeeding peer support: Insights from an evaluation of a voluntary breastfeeding peer support service in North-West England

Background: Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013. Methods: Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed. Results: Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with ’bonding’, ‘bridging’ and ‘linking’ forms of social capital. These insights illuminate how the peer support service facilitates ‘bonds’ with its members, and within and between women who access the service; how the service ‘bridges’ with individuals from different interests and backgrounds, and how ‘links’ were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified. Conclusions: Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted

Charge separation and triplet exciton formation pathways in small molecule solar cells as studied by time-resolved EPR spectroscopy

Funding: EPSRC EP/G03673X/1 (SAJT), Royal Society Wolfson research merit award (IDWS).Organic solar cells are a promising renewable energy technology, offering the advantages of mechanical flexibility and solution processability. An understanding of the electronic excited states and charge separation pathways in these systems is crucial if efficiencies are to be further improved. Here we use light induced electron paramagnetic resonance (LEPR) spectroscopy and density functional theory calculations (DFT) to study the electronic excited states, charge transfer (CT) dynamics and triplet exciton formation pathways in blends of the small molecule donors (DTS(FBTTh2)2, DTS(F2BTTh2)2, DTS(PTTh2)2, DTG(FBTTh2)2 and DTG(F2BTTh2)2) with the fullerene derivative PC61BM. Using high frequency EPR the g-tensor of the positive polaron on the donor molecules was determined. The experimental results are compared with DFT calculations which reveal that the spin density of the polaron is distributed over a dimer or trimer. Time-resolved EPR (TR-EPR) spectra attributed to singlet CT states were identified and the polarization patterns revealed similar charge separation dynamics in the four fluorobenzothiadiazole donors, while charge separation in the DTS(PTTh2)2 blend is slower. Using TR-EPR we also investigated the triplet exciton formation pathways in the blend. The polarization patterns reveal that the excitons originate from both intersystem crossing (ISC) and back electron transfer (BET) processes. The DTS(PTTh2)2 blend was found to contain substantially more triplet excitons formed by BET than the fluorobenzothiadiazole blends. The higher BET triplet exciton population in the DTS(PTTh2)2 blend is in accordance with the slower charge separation dynamics observed in this blend.PostprintPostprintPeer reviewe

Protocol for a feasibility trial for improving breastfeeding initiation and continuation: Assets-based infant feeding help Before and After birth (ABA)

Introduction: Breastfeeding improves the health of mothers and infants; the UK has low rates, with marked socio-economic inequalities. Whilst trials of peer support services have been effective in some settings, UK trials have not improved breastfeeding rates. Qualitative research suggests many women are alienated by the focus on breastfeeding. We propose a change from breastfeeding focussed interactions to respecting a woman’s feeding choices, inclusion of behaviour change theory and an increased intensity of contacts in the two weeks after birth when many women cease to breastfeed. This will take place alongside an assets-based approach which focuses on the positive capability of individuals, their social networks and communities. We propose a feasibility study for a multicentre randomised controlled trial of the ABA infant feeding service versus usual care. Methods and analysis: A two-arm, non-blinded randomised feasibility study will be conducted in two UK localities. Women expecting their first baby will be eligible, regardless of feeding intention. The ABA infant feeding intervention will apply a proactive, assets-based, woman-centred, non-judgemental approach, delivered antenatally and postnatally tailored through face-to face contacts, telephone and SMS texts. Outcomes will test the feasibility of delivering the intervention with recommended intensity and duration to disadvantaged women; acceptability to women, feeding helpers and professionals; and feasibility of a future randomised controlled trial, detailing recruitment rates, willingness to be randomised, follow-up rates at 3 days, 8 weeks and 6 months and level of outcome completion. Outcomes of the proposed full trial will also be collected. Mixed methods will include qualitative interviews with women/partners, feeding helpers and health service staff; feeding helper logs and review of audio-recorded helper-women interactions to assess intervention fidelity. Ethics and dissemination: Study results will inform the design of a larger multicentre RCT. The National Research Ethics Service Committee approved the study protocol. Trial registration number: ISRCTN14760978. STRENGTHS AND LIMITATIONS OF THE STUDY • This study uses a two-centre randomised controlled trial design to determine the feasibility of a definitive trial. • The intervention design draws on evidence from best practice to support women who want to breastfeed behavioural change theory and makes use of women’s personal social and community assets. • A process evaluation will explore reach, fidelity of intervention delivery and the experience of women, feeding helpers and other key stakeholders

Humoral and cellular responses to SARS-CoV-2 in patients with B-cell haematological malignancies improve with successive vaccination

Patients with haematological malignancies are more likely to have poor responses to vaccination. Here we provide detailed analysis of the humoral and cellular responses to COVID-19 vaccination in 69 patients with B-cell malignancies. Measurement of anti-spike IgG in serum demonstrated a low seroconversion rate with 27.1% and 46.8% of patients seroconverting after the first and second doses of vaccine, respectively. In vitro pseudoneutralisation assays demonstrated a poor neutralising response, with 12.5% and 29.5% of patients producing a measurable neutralising titre after the first and second doses, respectively. A third dose increased seropositivity to 54.3% and neutralisation to 51.5%, while a fourth dose further increased both seropositivity and neutralisation to 87.9%. Neutralisation titres post-fourth dose showed a positive correlation with the size of the B-cell population measured by flow cytometry, suggesting an improved response correlating with recovery of the B-cell compartment after B-cell depletion treatments. In contrast, interferon gamma ELISpot analysis showed a largely intact T-cell response, with the percentage of patients producing a measurable response boosted by the second dose to 75.5%. This response was maintained thereafter, with only a small increase following the third and fourth doses, irrespective of the serological response at these timepoints