Continence promotion for older hospital patients following surgery for fractured neck of femur: Pilot of a randomized controlled trial

Evidence suggests that bladder control problems develop or worsen as a result of fractured neck of femur (#NOF) and its subsequent management

The importance of face to face, group antenatal education classes for first time mothers: A qualitative study

OBJECTIVES To explore and understand perspectives of women expecting their first child and why they wanted to attend NHS antenatal education. This included what worries and concerns they wanted to be addressed and why this would be beneficial. It also included what they wanted their partners to be able to gain from attending classes. DESIGN A longitudinal qualitative study using Template Analysis was undertaken with data collection during pregnancy and postpartum. A semi-structured topic guide was used to guide data collection, either via focus groups or one to one interviews which were audio recorded and transcribed. SETTING National Health Service Trusts providing maternity services to women for labour and birth, purposively selected to allow the perspectives of specific groups of women to be included. PARTICIPANTS Women expecting their first child from one of three groups: Women from the general population aged 20 years or more, women from ethnic minority groups and young women aged 16 to 19 years. FINDINGS Eighty-two pregnant women participated. Three substantive themes are reported: the search for information, the functions of antenatal classes, and the specific information desired. Women wanted to attend NHS antenatal education to access trustworthy information that would reassure, increase confidence, and help them feel prepared. Women wanted to meet others in the same situation to help normalise concerns and offer the potential for ongoing relationships. Classes were seen as a way to help partners engage more fully with the transition to parenthood. Specific information required and shared by all groups was around understanding the stages of labour, managing labour, and common interventions. CONCLUSIONS Access to a wide range of information increases women's anxieties about labour that women want addressed through antenatal education. However, antenatal classes serve broader functions beyond information- giving and women anticipate that attending antenatal classes will address both their own and their partners' needs. IMPLICATIONS Service providers should ensure their antenatal education provision provides the information required and is structured in a way that enables women to develop relationships and supports partners' engagement in the transition to parenthood

Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

Objectives Involvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulness and uptake of systematic reviews. However, there is a lack of evidence and resources to guide researchers in how to actively involve stakeholders in systematic reviews. In this paper we report the development of the ACTIVE framework to describe how stakeholders are involved in systematic reviews. Methods We developed a framework using methods previously described in the development of conceptual frameworks relating to other areas of public involvement, including: literature searching, data extraction, analysis, and categorisation. A draft ACTIVE framework was developed and then refined after presentation at a conference workshop, before being applied to a series of example systematic reviews. Data extracted from 32 systematic reviews, identified in a systematic scoping review, were categorised against pre-defined constructs, including: who was involved, how stakeholder were recruited, the mode of involvement, at what stage there was involvement and the level of control or influence. Results The final ACTIVE framework described whether patients, carers and/or families, and/or other stakeholders (including health professionals, health decision makers and funders) were involved. We defined: recruitment as either open or closed; the approach to involvement as either onetime, continuous or combined; and the method of involvement as either direct or indirect. The stage of involvement in reviews was defined using the Cochrane Ecosystem stages of a review. The level of control or influence was defined according to the roles and activities of stakeholders in the review process, and described as the ACTIVE continuum of involvement. Conclusions The ACTIVE framework provides a structure with which to describe key components of stakeholder involvement within a systematic review, and we have used this to summarise how stakeholders have been involved in a subset of varied systematic reviews. The ACTIVE continuum of involvement provides a new model that uses tasks and roles to detail the level of stakeholder involvement. This work has contributed to the development of learning resources aimed at supporting systematic review authors and editors to involve stakeholders in their systematic reviews. This framework may support the decision-making of systematic review authors in planning how to involve stakeholders in future review

Hazard ranking method for populations exposed to arsenic in private water supplies: relation to bedrock geology

Approximately one million people in the UK are served by private water supplies (PWS) where main municipal water supply system connection is not practical or where PWS is the preferred option. Chronic exposure to contaminants in PWS may have adverse effects on health. South West England is an area with elevated arsenic concentrations in groundwater and over 9000 domestic dwellings here are supplied by PWS. There remains uncertainty as to the extent of the population exposed to arsenic (As), and the factors predicting such exposure. We describe a hazard assessment model based on simplified geology with the potential to predict exposure to As in PWS. Households with a recorded PWS in Cornwall were recruited to take part in a water sampling programme from 2011 to 2013. Bedrock geologies were aggregated and classified into nine Simplified Bedrock Geological Categories (SBGC), plus a cross-cutting “mineralized” area. PWS were sampled by random selection within SBGCs and some 508 households volunteered for the study. Transformations of the data were explored to estimate the distribution of As concentrations for PWS by SBGC. Using the distribution per SBGC, we predict the proportion of dwellings that would be affected by high concentrations and rank the geologies according to hazard. Within most SBGCs, As concentrations were found to have log-normal distributions. Across these areas, the proportion of dwellings predicted to have drinking water over the prescribed concentration value (PCV) for As ranged from 0% to 20%. From these results, a pilot predictive model was developed calculating the proportion of PWS above the PCV for As and hazard ranking supports local decision making and prioritization. With further development and testing, this can help local authorities predict the number of dwellings that might fail the PCV for As, based on bedrock geology. The model presented here for Cornwall could be applied in areas with similar geologies. Application of the method requires independent validation and further groundwater-derived PWS sampling on other geological formation

The effect of Tai Chi on quality of life in male older people: A randomized controlled clinical trial

Background and purpose Physical activity can improve the mental and physical functioning of older people. This study investigated the impact of Tai Chi exercise on the quality of life of older men. Materials and methods This randomized controlled clinical trial was conducted on 132 older men in an urban area of Iran. The subjects were randomly assigned into two groups: a Tai Chi intervention group and a control group (n = 66 per group). Quality of life was evaluated using the Leiden-Padua quality of life questionnaire before and after the intervention. Data analysis was performed using analytical statistics via the SPSS software. Results After eight weeks of Tai Chi exercise, the mean scores of quality of life in different areas demonstrated a statistically significant difference between the two groups (p < 0 0.05). Conclusion This study illustrated that the 8-week Tai Chi intervention had a positive effect on the quality of life in older men

Placemaking through community and adaptable design (The Case of Coffee Park) (First Design Iteration).

Using participatory planning and community design methodologies (i.e. open planning, pattern language design, placemaking, community planning charrettes, planning-in-situ and wikiplanning) this project explores solutions to revitalize Coffee Park -- a small park along the CN railway in West Montreal. This is a complex site that shows issues of unsafety, lack of mobility and sense of place. The objective of this project is to integrate the park to its larger urban context to improve the mobility, safety and overall quality of life in this public space. After a series of visioning workshops, brainstorming sessions, two community planning charrettes and an open planning exercise, this project incorporates inputs from stakeholders, students and ordinary citizens into a collaborative urban design project. The project proposes strategies of urban re-stitching and regeneration through adaptable design and open community planning. With the objective of encouraging future adaptations and transformations, this project is published under a Creative Commons license. Adopt and adapt these ideas (but cite and acknowledge accordingly)