Moving home : exploring older peoples' experiences of hospital discharge

The overall aim of this research project is to investigate the impact of government policy, professional practice and social attitudes on the experiences of the older person leaving acute hospital care and returning to their own home. The project aims are summarised as below:*To develop an understanding of individuals' experiences within discharge preparation and planned support while they are preparing for home, getting home and being home. *To explore older people's experiences of co-production in the definition of needs and planning support to meet these needs. *To investigate the 'appropriateness' of the discharge package (plan or pathway) as seen by the individual once home. *To develop a model that allows a structured comparison between individual experiences and policy aims

A qualitative meta-synthesis of young peoples' experiences of ‘sexting’

Objective: To conduct a meta-synthesis of the qualitative research to explore young people's experiences and use of smart phones to send and receive sexually focused messages and images. Design: A qualitative meta-synthesis was conducted on the retrieved papers following a systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE, Embase, Medline and Psycinfo. The sample included five qualitative studies with a total sample size of 480 participants. Results: The meta-synthesis of the papers resulted in the development of four central themes: gender inequity, popularity with peers, relationship context, and costs and benefits. Conclusions: Drawing the qualitative work together highlights the manner in which ‘sexting’ is more nuanced than traditional ‘cyber-bullying’. The consensual sending of intimate images is a highly gendered activity. The gender issues require work with female students to explore the issue of ‘sexting’ and how it can be harmful. Work with male students around the issues of respect and gender harassment in relation to ‘sexting’ is also required and should contribute to sex and relationships education. The results indicate that school nurses working with young people need to build discussions about the use of technology within relationships into their work with young people

‘A fifty mile round trip to change a lightbulb’: An exploratory study of carers’ experiences of providing help, care and support to families and friends from a distance

While the role of carers has been widely investigated, the experiences of those who care from a distance have been little explored, especially in the United Kingdom. However, contemporary patterns of family life suggest that this may be a significant experience for many. This exploratory study employed an anonymous online survey, conducted April–November 2017, to collect data about specific issues (experiences, challenges and satisfactions) faced by carers living at a distance requiring at least 1hr travel time (each way) from the person they support. One hundred and twenty-eight participant responses were analysed. Qualitative (thematic) analysis identified that ‘distance carers’ carry out multiple care tasks, both when with, and apart from, the person they care for. Distance creates specific challenges for carers who have to work to ‘bridge the distance gap’ and who cannot ‘just drop in’ and see the person they support. Distance further exposes carers to emotional, financial and temporal demands. The use of technologies or the availability of a wider support network may support distance carers, and some explore the viability of relocation. However, these potential support strategies were identified as ‘fragile’ and at risk of breaking down. Despite the challenges identified, distance carers also reported satisfactions derived from supporting their relative/friend. While the numbers of those providing distance care are unknown, this research suggests that this is a significant carer group, whose needs should be recognised in health and social care policy, practice and research

Other Girls: a qualitative exploration of teenage mothers views on teen pregnancy in contemporaries

Perspectives that consider teenage mothers as a ‘social problem’ are well described in the literature. However, the attitudes towards teenage mothers held by other teenage mothers are not well understood. Given the growing use of peer support in the reproductive health of teenagers, the attitudes of teenage mothers towards their contemporaries is worthy of exploration. We aimed to examine the discourse around teenage pregnancy in teenage mothers who have recently experienced teenage pregnancy and motherhood for themselves. Fourty mothers aged 16 -19, who had recently given birth and used a homebased sexual health service took part in semi structured interviews to explore their views on pregnancy in other teenagers. The analytical framework of ‘othering’ and resistance are used to examine their discourse around teenage pregnancy in teenage mothers. Findings indicate that teenage pregnancy and parenting in teenage mother contemporaries is not always viewed positively. Some teenage mothers in this study used strategies to distance themselves from perceived negativity. Two overarching themes emerged from the data: Constructions of moral judgement and Maintenance of positive self-representations. The negative portrayal of teenage pregnancy within wider society impacts the ongoing stigma attached to teenage pregnancy within the teenage population. Approaches such as peer education and peer support used in reproductive health should not be considered neutral, taken for granted processes, but may be complex and more nuanced. Health and social care professionals supporting young parents should be aware of the potential for stigma, discrimination, isolation and exclusion within teenage peer groups. Policy makers need to ensure young mothers have access to a broad range of support opportunities and this should include formal, professional support

Experiences of Sexual Health Literacy in Sexual Relationship among Female Adolescent Students with Unplanned Pregnancy: A Qualitative Stud

บทคัดย่อ วัตถุประสงค์: เพื่ออธิบายประสบการณ์ความรอบรู้ด้านสุขภาพทางเพศในความสัมพันธ์ทางเพศของนักเรียนวัยรุ่นหญิงที่ตั้งครรภ์โดยไม่ได้วางแผน วิธีการศึกษา: ในการศึกษาเชิงคุณภาพนี้ คัดเลือกผู้ให้ข้อมูลแบบเฉพาะเจาะจง จำนวน 20 คน ข้อมูลจึงอิ่มตัว มีอายุระหว่าง 14 - 19 ปี ซึ่งตั้งครรภ์ขณะกำลังศึกษาอยู่ในโรงเรียน เก็บข้อมูลที่แผนกฝากครรภ์ของโรงพยาบาลชุมชน ตั้งแต่เดือนพฤศจิกายน 2561 – มิถุนายน 2562 เก็บข้อมูลด้วยการสัมภาษณ์เชิงลึก โดยใช้แบบสัมภาษณ์กึ่งโครงสร้าง, บันทึกเทปการสัมภาษณ์, การสังเกตแบบไม่มีส่วนร่วม, และการจดบันทึกภาคสนาม ใช้การวิเคราะห์แก่นสาระตามแนวคิดของ Braun และ Clarke ผลการศึกษา: ประสบการณ์ความสัมพันธ์ทางเพศ สามารถจำแนกได้ 3 ประเด็นหลัก คือ 1) การคบหากับเพศตรงข้าม 2) สถานการณ์ที่นำไปสู่การยินยอมมีเพศสัมพันธ์ และ 3) การแสวงหาวิธีแก้ปัญหาหลังการมีเพศสัมพันธ์ สรุป: ประสบการณ์ความรอบรู้ด้านสุขภาพทางเพศในความสัมพันธ์ทางเพศของนักเรียนวัยรุ่นหญิงที่ตั้งครรภ์โดยไม่ได้วางแผนที่พบนี้สามารถนำไปใช้ให้ความรู้เพื่อป้องกันการมีเพศสัมพันธ์โดยไม่ได้วางแผนและการส่งเสริมการคุมกำเนิดที่เหมาะสม คำสำคัญ: นักเรียนวัยรุ่นหญิง, วิจัยเชิงคุณภาพ, ความรอบรู้ด้านสุขภาพทางเพศ, ความสัมพันธ์ทางเพศ, ตั้งครรภ์โดยไม่ได้วางแผน Abstract Objective: To describe the experiences of sexual health literacy in sexual relationship among female adolescent students with unplanned pregnancy. Method: In this qualitative study, 20 informants were purposively sampled and interviewed until the data were saturated. They were 14 - 19 years old and got pregnant while in school. The recruitment participants at Ante natal care department of the Community hospitals from November 2018 to June 2019. Data were collected through in-depth interviews by semi-structured interview guide using voice recorder, non-participant observations, and field note. Thematic analysis of Braun and Clarke was employed to analyze the data. Results: The experiences of sexual relationship could be categorized into 3 groups, 1) dating the opposite sex, 2) situations leading to consent to have sexual intercourse, and 3) seeking a solution after sex. Conclusion: Experiences of sexual health literacy among female adolescents with unplanned pregnancy were identified. They could be used in education to promote the unplanned sex prevention and the proper use of birth control. Keyword: female adolescent students, qualitative study, sexual health literacy, sexual relationship, unplanned pregnanc

Teaching person-centered practice to pre-registration physiotherapy students: a qualitative study

Introduction: There has been a call for healthcare to consider more explicitly the needs of the individual patient by adopting a person-centered approach to practice. Consideration needs to be given to how this is taught to pre-registration physiotherapy students. Purpose: To understand how first-year pre-registration physiotherapy students envision their philosophy of practice and how person-centered aspects of that philosophy might be implemented in a clinical setting. Methods: Semi-structured interviews were carried out with 10 first-year physiotherapy students. Data were analyzed using thematic analysis. Results: Five themes were identified: 1) understanding the person and their direction of travel; 2) contextual factors that impact on the delivery of person-centered practice; 3) awareness of personality traits; 4) doing the small things; and 5) the person-centered learning curve. Conclusion: Understanding the person and knowing what is important to them is central to the participant’s philosophy of practice. They drew on specific personality traits such as listening, being patient, or using small talk to develop rapport to better understand the person they were working with. Despite the challenge of high-pressured, under resourced healthcare contexts, student physiotherapists would strive to do the small things for each person they were working with. Practice-based learning settings presented a steep learning curve and appeared to be important in developing person-centered skills which were introduced in the university setting

aDolescents gEnder surVey, rEsponsible coupLes evaluatiOn, and capacity building Project in India (DEVELOP): a study protocol

Gender-based violence against women is a serious concern in India. This affects the health and wellbeing of victims and their dependents, such as children. Published evidence has documented a variety of reasons for such violence in Indian societies, paving a pathway to design, implement, and evaluate intervention models to address this issue. DEVELOP is a research study designed by UK and Indian research teams to plan future projects to address gender-based discrimination and violence against women and girls in India. This study protocol provides detailed information on the objectives, research methods, data collection, storage, analysis, and dissemination plans of the DEVELOP. The first component is a survey of adolescent boys and girls from rural areas of Maharashtra state of India to understand their gender equality related knowledge and beliefs. The insight gathered will be used to design interventions targeted at adolescent populations through future research and development programmes. Secondly, an evaluation of the ‘Responsible Couples’ project will be conducted to assess its success and challenges, and to design suitable programme activities and models. The ‘Responsible Couples’ project is implemented in 40 villages of Maharashtra state to improve relationships in married couples, prevent violence against women, intervene during violence, and to provide support services for women and their family members. Research findings will be disseminated though public engagement events in India, international conferences, and peer reviewed publications. This will impact on the policy and work models of Indian partners to plan future project investments. Research findings will be also useful for local government authorities and other non-government agencies working on gender equality themes

The genomes of two key bumblebee species with primitive eusocial organization

Background: The shift from solitary to social behavior is one of the major evolutionary transitions. Primitively eusocial bumblebees are uniquely placed to illuminate the evolution of highly eusocial insect societies. Bumblebees are also invaluable natural and agricultural pollinators, and there is widespread concern over recent population declines in some species. High-quality genomic data will inform key aspects of bumblebee biology, including susceptibility to implicated population viability threats. Results: We report the high quality draft genome sequences of Bombus terrestris and Bombus impatiens, two ecologically dominant bumblebees and widely utilized study species. Comparing these new genomes to those of the highly eusocial honeybee Apis mellifera and other Hymenoptera, we identify deeply conserved similarities, as well as novelties key to the biology of these organisms. Some honeybee genome features thought to underpin advanced eusociality are also present in bumblebees, indicating an earlier evolution in the bee lineage. Xenobiotic detoxification and immune genes are similarly depauperate in bumblebees and honeybees, and multiple categories of genes linked to social organization, including development and behavior, show high conservation. Key differences identified include a bias in bumblebee chemoreception towards gustation from olfaction, and striking differences in microRNAs, potentially responsible for gene regulation underlying social and other traits. Conclusions: These two bumblebee genomes provide a foundation for post-genomic research on these key pollinators and insect societies. Overall, gene repertoires suggest that the route to advanced eusociality in bees was mediated by many small changes in many genes and processes, and not by notable expansion or depauperation

Genome-Wide Association Study Identifies Genetic Loci Associated with Iron Deficiency

The existence of multiple inherited disorders of iron metabolism in man, rodents and other vertebrates suggests genetic contributions to iron deficiency. To identify new genomic locations associated with iron deficiency, a genome-wide association study (GWAS) was performed using DNA collected from white men aged ≥25 y and women ≥50 y in the Hemochromatosis and Iron Overload Screening (HEIRS) Study with serum ferritin (SF) ≤ 12 µg/L (cases) and iron replete controls (SF>100 µg/L in men, SF>50 µg/L in women). Regression analysis was used to examine the association between case-control status (336 cases, 343 controls) and quantitative serum iron measures and 331,060 single nucleotide polymorphism (SNP) genotypes, with replication analyses performed in a sample of 71 cases and 161 controls from a population of white male and female veterans screened at a US Veterans Affairs (VA) medical center. Five SNPs identified in the GWAS met genome-wide statistical significance for association with at least one iron measure, rs2698530 on chr. 2p14; rs3811647 on chr. 3q22, a known SNP in the transferrin (TF) gene region; rs1800562 on chr. 6p22, the C282Y mutation in the HFE gene; rs7787204 on chr. 7p21; and rs987710 on chr. 22q11 (GWAS observed P<1.51×10−7 for all). An association between total iron binding capacity and SNP rs3811647 in the TF gene (GWAS observed P = 7.0×10−9, corrected P = 0.012) was replicated within the VA samples (observed P = 0.012). Associations with the C282Y mutation in the HFE gene also were replicated. The joint analysis of the HEIRS and VA samples revealed strong associations between rs2698530 on chr. 2p14 and iron status outcomes. These results confirm a previously-described TF polymorphism and implicate one potential new locus as a target for gene identification

Mucedorus: the last ludic playbook, the first stage Arcadia

This article argues that two seemingly contradictory factors contributed to and sustained the success of the anonymous Elizabethan play Mucedorus (c. 1590; pub. 1598). First, that both the initial composition of Mucedorus and its Jacobean revival were driven in part by the popularity of its source, Philip Sidney's Arcadia. Second, the playbook's invitation to amateur playing allowed its romance narrative to be adopted and repurposed by diverse social groups. These two factors combined to create something of a paradox, suggesting that Mucedorus was both open to all yet iconographically connected to an elite author's popular text. This study will argue that Mucedorus pioneered the fashion for “continuations” or adaptations of the famously unfinished Arcadia, and one element of its success in print was its presentation as an affordable and performable version of Sidney's elite work. The Jacobean revival of Mucedorus by the King's Men is thus evidence of a strategy of engagement with the Arcadia designed to please the new Stuart monarchs. This association with the monarchy in part determined the cultural functions of the Arcadia and Mucedorus through the Interregnum to the close of the seventeenth century