Cultural beliefs and thermal care of infants: protecting South Asian and white British infants in Bradford from heat and cold

Maintaining an adequate body temperature is essential for human survival, yet infants are born with significant thermal challenges. Thermoregulation of infants is achieved through both physiological processes and through the thermal care behaviour of their caregivers. Little attention has been paid to infant thermal care beliefs and how thermal care is provided in practice. Thermal care beliefs vary across the world. Humoral beliefs that prescribe thermal balance to maintain health are extremely common globally, but less so in the UK. Methods This study primarily employed a mixed methods approach, using semi-structured and structured questions in interviews to explore ethnic differences in infant thermal care beliefs and practices of white British and South Asian mothers in the Bradford District, West Yorkshire, England. Results White British mothers were found to use significantly more bedding in winter for their infants than South Asian mothers (Man Whitney U p=<0.001). White British and South Asian infants were found to sleep in different environmental conditions. Mothers used several physical and behavioural cues to identify thermal stress in their infants and reported 24 different infant health problems caused by heat stress and 21 by cold stress. White British mothers were significantly more likely to be concerned about their infant getting too hot than too cold and South Asian mothers about both (Pearson Chi squared p=<0.001). Conclusions This thesis has demonstrated that thermoregulation of infants is achieved through internal physiological processes but also cannot be removed from the thermal care behaviour and beliefs of their caregivers. By exploring health beliefs and practices in other cultures, bias in the choice and focus of clinical research in the UK can be understood and addressed. Implications This thesis provides evidence to inform future directions for research, and policy on infant thermal care and manufacture of infant bedding in the UK

Keeping warm with sickle cell disease research project

Sickle cell disease (SCD) is the most common inherited disease in the UK. Painful crisis can require several days of hospitalisation and lead to stroke, organ failure and death. Exposure to cold is one of the principle triggers for a crisis. Research by Sheffield Hallam University involved interviews with 15 adults with SCD or parents of a child with SCD from Yorkshire, Manchester and the Midlands and some home temperature readings were recorded. Multiple examples of where cold exposures led directly to hospitalisation were cited. Whilst maintaining a warm home was an extremely high priority, the ability to heat the home was challenged by low and unpredictable incomes. Employment was difficult to maintain due to frequent episodes of illness, yet they found it problematic to qualify for disability benefits because SCD is a fluctuating condition. Participants reported being sanctioned for not signing on while hospitalised, resulting in self-disconnection from heating and immediate risk of further hospitalisation on being discharged. The cost of a short stay in hospital for SCD is seven times the cost of an average annual fuel bill, making warm interventions potentially highly cost-effective in preventing sickle crisis. People with other fluctuating health conditions may experience similar problems

Honour based violence as a global public health problem: a critical review of literature

Purpose : 'Honour' Based Violence (HBV), a form of Gender Based Violence (GBV), has received increasing interest from media, human rights organisations, academics and public. A significant increase in the occurrence and reporting of HBV in many parts of the world and its detrimental impact on health and wellbeing of women, girls, communities and wider society; marks it a major public health concern. However, awareness and recognition of HBV in field of public health is low in many countries and there is little known about its nature, roots and distribution. Aim : The aim was to analyse existing literature to understand what is HBV; how it is understood, its nature and distribution. Methods : The literature was searched using the Scopus database and a series of search terms related to HBV, gender based violence and health and wellbeing. Findings : Definition of HBV and its forms is varied across cultures. There is a lack of consensus on how HBV can be identified over other forms of violence and no explicit theoretical perspectives have been sufficiently developed to deepen our understanding of HBV. Although findings from the review suggest that HBV forms and patterns may be regionally distinct, causes emanate from gender based and socio-economic inequalities. Value of findings : Findings from the review highlight the complexity of tackling HBV in a globalised world. Findings also provide insights on how public health model can be used to analyse causes and prevention of HBV. Further, a non-culturalised, unprejudiced and inclusive definition is required to flag-up and record HBV cases. Keywords : Honour-based violence, female genital mutilation, gender-based violence, public health, honour killin

Cultural beliefs and thermal care of infants Protecting South Asian and white British infants in Bradford from heat and cold

Abstract Maintaining an adequate body temperature is essential for human survival, yet infants are born with significant thermal challenges. Thermoregulation of infants is achieved through both physiological processes and through the thermal care behaviour of their caregivers. Little attention has been paid to infant thermal care beliefs and how thermal care is provided in practice. Thermal care beliefs vary across the world. Humoral beliefs that prescribe thermal balance to maintain health are extremely common globally, but less so in the UK. Methods This study primarily employed a mixed methods approach, using semi-structured and structured questions in interviews to explore ethnic differences in infant thermal care beliefs and practices of white British and South Asian mothers in the Bradford District, West Yorkshire, England. Results White British mothers were found to use significantly more bedding in winter for their infants than South Asian mothers (Man Whitney U p=<0.001). White British and South Asian infants were found to sleep in different environmental conditions. Mothers used several physical and behavioural cues to identify thermal stress in their infants and reported 24 different infant health problems caused by heat stress and 21 by cold stress. White British mothers were significantly more likely to be concerned about their infant getting too hot than too cold and South Asian mothers about both (Pearson Chi squared p=<0.001). Conclusions This thesis has demonstrated that thermoregulation of infants is achieved through internal physiological processes but also cannot be removed from the thermal care behaviour and beliefs of their caregivers. By exploring health beliefs and practices in other cultures, bias in the choice and focus of clinical research in the UK can be understood and addressed. Implications This thesis provides evidence to inform future directions for research, and policy on infant thermal care and manufacture of infant bedding in the U

Keeping warm with sickle cell disease research project

Sickle cell disease (SCD) can lead to frequent hospitalisation for extremely painful sickle crisis and to several severely disabling secondary conditions or even death. 12,000-15,000 people in the UK have SCD and it affects people of all ages. One of the main triggers for a crisis is getting cold. Therefore staying warm, as well as eating well, drinking plenty and avoiding stress, is recommended by healthcare professionals as a preventative strategy. As SCD is most common among Black British, Black African and Black Caribbean groups, who are already at higher risk to fuel poverty than the general population, combined with increasing fuel costs, maintaining a home warm enough to avoid a crisis may be extremely challenging. This research looks at challenges people with SCD have in staying warm enough to prevent a painful sickle crisis

Warm Well Families: Doncaster Final Report

Cold homes harm health. There is a growing knowledge and evidence base related to the direct negative impacts on morbidity and mortality of living in cold housing. We know for example that in children, cold homes are associated with poor infant weight gain, slower development, worse asthma, and more hospital admissions. Adolescents are five times more likely to suffer multiple mental health problems. Adults – particularly those who are vulnerable – suffer more heart disease, stroke and respiratory disease, their general health is worse and existing conditions are exacerbated by living in cold properties. Older people suffer worse mental health and higher mortality rates. Living in cold housing can also indirectly harm health. It afects children’s educational attainment, emotional wellbeing and resilience; limits the dietary opportunities and choices people make; and the impact of cold on dexterity leads to a higher risk of accidents and injuries. The Warm Homes, Warm Families research project adds to our knowledge about the complex interaction between cold homes and health by exploring factors influencing the ability of households with children with asthma to keep warm at home in winter and access help. The experience, knowledge, beliefs and values of adults living in households with children with asthma affect the choices they make. This work will help to design improved information and support to enable families to protect themselves better from the harm to health caused by cold, damp housing. This work is particularly important at a time when energy costs are spiralling upward and when many families are faced with very stark economic choices

Cold Snaps - children’s health in a cold, damp home : influencing policy and practice

Children living in cold homes experience worse outcomes. This paper considers some of the findings from the Warm Well Families (WWF) study, which aimed to explore factors influencing the abilities of households including children with asthma to keep warm at home in winter. Individual and group interviews with children, families and professionals were conducted and home temperature and humidity measurements were taken. The experience, knowledge, beliefs and attitudes of adults living in households with children with asthma affect the choices they make. The concept of a ‘trade-off’ is used, to describe the complex process by which families in fuel poverty are juggling competing priorities in order to make decisions. The paper explores three participant families in detail, through the use of case studies, to illustrate the trade-offs made and the impact of those trade-offs on a family’s ability to keep warm and well at home. It is argued that policy initiatives and interventions need to engage with the full range of decisions families make, and the constraints on these decisions, in order to reduce the impact of fuel poverty on the wellbeing of families

Warm Well Families: Rotherham Final Report

Living in a cold home harms the health of babies, children and teenagers. Growing up in a cold home can impact on weight gain, development and emotional wellbeing. Living in fuel poverty directly affects people’s ability to afford decent food. The likelihood of suffering from respiratory illnesses such as asthma is more than doubled for children living in a cold home. Teenagers are more likely to participate in risk taking behaviours outside the home and their risk of developing multiple mental health problems is increased by cold homes. Educational achievement can be negatively affected as living in overcrowded or damp housing means children are more likely to miss school. Cold homes are also known to impact on resilience and emotional well-being which will ultimately worsen life chances. Ultimately growing up in cold damp homes will have a real effect on a child’s health, learning and enjoyment of life

Addressing obesity in Roma communities: : A community readiness approach

YesParticipation in community programmes by the Roma community is low whilst this community presents with high risk of poor health and low levels of wellbeing. To improve rates of participation in programmes compatibility must be achieved between implementation efforts and levels of readiness in the community. The Community Readiness Model (CRM) is a widely used toolkit which provides an indication of how prepared and willing a community is to take action on specific issues. We present findings from a CRM assessment for the Eastern European Roma community in Bradford, UK on issues related to nutrition and obesity. We interviewed key respondents identified as knowledgeable about the Roma community using the CRM. This approach applies a mixed methodology incorporating readiness scores and qualitative data. A mean community readiness score was calculated enabling researchers to place the community in one of nine possible stages of readiness. Interview transcripts were analysed using a qualitative framework analysis to generate contextual information. An overall score consistent with vague awareness was achieved, which indicates a low level of community readiness. This score suggests there will be a low likelihood of participation in currently available nutrition and obesity programmes. To our knowledge this is the first study to apply the CRM in the Roma community for any issue. We present the findings for each of the six dimensions that make up the CRM together with salient qualitative findings.Better Start Bradfor