Postnatal experiences, knowledge and perceptions of women with gestational diabetes

Introduction: Women with gestational diabetes mellitus (GDM) are at increased risk of Type 2 diabetes (T2DM). This study aimed to explore experiences, knowledge and perceptions of women with GDM to inform the design of interventions to prevent or delay T2DM.  Methods: Semi-structured interviews were carried out with 16 women with GDM who were recruited from a clinic in one Scottish health board. Framework approach was used to manage and analyse data according to themes informed by psychological theory (Self Regulation Model and Theory of Planned Behaviour).  Results: GDM is not seen as an important, or even real diagnosis, among some women, and this perception may result from perceived minimal impact of GDM on their lives. Some women did experience a bigger emotional and practical impact. Knowledge and understanding of T2DM was poor in general and many women were unconcerned about their future risk. Lower concern appeared to be linked to lower perceived impact of GDM. Lifestyle changes discussed by women mostly related to diet and were motivated primarily by concern for their baby’s health. Many women did not maintain these changes postnatally, reporting significant barriers.  Conclusions: This study has suggested potential avenues to be explored in terms of content, timing and potential recipients of interventions. Educational interventions postnatally could address illness perceptions in women with GDM and redress the situation where lack of aftercare downplays its seriousness. For lifestyle interventions, the child’s health could be used as a motivator within the context of a joint or family intervention later on

Steady and delayed: explaining the different development of meta-ethnography in health care and education

Since its inception in the 1980s, the meta-ethnography approach for synthesising qualitative study accounts has been used extensively in health and social care research and to a lesser extent in educational research. The aim of this article is to reflect on the evolution of the method in both fields. It starts by describing the meta-ethnography approach, charts the rise of evidence-based research in health-related research, and explores the growth in the rate of published health-related meta-ethnographies. It proceeds by offering some explanation for the slower growth in the use of meta-ethnography in educational research. It explains this using the history of the early developments of qualitative approaches in Education and their underpinning paradigms. It then discusses key meta-ethnographies conducted in education, comparing those to more recent ones, in terms of methodological development. The article concludes by drawing lessons about how the conduct of meta-ethnography may be improved in any discipline

Prevalence of impaired glucose regulation in Europe: a meta-analysis

Background: Impaired glucose regulation represents an opportunity to prevent Type 2 diabetes mellitus. It is important to have a clear understanding of the prevalence of this condition in order to be able to plan interventions and health care provision. This paper presents a meta-analysis of literature assessing the prevalence of impaired glucose regulation in the general population of developed countries in Europe. Methods: Five electronic databases were systematically searched in March 2014 to identify English language articles with general population samples aged 18 and over from developed countries in Europe. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. Results: A total of 5594 abstracts were screened, with 46 studies included in the review. Overall prevalence of impaired glucose regulation was 22.3%. Mean prevalence of impaired glucose tolerance was 11.4% (10.1–12.8) and did not differ by gender. Sample age, diagnostic criteria and country were found to have a significant univariate effect on prevalence of impaired glucose tolerance but only diagnostic criteria remained significant in multivariate analysis. Mean prevalence of impaired fasting glucose was significantly higher in men at 10.1% (7.9–12.7) compared with 5.9% in women (4–8.7). The only moderator variable with a significant effect on impaired fasting glucose prevalence was country. Conclusions: This meta-analysis shows a moderate prevalence of impaired glucose regulation in developed Europe with over one in five people meeting the criteria for either impaired glucose tolerance, impaired fasting glucose or both

Modelling the Multi in Multi-Party Communication

This thesis investigates the effects of multimedia communications technology on the interaction of mixed- and same-role groups. The first study explores the effect of video and audio conferencing on small, role-differentiated problem-solving groups in the laboratory. The second laboratory study examines the impact of shared video technology on the communication of role-undifferentiated groups. A multi-faceted analytical approach is employed, including indices of task performance, process and content of communication, patterns of interaction and subjective user evaluations. Lastly, a field study looks at how the communication process of business meetings is affected by status constraints and audio conferencing technology. The findings show that both multimedia video and audio communications technology have similar impacts on the patterns of speaker contributions in different types and sizes of groups, and that the extent of their effect is influenced by the presence or absence of role differences between group members - whether experimentally manipulated in the laboratory or organisationally assigned roles in a naturalistic setting. Technology-mediation appears to exaggerate the impact of status and role such that group members say more disparate amounts and interact less freely than in face-to-face groups, in particular it exaggerates the dominance of one individual. Surprisingly, multimedia conferencing technology can support free and equal participation in groups whose speakers have similar roles but evidence of its effect on speakers of similar status is equivocal. The implications for communication outcome and design of communications technology are discussed

Caractérisation et évaluation in vitro de l’effet antifalcimiant des graines de Cajanus cajan (Fabacées) sur les drépanocytes à Abidjan - Côte d’Ivoire

La drépanocytose est une maladie génétique qui constitue un problème de santé publique en Côte d’Ivoire. Etant donné les coûts onéreux du traitement, les patients s’orientent vers la médecine traditionnelle avec l’utilisation de plantes, parmi lesquelles Cajanus cajan. L’objectif de ce travail était de réaliser une étude phytochimique et d’évaluer in vitro l’effet antifalcimiant des graines de Cajanus cajan. Cette étude expérimentale s’est effectuée en deux phases : une première consacrée à la caractérisation des graines et l’autre concernait l’étude de l’activité antifalcimiante in vitro de ces graines. L’étude de l’activité antifalcimiante s’est faite sur les prélèvements sanguins de 30 drépanocytaires homozygotes SSFA2. Après induction de la falciformation des globules rouges, l’ajout de l’extrait aqueux de la plante a permis d’évaluer l’activité antifalcimiante par la recherche des drépanocytes au microscope optique. Les graines de Cajanus cajan contiennent des stérols, polyterpènes, polyphénols, des flavonoïdes, des tanins et des alcaloïdes. Elles sont dépourvues de toute toxicité aigüe. L’extrait aqueux diminuait le taux de drépanocytes d’environ 50% après 30 mn de contact. Cette étude a permis de montrer que les graines de Cajanus cajan possèdent des vertus antifalcimiantes.© 2015 International Formulae Group. All rights reserved.Mots clés: Cajanus cajan, phytochimie, activité antifalcimiante, drépanocytose, AbidjanEnglish Title: Characterization and in vitro evaluation of the antisickling effect of the seeds of Cajanus cajan (Fabaceae) on sickle cells in Abidjan - Côte d’IvoireEnglish AbstractSickle cell anemia is a genetic disease that constitutes a public health problem in Côte d'Ivoire. Given the high cost of treatment, patients in Africa turn to traditional medicine with the use of plants, including  Cajanus cajan. The objective of this work was to make a phytochemical study and to evaluate in vitro the antisickling effect of seeds of Cajanus cajan. This experimental study was carried out in two phases: the first was devoted to the characterization of the seeds and the other concerned the study of the in vitro antisickling activity of these seeds. The study was done on the blood samples of 30 SSFA2 homozygote patients with sickle cell anemia. After induction of the sickling of red blood cells, the addition of the aqueous extract of the plant allowed the evaluation of the antisickling activity by the search for sickle cells under an optical microscope. Cajanus cajan seeds contain sterols, polyterpenes, polyphenols, flavonoids, tannins and alkaloids. They are without any acute toxicity. The aqueous extract reduced the rate of sickle cells of about 50% after 30 min of contact. This study made it possible to show that the seeds of Cajanus cajan have antisickling virtues.© 2015 International Formulae Group. All rights reserved.Keywords: Cajanus cajan, phytochemical, antisickling activity, sickle cell anemia, Abidja

Short-stay urgent hospital admissions of children with convulsions:A mixed methods exploratory study to inform out of hospital care pathways

Objective To inform interventions focused on safely reducing urgent paediatric short stay admissions (SSAs) for convulsions. Methods Routinely acquired administrative data from hospital admissions in Scotland between 2015- 2017 investigated characteristics of unscheduled SSAs (an urgent admission where admission and discharge occur on the same day) for a diagnosis of febrile and/or afebrile convulsions. Semi-structured interviews to explore perspectives of health professionals (n = 19) making referral or admission decisions about convulsions were undertaken. Interpretation of mixed methods findings was complemented by interviews with four parents with experience of unscheduled SSAs of children with convulsion. Results Most SSAs for convulsions present initially at hospital emergency departments (ED). In a subset of 10,588 (11%) of all cause SSAs with linked general practice data available, 72 (37%) children with a convulsion contacted both the GP and ED pre-admission. Within 30 days of discharge, 10% (n = 141) of children admitted with afebrile convulsions had been readmitted to hospital with a further convulsion. Interview data suggest that panic and anxiety, through fear that the situation is life threatening, was a primary factor driving hospital attendance and admission. Lengthy waits to speak to appropriate professionals exacerbate parental anxiety and can trigger direct attendance at ED, whereas some children with complex needs had direct access to convulsion professionals. Conclusions SSAs for convulsions are different to SSAs for other conditions and our findings could inform new efficient convulsion-specific pre and post hospital pathways designed to improve family experiences and reduce admissions and readmissions.</p

The existence and importance of patients’ mental images of their head and neck cancer:A qualitative study

This study was supported by the Chief Scientist Office Scotland, grant number: CZS/1/48, URL http://www.cso.scot.nhs.uk/.OBJECTIVES: To explore the existence and importance of mental images of cancer among people with head and neck cancers with a focus on the perceived origins and meaning of mental images, their development over time, and their relationship to illness beliefs. METHODS: A longitudinal qualitative study consisting of 44 in-depth semi-structured interviews with 25 consecutive, newly-diagnosed head and neck cancer patients. Participants were invited to draw their images during the interviews. Follow-up interviews occurred after treatment completion. Analysis drew upon the principles of Interpretative Phenomenological Analysis (IPA). RESULTS: Many participants had mental images of their cancer which appeared to both embody and influence their beliefs about their illness, and affect their emotional response. For those who held them, mental images appeared to constitute an important part of their cognitive representation (understanding) of their illness. For some, their images also had a powerful emotional impact, being either reassuring or frightening. Images often appeared to originate from early clinical encounters, and remained fairly stable throughout treatment. Images could be conceptualised as 'concrete' (the perceived reality) and/or 'similic' (figurative). Patients' images reflected the perceived meaning, properties or 'intent' of the cancer-that is beliefs concerning the disease's identity, consequences and prognosis (likelihood of cure or control). CONCLUSIONS: People with head and neck cancer may develop a mental image of their disease, often generated early within clinical encounters, which can both reflect and influence their understanding of the cancer. Such images tend to be stable over time. We theorise that careful use of images in early consultations could avoid or minimise some distress, including fears of outcome or recurrence. Concrete or similic images and language could be employed later to change perceptions and reduce distress.Publisher PDFPeer reviewe

Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK : a mixed-methods study

Acknowledgments Amy Woodhouse of Children in Scotland registered charity critically reviewed and commented on drafts of this manuscript. We are grateful for Dave Kelly at Albasoft for providing primary care data. We are grateful to Rebecca Fairnie at Electronic Data Research and Innovation Service for managing our access to all data. The authors would like to extend our thanks to the parents and health professionals who participated in this study, and to the stakeholders who participated in both public and patient involvement activities and the engagement and prioritisation event. Funding :This work was supported by the Chief Scientist Office of the Scottish Government, grant number HIPS/18/09Peer reviewedPublisher PD

Regional variations in short stay urgent paediatric hospital admissions : a sequential mixed-methods approach exploring differences through data linkage and qualitative interviews

Acknowledgments We are grateful to Nobel Yuen and Michelle Chan for their help in calculating distance to hospital and to all the parents and NHS staff who participated Funding This work was supported by Chief Scientific Officer grant number HIPS 18-09Peer reviewedPublisher PD

Insights from and limitations of data linkage studies : analysis of short stay urgent admission referral source from routinely collected Scottish data

ACKNOWLEDGEMENTS The study was funded by the Chief Scientist Officer (HIPS/18/09). We are grateful for Dave Kelly at Albasoft for providing primary care data. We are grateful to Rebecca Fairnie at Electronic Data Research and Innovation Service for managing our access to all data.Peer reviewedPostprin