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Exploring Newly Qualified Midwives’ Lived Experiences of Out-of-Hospital Births Through Voice Messaging and Interviews
Get PDFWhen newly qualified midwives in Germany commence work in free-standing birth centres, a setting dissimilar to the hospitals where they trained, they undergo a period of orientation in which they must broaden their skills and knowledge. Using a hermeneutic phenomenological framework, this study explored their skill and knowledge acquisition in the first 9–12 months using two methods of data collection—voice messaging and interviews. As there appeared to be important differences in what was shared using these different methods of data collection, further analysis was undertaken. This paper presents a secondary analysis of a larger study on the training of newly qualified midwives in out-of-hospital birth settings. In this secondary analysis, the aims were (a) to compare and identify distinct aspects of the same lived experience as they were revealed in different forms of data collection; and (b) to draw on philosophical inquiry to deepen our understanding of professional learning and identity formation for newly qualified midwives. Participants included fifteen newly qualified midwives who were each interviewed three times in their first year working in a free-standing birth centre. In addition to this, they also left a total of 123 voice messages, in which they shared emotionally profound experiences. Data analysis focused on exploring the similarities and differences of the same stories of attending a birth told through voice messaging close to the actual experience and again in an in-person interview up to several months later. Voice messaging captured immediate, visceral reactions. The unstructured interviews revealed reflective, contextualised perspectives, bringing social, environmental, and wider contextual factors into view. Together, these findings show how temporality and data collection method shape the disclosure of meaning in lived experience and illustrate the value of using multiple methods to expand interpretive depth in hermeneutic phenomenological inquiry. This research advances hermeneutic phenomenological research methods by demonstrating that multiple methods of data collection can provide distinct layers of meaning in lived experience accounts
Co-constructing safety: how air traffic controllers change goals from efficiency to safety
Get PDFWhile relatively rare, air traffic control (ATC) loss of control incidents have the potential to lead to accidents with major loss of life. In such situations, controllers need to rapidly transition from efficiency to safety as the primary goal of the operation. To date, there has been relatively little investigation of how controllers collaboratively manage these goal changes (known as co-construction) in time critical safety compromised events. This paper examines whether co-construction occurs in real-time ATC collaboration and, if it does, identifies the different forms it takes and how efficiently it is conducted. 27 ATC incident occurrence reports from a major air navigation service provider that concerned a loss of separation, runway incursion, or loss of separation assurance were analysed. Each occurrence report was coded for the sequence of actions, plans, and goals, and the point at which co-construction occurred was identified. Co-constructive interactions were then classified as optimal or sub-optimal. A bottom-up thematic analysis identified characteristics of optimal and sub-optimal interactions. The analysis revealed 27 instances of co-construction. These instances of co-construction could be categorized into one of three types: Type 1 (communication about a primary goal change, N = 1), Type 2 (plan changes indexing a new primary goal, N = 13), and Type 3 (actions indexing a new plan and primary goal, N = 13). The data analysis showed that nearly half of the co-constructive interactions were suboptimal in terms of communicative efficiency. The findings suggest that controllers infer goal changes from plans and actions rather than explicitly communicating them. This lack of explicit co-construction is concerning because goal changes (e.g., prioritizing safety over efficiency) often indicate a critical system state. To enhance co-construction, we propose a formal communicative structure. This structure can be used to enhance compromised separation training, supplement occurrence investigations, and enhance future system enhancement initiatives
Does Information Communication Technology facilitate or solve crime? Exploring the experience of law enforcement practitioners in three countries
Get PDFPurpose (limit 100 words) The frequency, harm and reach of transnational serious organised crime (SOC) is increasing. This study examines how Information Communication Technology (ICT) has facilitated this type of crime and has been used by law enforcement agencies to tackle it. Design/methodology/approach (limit 100 words) 62 law enforcement practitioners, from the UK, Australia and New Zealand, who had experience of tackling SOC through intelligence-led approaches were interviewed. Following thematic analysis of the semi-structured interviews four themes were highlighted. Findings (limit 100 words) The study found a high degree of practitioner consensus across the UK, Australia and New Zealand on four points. First, SOC had become more transnational, significantly increasing in frequency and diversity. Second, this trajectory had been facilitated using ICT. Third, law enforcement practitioners were using ICT to improve the detection and disruption of SOC offenders. Finally, the potential of ICT was not being maximised by law enforcement as practice continued to rely heavily on manual processes and human relationships. The reasons behind this trend were explored. Originality/value (limit 100 words) It is the first to show law enforcement agencies across three countries share similar organisational and individual behaviour concerning information management practice when engaged on intelligence-led approaches. It suggests new ways to enhance effectiveness and efficiency of approach
RETRACTED: Grebenar (2024). Building the Virtual Dancefloor: Delivering and Experiencing House Music Events in the Time of COVID-19. Tourism and Hospitality, 5(1), 32–50
Get PDFA narrative inquiry of men’s perceptions of support and masculinity: semi-structured interviews of men living with non-cancer-related lymphoedema in the United Kingdom
Get PDFBackground:
Lymphoedema, a chronic and visible condition, can significantly impact men’s perception of support and masculinity. The absence of research in this area, along with increased interest in men’s health, led to this study, which explores men’s perceptions of support and their sense of masculinity while living with lymphoedema.
Method:
This qualitative study used narrative inquiry with 12 participants through online semi-structured interviews (45–90 minutes) via Zoom. Data were analysed using linguistic narrative analysis, focusing on hegemonic masculinity and the Health, Illness, Men and Masculinities (HIMM) framework.
Results:
The analysis revealed three main themes. All men perceived disruption following their initial diagnosis of lymphoedema, exacerbated by limited support, such as peer support groups and timely information. They then adapted and managed changes in their lives and masculinity using available behaviours and resources, such as gaining expertise and depending on partners. Their perception of masculinity evolved, incorporating their past masculine baseline with present and future expectations.
Discussion:
Findings suggest that hegemonic masculinity persists amid multiple masculinities disrupted by chronic conditions like lymphoedema. Some men uphold traditional masculinity, whereas others adapt their expressions of masculinity. Recognising lymphoedema’s impact on health and masculinity could inform more tailored approaches in services, policies and strategies
An S-shaped Filament Formed Due to Cloud–Cloud Collision in Molecular Cloud G178.28-00.61
Get PDFWe present compelling observational evidence supporting G178.28-00.61 as an early-stage candidate for cloud–cloud collision (CCC), with indications of the formation of an S-shaped filament, evenly separated dense cores, and young star clusters. The observations of CO molecular line emission demonstrate the existence of two interacting molecular clouds with systemic velocities of 0.8 km s−1 and −1.2 km s−1, respectively. The convergence zone of these two clouds reveals an S-shaped filament in the James Clerk Maxwell Telescope 850 μm continuum image, suggesting cloud interaction. In line with expectations from CCC simulations, broad bridging features are discernible in the position–velocity diagrams. An elevated concentration of identified Class I and II young stellar objects along the filament at the intersection area further supports the hypothesis of a collision-induced origin. This observation could be explained by a recent MHD model of CCC, which predicts a similar morphology, scale, density, and unbound status, as well as the orientation of the polarization
Editorial: Genetic and environmental interactions in oral disease: advancing diagnostic and therapeutic strategies
Get PDFService delivery, behavioural, and self-management interventions for adults with epilepsy
No full textBackground
Epilepsy is a common condition, affecting around 660 per 100,000 people worldwide. Despite treatment with anti‐seizure medications, one‐third of people do not achieve seizure control. There is a need to focus on models of service delivery and therapies that target cognitive, psychological, and behavioural aspects to improve seizure control and quality of life.
Objectives
To assess the effects of service delivery, behavioural, and self‐management inventions on seizure control and health‐related quality of life in adults with epilepsy.
Search methods
We used the Cochrane Register of Studies, MEDLINE, and two other databases, together with reference checking and contact with study authors, to identify the studies included in the review. The latest search date was 21 August 2023.
Selection criteria
We included randomised controlled trials (RCTs) or quasi‐RCTs of any design (double/single‐blinded, unblinded; parallel, cross‐over, or cluster) involving participants with a mean age of 16 or older. Eligible interventions included behavioural, self‐management, or service‐delivery approaches. Behavioural and self‐management interventions had to report seizure control as an outcome.
Data collection and analysis
Our primary outcome was seizure frequency. Our secondary outcomes were: seizure severity, health‐related quality of life (HRQoL), medication usage, knowledge, general health, social and psychological function, and adverse events. We classified outcomes as short‐term (up to six months) or long‐term (over six months). At least two review authors independently screened all papers, extracted data, assessed the risk of bias, and analysed data. We used GRADE to assess the certainty of the evidence.
Main results
We included 36 studies with 5834 randomised participants. Twenty‐six studies included participants with a diagnosis of epilepsy, six studies included participants with severe or drug‐resistant epilepsy, and four studies included participants with epilepsy and another comorbidity, including depression, psychosocial problems, or learning disabilities. We rated 16 studies as having an overall low risk of bias, 11 studies as high risk, and nine studies with an unclear risk of bias. Twenty‐one studies were conducted in high‐income countries, seven in upper‐middle‐income countries, and eight in lower‐middle‐income countries. We categorised interventions into psycho‐behavioural, mind‐body, self‐management, physical exercise, nurse‐led service delivery, and other service delivery interventions.
Seizure frequency
Two studies showed that psycho‐behavioural interventions likely reduce seizure frequency at three to six months (mean seizure frequency reduction 4.42 per month, 95% confidence interval (CI) 6.41 per month lower to 2.43 per month lower; 64 participants; moderate‐certainty evidence). However, this intervention may not improve seizure frequency immediately post‐intervention.
Three studies showed that mind‐body interventions may reduce seizure frequency slightly at six to eight weeks (mean seizure frequency reduction 3.28 per month, 95% CI 6.36 per month lower to 0.20 per month lower; 148 participants; low‐certainty evidence). However, evidence from two studies suggests that such interventions have no effect on seizure control.
Evidence from three studies suggests that self‐management interventions may not reduce seizure frequency between 20 weeks and six months (mean seizure frequency was 1.61 per month higher, 95% CI 6.08 per month lower to 9.29 per month higher; 222 participants; low‐certainty evidence). However, three studies showed these interventions are likely to increase seizure freedom.
In the short term, the effect of physical exercise on seizure control is very uncertain. Evidence from one study suggests that a nurse‐led service delivery intervention does not improve seizure frequency. No data were available for other service‐based interventions.
The long‐term data (> six months) for psycho‐behavioural, self‐management, and service‐based interventions are limited. There are no long‐term data available for mind‐body, physical exercise, or nurse‐led service delivery interventions.
Health‐related quality of life
One study reported that psycho‐behavioural interventions likely result in no difference in Quality of Life in Epilepsy Inventory (QOLIE)‐10 total score at six months (mean total score was 0.89 higher, 95% CI 1.06 lower to 2.84 higher; 120 participants; moderate‐certainty evidence). Overall, there is very uncertain evidence of the short‐ and long‐term effect of psycho‐behavioural interventions on HRQoL outcomes.
One study showed that mind‐body interventions may result in no difference in QOLIE‐31‐P (31‐item questionnaire with patient‐weighted scoring system) total scores at six weeks (mean total score was 0.75 higher, 95% CI 5.49 lower to 6.99 higher; 60 participants; low‐certainty evidence).
Two studies showed that self‐management interventions probably do not improve the mean QOLIE‐31 or QOLIE‐31‐P total scores at six months (mean scores 2.42 higher, 95% CI 2.58 lower to 7.42 higher; 393 participants; moderate‐certainty evidence). However, one study showed that these interventions are likely to result in a slight improvement in QOLIE‐10 total scores. Four studies showed that this intervention probably does not improve HRQoL outcomes. We are very uncertain about the effect of this intervention on long‐term outcomes.
Three studies showed that physical exercise may result in no difference to HRQoL outcomes in the short term. Two studies showed that nurse‐led service delivery interventions probably do not improve outcomes in the short or long term. One study showed that a service delivery‐based intervention likely results in an improvement in HRQoL in the long term.
Other outcomes
Evidence for improvements in epilepsy knowledge, medication usage, general health, social and psychological function was very limited and showed no consistent differences between interventions and controls.
There were no reported adverse events related to the interventions.
Authors' conclusions
There is no high‐certainty evidence that service delivery, behavioural, and self‐management interventions improve seizure control or quality of life outcomes for adults with epilepsy. There were wide variations in the size of the effect estimate, depending on how outcomes were measured. Furthermore, there was significant clinical heterogeneity amongst the populations studied, types of interventions delivered, study setting, and study design, which limit interpretation of the currently available evidence and its overall applicability. Further research is needed from well‐designed studies using validated measures to assess long‐term improvement in outcomes important to adults with epilepsy
Changing tastes: A review of Later Prehistoric and Norse-period marine mollusc exploitation in Scotland's Western Isles
Get PDFThis paper examines the exploitation of marine molluscs in the Western Isles of Scotland, from the Bronze Age to Norse periods (2500 BCE - 1266 CE). Through analysis of shell assemblages from thirteen archaeological sites, we investigate changing shellfish exploitation practices across time and space. We consider whether these variations reflect
cultural preferences, local availability and environments, or evidence of unsustainable harvesting practices. The research examines not only dietary contributions but also explores potential non-food uses of shells, as well as providing insights into coastal environment exploitation. While limpets (Patella spp.) remained consistently important throughout much of prehistory, there was a notable shift toward periwinkles (Littorina littorea) beginning in the Late Iron Age and continuing into the Norse period. This transition appears to reflect a combination of cultural preferences and local ecological availability rather than simple resource depletion. The study highlights the value of standardized methodological approaches to shell analysis and the importance of considering individual and community agency in the interpretation of zooarchaeological assemblage
What are “dark kitchens”? A consensus definition from public, local authority, business and academic stakeholders in the United Kingdom
Get PDFBackground
“Dark kitchens” are an innovative and potentially disruptive addition to the global food environment with potential implications for policy, practice and public health. In the UK, dark kitchens currently represent approximately 15% of all food retailers across the three major online food delivery platforms in England (e.g., Just Eat, Deliveroo, Uber Eats), contributing significantly to the digital food environment. To date, dark kitchens have been poorly defined, under researched and their wider impact poorly understood.
Aim
Therefore, the aim of this work was to coproduce a consensus definition of dark kitchens to be used across multiple disciplines.
Methods
A series of consultations took place with stakeholders including consumers, local authority representatives, academics, dark kitchen employees and national governing bodies to understand knowledge and currently used definitions of dark kitchens. Mixed method approaches were used involving questionnaires, interviews, focus groups and workshops.
Results
The stakeholder consultation process provided a robust methodology through which a consensus definition of dark kitchens was agreed. Each project group provided a definition which was scribed and annotated to understand the key components of importance within the definitions, whilst additional and unique components were discussed and debated before being accepted or rejected. In addition, short- and long-term benefits of such a definition were outlined for all stakeholder groups. Following peer-review from local authority, industry and governing body stakeholders, a final definition was produced.
Conclusion
The adoption of a consensus definition of dark kitchens is pivotal to the cross-sectoral work and understanding of many stakeholder groups. The definition allows for transparency and improved communication between dark kitchen stakeholders and provides the opportunity to drive public health agendas at multiple points within the food system