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Multiple and Fluid Positionalities in Community Research With Socially Excluded Families: A Case for Reflexive Sociology
No full textIntersectionality and positionality are critical issues to consider in community research. Drawing on ten years of research in white, working-class communities in Northwestern England (WILSON, 2024a), I present a critical reflection on the temporal and structural dimensions of positionality through the application of reflexive sociology (BOURDIEU & WACQUANT, 1992). Focusing specifically on my maternal positionality and my journey from being a childless researcher into that of a mother, I attempt to articulate the complex task of negotiating the intersectionalities of class, gender and motherhood in community research in areas experiencing economic disadvantage. The centrality of relational practice is highlighted as key in overcoming potential conflicts or discrepancies in identities or positionalities, thus helping to build trust in the research context
Comparison of hyperbolic embedding methods for Autonomous Systems (AS) networks: machine learning versus network science
No full textHyperbolic space has emerged as a powerful framework for representing complex networks due to its ability to capture hierarchical and scale-free structures. In this work, we perform a comparative analysis of three representative hyperbolic embedding methods—Poincaré, Lorentz, and D-Mercator—on a real-world dataset: the Autonomous System (AS) Internet topology. While Poincaré and Lorentz are rooted in machine learning-based optimization, D-Mercator is derived from network science principles and provides interpretable parameters such as node popularity and similarity. We evaluate these methods using three complementary tasks: greedy routing, missing link prediction, and embedding correlation analysis. Our results show that Lorentz consistently achieves the best performance in greedy routing and ROC-based link prediction, while D-Mercator outperforms others in precision-recall evaluation. Furthermore, correlation analyses reveal strong agreement between Poincaré and Lorentz embeddings, especially for high-degree nodes, while D-Mercator produces significantly different distance structures, indicating a distinct geometric interpretation of the same network. These findings highlight the trade-offs between machine-learning-based and algorithmic hyperbolic embeddings in terms of overall accuracy, interpretability, and task-specific performance
Birth Plans: An opportunity for women to be autonomous, seek choice and feel in control of their childbirth experiences: an integrative literature review
No full textOverview:
Birth plans are tools to facilitate women to write down, negotiate and communicate their needs. Birth plans help women to participate in informed decision-making and maintain control in their childbirth experience. The World Health Organisation (WHO), goes on to classify the use of birth plans in the top category of recommended practices for making pregnancy safer. However, despite such recommendations, there seems to be a lack of consensus on the impact of birth plans on womens physical and psychological outcomes of childbirth.
Aims and Objectives:
The aim of this review was to collect, analyse and summarise results of studies that might indicate that the formulation of a birth plan in the antenatal period can potentially empower women to feel autonomous, in control and thus able to participate in shared decision-making during childbirth.
Method:
Guided by the inclusion and exclusion criteria, a comprehensive literature review was carried out involving 15 primary literature. The selected studies were critically analysed using specific critical appraisal tools with the aim to answer the research question.
Results:
Findings from this review were drawn from the 2,078 participants of which 1,231 were primiparous and 621 were multiparous. No details on parity was given on the remaining 226 participants. Two themes emerged: Theme One of the experiences of completing a birth plan with 4 further sub-themes: maternity care system, multidisciplinary team relationship and philosophy of birth, personal education and preparedness and feeling of empowerment and control. Theme Two- the experiences of using a birth plan in labour with 3 further sub-themes: health professionals mindfulness to womens birth plan, implementing the birth plan during labour and healthcare professional attitude towards the birth plan. Findings from this review suggests that the potential positive outcomes of completing a birth plan antenatally might not match the outcomes of women using a birth plan in labour. One might say that there could be is a gap between what the birth plan is meant to be offering women (a sense of empowerment and feeling of control enabling them to participate in decision-making) and what in effect they are might experiencing (a secondary effect of negative emotions circling around unrealistic expectations, disappointment and dissatisfaction with their experience).
Conclusion:
There is reason to believe that birth plans are not limited to midwifery practice alone but are in fact becoming common occurrence in obstetric care. Hence, rather than being the exception, there is evidence to suggest incorporating the birth plan as part of the woman’s maternity care. This review reinforces findings of other studies in that even when birth events do not go according to the birth plan, because women are given the opportunity to negotiate changes to their birth plan and voice their needs, regardless of the birth outcome women will recall a positive birth experience. This review proposes further research on midwives and obstetricians’ views on the concept of the birth plan, and highlights the need to organised Continuous Professional Development (CPD) study days for all maternity care providers on the use and importance of birth plans to help disseminate and bridge the gap between misconception and evidence-based practice
O-18 Design with us, not for us: motivations and challenges of digital technology use in palliative care from the patient’s perspective
No full textBackground Digital technologies are increasingly present in palliative care, yet there is limited understanding about how patients experience, value, or avoid them. The voices of patients, who often face physical, emotional, and cognitive challenges, are frequently under-represented in decisions about how these tools are selected, designed and implemented.
Aim To explore the motivations and challenges for digital technology use in palliative care from the perspective of patients, including ideas for innovation, grounded in lived experiences.
Method Semi-structured interviews (n=20) were conducted with multiple stakeholders including patients receiving in-patient and community-based palliative care at a hospice in North West England. A hybrid inductive and deductive thematic analysis was applied, resulting in eleven overarching themes, including ethics, technology implementation and physical needs.
Results Patients described using a range of technologies from Virtual Reality (VR), and WhatsApp to iPads and mobile phones. VR was described by one patient as profoundly meaningful, allowing them to experience a mountain walk from the hospice bed. When technology did not meet their needs, however, it became burdensome, one patient reporting that using an iPad in bed was difficult because of physical constraints. Technology innovation ideas included a desire for a virtual hospice linked to patients’ smart televisions at home, to provide remote care and support. Pain and symptom management remained a priority, with ideas including apps for tracking and communicating symptoms. Findings show that although patients had mixed digital confidence, many saw value in technology when it offered reassurance, reduced isolation, or supported care.
Conclusion Patients did not reject technology, they asked for it to be easy and meaningful. Listening to what matters to patients should inform how we design with them, not just for them. Their experiences are not just stories; they are evidence to guide more usable and inclusive digital technologies in palliative care
Organising maternal and newborn care in high-income countries: a scoping review of organisational elements and their association with outcomes
No full textIntroduction
Countries face challenges in maternal and newborn care (MNC) regarding costs, workforce and sustainability. Organising integrated care is increasingly seen as a way to address these challenges. The evidence on the optimal organisation of integrated MNC in order to improve outcomes is limited.
Objectives
(1) To study associations between organisational elements of integrated care and maternal and neonatal health outcomes, experiences of women and professionals, healthcare costs and care processes and (2) to examine how the different dimensions of integrated care, as defined by the Rainbow Model of Integrated Care, are reflected in the literature addressing these organisational elements.
Results
We included 288 papers and identified 23 organisational elements, grouped into 6 categories: personal continuity of care; interventions to improve interdisciplinary collaboration and coordination; care by a midwife; alternative payment models (non-fee-for-service); place of birth outside the obstetric unit and woman-centred care. Personal continuity, care by a midwife and births outside obstetric units were most consistently associated with improved maternal and newborn outcomes, positive experiences for women and professionals and potential cost savings, particularly where well-coordinated multidisciplinary care was established. Positive professional experiences of collaboration depended on clear roles, mutual trust and respectful interdisciplinary behaviour. Evidence on collaboration interventions and alternative payment models was inconclusive. Most studies emphasised clinical and professional aspects rather than organisational integration, with implementation barriers linked to prevailing biomedical system orientations.
Conclusions
Although the literature provides substantial evidence of organisational elements that contribute to improved outcomes, a significant gap remains in understanding how to overcome the barriers in sustainable implementation of these elements within healthcare systems. Interpreted through a systems and transition science lens, these findings suggest that strengthening integrated maternity care requires system-level changes aligning with WHO policy directions towards midwifery models of person-centred care
A multifrequency study of sub-parsec jets with the Event Horizon Telescope
Get PDFContext. The 2017 observing campaign of the Event Horizon Telescope (EHT) delivered the first very long baseline interferometry (VLBI) images at the observing frequency of 230 GHz, leading to a number of unique studies on black holes and relativistic jets from active galactic nuclei (AGN). In total, eighteen sources were observed, including the main science targets, Sgr A* and M 87, and various calibrators. Sixteen sources were AGN.
Aims. We investigated the morphology of the sixteen AGN in the EHT 2017 data set, focusing on the properties of the VLBI cores: size, flux density, and brightness temperature. We studied their dependence on the observing frequency in order to compare it with the Blandford-Königl (BK) jet model. In particular, we aimed to study the signatures of jet acceleration and magnetic energy conversion.
Methods. We modeled the source structure of seven AGN in the EHT 2017 data set using linearly polarized circular Gaussian components (1749+096, 1055+018, BL Lac, J0132–1654, J0006–0623, CTA 102, and 3C 454.3) and collected results for the other nine AGN from dedicated EHT publications, complemented by lower frequency data in the 2–86 GHz range. Combining these data into a multifrequency EHT+ data set, we studied the dependences of the VLBI core component flux density, size, and brightness temperature on the frequency measured in the AGN host frame (and hence on the distance from the central black hole), characterizing them with power law fits. We compared the observations with the BK jet model and estimated the magnetic field strength dependence on the distance from the central black hole.
Results. Our observations spanning event horizon to parsec scales indicate a deviation from the standard BK model, particularly in the decrease of the brightness temperature with the observing frequency. Only some of the discrepancies may be alleviated by tweaking the model parameters or the jet collimation profile. Either bulk acceleration of the jet material, energy transfer from the magnetic field to the particles, or both are required to explain the observations. For our sample, we estimate a general radial dependence of the Doppler factor δ ∝ r≤0.5. This interpretation is consistent with a magnetically accelerated sub-parsec jet. We also estimate a steep decrease of the magnetic field strength with radius B ∝ r−3, hinting at jet acceleration or efficient magnetic energy dissipation
Augmenting Secondary Intention Healing in Dermatologic Surgery Through Low-Cost Interventions.
No full textThe Relationship Between Distractibility, Insight Problem-Solving & Working Memory Capacity
Get PDFThe current study was an exploratory piece of research to investigate the relationship between Distractibility, Working Memory Capacity (WMC) and insight problem-solving. There were three main aims of the study. Firstly, the present study aimed to determine whether distractibility predicts insight problem-solving. Secondly, this research aimed to determine whether WMC predicts distractibility. Finally, to determine whether WMC predicts performance on insight problem-solving tasks. A total of 59 participants completed an online study deployed via Qualtrics experimental survey software and comprised of three parts. Firstly, a typical digit serial recall task was employed to test distractibility. Also, to test insight problem solving, the study employed both Compound Remote Associate Tasks (CRATs) and Rebus Puzzles. Finally, two working memory span tasks, Symmetry Span and Operation Span, were employed to measure visuo-spatial and verbal WMC.
The present study aimed to determine whether distractibility predicts insight problem-solving. A relationship was discovered between the number of correct answers given and time taken to solve visual and pictorial problem-solving tasks and distractibility by meaningless speech. Also, it was found distractibility by meaningless speech predicts the number of correct answers given to visual and pictorial problem-solving tasks, and the time taken to solve pictorial problem-solving tasks. Furthermore, a relationship was revealed between the number of correct answers given to visual and pictorial problem-solving tasks and distractibility for meaningful speech. Finally, it was shown that distractibility for meaningful speech predicts the number of correct answers given to visual problem-solving tasks.
Secondly, the current study aimed to determine whether WMC predicts distractibility. A relationship was discovered between a domain-general or domain-specific representational system of verbal and visuo-spatial WMC and one been less distracted by meaningful and meaningless speech.
Finally, the present study aimed to investigate whether WMC predicts insight problem-solving. It was discovered verbal WMC in a domain-specific representational system, and a combination of verbal and visuo-spatial WMC in a domain-general representational system predicts the time taken to solve difficult pictorial problem-solving tasks. Also, a relationship was revealed between verbal WMC been a domain-specific representational system and the time taken to solve visual pictorial problem-solving tasks. Additionally, a relationship was discovered between visuo-spatial WMC been a domain-specific representational system, and the time-taken to solve word pictorial problem-solving tasks. Furthermore, a relationship was shown between visuo-spatial WMC been a domain-specific representational system, and the number of correct answers given to easy word pictorial problem-solving tasks, and the time taken to solve difficult word pictorial problem-solving tasks. Finally, it was revealed verbal WMC in a domain-general representational
system, and verbal and visuo-spatial WMC in a domain-specific representational system predicts the time taken to solve difficult word pictorial problem-solving tasks
Improving sustainability and reducing waste in operating theatres: A snapshot quality improvement project on waste disposal adherence in operating theatres.
Get PDFBackground: Appropriate disposal of clinical waste is critical for ensuring safety, reducing environmental impact and lowering incineration costs. From 2018-2021 it is estimated that East Lancashire Hospital NHS Trust (ELHT) spent ~£100-150,000 on incineration of clinical waste, with incineration costing £535 per tonne. Despite the availability of six specialised waste streams in operating theatres, there are concerns of incorrect waste disposal. Contamination of recyclable streams leads to unnecessary incineration, further increasing CO2 emissions and disposal costs. This study aimed to identify common errors in waste segregation to align with the Greener NHS programme goal of a carbon-neutral NHS by 2040.
Methods: Photographs of cytotoxic/cytostatic drug waste, sharps bins, clinical waste bins and domestic/non-clinical waste bins were taken at 11 theatres over four weeks. These photographs were compared to ELHT’s standard operating procedures to identify disposal errors. Exclusion criteria including duplicate and blurry images were applied.
Results: Sharps bins had the highest contamination rate, with >90% of waste incorrectly disposed. Cytotoxic/cytostatic waste streams followed, with almost 80% of waste incorrectly disposed. Both clinical waste and pharmaceutical waste streams showed similar contamination rates of around 46%. Recyclable waste bins had a >38% rate of incorrect disposal.
Discussion: These results highlight major missed opportunities to recycle and numerous instances of waste being unnecessarily incinerated. Correct disposal of these items would result in a tangible reduction in CO2 emissions and disposal costs. Targeted interventions, such as staff education and improved signage, are essential to address these issues
