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Key dimensions of women’s and their partners’ experiences of childbirth: a systematic review of reviews of qualitative studies
No full textBackgroundThe World Health Organization 2018 intrapartum guideline for a positive birth experience emphasized the importance of maternal emotional and psychological well-being during pregnancy and the need for safe childbirth. Today, in many countries birth is safe, yet many women report negative and traumatic birth experiences, with adverse effects on their and their families’ well-being. Many reviews have attempted to understand the complexity of women’s and their partners’ birth experience; however, it remains unclear what the key dimensions of the birth experience are.ObjectiveTo synthesize the information from reviews of qualitative studies on the experience of childbirth in order to identify key dimensions of women’s and their partners’ childbirth experience.MethodsSystematic database searches yielded 40 reviews, focusing either on general samples or on specific modes of birth or populations, altogether covering primary studies from over 35,000 women (and >1000 partners) in 81 countries. We appraised the reviews’ quality, extracted data and analysed it using thematic analysis.FindingsFour key dimensions of women’s and partners’ birth experience (covering ten subthemes), were identified: 1) Perceptions, including attitudes and beliefs; 2) Physical aspects, including birth environment and pain; 3) Emotional challenges; and 4) Relationships, with birth companions and interactions with healthcare professionals. In contrast with the comprehensive picture that arises from our synthesis, most reviews attended to only one or two of these dimensions.ConclusionsThe identified key dimensions bring to light the complexity and multidimensionality of the birth experience. Within each dimension, pathways leading towards negative and traumatic birth experiences as well as pathways leading to positive experiences become tangible. Identifying key dimensions of the birth experience may help inform education and research in the field of birth experiences and gives guidance to practitioners and policy makers on how to promote positive birth experiences for women and their partners.</p
Child sexual abuse and social identity loss: A qualitative analysis of survivors' public accounts
No full textEmerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma-related changes in their social identities. Analysis of these accounts high-lighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families.</p
Learning online and teaching face to face: exploring the planned and enacted conception of teaching of preservice teachers on school placement
No full textThis research delved into the experiences of a group of preservice teachers (PSTs) who were taught online and participated in teaching in person as part of their school placement. The study analysed the planning and reflection documents of 101 PSTs, as well as evaluations from their instructors, using a thematic and document analysis. The findings showed that PSTs exhibited strong planning abilities, and a solid understanding of teaching skills. However, these PSTs struggled in managing the classroom and individualising instruction. It is proposed that future teachers’ learning occurred through an ongoing process of construction and refinement across formal and informal educational settings, although the transfer of learning remains inconclusive. </p
Rethinking schools as a setting for physical activity promotion in the 21st century–a position paper of the working group of the 2PASS 4Health project
No full textSchools are ideal settings to promote adolescent physical activity (PA), yet school-based interventions have shown limited long-term impact. This position paper presents key issues surrounding school-based PA interventions. Collaborative conceptual thinking drawing on multi-author expertise and available evidence advanced our understanding and opinion. Key arguments: 1) the adoption of a systems approach, which maximizes partnership action and leverages policy, is crucial for understanding the complexities of implementing whole-school programs; 2) a reorientation to an assets perspective optimizes existing strengths and resources allowing greater emphasis on the full range of physical, cognitive, emotional and social benefits that PA provides, and 3) a move beyond traditional positivist research designs to advance our knowledge of what works better, for whom and in what context is needed for greater progress We provide suggestions, specifically advocating for systems approaches, as a realistic way to improve how we support PA in schools in the future.</p
Contribution of a C‑terminal extension to the substrate affinity and oligomeric stability of aldehyde dehydrogenase from thermus thermophilus HB27 item
No full textAldehyde dehydrogenase enzymes (ALDHs) are widely studied for their roles in disease propagation and cell metabolism. Their use in biocatalysis applications, for the conversion of aldehydes to carboxylic acids, has also been recognized. Understanding the structural features and functions of both prokaryotic and eukaryotic ALDHs is key to uncovering novel applications of the enzyme and probing its role in disease propagation. The thermostable enzyme ALDHTt originating fromThermus thermophilus, strain HB27, possesses a unique extension of its C-terminus, which has been evolutionarily excluded from mesophilic counterparts and other thermophilic enzymes in the same genus. In this work, the thermophilic adaptation is studied by the expression and optimized purification of mutant ALDHTt-508, with a 22-amino acid truncation of the C-terminus. The mutant shows increased activity throughout production compared to native ALDHTt, indicating an opening of the active site upon C-terminus truncation and giving rationale into the evolutionary exclusion of the C-terminal extension from similar thermophilic and mesophilic ALDH proteins. Additionally, the C-terminus is shown to play a role in controlling substrate specificity of native ALDH, particularly in excluding catalysis of certain large and certain aromatic ortho-substituted aldehydes, as well as modulating the protein’s pH tolerance by increasing surface charge. Dynamic light scattering and size-exclusion HPLC methods are used to show the role of the C-terminus in ALDHTt oligomeric stability at the cost of catalytic efficiency. Studying the aggregation rate of ALDHTt with and without a C-terminal extension leads to the conclusion that ALDHTt follows a monomolecular reaction aggregation mechanism.</p
Whole-body MRI screening for carriers of germline TP53 mutations—A systematic review and meta-analysis
No full textPurpose: This systematic review evaluated whole-body MRI (WB-MRI) as a cancer screening tool for individuals carrying germline TP53 mutations, a population known to be at a significantly elevated risk of malignancy. The primary objective is to assess the diagnostic performance of WB-MRI in detecting cancer in this cohort. Methods: PubMed, MEDLINE, EMBASE and the Cochrane Central Registry of Controlled Trials were searched until 18 August 2023. Eligible studies were selected based on predefined inclusion criteria. The data extracted included information on study characteristics, patient demographics, and the WB-MRI diagnostic performance. Results: This systematic review identified eight eligible studies, comprising 506 TP53 mutation carriers. The mean age was 34.6 ± 16.3 (range 1–74) years. In total, 321/506 (63.4%) of the patients were female and 185/506 (36.6%) were male. In addition, 267/506 (52.8%) had a previous oncological diagnosis. Thirty-six new cancers were diagnosed with WB-MRI (36/506 (7.1%)). The overall pooled proportion of cancer detected on MRI was 7% (95% confidence interval 5–10). In total, 44 new lesions were picked up, as multiple lesions were found in some patients. Conclusion: WB-MRI is an effective cancer screening tool for TP53 mutation carriers. While these findings suggest the potential for WB-MRI to contribute to early cancer detection in this high-risk population, further research and the standardisation of protocols internationally are warranted to optimise its clinical utility</p
Bridging the gap in antioxidant activity of flavonoids: Correlating the oxidation of human plasma with chemical and cellular assays
No full textTraditional antioxidant screening relies on chemical assays to assess compounds’ potential in combating oxidative processes. However, translating chemical antioxidant activity to complex biological systems poses challenges. In this study, the antioxidant potential of fruit-derived phenolic compounds, hyperoside (HP), epicatechin (EC), and phlorizin (PZ), and their combinations in a specific ratio were investigated using a simplex-centroid design of experiments. The research included in vitro antioxidant assays, plasma protection against oxidation tests, and cytotoxicity assessments in human cell lines. The results revealed the complex relationship between chemical antioxidant activity and its relevance to cellular oxidative and antioxidative processes. HP and EC exhibited significant antioxidant activity, with HP outperforming EC in multiple assessments. Cytotoxicity assay confirmed that these compounds did not induce cell death or hinder proliferation, even at higher concentrations (>100 μmol/mL). In the cell antioxidant activity (CAA) test, HP and EC exhibited higher CAA, while PZ displayed lower antioxidant activity. In conclusion, a synergistic effect emerged when HP, EC, and PZ were combined, particularly in plasma protection, suggesting protective effects and potential health benefits. This research emphasized the need for a nuanced understanding of the interplay between chemical assays and cellular behavior in comprehending the relationship between chemical-based, human plasma oxidation, and CAA.</p
Real-time TEM observation of the role of defects on nickel silicide propagation in silicon nanowires
No full textMetal silicides have received significant attention due to their high process compatibility, low resistivity, and structural stability. In nanowire (NW) form, they have been widely prepared using metal diffusion into preformed Si NWs, enabling compositionally controlled high-quality metal silicide nanostructures. However, unlocking the full potential of metal silicide NWs for next-generation nanodevices requires an increased level of mechanistic understanding of this diffusion-driven transformation. Herein, using in situ transmission electron microscopy (TEM), we investigated the defect-controlled silicide formation dynamics in one-dimensional NWs. A solution-based synthetic route was developed to form Si NWs anchored to Ni NW stems as an optimal platform for in situ TEM studies of metal silicide formation. Multiple in situ annealing experiments led to Ni diffusion from the Ni NW stem into the Si NW, forming a nickel silicide. We observed the dynamics of Ni propagation in straight and kinked Si NWs, with some regions of the NWs acting as Ni sinks. In NWs with high defect distribution, we obtained direct evidence of nonuniform Ni diffusion and silicide retardation. The findings of this study provide insights into metal diffusion and silicide formation in complex NW structures, which are crucial from fundamental and application perspectives.</p
Unleashing transformative potential of artificial intelligence (AI) in countering terrorism online radicalisation extremism and possible recruitment
No full textThis research explores the implications of Artificial Intelligence (AI) in deciphering the multifarious manifestations of online Radicalisation, Extremism, and possible recruitment. It analyses AI's capabilities in disseminating positive representations and counter-narratives, its instrumental role in analysing positive imagery, optimising platform reach, and its pivotal contribution to global efforts to combat online extremism. However, AI's dualistic nature underscores the need for its ethical and responsible utilisation to curb extremist content effectively. It necessitates the development of balanced,nuanced, and coherent approaches, amalgamating enhanced analytical paradigms, collaborative efforts, ethical frameworks, strategic insight, and diversified applications. The formulation of such multifaceted approaches and cohesive strategies is paramount in navigating the intricate terrains of online extremism and in enhancing societal resilience against the proliferation of extremist ideologies. The study concludes that the strategic and ethical deployment of AI technologies is pivotal in reshaping digital discourse and in the collective endeavour to counterbalance extremist ideologies.</p
Comprehensive geriatric assessment in the emergency department: a prospective cohort study of process, clinical, and patient-reported outcomes
No full textBackground: This study aimed to explore the process, clinical, and patient-reported outcomes of older adults who received an interdisciplinary Comprehensive Geriatric Assessment (CGA) in the emergency department (ED) over a six-month period after their initial ED attendance.Patients and Methods: A prospective cohort study recruited older adults aged ≥65 years who presented to the ED of a university teaching hospital in Ireland. Baseline assessment data comprising a battery of demographic variables and validated indices were obtained at the index ED attendance. Telephone interviews were completed with participants at 30- and 180-day follow-up. The primary outcome was incidence of hospital admission following the index ED attendance. Secondary outcomes included participant satisfaction, incidence of functional decline, health-related quality of life, incidence of unscheduled ED re-attendance(s), hospital (re) admission(s), nursing home admission, and death.Results: A total of 133 participants (mean age 82.43 years, standard deviation = 6.89 years; 71.4% female) were recruited; 21.8% of the cohort were admitted to hospital following the index ED attendance with a significant decline in function reported at hospital discharge (Z = 2.97, p = 0.003). Incidence of 30- and 180-day unscheduled ED re-attendance was 10.5% and 24.8%, respectively. The outcome at the index ED attendance was a significant predictor of adverse outcomes whereby those who were ischarged home had significantly lower odds of multiple adverse process outcomes at 30- and 180-day follow-up, and significantly higher function and health-related quality of life at 30-day follow-up.Conclusion: While this study was observational in nature, findings suggest CGA in the ED may improve outcomes by mitigating against the adverse effects of potentially avoidable hospital admissions and focusing on a longitudinal approach to healthcare delivery at the primary-secondary care interface. Future research should be underpinned by an experimental study design to address key limitations in this study.</p