OARS - Open Access Repository Suffolk
Not a member yet
2036 research outputs found
Sort by
UK midwives’ perspectives on the practice of intrapartum midwifery-led care within the hospital setting: a qualitative study
Get PDFBackground: Increasing intervention rates and decreasing physiological birth rates indicate the continuing medicalisation of childbirth in the United Kingdom (UK). This could reduce access to midwifery-led care, which adopts a ‘with woman’ approach, and support physiology. Medical care is associated with a decline in maternal and neonatal morbidity and mortality but can have significant consequences for physical and psychological health.
It is therefore imperative to understand the driving forces behind this trend.
Aims: This qualitative research sought to explore the extent to which midwives feel they can practise midwifery-led care and identify midwives’ perceived barriers and facilitators to providing midwifery-led care.
Methodology: Three focus groups were conducted with midwives from across the UK. One group was composed of midwives experienced on the obstetric-led unit (n=4); one group included midwives who worked in midwife-led units (n=4); and finally, there was a mixed group of midwives (n=6). Focus groups were conducted via Microsoft Teams, transcribed verbatim and analysed using thematic analysis.
Results: Participants identified a shift in midwifery practice, whereby obstetrics is playing an increasing role in maternity care. They perceived an erosion of midwifery practice, defined by a reduction in physiological practices and the promotion of women’s choice. This was attributed to numerous interconnected structural, cultural, and individual factors. These included but were not limited to: midwife mental health and a perceived lack of experience in promoting physiology; a shift in a perception of maternity care; a change in maternity culture; and the changing epidemiology of the birthing population.
Conclusion: This study concludes that the identified barriers and facilitators to midwifery led care require further exploration to address these issues within practice. As a key theme identified, methods to support midwives’ mental health should also be implemented. In addition, addressing staffing to reduce burnout, incorporating midwifery philosophy into training, developing antenatal and preconceptual education for women, and improving access to midwifery-led birthing units, have been identified as key recommendations from this study
Introduction
No full textIn this chapter, Introduction, John Pitts summarises the development of UK gangs and subsequent gang studies giving an overview of policy developments and contributions from authors
Post-cyclonic migration in coastal areas: an assessment of who, where, why migrates, and barriers to migration
No full textAs cyclones increase in frequency and severity, more people experience their adverse impacts. However, little is known about post-cyclonic migration patterns in coastal southern Bangladesh, a cyclone-prone area. This paper compares post-cyclonic migration patterns with non-cyclonic migration in terms of who migrates, where they migrate to, why they migrate, and the barriers to migration. 472 households across 16 blocks (moujas) were selected by stratified sampling. A survey collected individual and household-level information regarding demographics, socio-economy, and migration patterns in non-cyclonic and post-cyclonic situations. The analysis demonstrated that, in non-cyclonic situations, secure employment represented the migrants’ main livelihood while, following a cyclone, non-secure professions such as day-labouring were the most prevalent. The post-cyclonic migrants were, overall, less educated and less wealthy landless and marginal farm holders compared to those who migrated in the non-cyclonic period. Most people migrated to nearby districts following a cyclone, whereas long-distance migrations were found in non-cyclonic periods. We thus argue that, in a non-cyclonic period, people migrate for employment and are in a stronger position, socio-economically, than post-cyclonic migrants, while, in a post-cyclonic period, it is mainly socio-economically distressed people with non-secured day-labouring jobs who migrate a short distance area
Training load comparison between small, medium, and large-sided games in professional football
Get PDFThis study aimed to assess if internal and external load parameters were different between sided game formats, if players' positions influenced these parameters, and if load parameters were different among sided game types (from 2vs2 to 10vs10) in professional football players. Twenty-five male players of the same club were enrolled in this study (age = 27 ± 9 years and body mass = 78 ± 14 kg). Sided games were categorized in formats as small-sided games (SSG, n = 145), medium-sided games (MSG, n = 431), and large-sided games (LSG, n = 204). Players were divided into roles such as center backs (CB), fullbacks (FB), center midfielders (CM), attacking midfielders (AM), and strikers (ST). STATSports 10 Hz GNSS Apex units were used to monitor external load parameters such as distance, high-speed running (HSR), sprinting distance, accelerations, and decelerations. The linear mixed model analysis found differences between formats (p < 0.001) for the rate of perceived exertion (RPE), distance, HSR, sprinting, accelerations, and decelerations. Differences were found between positions for HSR (p = 0.004), sprinting (p = 0.006), and decelerations (p < 0.001). Moreover, a significant difference was found between sided game types (p < 0.001) for RPE, distance, HSR, sprinting, accelerations, and decelerations. In conclusion, some sided games formats are more suitable for specific load-specific parameters (e.g., distance per minute, HSR, and sprinting are greater during LSG). The number of accelerations and decelerations is higher in MSG compared to other formats. Finally, players' positions influenced external load metrics, specifically HSR and decelerations but not RPE and distance
A transfiguration paradigm for quest design
Get PDFQuest design is an important design aspect of video games. The current approach to quest design is dominated by a task-orientated paradigm in which a quest is viewed as a series of tasks to be completed as part of the narrative structure of the game. This paper presents an alternative paradigm that shifts away from the predominant task based approach to quest design. Based on a study of existing quest models, a dual quest framework of singular and synergy quests is proposed. Within the frameworks, tasks become an intermediary step within the quest which is now focused on the transfiguration of the player character. This approach offers a practical design structure for both procedural and manual quest design
Effects of submaximal and supramaximal accentuated eccentric loading on mass and function
Get PDFIntroduction: Eccentric-overload (EO) resistance training emerges as an alternative to more optimally prescribe intensity relative to the force generation capabilities of the eccentric muscle contraction. Given the difficulties to individually prescribe absolute eccentric loads relative to each person’s eccentric ability, setting the load relative to the concentric one-repetition maximum (1-RM) is the most used EO training approach. Therefore, we investigated the effects of submaximal and supramaximal (i.e., eccentric loads above 100% of 1-RM) accentuated eccentric training on changes in lean mass, anabolic hormonal responses and muscle function.
Methods: Physically active university students (n = 27) were randomly assigned to two training groups. Participants in the training groups performed dominant leg isotonic training twice a week for 10 weeks (four sets of eight repetitions). Isotonic resistance was generated by an electric-motor device at two different percentages of 1-RM for the eccentric phase; 90% submaximal load, SUB group) and 120% (supramaximal load, SUPRA group). Concentric load was the same for both groups (30% of 1-RM). Changes in total thigh lean mass (TTLM), anabolic hormonal responses (growth hormone, IGF-1, IL-6, and total testosterone), unilateral leg-press 1-RM, maximal voluntary isometric contractions (MVIC), local muscle endurance (XRM), muscle power at 40 (PP40), 60 (PP60) and 80% (PP80) of the 1-RM, and unilateral vertical jump height before and after training were compared between groups.
Results: After training, both SUB and SUPRA groups showed similar increases (p < 0.05) in MVIC (19.2% and 19.6%), XRM (53.8% and 23.8%), PP40 (16.2% and 15.7%), TTLM (2.5% and 4.2%), IGF-1 (10.0% and 14.1%) and IL-6 (58.6% and 28.6%). However, increases in 1-RM strength (16.3%) and unilateral vertical jump height (10.0%–13.4%) were observed for SUPRA only. Indeed, SUPRA was shown to be more favorable than SUB training for increasing 1-RM [ES = 0.77 (1.49–0.05)]. Unilateral muscle power at medium and high intensity (10.2% and 10.5%) also increased in SUB but without significant differences between groups.
Discussion: Similar functional and structural effects were demonstrated after 10 weeks EO training with submaximal and supramaximal eccentric loads. Although supramaximal loading might be superior for increasing 1-RM, the use of this approach does not appear to be necessary in healthy, active individuals
Mesenchymal stem cells isolated from equine hair follicles using a method of air-liquid interface.
Get PDFEquine mesenchymal stem cells (MSC) of various origins have been identified in horses, including MSCs from the bone marrow and adipose tissue. However, these stem cell sources are highly invasive in sampling, which thereby limits their clinical application in equine veterinary medicine. This study presents a novel method using an air-liquid interface to isolate stem cells from the hair follicle outer root sheath of the equine forehead skin. These stem cells cultured herewith showed high proliferation and asumed MSC phenotype by expressing MSC positive biomarkers (CD29, CD44 CD90) while not expressing negative markers (CD14, CD34 and CD45). They were capable of differentiating towards chondrogenic, osteogenic and adipogenic lineages, which was comparable with MSCs from adipose tissue. Due to their proliferative phenotype in vitro, MSC-like profile and differentiation capacities, we named them equine mesenchymal stem cells from the hair follicle outer root sheath (eMSCORS). eMSCORS present a promising alternative stem cell source for the equine veterinary medicine. [Abstract copyright: © 2023. The Author(s).
Evaluating a specialist palliative care service in a community setting
Get PDFAbstract
Background/Aims
In the Norfolk and Waveney Integrated Care System, a community organisation and a hospice have collaborated to develop an innovative specialist palliative care service in a community hospital. The aim of this service evaluation was to review the specialist palliative care service 2 years after implementation began across the integrated care system.
Methods
A multi-method approach was used to evaluate this service. Data were collected from pre-existing datasets on referrals, discharge and service use and described using descriptive statistics to assess how the service was used during the evaluation period (1 April 2019–31 March 2021). Qualitative data were collected via semi-structured interviews with 25 patients, carers, staff and other stakeholders. Interview transcripts were analysed using thematic analysis.
Results
During the 2-year evaluation period, the service recorded 1800 referrals, 189 admissions to specialist beds and 19 712 telephone calls to the 24-hour advice line. Thematic analysis of interview transcripts identified four themes: impact of the specialist palliative care beds, implementation of changes to practice, communication and coordination, and challenges related to providing the service. Overall, patients and carers had very positive views of the quality of care they received. Staff also identified benefits, including access to training and improved morale. Challenges included the limited number of beds and difficulties balancing the care needs of palliative care patients with other patients in the inpatient ward.
Conclusions
The specialist palliative care service promoted collaborative working, leading to enhanced knowledge and skills for staff supporting patients with specialist palliative care needs. The service was well-used and patients and their carers were generally very satisfied with the care they received
Testing the peak running speed in analytical and contextual-based scenarios: applied research in young adult soccer players
Get PDFThe primary aim was to compare the peak running speed (PRS) attained in the 40-m linear sprint test, in an analytical-based soccer drill, in the 5-0-5 test, and a training match scenario. The secondary aim of the study was to evaluate the differences between the three assessment sessions and identify how the tests can vary from session to session. Additionally, we aimed to investigate the within-test variability to understand how consistent the performance is within each test format across the different sessions. Forty male under-19 players competing at the national level participated in this study. A training session was observed for each of the three study weeks in which the following tests/scenarios were monitored using a GPS. The 40-m linear sprint test and the analytical-based soccer drill presented the smallest within-subject coefficients of variation between the sessions. A large correlation (r=0.742) was found between the PRS during the 40-m linear sprint test and the analytical-based soccer drill. The 40-m linear sprint test was the best method of those examined for measuring PRS. The analytical drill provides a reliable method for measuring PRS, although it differs from the 40-meter linear sprint test
The concise guide to pharmacology 2023/24: transporters
Get PDFThe Concise Guide to PHARMACOLOGY 2023/24 is the sixth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of approximately 1800 drug targets, and over 6000 interactions with about 3900 ligands. There is an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (https://www.guidetopharmacology.org/), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes almost 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point‐in‐time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/10.1111/bph.16182. Transporters are one of the six major pharmacological targets into which the Guide is divided, with the others being: G protein‐coupled receptors, ion channels, nuclear hormone receptors, catalytic receptors and enzymes. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid‐2023, and supersedes data presented in the 2021/22, 2019/20, 2017/18, 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature and Standards Committee of the International Union of Basic and Clinical Pharmacology (NC‐IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate