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Multifactorial determinants of postpartum care uptake in low- and middle-income countries: A systematic review and meta-analysis.
No full textBackground: Postpartum care (PPC) uptake within six weeks after delivery is essential to prevent maternal morbidity and mortality.
Aim: to understand the determinants contributing to PPC uptake in low-and-middle income countries (LMIC).
Method: PubMed, Embase, CINAHL, Cochrane, Web of Science databases were searched on PPC uptake for childbearing women in LMIC. Studies published in English in peer-reviewed journals since 2013 were eligible. A meta-analysis using a random-effect model was undertaken to measure the pooled effect of five key determinants of PPC uptake.
Findings: Among 1602 generated records, 24 cross-sectional studies were selected for the review. Nine of them were included in the meta-analysis (n=198 402 women). Overall, 55.4% of women used PPC. The pooled findings of PPC uptake were associated with urban locations (OR=1.88, 95% confidence interval (CI):0.76-1.91), and women’s primary (OR=1.45,95%CI:1.31-1.61) and secondary (OR=1.67,95%CI:1.45-1.92) education levels. Moreover, women from poor (OR=1.38,95%CI:1.23-1.56), middle (OR=1.56,95%CI:1.35-1.80), richer (OR=2.01,95%CI:1.71-2.35) and the richest (OR=3.31,95%CI:2.82-3.88) households were more likely to use PPC. Other facilitators included: PPC awareness, knowledge of postpartum morbidities, antenatal care, skilled birth attendant, health facility-based delivery, caesarean, women’s autonomy in decision-making, wanted pregnancy, primiparity, mass media exposure, women’s partner education and employment. Barriers to PPC uptake included: distance from health facilities, single marital status, unwanted pregnancy, cultural belief.
Conclusion: The differences in PPC uptake in LMIC reflect social inequities. These findings can inform equitable maternal health policies and programs in LMICs. Strengthening community outreach and addressing structural barriers by improving PPC quality and access may enhance uptake and reduce preventable complications
Hydration Kinetics of Biochar-Enhanced Cement Composites: a mini-review
Get PDFThe construction sector makes a major contribution to global greenhouse gas emissions, in which cement alone produces approximately 7–8% of global CO₂ emissions. To abate environmental impact and promote sustainable construction, alternative low-carbon cementitious materials are gaining attention. Biochar (BC), a carbon-rich material obtained from biomass sources through the process of pyrolysis, has surfaced as a capable supplementary cementitious material due to its carbon capture capabilities and positive impact on the characteristics of cement composites. This review investigates the role of BC in cement composites, including its effects on hydration kinetics, microstructural development, fresh-state properties, and its optimal utilisation. The study also highlights the internal curing capabilities of BC when used in cement composites, its role in promoting hydration product formation, and its dual function in enhancing mechanical performance while facilitating carbon capture. Despite the benefits, there are some challenges such as variable BC properties, optimal dosage, and scalability. The review highlights the need for standardisation and further research to fully harness BC’s potential as a sustainable component in low-carbon construction technologies
Automated penetration testing for industrial IOT systems: enhancing efficiency and reducing reliance on human expertise
No full textPenetration testing is an important aspect when building or deploying Industrial Internet of Things (IIoT) systems. This involves using specialised hacking tools that would help identify exploitable vulnerabilities in an industrial systems, device, and/or network. Conventionally, security experts rely on penetration testing performed by expert individuals where these individuals are expected to have considerable experience and knowledge in the specified domain. This dependence on skill evaluation makes the process unreliable as failure in a penetration test does not guarantee system security. Therefore, this paper proposes the use of automated penetration testing using script files. Tools such as Nessus are employed for vulnerability scanning, PostgreSQL serves as the database management system to store test results and configurations, and Metasploit is utilised for automating the exploitation of identified vulnerabilities. The research shows a considerable improvement in task efficiency in terms of time consumed to find a suitable exploit and execute it in comparison to manual penetration testing
Finding identity through gait
No full textHuman gait identification is the recognition of a person from a series of walking images. In contrast to fingerprint or iris-based identification methods, gait identification offers the significant benefit of remote execution. Gait detection is emerging as one of the most promising biometric identification techniques. Traditional methods to identify the identity of gait are Background subtraction, Gait Energy Image, Gait Entropy, etc., human gait identification is a potential new tool for identifying individuals beyond traditional methods. The objectives of this study were to develop an automated gait detection system and examine the unique aspects of gait. This study encompassed the following: gait predictions and estimation based on HRNet 17 joint positions (locating body joints of humans in an image/video), better predictions with higher confidence scores by eliminating poor predictions, and the 14 joint coordinates and 17 joint points are fed into Graph Convolutional Network by eliminating low confidence pose to classify labels. Semi-supervised learning on graph-structured data can be accomplished via Graph Convolutional Networks. Graph Convolutional Networks is a very effective version of convolutional neural networks, which function directly on graphs. The experimental results show that the Graphical Convolutional Network identifies gait subjects with higher accuracy of normal walking and carrying a backpack with 98% and 96% respectively. This work will be extended in the future by fusing face and gait to identify various gait subjects and the gait in forensic identifications
Experiences and management of distress and the use of music, including music therapy, on NHS inpatient mental health dementia wards: a qualitative study.
Get PDFBackground: Inpatient mental health dementia wards in the National Health Service (NHS) provide specialist care for people with dementia experiencing acute levels of distress. There is little research exploring how best to manage and prevent distress. Music therapy may be feasible to deliver and reduce the prevalence of distress behaviours.
Aims: To further understanding of experiences of distress in inpatient mental health dementia NHS wards, how distress is managed and ways music and music therapy is used.
Methods: Semi‐structured focus groups and interviews were co‐designed and conducted with people with dementia, families, staff, music therapists and managers with experience of this setting. Data were transcribed and analysed using reflexive thematic analysis, with findings corroborated with participants, a co‐design group and experts‐by‐experience.
Results: 49 people took part from 17 wards. Three overarching themes were identified, with 10 subthemes. The first theme highlighted the complex physical and mental health care needs of people on these wards, including high levels of distress. Secondly, staff and families aimed to personalise care to manage and prevent distress. Thirdly, music, including music therapy, could support the delivery of personalised care and help prevent and deescalate distress behaviours, potentially reducing the need for restrictive interventions. However, managers, staff, families and patients reported that care provision did not always
meet patient need and resource limitations often prevented delivery of personalised care.
Conclusions: NHS mental health dementia wards provide specialist care for people with dementia experiencing high levels of distress. Personalised care, including the use of music, was essential for preventing and managing distress, and could be enhanced through specialist support from a music therapist. Findings should inform best practice guidelines for NHS inpatient mental health dementia wards, including the use of music and music therapy, to support the prevention and management of distress for this client group
The influence of soccer-specific exercise on isokinetic angle-specific thigh musculature strength in female soccer players
Get PDFThis study assessed the influence of soccer-specific exercise on thigh musculature strength in female soccer players. Eight amateur female soccer players (age 24 ± 6 years; height 163 ± 8 cm; mass 68 ± 11 kg) participated in the study. Participants completed the female match simulation-90 (FEMS-90), replicating a 90-minute match. Isokinetic strength assessments of the concentric knee extensors (conKE), concentric knee flexors (conKF), eccentric knee extensors (eccKE) and eccentric knee flexors (eccKF) for the dominant lower limb were conducted at 60°∙s-1 where conventional ratios (CR) and dynamic control ratios (DCR) were determined. All strength data were expressed as angle-specific torque (AST). A Bayesian approach identified a 66-78% probability that AST of all muscle actions were lower post SSEP, and a 57-66% probability of a difference that CRAST and DCRAST were lower post SSEP across all angles. The results of this study provides unique insight into how female soccer players respond to soccer match-play, and may have implications for potential injury risk, exercise prescription and recovery. Moreover, given the prevalence and burden of knee ligament injuries in female soccer players, this study provides insight into thigh musculature strength acutely responds following simulated match-play
Choices and challenges in end-of-life care and decision-making: a nationwide cross-sectional study in Bangladesh
Get PDFBackground:
End-of-life (EoL) care is the final phase of life (typically the last year when death is imminent), distinct from but related to palliative care, which provides broader support for serious illness. In many low- and middle income countries, including Bangladesh, end-of-life care remains underdeveloped. Cultural norms, socio-economic disparities, limited palliative care infrastructure, and lack of healthcare provider training further complicate informed decision-making at EoL. This study aimed to evaluate EoL care awareness, preferences, and decision-making factors among critically ill older adult patients in Bangladesh.
Methods:
This cross-sectional study was conducted from September 2024 to February 2025 across eight administrative divisions of Bangladesh, involving 1,270 patients aged ≥ 50 years with chronic or advanced illnesses, including hospitalized patients aged ≥ 18 years with life expectancy < 1 year from private (n = 368), public (n = 439), and community (n = 463) settings. Divisional hospitals provided hospital-based data, while three randomly selected sub-districts per division ensured proportional community representation. Data was collected using structured questionnaires adapted from validated international tools, capturing socio-demographics, and end-of-life (EoL) awareness, preferences, and experiences. Predictors of end-of-life preferences were examined using multiple logistic regression analysis.
Results:
Only 6.93% had health insurance, with just 1.7% in community settings. Palliative care awareness was highest in private hospitals (70%), followed by public (31%) and community settings (7.1%) (p < 0.01). Advance care planning awareness and documentation were lowest in community patients (p < 0.01). Older adults (≥ 60 years) were more likely to prefer home care (OR = 2.96, p = 0.004), avoid hospitalization (OR = 17.55, p < 0.001), and choose home death (OR = 10.29, p < 0.001). Greater understanding of palliative care (OR = 7.38, p < 0.001) and hospice comfort (OR = 25.26, p < 0.001) strongly predicted documentation of end-of-life preferences. Family openness varied widely (private: 81%, public: 21%, community: 7.1%). Proxy appointment was significantly associated with prior discussions (AOR = 4.11), while trust in healthcare providers reduced the likelihood (AOR = 0.39).
Conclusion:
Profound disparities in end-of-life awareness and preferences exist across healthcare settings in Bangladesh, driven by socio-economic, cultural, and institutional factors. Efforts must prioritize patient choice through enhanced communication, culturally sensitive advance care planning, and expanding home-based palliative options to honor care preferences at the end of life
Condensation of the RNA chaperone Hfq is coupled to inhibition of glucose uptake and contributes to the stabilization of regulatory RNAs in nitrogen-starved Escherichia coli
Get PDFRibonucleoprotein condensates are membraneless compartments that concentrate RNA-binding proteins and RNA, and play key roles in cellular adaptation across both eukaryotes and bacteria. While the biological roles of ribonucleoprotein condensates are better understood in eukaryotic systems, the knowledge of metabolic processes that govern their formation and their contribution to stress adaptation remains at a nascent stage in bacterial RNA biology. Hfq is an RNA chaperone conserved in many bacteria that undergoes condensation in response to diverse stresses. Using nitrogen (N) starvation in Escherichia coli as a model stress condition, we show that Hfq condensation occurs independently of any extracellular metabolic cues, cytoplasmic shrinkage that cells undergo during N starvation, or the canonical NtrBC-dependent adaptive response to N starvation. We demonstrate that Hfq condensation is coupled to α-ketoglutarate-dependent inhibition of glucose uptake in N-starved E. coli. Further, by comparing the transcriptomes of wild-type bacteria and bacteria unable to form Hfq-condensates, we reveal that Hfq-condensates contribute to the maintenance of Hfq-associated non-coding regulatory RNAs during N starvation. We propose that coordination of carbon and N metabolism during N starvation, critical for metabolic adaptation, is accompanied by preservation of non-coding regulatory RNAs via Hfq condensation
Social prescribing in primary care for people living with dementia: a qualitative exploration of different roles and services in England
Get PDFAbstract
Background Dementia is a global public health challenge with the number of people living with the condition rapidly rising. Social prescribing in primary care has emerged as a person-centred approach connecting individuals with community support. It is increasingly explored for its potential to support people with complex needs, yet its role in dementia care remains uncertain. This study aimed to explore current provision of social prescribing for people living with dementia across England, identifying relevant aspects for dementia care, with particular focus on generic
and specialist services.
Methods Semi-structured interviews were conducted with regional leads of social prescribing services and social prescribing link workers (SPLWs) across England. Data were analysed using template analysis to identify key themes.
Results Twenty-two participants were interviewed: ten social prescribing regional leads, four generic SPLWs commissioned to work with people aged > 18 years, and eight SPLWs working exclusively or partly with a specific adult population. Four themes were identified: family carer engagement key to supporting people living with dementia; service rather than person-centred care; the dominance of dementia in influencing support; and strategies for success: dementia centred social prescribing.
Participants identified the central role of family carers in facilitating access to social prescribing, highlighting that carer support was often essential. Generic social prescribing frequently followed a ‘service-led’ approach, with service constraints negatively influencing interactions. Dementia was often perceived as the dominant support need, potentially marginalising individuals within broader social prescribing services. Despite these challenges, participants with more role flexibility, and/or more experience of dementia, demonstrated a range of successful strategies, illustrating the potential of social prescribing for people living with dementia.
Conclusion SPLWs perceive that social prescribing has potential to play a key role in support for people living with dementia and family carers. While its core principles align well with dementia care, our findings suggest a socia
A personal and networked practice account of how voluntary and community sector leadership works in Bermondsey
No full textThe chapter describe voluntary and community leadership in Bermondsey, England, where the authors worked together as partners in a regeneration programme. They describe how they provided grassroots, networked leadership from the ‘bottom up’, working together in response to chronic austerity and the growing failure of the welfare state. This place-based leadership was based on an understanding of the unique circumstances in Bermondsey, committing to this and tailoring their work to fit. The authors argue that what deprived places need ultimately is a guaranteed minimum level of state support but a place-based approach has intense value through partnership working across the public and voluntary and community sector