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Protocol for a scoping review of the international guidance on the consumption of alcohol during breastfeeding
Get PDFIntroduction: The long-term detrimental health impacts of alcohol consumption are long understood, with alcohol use one of the leading global causes of disability-adjusted life-years (DALYs) in 25–49-year-olds (Vos et al 2019). Alcohol is a casual factor in over 200 medical conditions such as diseases of the liver, cancers of the breast, bowel, mouth, throat and oesophagus, and liver), Major Adverse Cardiovascular Events (MACE) (stroke, myocardial infarction or vascular death) depression and anxiety, and alcohol use disorders (Rehm et al 2012; Nyberg et al 2022; Jani et al 2021). Perinatal alcohol consumption, defined as the time between conception and up to one-year postpartum (Wadephul et al 2020), can result in adverse pregnancy outcomes, and numerous maternal and infant health complications (Mamluk et al 2017; May et al 2016). The effects of alcohol consumption if a mother is breast feeding is less established, reflecting the lack of clear and consistent guidance for both health professionals and breastfeeding mothers. Objectives: To identify and review available strategies, policies, guidelines, and policy statements that have been developed addressing the consumption of alcohol during breastfeeding. To identify the target audience, key recommendations and empirical evidence used to form the identified strategies, policies, guidelines, and policy statements the consumption of alcohol during breastfeeding. To understand why strategies, policies, guidelines, and policy statement may vary, and to identify the gaps of knowledge in relation to addressing the consumption of alcohol during breastfeeding. Methods: This scoping review will employ the approach described by Arksey and O’Malley (2005) and will be conducted in accordance with recommendations for scoping reviews from the Joanna Briggs Institute (JBI) (Peters et al 2020). The Preferred Reporting Items for Systematic Reviews extension for Meta-Analyses-Scoping Review Extension (PRISMA-ScR) will be used as a framework for reporting the review (Peters et al 2015; Peters et al 2020; Tricco et al 2018). Google Advance search will be used to source international and national guidelines including links to governmental websites and third sector organisations (charities, local peer support groups and national organisations). Eligibility criteria will follow, Population, Concept, Context (PCC) developed in line with the scoping reviews objectives and the framework designed by Peters et al (2020) and will include guidance or recommendations for health professional or breast- feeders on the consumption of alcohol during breastfeeding. Key information will be recorded, coded, analysed and summarised using a narrative synthesis to produce an evidence-base for the current guidance in relation to alcohol consumption during breastfeedin
Adding empagliflozin to ongoing metformin improves metabolic profile, tg-g and fib-4 indexes and liver function tests in type 2 diabetic patients with NAFLDS, a clinical trial
No full textBackground: SGLT2 inhibitors offer strong glucose-lowering effects in patients with T2DM, but their impact on MAFLD when added to ongoing metformin therapy is not fully understood. This study aimed to evaluate the effects of empagliflozin (a SGLT2 inhibitor) on metabolic profile, liver fibrosis index, and liver function tests in metformin-treated T2DM patients with MAFLD. Research design and methods: This 12-week, prospective, single-center clinical trial enrolled 80 T2DM patients with MAFLD who were already receiving metformin but required further intervention. They received empagliflozin (10 mg/day) in addition to metformin (2000 mg/day). Metabolic parameters including FBS, HbA1c, Chol, TG, LDL, HDL, vitamin D3, ALT, ALP, and AST were measured at baseline and after 12 weeks. Triglyceride-glucose (TG-G) index and fibrosis-4 (FIB-4) score were also calculated. Results: Seventy-four patients completed the trial. Significant reductions were seen in FBS, HbA1c, Chol, LDL, TG, and TG-G index (p < 0.001). Liver markers ALT, AST, and FIB-4 also improved significantly (p < 0.001 and p < 0.02, respectively). Although HDL, ALP, and vitamin D3 increased, these changes were not statistically significant. Conclusion: Adding empagliflozin to ongoing metformin significantly improved metabolic and liver-related markers in T2DM patients with MAFLD, supporting its therapeutic benefit in this population (Clinical Trial Registration: https://irct.behdasht.gov.ir/trial/73164)
Dissecting the genetics of chronic cough
No full textExtractIn the 1980s a novel antihypertensive was introduced which inhibited the conversion of angiotensin I to the vasoactive angiotensin II. This mainly occurs in the endothelium of the pulmonary vasculature through the action of angiotensin-converting enzyme (ACE). The first ACE inhibitor, captopril, was introduced into our clinic. I reviewed a lady who complained that she had developed a dry cough. Simple investigations revealed no cause. She said, “it couldn't be that new drug you have given me doctor?”. I said, “don't be silly how could a tablet cause a cough”. We stopped the captopril and the cough abated. Reintroduced, the cough returned. There were sporadic case reports of ACE inhibitor associated cough in the literature, but the question remained. How could a tablet cause a cough
Brain Health and Wellness Guides for Adults
Get PDFThese 14 guides for adults may be used alongside the Brain Health Board when talking about, reflecting upon, or supporting aspects of brain health and wellness with adults
Enhancing Employee Engagement Among Lecturers in Nigeria: Insights from the UK Higher Education System
Get PDFEmployee engagement is an essential feature that influences an organisation's success, especially in higher education institutions, where the quality of research and teaching directly influences academic outcomes. The title of this PhD thesis, "Enhancing Employee Engagement Among Lecturers in Nigeria: Insight from the UK Higher Education System," examines the main drivers of employee engagement among lecturers in Nigeria, taking a clue from the comparative analysis as practised in the UK higher education system. Furthermore, the differences and similarities between identified patterns, such as motivation, leadership styles, organisational culture, institutional support mechanisms and professional development opportunities among the two contexts to determine how the engagement levels, were explored.Adopting qualitative research methods and taking an interpretative stance was the best approach for this study. This research design was appropriate for the investigation as it entails the researcher creating rapport with participants during the interview to understand their intentions, motives, and actions, thereby gaining deeper insight into the study. With lecturers from Nigerian and UK universities, the study identifies the significant factors of the research that either promote or hinder lecturers' engagement levels. These factors include access to continuous professional development, leadership support, job security, and the recognition of academic achievements. The study also examines the role of technological integration (teaching experience), institutional reputation, funding, and work-life balance in fostering engagement among the academic workforce.The findings highlight areas where Nigerian universities can adapt successful engagement strategies from UK institutions, particularly in terms of offering structured professional growth opportunities, encouraging supportive leadership, and improving workplace conditions. Recommendations are made for policy reforms and institutional practices to enhance lecturer engagement, thereby improving the overall quality of education in Nigeria. Academics in both countries widely acknowledge that diversity, inclusivity, and cultural norms play a significant role in shaping their professional interactions and relationships with colleagues and students, thereby leading to employee engagement.This research contributes to the broader discourse on employee engagement in higher education, providing practical insights for university administrators, policymakers, and stakeholders aiming to create a more motivated and engaged academic workforce in Nigeria
Talent Management and Career Issues of Persons with Disability in Saudi Arabia
Get PDFResearch has consistently shown that persons with disabilities (PWDs) face more significant career obstacles than their non-disabled counterparts, often leading to the underutilisation of their talents and skills. Despite the growing body of work in the field of talent management (TM), only a few studies have specifically addressed the career management issues faced by PWDs. This study aims to address this gap by focusing on the career management challenges of PWDs in Saudi Arabia, a country that has received comparatively little attention in this area, particularly within the context of the Arab Gulf region. While developed nations have been the primary focus of such research, Saudi Arabia’s unique political, economic, religious, and cultural context offers valuable insights, making it a significant case study. Moreover, the findings of this study could have broader implications for other countries in the Gulf region, which face similar challenges and opportunities related to PWDs inclusion in the workforce. This study represents a substantial contribution to the field of TM by adopting an empirical approach, given that much of the existing literature remains conceptual or theoretical. By conducting semi-structured interviews with PWDs in Saudi Arabia, this research explores the career management issues faced by this often underrepresented group, particularly within the context of developing countries. This study’s central focus is exploring the proactive strategies PWDs adopt to manage their careers. Key activities identified include goal setting and planning, relationship-building and networking, cultivating resilience and adaptability, obtaining professional qualifications, completing educational studies, maintaining discipline and commitment, and enhancing language skills such as learning English. Additionally, the study draws on Hofstede’s cultural dimensions to argue that an inclusive talent management approach may be better suited to the Saudi context rather than an exclusive one. This research highlights the critical role of contextual factors in shaping talent management practices, contributing to the growing body of literature on TM in non-Western settings, particularly in the Gulf region
Ultrahigh X-ray imaging and diffraction operando studies of ultrasound processing of Al alloys and graphites
Get PDFThis thesis presents a comprehensive investigation into the ultrasound-assisted processing of Al alloys and graphite materials using ultrafast synchrotron X-ray imaging and megahertz (MHz) X-ray free electron laser (XFEL) microscopy techniques, with emphasis on understanding the multiscale and multiphysics mechanisms driving multiphase evolution of Al alloy in solidification and the layer exfoliation of graphite materials. The unifying theme is the exploration of how ultrasonically generated physical phenomena, i.e., cavitation, shockwaves, and acoustic streaming, govern microstructural evolution at multiple scales. This comparative approach provides a comprehensive understanding of ultrasound-matter interactions, revealing universal principles that can be applied to optimize processing parameters for a wide range of materials. The key findings are summarized as follows:(1) In-situ synchrotron X-ray tomography and diffraction revealed, for the first time, the nucleation and co-growth dynamics of multiple Fe-rich intermetallics and their dynamic interactions with the Al dendrites of the recycled Al-5Cu-1.5Fe-1Si alloy in solidification under ultrasound melting processing (USMP). USMP significantly refined the α-Al dendrites, modified the morphologies of α-Fe and β-Fe phases, and altered their spatial distributions, thereby enhancing structural homogeneity and potentially improving mechanical properties. (2) By taking the full advantage of MHz XFEL microscopy, we have imaged and quantified, at ns time scale and μm length scale simultaneously, the local shockwaves produced by the implosion of a single cavitation bubble, multiple bubbles and bubble clouds, as well as the layer exfoliation dynamics under such shockwave impacts. The results confirmed that exfoliation is governed not by a single implosion event, but by repeated cyclic forces induced by shockwave impact, with exfoliation behaviour strongly dependent on local defects and graphite structure. (3) Using quasi-simultaneous synchrotron X-ray tomography and diffraction, we have studied in-situ the complicated peritectic reaction mechanisms involving Al4Mn and Al6Mn phases in an Al-8Mn alloy during the solidification process. The real-time evolution of the spatial and orientation relationships between these intermetallics was quantified for the first time, revealing the highly anisotropic faceted growth and intricate coalescence patterns that deviated from the equilibrium solidification models
Palliative and end-of-life care research funding: an analysis of current UK health research spending
Get PDFObjectives Despite increasing demand for palliative and end-of-life care, the funding for research in this area has historically been low. Previous UK analyses in 2016 found that less than 0.3% of the funding for cancer research was directed towards palliative care research; current expenditure on palliative and end-of-life care research is unknown. We therefore sought to determine current UK expenditure on palliative and end-of-life care research. Methods Secondary analysis of publicly available research funding data—UK Health Research Analysis 2022, from the UK Clinical Research Classification System Health Research Classification System. This dataset details UK health research funding from all public sectors (including the governments of the four nations of the UK), charities, societies and professional bodies for the year 2022. Results Out of 18 023 research funding awards in total in 2022, we identified 136 relating to palliative and end-of-life care research. The total funding for palliative and end-of-life care research was £10.9 million, representing just 0.26% of the total £4.2 billion awarded. Conclusions Palliative and end-of-life care research continues to be one of the lowest-funded areas of healthcare research in the UK. More investment into palliative and end-of-life care research is urgently needed to advance evidence to meet the rising demand for palliative care
Athletes’ beliefs about whistleblowing doping misconduct from six European countries: A social cognitive perspective
Get PDFBackground: Doping in sports is a worldwide problem which affects the integrity of sports and can endanger the physical and psychological health of athletes. Whistleblowing represents a method for detecting doping offences that may otherwise have gone undetected, but our understanding of whistleblowing against doping offences is limited. The purpose of this paper was to identify whether personal and social psychological variables were associated with intentions to report doping in sport. Method: 1146 active athletes aged ≥15 years, regularly training and participating in competitions participated to the study. Athletes were informed about study aims and gave informed consent. The sample completed measures related to organizational support, protection and costs of whistleblowing behaviours, justice/legitimacy, personal responsibility, group identification, similarity/favourability, personal benefits, perceived behavioral control, attitudes, and intentions. Internal consistency across multi-item scales was good to excellent (ω range 0.78–.96). Data were analysed using structural equation modeling. Results: There were significant relationships between intentions and among perceived costs, benefits, personal factors, and organizational structures. The structural model fit was acceptable (CFI = 0.95, TLI = 0.94, RMSEA = 0.03) and showed that personal responsibility, group identification, and role-model favorability/similarity positively predicted perceived benefits, whereas organizational support/protection negatively predicted perceived costs. In turn, perceived benefits were associated with more positive attitudes and greater perceived behavioral control, which was the strongest direct predictor of whistleblowing intentions. Conclusions: The findings underscore the complex interplay between personal and organizational factors in shaping attitudes and perceived behavioral control toward whistleblowing, ultimately influencing intentions
A search for Hiabsorption in distant star-forming galaxies with ASKAP-FLASH – I. Selection and analysis of the radio sample
Get PDFWe present and discuss two catalogues of UV-selected (NUV 80 percent) star-forming and resemble the overall WiggleZ population. The (g-i) colour evolution with redshift is consistent with a history of active star-formation, but the radio-associated objects are typically redder and have colours similar to high-excitation radio galaxies. The redshift distribution of the two catalogues matches the overall distribution for WiggleZ galaxies, despite their otherwise rare radio properties. These catalogues can be expanded in future as new radio data become available, and a forthcoming paper will present the H i absorption results