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Healthcare use and costs of perinatal anxiety: a UK NHS perspective
Full text linkBackground: Perinatal anxiety is a significant public health issue with potential adverse outcomes for both mothers and their babies. This study provides a comprehensive analysis of the costs associated with health service use for women with and without perinatal anxiety in the UK National Health Service (NHS) at six and twelve months postpartum. This research is part of the MAP Alliance Study—a large programme of research on perinatal anxiety. Methods: A cost of illness (COI) analysis was performed using a retrospective approach in which recorded data of self-reported health resource use was analysed. The COI analysis identified the different components of costs and the size of the contribution of each health resource and quantified the direct costs incurred by the NHS due to perinatal anxiety. Results: Results found that women experiencing perinatal anxiety use healthcare services more frequently and incur higher healthcare costs compared to those without. At six months postpartum, the mean total healthcare cost per woman with perinatal anxiety was £1174 (95% CI: 1080.67, 1263.05) compared with £1046 (95% CI: 975.16, 1123.83) for women without. At twelve months postpartum, the mean total healthcare cost per woman with perinatal anxiety was £414 (95% CI: 347.76, 488.87) compared with £267 (95% CI: 226.06, 314.81) for women without. However, this cost difference between the two groups was not statistically significant (-£14; 95% CI: -161.88, 135.65, p = 0.808). Conclusion: These findings underscore the economic impact of perinatal anxiety on healthcare systems and highlight the need for targeted interventions to improve care pathways for affected women. The results of this analysis have significant implications for public health policy, emphasising the importance of optimising perinatal mental health care pathways to reduce long-term costs and improve outcomes for women
Implementation and Validation of Competency-Based Spiritual Care Education using the EPICC Self-Assessment Tool in Undergraduate Nursing Students.
Full text linkBackgroundThe World Health Organization and various healthcare organizations recognize the spiritual dimension as crucial for well-being and health, particularly in person-centered care. The EPICC project developed a consensus-based model for spiritual care education, contributing tools like the EPICC Spiritual Care Competency Self-Assessment Tool to support competency development.AimTo translate, culturally adapt, and validate the EPICC Spiritual Care Competency Self-Assessment Tool for undergraduate nursing students in Portugal.MethodsCross-cultural adaptation followed by Beaton et al.'s method. Reliability and validity were assessed using Kaiser–Meyer–Olkin (KMO) and Bartlett’s tests for factor analysis, with internal consistency measured using Cronbach’s α.ResultsData collected between November 2023 and October 2024 showed 100% agreement and a Content Validity Index (CVI) of 1 among experts. A pretest with 39 students indicated 79.1% agreement and acceptable internal consistency (KR-20 = 0.573). Psychometric properties showed KMO of 0.845, CFI of 0.895, GFI of 0.805, RMSEA of 0.082 and Cronbach’s α of 0.92 (n = 161 nursing students from a Portuguese higher education institution).ConclusionsThe European Portuguese version of the EPICC Spiritual Care Competency Self-Assessment Tool is a valid and reliable instrument for assessing spiritual care competency in nursing and midwifery students. However, some limitations of this study should be addressed in future research to enhance the generalisability of the findings to broader educational contexts
Program standards and student competencies among global chiropractic accreditation agencies: a content analysis
Full text linkBackgroundAccreditation of healthcare provider training programs ensures graduate competency and provides a means for programs to improve. Accreditation consistency assures the public that healthcare providers have similar basic training across world regions. Currently, it is unknown if chiropractic accrediting agencies have congruent standards globally. Therefore, the purpose of this study was to investigate similarities and differences in student competencies and program standards among four chiropractic accreditation agencies worldwide.MethodsA quantitative content analysis was performed on accreditation standards from regional international accreditation agencies responsible for accrediting the majority of the world's chiropractic degree programs. Agencies included the Council on Chiropractic Education (United States), the European Council on Chiropractic Education (Europe, United Kingdom, South Africa), the Council on Chiropractic Education Australasia (Australia, New Zealand, Malaysia), and the Council on Chiropractic Education Canada (Canada). The contents of the accrediting standards were coded using a standardized coding list. A modified Delphi technique was used by 21 international experts from December 1, 2023, to April 18, 2024. After four rounds of consideration to achieve consensus, the contents were analyzed for frequency and congruence of coded items across the accrediting agencies' standards. A two-way analysis of variance was conducted to identify if there were any differences among the accreditation agencies.ResultsNeither student competencies [F(3,8) = 0.007, p > .05] nor program standards [F(3,4) = 0.002, p > .05] differed significantly across the accrediting agencies. The statistical relationships between accreditation agencies and coding frequencies remained stable across all coded items, with no single code exhibiting differential performance depending on the accrediting body. The overall model showed R2 = 0.96 for student competencies and R2 = 0.87 for program standards; thus, the models' predictions align with the observed data.ConclusionsThe study findings demonstrate congruence for student competencies and program standards among chiropractic accreditation agencies across multiple geographic regions. The patterns of content were stable and consistent across the four accrediting agencies, with no evidence of differential effects among the agencies. In addition, this study provides essential details and standardized codes for agencies' documents, which may facilitate dialogue and comprehension among agencies, educators, regulators, governing officials, and other stakeholders in chiropractic education.Study registrationThe study protocol was prospectively registered with Open Science Framework on November 30, 2023 https://doi.org/10.17605/OSF.IO/259WC
Cooling down for going up: Could selective ‘brain chilling’ mitigate high-altitude illness?
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Same data, different analysts: variation in effect sizes due to analytical decisions in ecology and evolutionary biology
Full text linkAlthough variation in effect sizes and predicted values among studies of similar phenomena is inevitable, such variation far exceeds what might be produced by sampling error alone. One possible explanation for variation among results is differences among researchers in the decisions they make regarding statistical analyses. A growing array of studies has explored this analytical variability in different fields and has found substantial variability among results despite analysts having the same data and research question. Many of these studies have been in the social sciences, but one small "many analyst" study found similar variability in ecology. We expanded the scope of this prior work by implementing a large-scale empirical exploration of the variation in effect sizes and model predictions generated by the analytical decisions of different researchers in ecology and evolutionary biology. We used two unpublished datasets, one from evolutionary ecology (blue tit, Cyanistes caeruleus, to compare sibling number and nestling growth) and one from conservation ecology (Eucalyptus, to compare grass cover and tree seedling recruitment). The project leaders recruited 174 analyst teams, comprising 246 analysts, to investigate the answers to prespecified research questions. Analyses conducted by these teams yielded 141 usable effects (compatible with our meta-analyses and with all necessary information provided) for the blue tit dataset, and 85 usable effects for the Eucalyptus dataset. We found substantial heterogeneity among results for both datasets, although the patterns of variation differed between them. For the blue tit analyses, the average effect was convincingly negative, with less growth for nestlings living with more siblings, but there was near continuous variation in effect size from large negative effects to effects near zero, and even effects crossing the traditional threshold of statistical significance in the opposite direction. In contrast, the average relationship between grass cover and Eucalyptus seedling number was only slightly negative and not convincingly different from zero, and most effects ranged from weakly negative to weakly positive, with about a third of effects crossing the traditional threshold of significance in one direction or the other. However, there were also several striking outliers in the Eucalyptus dataset, with effects far from zero. For both datasets, we found substantial variation in the variable selection and random effects structures among analyses, as well as in the ratings of the analytical methods by peer reviewers, but we found no strong relationship between any of these and deviation from the meta-analytic mean. In other words, analyses with results that were far from the mean were no more or less likely to have dissimilar variable sets, use random effects in their models, or receive poor peer reviews than those analyses that found results that were close to the mean. The existence of substantial variability among analysis outcomes raises important questions about how ecologists and evolutionary biologists should interpret published results, and how they should conduct analyses in the future
A Computational Approach for Graphene Doped with N,P,B Structures as Possible Electrode Materials for Potassium Ion Batteries (PIBs): A DFT Investigation
Full text linkAlthough lithium-ion batteries are considered an ideal postulant for renewable energy harvesting, storage and applications, these batteries show promising performance; however, at the same time, these harvesting devices suffer from some major limitations, including scarce lithium resources, high cost, toxicity and safety concerns. Potassium ion batteries (PIBs) can be proven a favorable alternative to metal ion batteries because of their widespread potassium reserves, low costs and enhanced protection against sparks. In this study, DFT simulations were employed using the B3LYP/6-311++g(d p) method to explore the application of graphene and its doped variants (N,B,P-graphene) as potential anode materials for PIBs. Various key parameters such as adsorption energy, Gibbs free energy, molecular orbital energies, non-covalent interactions, cell voltage, electron density distribution and density of states were computed as a means to evaluate the suitability of materials for PIB applications. Among the four structures, nitrogen- and phosphorus-doped graphene exhibited negative Gibbs free energy values of −0.020056 and −0.021117 hartree, indicating the thermodynamic favorability of charge transfer processes. Doping graphene with nitrogen and phosphorus decreases the HOMO-LUMO gap energy, facilitating efficient ion storage and charge transport. The doping of nitrogen and phosphorus increases the cell voltage from −1.05 V to 0.54 V and 0.57 V, respectively, while boron doping decreases the cell voltage. The cell voltage produced by graphene and its doped variants in potassium ion batteries has the following order: P-graphene (0.57 V) > N-graphene (0.54 V) > graphene (−1.05 V) > B-graphene (−1.54 V). This study illustrates how nitrogen- and phosphorus-doped graphene can be used as a propitious anode electrode for PIBs
Behaviours that challenge and disrupt in schools across Wales: effective strategies and mitigations
Full text linkMaking the private public: (life) writing, shame and the abjection of homosexual sex in Wales
Full text linkConsolation in Sixteenth Century Protestant Church Orders
Full text linkThis article presents four ways that demonstrate how Protestant church orders provided comfort and consolation to the laity in sixteenth century Germany, with specific focus on the sacraments of baptism and communion and their respective rituals. The turmoil that could accompany religious change demonstrated that reforms needed to be approached sensitively and implemented in ways that supported the laity as they adjusted to new confessional realities, the loss of past certainties, and changed ritual experiences. Existing literature considers how reformers comforted parishioners through their ministry, sermons, consolatory works and other practices but church orders traditionally have not been seen as belonging to this broader framework of consolation. Thus, exploring how consolation can be detected in the church orders situates them within the wider landscape of consolatory literature.</p