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Ethnic minority women's experiences of accessing antenatal care in high income European countries: a systematic review.
Get PDFWomen from ethnic minority backgrounds are at greater risk of adverse maternal outcomes. Antenatal care plays a crucial role in reducing risks of poor outcomes. The aim of this study was to identify, appraise, and synthesise the recent qualitative evidence on ethnic minority women's experiences of accessing antenatal care in high-income European countries, and to develop a novel conceptual framework for access based on women's perspectives. We conducted a comprehensive search of seven electronic databases in addition to manual searches to identify all qualitative studies published between January 2010 and May 2021. Identified articles were screened in two stages against the inclusion criteria with titles and abstracts screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist and extracted data were synthesised using a 'best fit' framework, based on an existing theoretical model of health care access. A total of 30 studies were included in this review. Women's experiences covered two overarching themes: 'provision of antenatal care' and 'women's uptake of antenatal care'. The 'provision of antenatal care' theme included five sub-themes: promotion of antenatal care importance, making contact and getting to antenatal care, costs of antenatal care, interactions with antenatal care providers and models of antenatal care provision. The 'women's uptake of antenatal care' theme included seven sub-themes: delaying initiation of antenatal care, seeking antenatal care, help from others in accessing antenatal care, engaging with antenatal care, previous experiences of interacting with maternity services, ability to communicate, and immigration status. A novel conceptual model was developed from these themes. The findings demonstrated the multifaceted and cyclical nature of initial and ongoing access to antenatal care for ethnic minority women. Structural and organisational factors played a significant role in women's ability to access antenatal care. Participants in majority of the included studies were women newly arrived in the host country, highlighting the need for research to be conducted across different generations of ethnic minority women taking into account the duration of stay in the host country where they accessed antenatal care. The review protocol was registered on PROSPERO (reference number CRD42021238115)
Long-term care facilities' response to the COVID-19 pandemic:An international, cross-sectional survey
Get PDFAIMS: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions.DESIGN: Cross-sectional survey.METHODS: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines.RESULTS: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance.CONCLUSIONS: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks.IMPACT: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks.PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.</p
The impact of COVID-19 on the changes in health behaviours among Black, Asian and Minority Ethnic (BAME) communities in the United Kingdom (UK): a scoping review.
Get PDFThe COVID-19 pandemic has led to changes in health behaviours, which include eating patterns and nutrition, smoking, alcohol consumption, sleeping patterns, physical activity and sedentary behaviour. There is a dearth of evidence reporting the impact of COVID-19 on the health behaviour of Black, Asian and minority ethnic (BAME) communities. This scoping review synthesises the available evidence on the impact of COVID-19 on the changes in health behaviours among BAME communities in the UK. Following a keyword strategy, 16 electronic databases were searched for articles that met the screening criteria. These articles were then reviewed in full text. Empirical studies that assessed COVID-19 related health behaviour changes among BAME communities in the UK, conducted during the COVID-19 pandemic between July 2020 and August 2021 and published in English language, were set as inclusion criteria. An initial 2160 studies were identified in the selected databases. After removing duplications and screening the title and abstracts of the 2154 studies, only 4 studies were selected to be reviewed as they met the inclusion criteria. The included studies employed different sample sizes which ranged from N = 47 to N = 30,375 and reported several health behaviour changes. Out of the 4 included studies, 3 studies included BAME groups within their sample as a subgroup while one study focused specifically on BAME groups. The scoping review found that there were lower levels of physical activity among BAME groups compared to the White ethnic groups. About 41.7% of BAME groups reported drinking less alcohol than usual compared to their white counterparts who were 34%. Study participants from BAME backgrounds had the greatest effect of COVID-19 on decisions to purchase healthier food compared to those from white backgrounds whose decisions on purchasing healthier food were least affected. Some participants reported an increase in positive hygiene practices due to the COVID-19 pandemic. COVID-19 had a significant impact on the health behaviours of BAME groups especially during the lockdowns as they reported changes to behaviour such as low levels of physical activities. Hence, it is important to promote health awareness among BAME groups to encourage healthy living. In addition, programmes such as physical fitness activities that favour BAME groups should be put in place, for example BAME women's walking groups to encourage people from BAME backgrounds to engage in physical activities. Furthermore, healthy food programmes such as food parcels can be given to people from BAME backgrounds who are not able to afford healthy food due to the impact of COVID-19. Nonetheless, the COVID-19 pandemic has increased positive hygiene among BAME groups which is important in preventing other diseases and infections
Relevance and multimodal prosody: implications for L2 teaching and learning
Get PDFIn this paper, I build on Scott's relevance-theoretic account of contrastive stress (2021). Contrastive stress works as an extra cue to ostension in altering the salience of a particular constituent in an utterance and, as a result, the salience of one particular interpretation of that utterance. I draw on Scott’s argument that contrastive stress does not encode procedural meaning. Contrastive stress is unpredictable and, as such, it is in confounding the hearer’s expectations that it draws his attention to the accented word and prompt his search for different interpretive effects. I argue that contrastive stress is interpreted purely inferentially precisely because it is one of many pointing devices. It is to be interpreted by virtue of its interaction with other paralinguistic behaviours, all of which being different aspects of the same ostensive act of communication. This leads me to focus on the gestural nature of contrastive stress working as an act of pointing, which, as an ostensive communicative behaviour, conveys that if you look over there, you’ll know what I mean (Tomasello et al., 2007). Finally, I present the implications of analysing contrastive stress in its multimodal context – as prosodic pointing – for the teaching and learning of L2 prosodic pragmatics and the development of interpretive abilities in the L2 hearer’s mind
Responses of extreme climates in South Asia under a G6sulfur scenario of climate engineering
Get PDFUnder global warming scenarios, extreme climate events in South Asia will occur more frequently which will seriously threaten the safety of local residents. South Asia faces dual pressures of the obligation of carbon emissions reduction globally and the demand for a better life for huge populations. Stratospheric Aerosol Injection (SAI) climate engineering provides a potential solution to this dilemma. We compared the evolution of 12 climate extreme indices under historical scenarios, two future scenarios (SSP245, SSP585) and an implementation scenario of SAI climate engineering (G6sulfur). We showed that the intensity and frequency of extreme climates under a G6sulfur scenario would be significantly higher than those under historical scenarios, and that the difference in extreme climates under three scenarios (SSP245, SSP585, and G6sulfur) would be widely varying, with some indices being considerably mitigated while others would reflect a worse set of circumstances than would be the case without SAI climate engineering. Therefore, SAI climate engineering is not an effective tool to mitigate future climate extremes in South Asia under global warming scenarios
An extended study of search user interface design focused on Hofstede’s cultural dimensions
Get PDFGeert Hofstede’s classic cultural model has been studied and applied to website design for a number of years. In this paper we examine if Geert Hof-stede’s six cultural dimensions can also be applied to search user interface de-sign. Two user studies have been conducted to evaluate the culturally designed search user interfaces, and the findings are reported in this paper. Our first study comprised of 148 participants from different cultural backgrounds. The second study was smaller with 25 participants, also from different cultural back-grounds. The results from these studies have been analyzed to ascertain if Hof-stede’s cultural dimensions are suitable for understanding users’ preferences for search user interface design. Whilst the key findings from these studies suggest Hofstede cross-cultural dimensions can be used to model users’ preferences on search interface design, further work is still needed for particular cultural di-mensions to reinforce the conclusions
Insights into the spray impingement process from a gasoline direct injection fuel system fuelled with gasoline and ethanol
Get PDFParticulate Matter (PM) emissions have a negative impact on both climate change and human health. To control PM emissions emitted by vehicles with the Gasoline Direct Injection (GDI) fuel system, increasing fuel injection pressure is being developed as a practical approach. In this paper, an experimental and numerical study was presented to thoroughly explore the entire development process of gasoline and ethanol impingement spray from a GDI injector under injection pressure of 10 MPa and 50 MPa. The results demonstrate that more droplets are predicted to distribute in the splash region with the increase of injection pressure ( ) from 10 MPa to 50 MPa, which helps improve air-fuel mixing quality and reduce PM emissions. The splash probability of gasoline droplets is about two percent higher than ethanol. By increasing from 10 MPa to 50 MPa, droplets with higher absolute normal velocity would promote the growth of impingement spray. The probability curves of droplet diameter are more concentrated in the smaller size range. Besides, the probability of relatively large droplets of gasoline is slightly lower than that of ethanol. Regarding the fuel film distribution, more folds and bulges can be seen at the boundary of fuel film with the increase to 50 MPa. Meantime, the film distribution becomes more scattered, which would benefit the homogeneity of air-fuel mixture. The film distribution area and boundary irregularity of gasoline are greater than those of ethanol, further promoting a homogeneous air-fuel mixture
Effect of probe lifting height in jumping mode AFM for living cell imaging
Get PDFAtomic force microscopy (AFM) is one of the effective methods for imaging the morphological and physical properties of living cells in a near-physiological environment. However, several problems caused by the adhesion of living cells and extension of the cell membranes seriously affect the image quality during living cell imaging, hindering the study of living cells. In this work, jumping mode AFM imaging was used to image living cells at varied probe lifting heights to meet image quality requirements, and image quality related to the probe lifting height is discussed in detail. The jumping mode was divided into three parts based on the varying heights of the lifted probe, namely near-contact mode, half-jumping mode, and full-jumping mode, and the causes of their imaging drawbacks were analyzed. At an appropriate lifting height, the probe can be completely free from the influence of cell adhesion and self-excited oscillation, thus avoiding the occurrence of “trail” phenomena and invalid points in the imaging of living cells and improving the image quality. Additionally, this work provides a new approach to calculating the lateral force through the adhesion of trace and retrace scanning at a low height, which is important for studying the extension characteristics of the cell membrane
Large-scale biomedical relation extraction across diverse relation types: model development and usability study on COVID-19
Get PDFBackground: Biomedical relation extraction (RE) is of great importance for researchers to conduct systematic biomedical studies. It not only helps knowledge mining, such as knowledge graphs and novel knowledge discovery, but also promotes translational applications, such as clinical diagnosis, decision-making, and precision medicine. However, the relations between biomedical entities are complex and diverse, and comprehensive biomedical RE is not yet well established. Objective: We aimed to investigate and improve large-scale RE with diverse relation types and conduct usability studies with application scenarios to optimize biomedical text mining. Methods: Data sets containing 125 relation types with different entity semantic levels were constructed to evaluate the impact of entity semantic information on RE, and performance analysis was conducted on different model architectures and domain models. This study also proposed a continued pretraining strategy and integrated models with scripts into a tool. Furthermore, this study applied RE to the COVID-19 corpus with article topics and application scenarios of clinical interest to assess and demonstrate its biological interpretability and usability. Results: The performance analysis revealed that RE achieves the best performance when the detailed semantic type is provided. For a single model, PubMedBERT with continued pretraining performed the best, with an F1-score of 0.8998. Usability studies on COVID-19 demonstrated the interpretability and usability of RE, and a relation graph database was constructed, which was used to reveal existing and novel drug paths with edge explanations. The models (including pretrained and fine-tuned models), integrated tool (Docker), and generated data (including the COVID-19 relation graph database and drug paths) have been made publicly available to the biomedical text mining community and clinical researchers. Conclusions: This study provided a comprehensive analysis of RE with diverse relation types. Optimized RE models and tools for diverse relation types were developed, which can be widely used in biomedical text mining. Our usability studies provided a proof-of-concept demonstration of how large-scale RE can be leveraged to facilitate novel research.</p
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