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Evaluating step-down, intermediate care programme in Buckinghamshire, UK:a mixed methods study
Get PDFIntermediate care (IC) services are models of care that aim to bridge the gap between hospital and home, enabling continuity of care and the transition to the community. The purpose of this study was to explore patient experience with a step-down, intermediate care unit in Buckinghamshire, UK. A mixed-methods study design was used. Twenty-eight responses to a patient feedback questionnaire were analysed and seven qualitative semi-structured interviews were conducted. The eligible participants were patients who had been admitted to the step-down IC unit. Interview transcripts were analysed using thematic analysis. Our interview data generated five core themes: (1) "Being uninformed", (2) "Caring relationships with health practitioners", (3) "Experiencing good intermediate care", (4) "Rehabilitation" and (5) "Discussing the care plan". When comparing the quantitative to the qualitative data, these themes are consistent. Overall, the patients reported that the admission to the step-down care facility was positive. Patients highlighted the supportive relationship they formed with healthcare professionals in the IC and that the rehabilitation that was offered in the IC service was important in increasing mobility and regaining their independence. In addition, patients reported that they were largely unaware about their transfer to the IC unit before this occurred and they were also unaware of their discharge package of care. These findings will inform the evolving patient-centred journey for service development within intermediate care
Examining the role of the health belief model framework in achieving diversity and equity in organ donation among South Asians in the United Kingdom
Get PDFOrgan donation continues to be low among ethnic minorities in the United Kingdom (UK), especially within the South Asian community, with a disproportionate number of patients of South Asian ethnicity awaiting organ transplants. In 2020/21, Minority Ethnic (ME) patients comprised almost a third of the national transplant waiting list, highlighting the continued imbalance between the need for transplants in South Asian communities and the availability of suitable organs. Median waiting times for transplants show that, generally, white patients wait less time than ME patients; Only 39.5% of ME families consented to proceed with deceased organ donation when approached compared to 69% of white families. How to increase awareness among the South Asian community on the scarcity of organ donors continues to be a growing challenge facing the healthcare system in the UK and globally. This article reflects on the education strategy implemented using the Health Belief Model. It provides a detailed framework with which to consider the rationale that led to a specific behaviour, in this case organ donation among the three major ethnicities (i.e., Indian, Pakistani, Bangladeshi) within the South Asian community as part of a single study
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
Ethnic minority women's experiences of accessing antenatal care in high income European countries: a systematic review
No full textBackground and Objective: Women from ethnic minority background are at greater risk of adverse maternal outcomes. Timely antenatal care is crucial in reducing risks of poor outcomes. The aim of this study was to identify, appraise, and synthesise recent qualitative evidence on ethnic minority women’s experiences of accessing antenatal care in high-income European countries, and to develop a novel conceptual access framework based on women’s perspectives. Methods: We searched eight 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 abstract 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. Results: Thirty studies conducted in 11 European countries were included. Participants in majority of studies were women newly arrived in the host country. Women’s experiences covered two overarching themes: ‘provision of antenatal care’ and ‘uptake of antenatal care’. The ‘provision of antenatal care’ theme included five sub-themes: promotion of antenatal care importance, getting to antenatal care, costs of antenatal care, interactions with care providers and models of antenatal provision. The ‘uptake of antenatal care’ theme included seven sub-themes: delaying initiation of antenatal care, seeking antenatal care, reaching antenatal care, engaging with antenatal care, previous experiences of interacting with maternity services, ability to communicate and immigration status. Conclusions: Findings demonstrated 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. Need for research on experiences across different generations of ethnic minority women, taking into account duration of stay in the host country in the host country was evident
Quantitative analysis of water injection mass and timing effects on oxy-fuel combustion characteristics in a GDI engine fuelled with E10
Get PDFThe climate change issue has become a growing concern due to the increasing greenhouse gas emissions. To achieve carbon neutrality for mitigating the climate problem, the oxy-fuel combustion (OFC) technique on internal combustion engines (ICEs) has attracted much attention. Furthermore, the water injection (WI) strategy was proven effective in improving the combustion process and thermal efficiency in engines under OFC mode. However, WI strategy effects on gasoline direct injection (GDI) engines fuelled with gasoline–alcohol blends have not been reported. This study quantitatively analysed WI mass and timing effects on oxy-fuel combustion performance from a GDI engine fuelled with E10 (10% ethanol and 90% gasoline in mass) by simulation. The results show that equivalent brake-specific fuel consumption (BSFCE) shows a monotonically decreasing trend with the increase in the water–fuel mass ratio (Rwf ) from 0 to 0.2. However, further increasing Rwf would cause a deterioration in BSFCE due to the enhanced cooling effects of water vaporisation. Moreover, an appropriate water injection timing (tWI ) could be explored for improving OFC performance, especially for large Rwf conditions. The difference in BSFCE between tWI = 100CA and tWI = 60CA can be up to around 6.3 g/kWh by increasing Rwf to 0.6
KEMIM: knowledge-enhanced user multi-interest modeling for recommender systems
Get PDFResearchers typically leverage side information, such as social networks or the knowledge graph, to overcome the sparsity and cold start problem in collaborative filtering. To tackle the limitations of existing user interest modeling, we propose a knowledge-enhanced user multi-interest modeling for recommender systems (KEMIM). First, we utilize the user-item historical interaction as the knowledge graph’s head entity to create a user’s explicit interests and leverage the relationship path to expand the user’s potential interests through connections in the knowledge graph. Second, considering the diversity of a user’s interests, we adopt an attention mechanism to learn the user’s attention to each historical interaction and each potential interest. Third, we combine the user’s attribute features with interests to solve the cold start problem effectively. With the knowledge graph’s structural data, KEMIM could describe the features of users at a fine granularity and provide explainable recommendation results to users. In this study, we conduct an in-depth empirical evaluation across three open datasets for two different recommendation tasks: Click-Through rate (CTR) prediction and Top-K recommendation. The experimental findings demonstrate that KEMIM outperforms several state-of-the-art baselines
The prevalence of metabolic syndrome and its components in firefighters: a systematic review and meta-analysis
Get PDFPrevious studies consistently report a high prevalence of cardiovascular disease (CVD) risk factors among firefighters. However, the clustering of CVD risk factors, defined as metabolic syndrome (MetSyn), has received little attention by comparison. Therefore, the aim of this study was to estimate the pooled prevalence of MetSyn among firefighters. Using combinations of free text for ‘firefighter’ and ‘metabolic syndrome’, databases were searched for eligible studies. Meta-analyses calculated weighted pooled prevalence estimates with 95% confidence intervals (CI) for MetSyn, its components and overweight/obesity. Univariate meta-regression was performed to explore sources of heterogeneity. Of 1440 articles screened, 25 studies were included in the final analysis. The pooled prevalence of MetSyn in 31,309 firefighters was 22.3% (95% CI: 17.7–27.0%). The prevalences of MetSyn components were hypertension: 39.1%; abdominal obesity: 37.9%; hypertriglyceridemia: 30.2%; dyslipidemia: 30.1%; and hyperglycemia: 21.1%. Overweight and obesity prevalence rates in firefighters were 44.1% and 35.6%, respectively. Meta-regression revealed that decreased risk of bias (RoB) score and increased body mass index (BMI) were positively associated with an increase in MetSyn prevalence. Since one in five firefighters may meet the criteria for MetSyn, novel interventions should be explored to both prevent MetSyn and reduce the onset of CVD risk factors
Drive-by sensing systems for environmental monitoring
Get PDFPhD proposal. The aim of this PhD is to investigate air pollution monitoring using vehicles such as busses, taxis, and UAVs as mobile sensing platforms
Interrupting sitting acutely attenuates cardiometabolic risk markers in South Asian adults living with overweight and obesity
Get PDFPurpose: This study examined the acute effects of interrupting sitting with light-intensity walking on postprandial cardiometabolic risk markers in South Asian adults. Methods: South Asians with overweight/obesity (n=19; body mass index [BMI] >23 kg·m-2) and normal-weight (n=8; BMI 18.0-22.9 kg·m-2) aged 48.8 ± 5.6 years completed two, 5-h conditions: (1) prolonged sitting (SIT), and (2) interrupted sitting with 5-min bouts of light-intensity walking every 30-min (INT-SIT). Blood samples and resting expired air samples were collected throughout each condition. Statistical analyses were completed using linear mixed models. Results: In participants with overweight/obesity, postprandial glucose, triglycerides (TAG) and metabolic load index (MLI) over time were lower, whereas resting substrate utilisation and resting energy expenditure (REE) were higher, in INT-SIT than SIT (all p≤0.05). Compared with SIT (0.18 [95% CI 0.13, 0.22] kcal.min-1), INT-SIT (0.23 [95% CI 0.18, 0.27] kcal.min-1) increased postprandial REE iAUC in participants with overweight/obesity (p=0.04, d=0.51). Postprandial TAG concentrations over time were lower in INT-SIT versus SIT (p=0.01, d=30) in normal-weight participants, with no differences in any other outcomes for this sample group. Conclusion: These findings suggest that interrupting sitting with 5-min bouts of light walking every 30-min acutely attenuates cardiometabolic risk markers among South Asians living with overweight/obesity, whereas limited effects may be seen in individuals with normal-weight
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