38 research outputs found
The leaky pipeline of hearing care: primary to secondary care evidence from the English Longitudinal Study of Ageing (ELSA)
No full textObjective: The proportions of older adults’ transitions through acknowledging their hearing loss to getting access to treatment are unknown. This was examined using data from a nationally representative cohort in England. Design: Patient and healthcare factors associated with referrals were examined cross-sectionally, through primary to secondary care. Non-report predictors identified using multiple logistic regression models. Study sample: 8529 adults with hearing data in the English Longitudinal Study of Ageing Wave 7. Results: Nearly 40% of those with acknowledged hearing loss did not tell a doctor or nurse (n = 857/2249). Women (OR 2.68, 95% CI 2.14–2.98), retirees (OR 1.30, 95% CI 1.17–1.44), those with foreign education (OR 2.74, 95% CI 2.47–3.04), lower education (OR 2.86, 95% CI 2.58–3.18), smokers (OR 4.39, 95% CI 3.95–4.87), and heavy drinkers (OR 1.67, 95% CI 1.58–1.85) were more likely to not report hearing loss. Of those who acknowledged and reported hearing difficulties, willingness to try hearing aid(s) was high (78.9%). Conclusions: Unacknowledged, or acknowledged but not reported hearing loss by individuals, and non-referrals by primary healthcare professionals, are barriers to accessing hearing healthcare. Future research should report hearing aid use as the proportion of individuals who acknowledge their hearing loss, to avoid an overestimation of the non-use of hearing aids within study samples
Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England
No full text<p>Background:
Asians are at increased risk of morbidity at a lower body mass index (BMI) than European Whites, particularly relating to metabolic risk. UK maternal obesity guidelines use general population BMI criteria to define obesity, which do not represent the risk of morbidity among Asian populations. This study compares incidence of first trimester obesity using Asian-specific and general population BMI criteria.</p>
<p>Method:
A retrospective epidemiological study of 502,474 births between 1995 and 2007, from 34 maternity units across England. Data analyses included a comparison of trends over time between ethnic groups using Asian-specific and general population BMI criteria. Logistic regression estimated odds ratios for first trimester obesity among ethnic groups following adjustment for population demographics.</p>
<p>Results:
Black and South Asian women have a higher incidence of first trimester obesity compared with White women. This is most pronounced for Pakistani women following adjustment for population structure (OR 2.19, 95% C.I. 2.08, 2.31). There is a twofold increase in the proportion of South Asian women classified as obese when using the Asian-specific BMI criteria rather than general population BMI criteria. The incidence of obesity among Black women is increasing at the most rapid rate over time (p=0.01).</p>
<p>Conclusion:
The twofold increase in maternal obesity among South Asians when using Asian-specific BMI criteria highlights inequalities among pregnant women. A large proportion of South Asian women are potentially being wrongly assigned to low risk care using current UK guidelines to classify obesity and determine care requirements. Further research is required to identify if there is any improvement in pregnancy outcomes if Asian-specific BMI criteria are utilised in the clinical management of maternal obesity to ensure the best quality of care is provided for women irrespective of ethnicity.</p>
Synthesis, Characterization And Properties Of Silver Nanoparticles And Silver/Polyaniline Nanocomposites
No full textSilver/polyaniline (ag/pani) nanocomposites are promising materials due to
improved properties enabling various applications to date. In this work, a
comparative study on the citrate reduction of silver nanoparticles (agnps) was
carried out to investigate the combinations of trilithium citrate (tc) along with
ascorbic acid (aa) and d-sorbitol (ds) in reducing silver nitrate (sn). The influence
of varying concentrations of precursors, time, and temperature conditions towards
diffraction (xrd), ultraviolet/visible spectroscopy (uv-vis), transmission electron
microscopy (tem), and field emission scanning electron microscopy (fesem). The
characterization results showed that increasing concentrations of sn and aa yielded
increasing sizes of agnps, but vice versa for the addition concentrations of tc and
ds. The xrd patterns confirmed distinct peaks at approximately 20 = 38.2, 44.4,
64.6, 77.6, and 81.7°, representing bragg’s reflections from the (111), (200), (220),
(311), and (222) planes of the face-centred cubic lattice phase of metallic silver while
the uv-vis results recorded surface plasmon resonance in ranges of 414-452nm
Hardware modifications to enhance the eye surface profiler
No full text<b>Purpose</b>\ud
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The <i>Eye Surface Profiler</i> (ESP) is an instrument that estimates the shape of the cornea, limbus and a portion of the sclera. Sodium fluorescein is instilled into the ocular tear film, the ESP projects blue fringe patterns from two directions and the resulting green fluorescent emission patterns are analysed. The ESP is a useful clinical and research tool and we found that its operation could be enhanced. The focusing system is relatively insensitive to changes in position and, although crucial to the operation of the instrument, tear film fluorescence cannot be viewed before data is collected. We addressed these issues to enhance its operation.\ud
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<b>Methods</b>\ud
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A video camera was attached to the ESP to view the instrument’s focusing spots from a second direction. The operator can then position the ESP at a more repeatable distance (Z) from the eye. X/Y alignment is handled via the original ESP focusing system. A blue LED ring light, operated via a footswitch, was also attached to the camera to give a live view of tear fluorescence. When consistent fluorescein coverage was observed, the operator switches off the ring light and collects data immediately with the original flash system.\ud
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To investigate repeatability, five maps were collected for the right eyes of 3 subjects using A) the original ESP focusing technique (ESPf) and B) our new camera and focusing technique (NEWf). Maps for each subject for each technique were filtered to remove artefacts then averaged to derive a standard deviation map (SD at each map grid point). To compare ESPf with NEWf, the SD maps for all subjects were averaged and split into ‘corneal’ (central 10 mm diameter) and ‘limbal/scleral’ (outside 10 mm diameter) regions.\ud
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<b>Results</b>\ud
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The ‘corneal’ average SD was 8.6 um for ESPf and 4.8 um for NEWf (44% reduction). The ‘limbal/scleral’ average SD was 19.6 um for ESPf and 11.1 um for NEWf (43% reduction).\ud
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<b>Conclusions</b>\ud
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The hardware modifications to the ESP have enhanced focusing precision and reduced variability between maps for the eyes tested. By viewing tear film fluorescence prior to collecting data, we have also ensured that tear film artefacts have less impact on data quality
Using Trust databases to identify predictors of late booking for antenatal care within the UK
No full textObjectives: To identify predictors of late booking for antenatal care using routinely collected data. Study design: Retrospective cohort study. Methods: Variables were selected with reference to comprehensive literature review. Data were extracted from a London hospital case-note database, and predictors of late booking were identified using logistic regression. Results: In total, 5629 women were included in the study. Median gestation at booking was 14 weeks, and 31% of women booked after 18 weeks of gestation. Variables with insufficient data recorded included language abilities, nationality and social risk. Women aged between 15 and 19 years, women with more than four children, and women belonging to the ethnic group 'other' were all significantly more likely to book late. Women with a body mass index >= 30kg/m(2) were 1.5 times more likely to book late (not significant). Conclusion: Case-note databases are a potentially easy and effective way to analyse access to care and provider compliance with quality standards. Current deficits in routine data collection need to be addressed urgently in order to make this possible.</p
Speech testing in adult audiology (Parmar et al., 2022)
No full textObjective: The aim of this study was to evaluate hearing health care professionals’ (HHPs) speech testing practices in routine adult audiology services and better understand the facilitators and barriers to speech testing provision.
Design: A cross-sectional questionnaire study was conducted.
Study Sample: A sample (N = 306) of HHPs from the public (64%) and private (36%) sectors in the United Kingdom completed the survey.
Results: In the United Kingdom, speech testing practice varied significantly between health sectors. Speech testing was carried out during the audiology assessment by 73.4% of private sector HHPs and 20.4% of those from the public sector. During the hearing aid intervention stage, speech testing was carried out by 56.5% and 26.5% of HHPs from the private and public sectors, respectively. Recognized benefits of speech testing included (a) providing patients with relatable assessment information, (b) guiding hearing aid fitting, and (c) supporting a diagnostic test battery. A lack of clinical time was a key barrier to uptake.
Conclusions: Use of speech testing varies in adult audiology. Results from this study found that the percentage of U.K. HHPs making use of speech tests was low compared to that of other countries. HHPs recognized different benefits of speech testing in audiology practice, but the barriers limiting uptake were often driven by factors derived from decision makers rather than clinical rationale. Privately funded HHPs used speech tests more frequently than those working in the public sector where time and resources are under greater pressure and governed by guidance that does not include a recommendation for speech testing. Therefore, the inclusion of speech testing in national clinical guidelines could increase the consistency of use and facilitate the comparison of practice trends across centers.
Supplemental Material S1. A summary of survey study results provided by HHPs in relation to the implementation of speech testing practices in adult audiology across the world.
Supplemental Material S2. Survey: Speech testing in Adult Audiology (UK).
Supplemental Material S3. All survey responses.
Parmar, B. J., Rajasingam, S. L., Bizley, J. K., & Vickers, D. A. (2022). Factors affecting the use of speech testing in adult audiology. American Journal of Audiology. Advance online publication. https://doi.org/10.1044/2022_AJA-21-00233</p
Micro-Raman temperature measurements for electric field assessment in active AlGaN - GaN HFETs
No full textTemperature profiles in the source/drain (S/D) opening of a single finger AlGaN-GaN heterostructure field-effect transistor wire studied at increasing S/D voltages by micro-Raman spectroscopy withTemperature profiles in the source/drain (S/D) opening of a single finger AlGaN-GaN heterostructure field-effect transistor wire studied at increasing S/D voltages by micro-Raman spectroscopy wit
A STABILITY-INDICATING RP-HPLC METHOD FOR SIMULTANEOUS DETERMINATION OF SIMVASTATIN AND NIACIN IN A COMBINED DOSAGE FORM
No full textObjective: To develop a simple, selective and rapid stability-indicating reverse phase high performance liquid chromatography (RP-HPLC) method and validate as per ICH guidelines for simultaneous determination of simvastatin and niacin in a combined dosage form.Methods: The chromatographic separation of the two cholesterol lowering drugs were achieved using Inertsil CN (5 µm, 250 mm x 4.6 mm i. d. column), maintained at 30 °C throughout the analysis. The drugs were separated in isocratic elution mode with a mobile phase of 0.1% acetic acid buffer-methanol (50:50, v/v) at a flow rate of 1.0 mL/min and a detection wavelength of 237 nm using a UV-PDA detector.Results: The linearity and range for niacin and simvastatin were 0.05 to 0.150 mg/mL (R2> 0.9999) and 0.004 to 0.012 mg/mL (R2> 0.9992), respectively. Mean recoveries observed for niacin and simvastatin were 99.36% and 99.93%, respectively. The precision of the method obtained was 99.66% for niacin and 99.34% for simvastatin with a relative standard deviation less than 2%. The lower degree of % RSD that was obtained for intermediate precision has proved that the method is robust and rugged.Conclusion: A simple and rapid stability-indicating RP-HPLC method was developed and validated for simultaneous determination of niacin and simvastatin in a combined dosage form and hence, it can be used in the quality control analysis of an active pharmaceutical ingredient and pharmaceutical dosage form.Â
Existing maternal obesity guidelines may increase inequalities between ethnic groups: a national epidemiological study of 502,474 births in England
No full textInside the ‘imperfect mosaic’: Minority ethnic women’s qualitative experiences of race and ethnicity during pregnancy, childbirth, and maternity care in the United Kingdom
No full textBackground: Persistent, high rates of maternal mortality amongst ethnic minorities is one of the UK’s starkest examples of racial disparity. With greater risks of adverse outcomes during maternity care, ethnic minority women are subjected to embedded, structural and systemic discrimination throughout the healthcare service. Methods: Fourteen semi-structured interviews were undertaken with minority ethnic women who had recent experience of UK maternity care. Data pertaining to ethnicity and race were subject to iterative, inductive coding, and constant comparison through Grounded Theory Analysis to test a previously established theory: The ‘Imperfect Mosaic’. Analysis & findings: A related theory emerged, comprising four themes: ‘Stopping Short of Agentic Birth’; ‘Silenced and Stigmatised through Tick-Box Care’; ‘Anticipating Discrimination and the Need for Advocacy’; and ‘Navigating Cultural Differences’. The new theory: Inside the ‘Imperfect Mosaic’, demonstrates experiences of those who received maternity care which directly mirrors experiences of those who provide care, as seen in the previous theory we set-out to test. However, the current theory is based on more traditional and familiar notions of racial discrimination, rather than the nuanced, subtleties of socio-demographic-based micro-aggressions experienced by healthcare professionals. Conclusions: Our findings suggest the need for the following actions: Prioritisation of bodily autonomy and agency in perinatal physical and mental healthcare; expand awareness of social and cultural issues (i.e., moral injury; cultural safety) within the NHS; and undertake diversity training and support, and follow-up of translation of the training into practice, across (maternal) health services
