43 research outputs found
Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion
No full textObjectives: To identify predictors of acceptable hearing at 5 weeks, 6 and 12 months in children with bilateral otitis media with effusion (OME). Design and setting: Secondary analysis of OSTRICH data, conducted in hospital ear, nose and throat (ENT) and paediatric audiology and audiovestibular medicine departments across Wales and England. Participants: The OSTRICH study included 389 children aged 2-8 years with bilateral hearing loss attributable toOME for at least 3 months. Main outcome measures: Baseline, 5-week, 6- and 12-month audiology measurements were collected and logistic regression models used to identify pre-randomisation baseline variables that predicted return of acceptable hearing, which was defined as less than or equal to 20 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in at least one ear in children assessed by pure tone audiometry, ear-specific insert visual reinforcement audiometry or ear-specific play audiometry less than or equal to 25 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in children assessed by sound-field visual reinforcement audiometry or sound-field performance/play audiometry, based on national guidelines. Results: Less severe baseline hearing loss across both ears most consistently predicted acceptable hearing at 5 weeks (adjusted odds ratio [aOR] 0.91, 95% CI 0.87-0.95), 6 months (0.94 [0.90-0.98]) and 12 months (0.93 [0.89-0.97]). Negative history of atopy (2.05 [1.16-3.61]), never using hearing aids (aOR 2.16 [1.04-4.48]), and being male (1.75 [1.02-2.99]) were significant at 6 months, but not at 12 months. Symptom duration was a predictor at 5 weeks, but not at 6 or 12 months. Conclusions: Milder baseline hearing loss most consistently predicts acceptable hearing at 5 weeks, 6 and 12 months in children with chronic OME. Negative history of atopy, never using hearing aids, and male gender are associated with better prognosis. These predictors can be used to identify children that may not require treatment.</p
Anaesthetic Safety: What Do Patients Understand and Expect?
No full text• Patients’ satisfaction depends on their prior expectations. These, in turn, are influenced by their understanding of a procedure.
• Provision of adequate pre-operative information can improve patients’ perioperative outcomes.
• Patients’ understanding of information provided may be optimised by employment of techniques including consolidation by multiple team members throughout the pre-operative period and the presence of a companion during consultations.
• A relative lack of awareness surrounding the anaesthesia and the role of the anaesthesiologists are contributing factors towards patient anxiety.
• A careful balance must be obtained between providing enough information to facilitate informed decision-making without causing unnecessary stress.
• Causes of patients’ perioperative anxiety are variable and are often underestimated. Efforts to acknowledge and alleviate this anxiety are known to have therapeutic benefit.
• Patients’ expectations of anaesthesia are influenced by a multitude of individual, social and cultural factors. This highlights the importance of meaningful discussion with the patient and a tailored approach to the pre-operative consenting procedure.
• In light of the COVID-19 pandemic, the good health of healthcare workers is increasingly being recognised as a priority for ensuring patient safety
Recommended from our members
Fox, hedgehog, human, machine: a cautious reappraisal of AI and copyright through rights and welfare
No full textThis chapter examines the challenges that generative AI (GenAI) poses for copyright law and argues for a carefully tailored regulatory approach. Placing the human author at the centre, it contends that fully autonomous AI-generated works, which lack meaningful human creative input, should fall outside the scope of copyright protection. At the same time, in support of a more participatory, socially inclusive, and responsive copyright framework, it argues that where human authors provide sufficiently detailed input and exercise creative choices that shape the final output, such contributions may qualify for protection. This analysis maintains that copyright’s adaptation in the age of GenAI is a cultural opportunity to redefine the future of creativity and advance human development. From a social welfare perspective, such an approach promotes democratic access to creativity and upholds the freedom to create, while highlighting essential questions about inclusivity and the evolving role of creativity in a GenAI-driven society
A high-fat diet impairs cardiac high-energy phosphate metabolism and cognitive function in healthy human subjects
No full textBACKGROUND: High-fat, low-carbohydrate diets are widely used for weight reduction, but they may also have detrimental effects via increased circulating free fatty acid concentrations. Objective: We tested whether raising plasma free fatty acids by using a high-fat, low-carbohydrate diet results in alterations in heart and brain in healthy subjects. DESIGN: Men (n = 16) aged 22 ± 1 y (mean ± SE) were randomly assigned to 5 d of a high-fat, low-carbohydrate diet containing 75 ± 1% of calorie intake through fat consumption or to an isocaloric standard diet providing 23 ± 1% of calorie intake as fat. In a crossover design, subjects undertook the alternate diet after a 2-wk washout period, with results compared after the diet periods. Cardiac 31P magnetic resonance (MR) spectroscopy and MR imaging, echocardiography, and computerized cognitive tests were used to assess cardiac phosphocreatine (PCr)/ATP, cardiac function, and cognitive function, respectively. RESULTS: Compared with the standard diet, subjects who consumed the high-fat, low-carbohydrate diet had 44% higher plasma free fatty acids (P < 0.05), 9% lower cardiac PCr/ATP (P < 0.01), and no change in cardiac function. Cognitive tests showed impaired attention (P < 0.01), speed (P < 0.001), and mood (P < 0.01) after the high-fat, low-carbohydrate diet. CONCLUSION: Raising plasma free fatty acids decreased myocardial PCr/ATP and reduced cognition, which suggests that a high-fat diet is detrimental to heart and brain in healthy subjects.Cameron J. Holloway, Lowri E. Cochlin, Yaso Emmanuel, Andrew Murray, Ion Codreanu, Lindsay M. Edwards, Cezary Szmigielski, Damian J. Tyler, Nicholas S. Knight, Brian K. Saxby, Bridget Lambert, Campbell Thompson, Stefan Neubauer and Kieran Clarkehttp://www.ajcn.org/content/93/4/748.full.pdf+htm
Transferring primary generalists’ positive classroom pedagogy to the physical education setting: a collaborative PE-CPD process
No full textBackground: The primary school age group (aged 5–11 years) is acknowledged as a critical period in the development of physical activity patterns and healthy lifestyle behaviours. Furthermore, high quality physical education (PE) is crucial for the development of lifelong physical activity behaviours and is highly dependent on the interaction between the teacher and the pupil. Despite this, there is a lack of training and confidence of many primary generalist teachers to teach PE in the UK. It is argued that effective continuing professional development (CPD) to address this issue should be supportive, job embedded, instructionally focused, collaborative and ongoing.
Purpose: This study was funded by a national government funded organisation and led by a university in collaboration with a secondary PE specialist and two primary teachers. The purpose was to develop a replicable PE-CPD process to improve primary generalist teachers’ PE pedagogy by transferring their positive pedagogy from the classroom to the PE setting.
Participants: The participants were two Year 3 (age 7–8 years) primary classroom teachers from the same school and one secondary PE specialist teacher who acted as a mentor.
Research approach: A collaborative professional learning (CPL) approach was utilised to develop the PE-CPD intervention process. CPL involves teachers and other members of a profession working together to improve their own and others’ learning on pedagogic issues. A six-week needs assessment phase was completed through classroom and PE lesson observations to identify key areas for development in the PE-CPD process over the duration of a 23 week intervention.
Data collection and analysis: Reflective logs, structured lesson observations and teacher interviews were used to collect the data during the PE-CPD intervention. Inductive and deductive qualitative thematic analysis was used to analyse and interpret the data.
Findings: A number of key themes were generated during the data analysis including the transfer of positive pedagogy from the classroom to the PE setting and the implementation of effective pedagogic principles including the setting of clear learning outcomes, differentiation and inclusion to enhance the PE pedagogy. A key element to the success of the intervention was the trusting relationships built by the secondary PE specialist with the primary teachers. Further, the results also revealed the importance of CPL in ensuring rigorous, evidence-based PE-CPD and providing the time and support required for fundamental sustainable changes in practice, which can endure beyond the life of the research project.
Conclusion: The major contribution of this paper is in demonstrating the potential of CPL between national organisations, universities, secondary and primary schools to improve the PE pedagogy of primary generalist teachers. Future research should build upon the findings in this study and replicate this PE-CPD approach with other classes and schools
Appreciative Inquiry as a methodological approach to collaboration between different sporting organisations in Wales to promote physical literacy
No full textThe aim of this study was for university consultants to apply and critically evaluate Appreciative Inquiry (AI) as a methodological approach to collaboration with the national organisation for promoting sport and physical activity in Wales, a Welsh national governing body for sport, and a Welsh local authority department responsible for sport and leisure, to develop a physical literacy (PL) programme for primary schools. Three phases of an AI cycle; the discovery phase, the dream phase, and the design phase were the focus of this study, within which the consultants acted as ‘boundary spanners’, to promote collaboration between the different organisations, over a period of six-months. In the discovery and dream phases data was gathered through AI conversations, written accounts and observation, whilst a collaborative meeting and specific follow up actions were employed for the design phase. Qualitative thematic analysis revealed key messages for the use of AI in such collaborative projects, and some interesting insight into the complexities of this methodological approach. Overall, in considering the key contribution to knowledge of this study, AI was shown to be an effective approach to adopt in multi-organisational collaborative ventures of this nature. However, the collaborative structures were often intricate and dynamic in nature, resulting in some challenges for the consultants convening them. The practical implications for those wishing to conduct AI, are that such approaches require large amounts of resources in the form of energy, commitment, skill and nurturing on the part of the leaders
Definitions, Foundations and Associations of Physical Literacy: A Systematic Review
No full textBackground: The concept of physical literacy has stimulated increased research attention in recent years—being deployed in physical education, sport participation, and the promotion of physical activity. Independent research groups currently operationalize the construct differently. Objective The purpose of this systematic review was to conduct a systematic review of the physical literacy construct,as reflected in contemporary research literature. Methods: Five databases were searched using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews. Inclusion criteria were English language, peer reviewed, published by March 2016, and seeking to conceptualize physical literacy. Articles that met these criteria were analysed in relation to three core areas: properties/attributes, philosophicalfoundations and theoretical associations with other constructs. A total of 50 published articles met the inclusion criteria and were analysed qualitatively using inductive thematic analysis.Results: The thematic analysis addressed the three core areas. Under definitions, core attributes that define physical literacy were identified, as well as areas of conflict between different approaches currently being adopted. One relatively clear philosophical approach was prominent in approximately half of the papers, based on a monist/holistic ontology and phenomenological epistemology. Finally, theanalysis identified a number of theoretical associations, including health, physical activity and academic performance.Conclusions: Current literature contains different representations of the physical literacy construct. The costs and benefits of adopting an exclusive approach versus pluralism are considered. Recommendations for both researchers and practitioners focus on identifying and clearly articulating the definitions, philosophical assumptions and expected outcomes prior to evaluating the effectiveness of this emerging concept
A ball of energy: The use of Laban movement analysis and imagery to develop a performer holistically in dance
No full textRisky Business: Constructing the ‘choice’ to ‘delay’ motherhood in the British press
No full textOver the last few decades the number of women becoming pregnant later on in life has markedly increased. Medical experts have raised concerns about the increase in the number of women having babies later, owing to evidence that suggests that advancing maternal age is associated with both a decline in fertility and an increase in health risks to both mother and baby (Nwandison & Bewley, 2006). In recognition of these risks, experts have warned that women should aim to complete their families between the ages of twenty and thirty-five (Bewley, Davis and Braude, 2005). As a consequence, women giving birth past the age of thirty-five have typically been positioned as ‘older mothers.’ In this paper we used a social constructionist thematic analysis in order to analyse how ‘older mothers’ are represented in newspaper articles in the British press. We examined how the topics of ‘choice’ and ‘risk’ are handled in discussions of delayed motherhood, and found that the media position women as wholly responsible for choosing the timing of pregnancy and, as a consequence, as accountable for the associated risks. Moreover, we noted the newspapers also constructed a ‘right’ time for women to become pregnant. As such, we discuss the implications for the ability of women to make real choices surrounding the timing of pregnancy
‘Measuring’ Physical Literacy and Related Constructs: A Systematic Review of Empirical Findings
No full textBACKGROUND:The concept of physical literacy has received increased research and international attention recently. Where intervention programs and empirical research are gaining momentum, their operationalizations differ significantly.OBJECTIVE:The objective of this study was to inform practice in the measure/assessment of physical literacy via a systematic review of research that has assessed physical literacy (up to 14 June, 2017).METHODS:Five databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines, with 32 published articles meeting the inclusion criteria. English-language, peer-reviewed published papers containing empirical studies of physical literacy were analyzed using inductive thematic analysis.RESULTS:Qualitative methods included: (1) interviews; (2) open-ended questionnaires; (3) reflective diaries; (4) focus groups; (5) participant observations; and (6) visual methods. Quantitative methods included: (1) monitoring devices (e.g., accelerometers); (2) observations (e.g., of physical activity or motor proficiency); (3) psychometrics (e.g., enjoyment, self-perceptions); (4) performance measures (e.g., exergaming, objective times/distances); (5) anthropometric measurements; and (6) one compound measure. Of the measures that made an explicit distinction: 22 (61%) examined the physical domain, eight (22%) the affective domain; five (14%) the cognitive domain; and one (3%) combined three domains (physical, affective, and cognitive) of physical literacy. Researchers tended to declare their philosophical standpoint significantly more in qualitative research compared with quantitative research.CONCLUSIONS:Current research adopts diverse often incompatible methodologies in measuring/assessing physical literacy. Our analysis revealed that by adopting simplistic and linear methods, physical literacy cannot be measured/assessed in a traditional/conventional sense. Therefore, we recommend that researchers are more creative in developing integrated philosophically aligned approaches to measuring/assessing physical literacy. Future research should consider the most recent developments in the field of physical literacy for policy formation
