A tale of two pregnancies: A Critical Interpretive Synthesis of women’s perceptions about delayed initiation of antenatal care

Background

Delayed access to antenatal care in high income countries is associated with poor maternal, fetal and neonatal outcomes. The aim was to synthesise the diverse body of evidence around women’s views of early antenatal care and barriers to attendance in such countries. Critical Interpretive Synthesis integrates the process of systematic review with the qualitative methods of meta-ethnography and grounded theory, with a focus on theory generation to inform policy, practice and future research.

Protective support and supportive protection for families “in the middle”: Learning from the Irish context

This paper critically examines the relationship between statutory family support and child protection using the case study of Ireland. It builds on the work of Devaney and McGregor (2017) to offer an additional contribution to existing frameworks for practice through adapting the Hardiker Exton and Barker (1991) model of prevention. Using evidence from current Irish developments, the case for moving away from linear and simplistic differentiation of family support and child protection is made. Evidence from three main sources in Ireland is presented to develop the argument. This evidence includes the Child Care Law Reporting project (Coulter, 2015, 2018); a recent evaluation of a family support practice model called Meitheal (Rodriguez Cassidy and Devaney, 2018) and recent findings about public awareness of family support (McGregor and NicGabhainn, 2018). We argue that special attention should be paid to families “in the middle” who are in need of both support and protection and propose an adapted version of Hardiker et al. model to aid in this work. We identify what should happen at different levels for macrostructural to micropractice levels. We conclude that the learning from the Irish case study can be applied to an international context.     

Maternal Affective Expression and Adolescents' Subjective Experience of Positive Affect in Natural Settings

This study investigated the association between maternal affective expression during laboratory‐based interaction tasks and adolescents' experience of positive affect (PA) in natural settings. Participants were 80 healthy adolescents and their mothers. Durations of maternal positive (PA) and negative affective (NA) expressions were observed during a conflict resolution task and a positive event planning interaction task. Ecological momentary assessment (EMA) procedures were employed to assess adolescents' momentary and peak experience of PA in daily life. Results indicated that maternal NA, but not maternal PA, was related to adolescents' EMA‐reported PA. Adolescents whose mothers expressed more NA experienced less PA in daily environments. Results suggest that adolescents' exposure to maternal negative affective behavior is associated with adolescents' subjective daily well‐being.     

Barriers and facilitators to adherence to group exercise in institutionalized older people living with dementia: a systematic review

Objectives

Research suggests targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to group exercise of institutionalized older people living with dementia.

Methods

We searched all available electronic databases. Additionally, we searched trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We searched for and included papers from January 1990 until September 2017 in any language. We included randomized, non-randomized trials. Studies were not eligible if participants were either healthy older people or people suffering from dementia but not living in an institution. Studies were also excluded if they were not focused on barriers and facilitators to adherence to group exercise.

Results

Using narrative analysis, we identified the following themes for barriers: bio-medical reasons and mental wellbeing and physical ability, relationships dynamics, and socioeconomic reasons. The facilitators were grouped under the following thematic frames: bio-medical benefits and benefits related to physical ability, feelings and emotions and confidence improvements, therapist and group relationships dynamics and activity related reasons.

Conclusions

We conclude that institutionalized older people living with dementia, even those who are physically frail, incontinent and/or have mild dementia can demonstrate certain level of exercise adherence, and therefore can respond positively to exercise programs. Tailored, individually-adjusted and supported physical activity, led by a knowledgeable, engaging and well communicating therapist/facilitator improves the adherence to group exercise interventions of institutionalized older people living with dementia.

     

Intra-rater reliability of hip abductor isometric strength testing in a standing position in older fallers and non-fallers

Background

Reduced hip muscle strength has been shown to be a major factor related to falls in older persons. However, comprehensive assessment of hip abduction strength in the clinical setting is challenging. The aim of this study was to investigate the feasibility and intra-rater reliability of a quick and simple hip abductor strength test in a functional standing position.

Methods

Individuals over 65 years of age were recruited from the geriatric department of a university hospital and an outpatient clinic. Thirty-two older subjects, including 16 fallers (≥1 fall during the last 12 months) and 16 non-fallers were included. Maximum voluntary isometric strength (MVIS) and rate of force generation (RFG) of the hip abductors of the right leg were evaluated in a standing position using a hand-held dynamometer. Two test-sessions were carried out. All hip strength values were normalized to participants’ weight. Reliability was determined using the intra-class correlation coefficient agreement (ICC_agreement), the standard error of measurement (SEM) and a Bland and Altman analysis (BA).

Results

All participants completed the strength tests, which took a mean 2.47?±?0.49 min (one limb). Intra-rater reliability was higher for MVIS (0.98_{[0.95–0.99]}) than RFG (ICC?=?0.93_{[0.87–0.97]}) for the entire sample. In the non-fallers, ICC was 0.98_{[0.95–1.00]} (SEM?=?0.08 N.kg^??1) for MVIS and 0.88_{[0.75–0.96]} for RFG (SEM?=?1.34 N.kg^-1.s^-1). In the fallers, ICC was 0.94_{[0.89–0.98]} (SEM?=?0.11 N.kg^??1) for MVIS and 0.93_{[0.84–0.98]} (SEM?=?1.12 N.kg^??1.s^??1) for RFG. The BA plot showed that the MVIS and RFG values did not differ across test-sessions, showing that no learning effect occurred (no systematic effect). The mean differences between test-sessions were larger and the LOA smaller in the fallers than in the non-fallers.

Conclusion

Assessment of hip strength in a standing position is feasible, rapid and reliable. We therefore recommend this position for clinical practice. Future studies should investigate the diagnostic value of hip abductor strength in standing to discriminate between fallers and non-fallers, and to determine if change in strength following a falls prevention program reduces the risk of falls.

     

Researching the occupational culture of public relations in Mexico

Within the field of international public relations, it is rare to find detailed accounts of the process of undertaking cross-cultural research. Yet researchers who collect data in cultural contexts different from their own face numerous ethical and cultural challenges. By failing to articulate these, researchers deny the accommodations they have to make in their methodological choices, limiting the explanatory power of their findings. This article reflects on how societal culture influenced the evolving research decisions and experiences in a study into the occupation of public relations in Mexico City. In considering how to explore in a culturally sensitive way the social reality of public relations practitioners, it raises ethical concerns regarding selectivity and relationship interactions in cross-cultural research.     

Cultural archaeology and historical geographies of the black presence in rural England

This paper focuses on the exclusion of black peoples from the English countryside. It particularly considers how white imaginaries of the English rural have ignored historical geographies of the black presence. Firstly the paper reflects upon the heritage of Englishness as represented in and through the rural tradition. It then presents some cultural excavations of black history undertaken by academics, community scholars and local history groups and asks how the histories they reveal challenge ideas of rural histories of England. The paper then considers how historical geographies of anti-racism may complement these new takes on rural heritage and provide a counter narrative to ’traditional’ English rurality.     

Gaussian Regularized Sliced Inverse Regression

Sliced Inverse Regression (SIR) is an effective method for dimension reduction in high-dimensional regression problems. The original method, however, requires the inversion of the predictors covariance matrix. In case of collinearity between these predictors or small sample sizes compared to the dimension, the inversion is not possible and a regularization technique has to be used. Our approach is based on a Fisher Lecture given by R.D. Cook where it is shown that SIR axes can be interpreted as solutions of an inverse regression problem. We propose to introduce a Gaussian prior distribution on the unknown parameters of the inverse regression problem in order to regularize their estimation. We show that some existing SIR regularizations can enter our framework, which permits a global understanding of these methods. Three new priors are proposed leading to new regularizations of the SIR method. A comparison on simulated data as well as an application to the estimation of Mars surface physical properties from hyperspectral images are provided.