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Literature reviews generally analyse and synthesis the evidence (or lack thereof) in a particular topic area and they are an increasingly popular form of scholarly activity. The scoping review is a popular literature review approach that has been adopted across the social and health sciences over the last fifteen years. With this upsurge in use, differences of opinion about how to analyse and report scoping reviews has also grown. Drawing on work carrying out a scoping review on oral health and child maltreatment, we put forward a structured approach to analysis and reporting of such reviews: the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework. In this article, we reflect on the strengths and limitations of the framework, drawing on examples, laying out the methodological processes, and making suggestions as to how it might improve reporting. The article makes a contribution to efforts that seek to improve the reporting and utility of scoping reviews in health and social research.

Pluralism and creativity are inherent and important parts of the qualitative endeavour. The multiplicity of approaches and methods can, however, be confusing. We undertook a focused mapping review and synthesis to obtain a snap-shot profile of the state of qualitative research in health and social science literature. We retrieved 102 qualitative articles published between January and March 2015 from six leading health and social science journals. Articles were scrutinised for alignment between researchers' reported orientation (methodological or philosophical positioning) and the techniques used (methods). In the sampled articles level of alignment was generally high, with considerable mastery of qualitative approaches evident. However, the complexity of the qualitative landscape highlighted in our review, led us to develop a diagrammatic representation: The Qualitative Research Level of Alignment Wheel™. This educational resource/teaching aid is designed to assist qualitative researchers (particularly those more novice) and research students to locate the orientation and techniques of their studies. As an important contribution to the international field of qualitative inquiry, it will assist in understanding and accounting for points at which techniques are melded and orientations blended. In turn this will lead to the individual and collective qualitative endeavour as being a coherent one.

Why you should read this article: • To better understand the detrimental effects of domestic violence and abuse on children and young people • To acknowledge the importance of having independent domestic violence advocates in children’s hospitals • To reflect on how you can enhance your practice with regard to domestic violence and abuse. Domestic violence and abuse (DVA) has detrimental effects on the health and well-being of children and young people exposed to it, whether they witness or experience it. The introduction of independent domestic violence advocates in UK hospitals has enhanced the safety of victims of DVA. In 2020-2021 an independent domestic violence advocate post was piloted at a children’s hospital for one year, the advocate’s role being to train hospital staff and support women who had experienced DVA. A service evaluation showed that the training and support provided by the independent domestic violence advocate had benefits for women, children and staff. It also confirmed that the commissioning of services for children exposed to DVA is often underfunded and overshadowed by the provision of support to adults. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The 2013 WHO guidelines for nutritional rehabilitation of malnourished infants under six months (u6m) focus on inpatient re-establishment of exclusive breastfeeding and recommends discharge when infant is gaining weight on breastmilk alone. Guided by a breastfeeding support tool, breastfeeding peer supporters (BFPS) can support implementation of these guideline by providing continuous individualised breastfeeding counselling to mothers of malnourished infants u6m. Recording and sharing information plays an important role in shaping in-patient care but little is known about recording practices for inpatient nutrition rehabilitation of infants u6m or how such practices affect care. We set out to explore introduction of BFPS into hospitals, and how it shaped the recording and practices of care for acutely malnourished infants u6m. Methods: We applied a descriptive, exploratory design involving a pre and during intervention audit of the infant u6m inpatient records in two hospitals in Kenya, as well as pre- and post-intervention in-depth interviews with health workers involved in the care of admitted infants u6m. We developed an audit tool and used it to extract routine data on patient information from hospital records. Data were entered into a REDCap database and analyzed using STATA 17.0 software. We conducted thirty in-depth interviews with health workers exploring their care practices and their perceived effect of the presence of the BFPS on health workers treatment practices. We analysed interview data using thematic framework approach. Results: A total of 170 and 65 inpatient files were available for the audit during the pre- and post-intervention period respectively. The presence of the BFPS seemed to have encouraged the recording of (i) breastfeeding status upon admission, (ii) breastfeeding management plan and (iii) reporting of its implementation and progress during treatment. The breastfeeding peer support intervention had a positive impact on breastfeeding recording and reporting practices. Health workers reported that the BFPS facilitated the recording of observed breastfeeding data and how their records influenced final inputs of breastfeeding support provided in the inpatient file. Conclusions: Guideline implementation tools facilitate effective application of guidelines and should accompany any guideline formulation process and have their effectiveness at recording and monitoring progress evaluated. [ABSTRACT FROM AUTHOR]

Purpose: The Australian English Communicative Development Inventory (OZI) is a 558-item parent report tool for assessing language development at 12–30 months. Here, we introduce the short form (OZI-SF), a 100-item, picture-supported, online instrument with substantially lower time and literacy demands. Method: In tool development (Study 1), 95 items were drawn from the OZI to match its item distribution by age of acquisition and semantic categories. Five items were added from four other semantic categories, plus 12 gestures and six games/routines. Simulations computed OZI-SF scores from existing long-form OZI norm data, and OZI and projected OZI-SF scores were correlated. In an independent norming sample (Study 2), parents (n = 230) completed the OZI-SF for their children aged 12–30 months. Child scores were analysed by age and sex. Result: OZI-SF and OZI scores correlate highly across age and language development levels. Vocabulary scores (receptive, expressive) correlate with age and the median for girls is higher until 24 months. By 24 months, 50% of the sample combine words "often". The median time to OZI-SF completion was 12 minutes. Conclusion: Fitted percentiles permit working guidelines for typical (median) performance and lower cut-offs for children who may be behind on age-based expectations and/or at risk for a communication difficulty. The OZI-SF is a short-form of the OZI that has promise for research and clinical/educational use with Australian families. [ABSTRACT FROM AUTHOR]

Purpose: Standardised testing tools within an Aboriginal Australian context have been found to produce inaccurate results due to language and cultural differences. The primary aim of the study is to compare Aboriginal children's scores in urban NSW across two language assessment tools: the Early Language Inventory (ERLI) and the Australian English Communicative Development Inventory, short form (OZI-SF). These tools are vocabulary checklists for children aged approximately 12–30 months. OZI-SF is an Australian tool for mainstream use and ERLI has been developed with and for Aboriginal families, but not in urban contexts, so its suitability there is unknown, given the great cultural and linguistic diversity among Aboriginal people across Australia. The second aim is to identify which tool is more culturally appropriate for urban Aboriginal families through parent perspectives. Method: Overall, 30 parents (of 31 children) participated in the study to complete the ERLI, and 14 parents from this sample completed both the ERLI and OZI-SF and interviews to explore child scores and parent perspectives, in a mixed methods approach. Result: Aboriginal children (N = 14) scored higher on the ERLI than the OZI-SF. Gender and age were significant contributors to the scores as scores were higher for older children and higher for girls than boys. In answer to the second aim, four themes emerged to explain parental perspectives and their preference for the ERLI, which supported connection to culture and language. Conclusion: Findings have implications for paediatric language assessments with urban Aboriginal families in clinical, educational and research settings. [ABSTRACT FROM AUTHOR]

Acute malnutrition in infants under 6 months (u6m) is increasingly recognised as a global public health problem. The World Health Organisation (WHO) guidelines for inpatient nutritional rehabilitation of infants u6m is re‐lactation: the re‐establishment of exclusive breastfeeding. Evidence suggests these guidelines are rarely followed in many low‐income settings. Two studies of infant nutritional rehabilitation undertaken in three public hospitals in coastal Kenya employed breastfeeding peer supporters (BFPSs) to facilitate WHO guideline implementation. To explore the acceptability of the strategy to health workers (HWs) and the BFPSs, in‐depth interviews were conducted with 20 HWs and five BFPSs in the three study hospitals. The HWs reported that the presence of the BFPSs changed the way infant nutritional rehabilitation was managed, increasing efforts at relactation and decreasing reliance on supplemental milk. BFPSs were said to help address staff shortages and had dedicated time to support and assist the mothers. Key to the success of the BFPSs was the social relationships they were able to establish with the mothers due to the similarity in their experiences and backgrounds. Despite the success of the BFPSs, human resource management and infrastructure challenges remained. BFPSs can successfully be employed to facilitate the implementation of the WHO guidelines for the nutritional rehabilitation of acutely malnourished infants u6m in hospitals in Kenya, establishing supportive social relationships and trust with the mothers of the acutely malnourished infants and helping to address the issue of human resource shortages. [ABSTRACT FROM AUTHOR]

Purpose: This study compares the plan quality of high-dose-rate brachytherapy (HDR-BT) and volumetric modulated arc therapy (VMAT) for superficial irradiation of large areas of skin with significant curvature in one or more planes.Methods: A total of 14 patients from two centres previously treated with either HDR-BT or VMAT were retrospectively replanned using the alternative technique. Sites included scalp and lower limbs. Identical computed tomography (CT) scans, clinical target volume (CTV) and organs at risk (OARs) and prescription were used for both techniques. Conformity, skin surface dose and OAR doses were compared.Results: Conformity index was consistently better with VMAT than HDR-BT (p < 0.01). Maximum skin surface dose (D0.1cc) had a higher mean of 49.6 Gy with HDR-BT compared to 31.4 Gy for VMAT (p < 0.01). Significantly smaller volumes of healthy tissue were irradiated with VMAT than with HDR-BT. This can be seen in brain volumes receiving 10, 20 and 30 Gy EQD2 and in extremities receiving 5 and 10 Gy. When close to the volume, the lens received significantly lower doses with VMAT (p < 0.01).Conclusion: In this small sample, VMAT gives equal coverage with lower OAR and skin surface doses than HDR-BT for both scalp and extremities. VMAT is a useful technique for treating large, superficial volumes with significant curvature in one or more planes. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: Closed, often tight‐knit army communities can potentially provide protective factors for children; however, this environment can make it difficult to seek help or to speak out when there are concerns about children's safety or wellbeing.The needs and experiences of non‐serving parents (often female partners) can be overlooked unless, or until, child protection concerns are serious.Army‐connected children benefit from accessing army and civilian health, education and welfare services; however, transitions and communication between these services need to be improved. [ABSTRACT FROM AUTHOR]

Many Aboriginal and Torres Strait Islander children are affected by chronic middle ear infection or otitis media from infancy that has a negative impact on development of listening and communication skills. Deficits in these skills are often not detected until school-age when the opportunity for early intervention is lost. Primary health and early childhood workers need screening tools to assist them with detecting the problem early, but there is a scarcity of tools. This study reports the development and validation of a screening tool for detecting communication problems in young Aboriginal and Torres Strait Islander children. The tool, called the Hearing and Talking Scale (HATS), relies on a systematic use of parent observations of communication behaviours of their children in everyday situations. Developed by using a co-design approach, the HATS is culturally and linguistically appropriate for use with parents/carers of young children by front-line workers not trained in speech-language pathology. We validated the HATS by comparing the HATS score of 68 children (46 Indigenous and 22 non-Indigenous children) with their performance in standardised assessments. The accuracy of the HATS was 80% and 81% when compared to the ASQ-TRAK and the Expressive Vocabulary Test respectively. The HATS takes 5 minutes to administer, and is easy to score and interpret. It can be used as part of a standard ear and hearing health check for young children to support early detection so that those with problems can be referred for specialist diagnosis and treatment at a young age. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Re‐establishment and maintenance of exclusive breastfeeding (EBF) is recommended by the World Health Organization for the nutritional rehabilitation of malnourished infants under 6 months; however, there is no explicit guidance on how this should be achieved. The IBAMI study—a pilot study conducted in Kilifi, Kenya—implemented these recommendations using an intervention for hospitalized infants and their mothers that included ward‐based breastfeeding peer supporters. This paper explores how the challenges of maintaining EBF are recontextualized after infant hospitalization for malnutrition. Four weeks after discharge, semistructured interviews on experiences of trying to maintain EBF in a postdischarge home setting were conducted with a total of 20 mothers. Although most stated the aspiration of maintaining EBF for 6 months, a range of challenges were reported and not all had successfully maintained EBF post discharge. Reported challenges include the stress of household chores, food insecurity, technical difficulties and social stigma of expressing breast milk, pressure from neighbours and family members to introduce mixed feeding, and needing more community‐based awareness and support. Most of these challenges were specific to the home setting and were not easily surmountable, despite the breastfeeding practices mothers had learned in the ward. Indeed, in some cases, challenges were exacerbated by the overmedicalized nature of the breastfeeding practices taught in the ward. In order to aid the transition from ward to home, there may be a need to further translate ward‐based education and promotional messaging for EBF into a community setting, targeting other caregivers as well. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to develop a checklist to assess vocabulary development in Indigenous Australian children, with a local focus on Indigenous Australian children growing up in the towns and communities of the Katherine Region in the Northern Territory of Australia. In this region, many families are multilingual and/or multidialectal and children's home languages include varieties of Aboriginal English, Kriol, traditional Aboriginal languages, and/or other languages. Method: Over four years, a checklist was iteratively developed from parent interviews, comparisons of potential items to the content and structure of the Communicative Development Inventories (CDI): Words & Gestures (Short Form), team discussions and pilot testing with 33 parents of infants aged 0–4 years. Result: The Early Language Inventory (ERLI) checklist offers new content compared with the CDI: Words & Gestures (short form) and the OZI (Australian English CDI, long form). Initial data from 33 parents suggests the checklist has desirable features: scores correlated positively with age and related to word combining, reaching ceiling around 3 years of age for many children. Infants whose parents had concerns tended to have lower scores. Conclusion: ERLI is a new local adaptation of the CDI (Words & Gestures) for assessing early communication among Indigenous infants growing up in the Katherine region of the Northern Territory, Australia. [ABSTRACT FROM AUTHOR]

Background: Exclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first 6 months of life among first-time mothers in rural Kenya. Methods: An observational longitudinal design aimed to provide rich data on breastfeeding behaviour. Twenty pregnant first-time mothers were recruited through antenatal clinics and snowballing. Mothers were visited nine times at home from late pregnancy, at 1 week and 2 weeks post-delivery, then monthly until the baby was aged 6 months. Visits were conducted between November 2016 and April 2018. At the first visit, participants were asked about breastfeeding intentions and infant feeding education received. At each postnatal visit, direct observation of breastfeeding, a recorded semi-structured interview on feeding, mother's and baby's health was performed. Interviews were transcribed, checked, content was grouped into categories and analyzed using a qualitative descriptive approach. Results: Most participants were adolescent (75%) and unmarried (65%). All 20 mothers intended to and did breastfeed, however additional fluids and semi-solids were commonly given. Only two mothers exclusively breastfed from birth up to 6 months of age. Prelacteal feeds, home remedies and traditional medicine were given by over a third of mothers in the first week of life. Concern over babies' bowel habits and persistent crying perceived as abdominal colic led to several mothers receiving advice to give gripe water and traditional remedies. Early introduction of maize porridge from 3 months of age because of perceived hunger of the child was recommended by other family members. Breastfeeding observation showed persistent problems with positioning and attachment of infants. Conclusions: Exclusive breastfeeding from birth to 6 months was uncommon. Prioritization of capacity to detect mothers with breastfeeding problems and provide breastfeeding education and support is necessary, particularly during the antenatal and early postnatal period. It is important to engage with other women resident in the household who may offer conflicting feeding advice. [ABSTRACT FROM AUTHOR]

Over the past decade, the potential harms regarding young people's use of technology have attracted mounting political, media and research attention worldwide. One practice engaged in by many young people is that of "sexting" and the sharing of partially, or complete nude images ("selfies"). Such images are not always retained within private spaces and are prone to be shared, with significant psychosocial consequences for young people involved. A significant risk is the hidden nature of some online interactions, with potential for grooming and child sexual exploitation. As key professionals working with young people, public health nurses have potential to educate and explore the risks with them. Yet to date, to our knowledge there has been no research in relation to public health nurses' understandings of the practices involved or their potential harms. A qualitative study was undertaken drawing theoretically on the common‐sense model (CSM) to frame the analysis. Eighteen semi‐structured interviews were conducted with public health nurses in a region of England in 2016. Data were analysed through thematic analysis, and mapped to the five domains of CSM. Public health nurses' understandings of young people's sexting practices were shaped largely by media reports, rather than scientific, disciplinary knowledge. Sexting did not resonate with many public health nurses' own experiences of being a young person and was therefore difficult to understand. All were able to express an opinion about the causes and consequences of sexting and we present these as a "perceived hierarchy of risk". All public health nurses acknowledged the importance of their role in dealing with harm reduction associated with sexting among young people, but they need education and support to do this effectively and confidently. Findings can be transferred carefully to many contexts and countries because sexting is a practice among young people that transcends geographical boundaries. [ABSTRACT FROM AUTHOR]

Background: In this paper we discuss the emergence of many different methods for doing a literature review. Referring back to the early days, when there were essentially two types of review; a Cochrane systematic review and a narrative review, we identify how the term systematic review is now widely used to describe a variety of review types and how the number of available methods for doing a literature review has increased dramatically. This led us to undertake a review of current practice of those doing a literature review and the terms used to describe them.Method: We undertook a focused mapping review and synthesis. Literature reviews; defined as papers with the terms review or synthesis in the title, published in five nursing journals between January 2017-June 2018 were identified. We recorded the type of review and how these were undertaken.Results: We identified more than 35 terms used to describe a literature review. Some terms reflected established methods for doing a review whilst others could not be traced to established methods and/or the description of method in the paper was limited. We also found inconsistency in how the terms were used.Conclusion: We have identified a proliferation of terms used to describe doing a literature review; although it is not clear how many distinct methods are being used. Our review indicates a move from an era when the term narrative review was used to describe all 'non Cochrane' reviews; to a time of expansion when alternative systematic approaches were developed to enhance rigour of such narrative reviews; to the current situation in which these approaches have proliferated to the extent so that the academic discipline of doing a literature review has become muddled and confusing. We argue that an 'era of consolidation' is needed in which those undertaking reviews are explicit about the method used and ensure that their processes can be traced back to a well described, original primary source. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Background Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Design Qualitative study with a case study design. Methods In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Findings Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Conclusion Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. [ABSTRACT FROM AUTHOR]

Introduction We evaluated two modes of delivery of an inflammatory arthritis education program ("Prescription for Education" (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% ( n = 117) at T2 and 62% ( n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups. [ABSTRACT FROM AUTHOR]

Background: In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia.Methods/design: A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide better protection against clinical malaria in children than LLINs alone in The Gambia. The unit of randomization will be the household, defined as a house and its occupants. A total of 800 households will be enrolled and will receive LLINs, and 400 will receive improved housing before clinical follow-up. One child aged 6 months to 13 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Episodes of clinical malaria will be the primary endpoint. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection, parasite density, and the prevalence of anemia. Exposure to malaria parasites will be assessed using light traps, followed by detection of Anopheles gambiae species and sporozoite infection. Ancillary economic and social science studies will undertake a cost-effectiveness analysis and use qualitative and participatory methods to explore the acceptability of the housing modifications and to design strategies for scaling-up housing interventions.Discussion: The study is the first of its kind to measure the efficacy of housing on reducing clinical malaria, assess the incremental cost-effectiveness of improved housing, and identify mechanisms for scaling up housing interventions. Trial findings will help inform policy makers on improved housing for malaria control in sub-Saharan Africa.Trial Registration: ISRCTN Registry, ISRCTN02622179 . Registered on 23 September 2014. [ABSTRACT FROM AUTHOR]

Copyright of Health Policy & Planning is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives. To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women. Background. Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse. Design. A two-phase, qualitative study was conducted in Scotland. Methods. Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach. Findings. Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process. Conclusion. Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women. Relevance to clinical practice. The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning. [ABSTRACT FROM AUTHOR]

Children's sleep is critical for optimal health and development; yet sleep duration has decreased in recent decades, and many children do not have adequate sleep. Certain sleep behaviours ('sleep hygiene') are commonly recommended, and there is some evidence that they are associated with longer nighttime sleep. Parents of 84 British 3-year-old children were interviewed about their children's sleep and completed five-night/four-day sleep diaries documenting their children's sleep, from which daily sleep duration was estimated. Diaries were validated by actigraphy in a subgroup of children. Sleep hygiene behaviours (regular bedtime, reading at bedtime, falling asleep in bed) were associated with each other, and were more common in the high socioeconomic status compared to the low socioeconomic status group. Parents' reasons for not practicing sleep hygiene included difficulty, inability or inconvenience. Sleep hygiene behaviours were associated with significantly longer child sleep at night but not over 24 h. Longer daytime napping compensated for shorter nighttime sleep in children whose parents did not implement sleep hygiene behaviours. Parents may need to be advised that certain behaviours are associated with longer nighttime sleep and given practical advice on how to implement these behaviours. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: The delivery of a simultaneous integrated boost to the intra-prostatic tumour nodule may improve local control. The ability to deliver such treatments with hypofractionated SBRT was attempted using RapidArc (Varian Medical systems, Palo Alto, CA) and Multiplan (Accuray inc, Sunnyvale, CA).Materials and Methods: 15 patients with dominant prostate nodules had RapidArc and Multiplan plans created using a 5 mm isotropic margin, except 3 mm posteriorly, aiming to deliver 47.5 Gy in 5 fractions to the boost whilst treating the whole prostate to 36.25 Gy in 5 fractions. An additional RapidArc plan was created using an 8 mm isotropic margin, except 5 mm posteriorly, to account for lack of intrafraction tracking.Results: Both RapidArc and Multiplan can produce clinically acceptable boost plans to a dose of 47.5 Gy in 5 fractions. The mean rectal doses were lower for RapidArc plans (D50 13.2 Gy vs 15.5 Gy) but the number of missed constraints was the same for both planning methods (11/75). When the margin was increased to 8 mm/5 mm for the RapidArc plans to account for intrafraction motion, 37/75 constraints were missed.Conclusions: RapidArc and Multiplan can produce clinically acceptable simultaneous integrated boost plans, but the mean rectal D50 and D20 with RapidArc are lower. If the margins are increased to account for intrafraction motion, the RapidArc plans exceed at least one dose constraint in 13/15 cases. Delivering a simultaneous boost with hypofractionation appears feasible, but requires small margins needing intrafraction motion tracking. [ABSTRACT FROM AUTHOR]

Domestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique ( CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness ( CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals ( Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of appropriate strategies to support women post-disclosure. [ABSTRACT FROM AUTHOR]

The DAPPLE (Dynamic Assessment of Preschoolers’ Proficiency in Learning English) is currently being developed in response to a clinical need. Children exposed to English as an additional language may be referred to speech and language therapy because their proficiency in English is not the same as their monolingual peers. Some, but not all, of these children are likely to have a core language learning difficulty. Clinicians need to be able to distinguish disorder from difference due to a child’s language learning context. The assessment used a test–teach–test format to examine children’s ability to learn vocabulary, sentence structure and phonology. The assessment, which takes less than 60 minutes to administer, was given to 26 children who were bilingual: 12 currently on a speech and language therapy caseload and 14 children matched for age and socio-economic status who had never been referred to speech and language therapy. The DAPPLE data clearly discriminated the two groups. The caseload group required a greater amount of prompting to identify targeted words in the receptive vocabulary assessment and performed less well in the post-teaching expressive component. For sentence structure, the caseload group required more cues to acquire the targeted clause elements in the teaching phase. The caseload group made more phoneme errors at the initial and final assessments than the controls, and the type of errors made differed. Teaching resulted in greater positive change in percent phonemes correct for the caseload participants. Qualitative analyses of individual children’s performance on the DAPPLE suggested that it has the potential to discriminate core language deficits from difference due to a bilingual language learning context. Future directions for development of the test are considered. [ABSTRACT FROM PUBLISHER]

Background: Promoting walking or cycling to work (active commuting) could help to increase population physical activity levels. According to the habit discontinuity and residential self-selection hypotheses, moving home or workplace is a period when people (re)assess, and may be more likely to change, their travel behavior. Research in this area is dominated by the use of quantitative research methods, but qualitative approaches can provide in-depth insight into the experiences and processes of travel behavior change. This qualitative study aimed to explore experiences and motivations regarding travel behavior around the period of relocation, in an effort to understand how active commuting might be promoted more effectively. Methods: Participants were recruited from the Commuting and Health in Cambridge study cohort in the UK. Commuters who had moved home, workplace or both between 2009 and 2010 were identified, and a purposive sample was invited to participate in semi-structured interviews regarding their experiences of, and travel behavior before and after, relocating. A grounded theory approach was taken to analysis. Results: Twenty-six commuters participated. Participants were motivated by convenience, speed, cost and reliability when selecting modes of travel for commuting. Physical activity was not a primary motivation, but incidental increases in physical activity were described and valued in association with active commuting, the use of public transport and the use of park-and-ride facilities. Conclusions: Emphasizing and improving the relative convenience, cost, speed and reliability of active commuting may be a more promising approach to promoting its uptake than emphasizing the health benefits, at least around the time of relocation. Providing good quality public transport and free car parking within walking or cycling distance of major employment sites may encourage the inclusion of active travel in the journey to work, particularly for people who live too far from work to walk or cycle the entire journey. Contrary to a straightforward interpretation of the self-selection hypothesis, people do not necessarily decide how they prefer to travel, relocate, and then travel in their expected way; rather, there is constant negotiation, reassessment and adjustment of travel behavior following relocation which may offer an extended window of opportunity for travel behavior change. [ABSTRACT FROM AUTHOR]

Cytosolic phospholipase A(2) (cPLA(2)) is a Ca(2+)-sensitive enzyme that has been implicated in insulin secretion in response to agents that elevate beta-cell intracellular Ca(2+) ([Ca(2+)](i)). We generated clones of the MIN6 beta-cell line that stably underexpress cPLA(2) by transfection with a vector in which cPLA(2) cDNA had been inserted in the antisense orientation. Reduced expression of cPLA(2) was confirmed by Western blotting. The insulin content of cPLA(2)-deficient MIN6 cells was reduced by approximately 90%, but they showed no decrease in preproinsulin mRNA expression. Measurements of stimulus-dependent changes in [Ca(2+)](i) indicated that reduced expression of cPLA(2) did not affect the capacity of MIN6 cells to show elevations in Ca(2+) in response to depolarizing stimuli. Perifusion experiments indicated that cPLA(2) underexpressing MIN6 pseudoislets responded to glucose, tolbutamide, and KCl with insulin secretory profiles similar to those of cPLA(2) expressing pseudoislets, but that secretion was not maintained with continued stimulus. Analysis of the ultrastructure of cPLA(2)-deficient MIN6 cells by electron microscopy revealed that they contained very few mature insulin secretory granules, but there was an abundance of non-electron-dense vesicles. These data are consistent with a role for cPLA(2) in the maintenance of insulin stores, but they suggest that it is not required for the initiation of insulin secretion from beta-cells. [ABSTRACT FROM AUTHOR]

Post-separation for domestic violence (DV) survivors is known to be a period of heightened risk of domestic homicide. Evidence points to increased rates of DV during the Covid-19 pandemic, with specific challenges in help-seeking from DV services, yet studies that capture this qualitatively are still emerging. This UK study investigated the experiences of 21 separated DV survivors (all women) during the Covid-19 pandemic. Inductive, thematic analysis highlighted participants' psychological distress, isolation, fear of Covid-19 transmission, and detachment from support networks. The findings reflect the interconnected nature of adversities experienced by DV survivors and the exacerbation of these due to the insidious, multifaceted, and synergistic impacts of DV and the pandemic. [ABSTRACT FROM AUTHOR]

Background: Point-of-care C-reactive protein (CRP) testing of adults with acute respiratory infection in primary care reduces antibiotic prescribing by 22%. The acceptability and impact of CRP testing in children is unknownObjective: To determine the acceptability and impact of CRP testing in acutely ill children.Design: Mixed methods study comprising an observational cohort with a nested randomised controlled trial and embedded qualitative study.Subjects and Setting: Children presenting with an acute illness to general practice out-of-hours services; children with a temperature ≥38°C were randomised in the nested trial; parents and clinical staff were invited to the qualitative study.Main Outcomes: Informed consent rates; parental and staff views on testing.Results: Consent to involvement in the study was obtained for 200/297 children (67.3%, 95% CI 61.7% to 72.6%); the finger-prick test might have been a contributory factor for 63 of the 97 children declining participation but it was cited as a definite factor in only 10 cases. None of the parents or staff raised concerns about the acceptability of testing, describing the pain caused as minor and transient. General practitioner views on the utility of the CRP test were inconsistent.Conclusions: CRP point-of-care testing in children is feasible in primary care and is likely to be acceptable. However, it will not reduce antibiotic prescribing and hospital referrals until general practitioners accept its diagnostic value in children.Trial Registration Number: ISRCTN 69736109. [ABSTRACT FROM AUTHOR]

Purpose: Health and social care professionals are ideally placed to identify and address gender-based violence (GBV), yet research continues to demonstrate that the subject is being poorly covered at undergraduate level. This qualitative study explored health and social care students' and educators' views on GBV education, with a view to identifying 'best practice'. We aimed to capture students' and educators' experiences and perceptions of GBV education across participating countries; how participants thought GBV should be taught/learned within their curricula; and their views on how GBV education might be 'optimized'. Methods: We conducted nine focus group discussions and one semi-structured interview with 23 students and 21 academic staff across the UK, Australia and Chile. Results: Thematic analysis yielded three themes: (1) GBV addressed in all but name, (2) Introduce sooner, explore later and (3) A qualitative approach to learning. Educators and students indicated that GBV is largely being overlooked or incompletely addressed within curricula. Many participants expressed a wish for the subject to be introduced early and revisited throughout their study, with content evolving as cohorts mature. Lastly, our findings indicate that GBV education could benefit from adopting a 'qualitative' approach, prioritizing survivor narratives and incorporating dialogue to facilitate student engagement. Conclusion: Though time constraints and competing demands within undergraduate curricula are frequently cited as barriers to moving away from traditional didactic methods, our findings suggest that teacher-centered strategies are insufficient and, in some regards, inappropriate for GBV education. The need for a paradigm shift in GBV education is discussed. [ABSTRACT FROM AUTHOR]