• Parents' expectations and experiences of the 6-week baby check: a qualitative study in primary care

      Gilworth, Gill; Milton, Sarah; Chater, Angel M.; Nazareth, Irwin; Roposch, Andreas; Green, Judith; King's College London; University of Bedfordshire; University College London (Royal College of General Practitioners, 2020-11-18)
      Background: The Newborn and Infant Physical Examination (NIPE) programme requires all babies to have a comprehensive health check at 6-8 weeks of age. These are typically completed by GPs. Although person-centred care has achieved prominence in maternity care policy in recent years, there is limited empirical evidence on what parents and/or carers expect from the check, and how far experiences meet their needs. Aim: To explore the expectations and experiences of parents attending their GP for a baby check. Design & setting: A qualitative study was undertaken in primary care in London. Method: Content analysis was undertaken of transcripts of semi-structured interviews. Interviews were conducted with a total of 16 participants (14 mothers and two fathers) who had recently attended for a 6-week check for their baby. Results: Despite the availability of plentiful sources of general advice on infants' health and development, a thorough check by a trusted GP was an important milestone for most parents. They had few specific expectations of the check in terms of what examinations were undertaken, but even experienced parents anticipated reassurance about their baby's normal development. Many also hoped for reassurance about their own parenting. Parents appreciated GPs who explained what they were doing during the examination; space to raise any concerns; and combined mother and baby checks. Referrals to secondary care were generally experienced as reassuring rather than a source of anxiety. Conclusion: The baby check meets needs beyond those of the NIPE screening programme. Protecting the time for a thorough consultation is important for parents at what can be a vulnerable time.
    • Parents’ expectations and experiences of the 6-week baby check: a qualitative study in primary care

      Gilworth, Gill; Milton, Sarah; Chater, Angel M.; Nazareth, Irwin; Roposch, Andreas; Green, Judith; King's College London; University of Bedfordshire; University College London (Royal College of General Practitioners, 2020-11-18)
      Background The Newborn and Infant Physical Examination (NIPE) programme requires all babies to have a comprehensive health check at 6–8 weeks of age. These are typically completed by GPs. Although person-centred care has achieved prominence in maternity care policy in recent years, there is limited empirical evidence on what parents and/or carers expect from the check, and how far experiences meet their needs. Aim  To explore the expectations and experiences of parents attending their GP for a baby check. Design & setting A qualitative study was undertaken in primary care in London. Method Content analysis was undertaken of transcripts of semi-structured interviews. Interviews were conducted with a total of 16 participants (14 mothers and two fathers) who had recently attended for a 6-week check for their baby. Results Despite the availability of plentiful sources of general advice on infants’ health and development, a thorough check by a trusted GP was an important milestone for most parents. They had few specific expectations of the check in terms of what examinations were undertaken, but even experienced parents anticipated reassurance about their baby’s normal development. Many also hoped for reassurance about their own parenting. Parents appreciated GPs who explained what they were doing during the examination; space to raise any concerns; and combined mother and baby checks. Referrals to secondary care were generally experienced as reassuring rather than a source of anxiety. Conclusion The baby check meets needs beyond those of the NIPE screening programme. Protecting the time for a thorough consultation is important for parents at what can be a vulnerable time.
    • Parents’ experiences of complementary feeding among a United Kingdom culturally diverse and deprived community

      Cook, Erica Jane; Powell, Faye; Ali, Nasreen; Penn-Jones, Catrin; Ochieng, Bertha; Randhawa, Gurch; University of Bedfordshire; DeMontfort University (Blackwell Publishing Ltd, 2020-11-09)
      Complementary feeding practices and adherence to health recommendations are influenced by a range of different and often interrelating factors such as socio-economic and cultural factors. However, the factors underlying these associations are often complex with less awareness of how complementary feeding approaches vary across the UK’s diverse population. This paper describes a qualitative investigation undertaken in a deprived and culturally diverse community in the UK which aimed to explore parents’ knowledge, beliefs and practices of complementary feeding. One hundred and ten mothers and fathers, self-identified as being White British, Pakistani, Bangladeshi, Black African/Caribbean or Polish took part in twenty-four focus group discussions, organised by age group, sex and ethnicity. The findings revealed that most parents initiated complementary feeding before the World Health Organisation (WHO) recommendation of 6 months. Early initiation was strongly influenced by breast feeding practices alongside the extent to which parents believed that their usual milk; that is, breastmilk or formula was fulfilling their infants' nutritional needs. The composition of diet and parents' approach to complementary feeding was closely aligned to traditional cultural practices; however, some contradictions were noted. The findings also acknowledge the pertinent role of the father in influencing the dietary practices of the wider household. Learning about both the common and unique cultural feeding attitudes and practices held by parents may help us to tailor healthy complementary feeding advice in the context of increasing diversity in the United Kingdom.
    • Parsec: a state channel for the Internet of Value

      Jaiswal, Amit Kumar (2018-07-30)
      We propose Parsec, a web-scale State channel for the Internet of Value to exterminate the consensus bottleneck in Blockchain by leveraging a network of state channels which enable to robustly transfer value off-chain. It acts as an infrastructure layer developed on top of Ethereum Blockchain, as a network protocol which allows coherent routing and interlocking channel transfers for trade-off between parties. A web-scale solution for state channels is implemented to enable a layer of value transfer to the internet. Existing network protocol on State Channels include Raiden for Ethereum and Lightning Network for Bitcoin. However, we intend to leverage existing web-scale technologies used by large Internet companies such as Uber, LinkedIn or Netflix. We use Apache Kafka to scale the global payment operation to trillions of operations per day enabling near-instant, low-fee, scalable, and privacy-sustainable payments. Our architecture follows Event Sourcing pattern which solves current issues of payment solutions such as scaling, transfer, interoperability, low-fees, micropayments and to name a few. To the best of knowledge, our proposed model achieve better performance than state-of-the-art lightning network on the Ethereum based (fork) cryptocoins.
    • Part segregation based on particle swarm optimisation for assembly design in additive manufacturing

      Maiyar, Lohithaksha M.; Singh, Sube; Prabhu, Vittal; Tiwari, Manoj Kumar (Taylor and Francis Ltd., 2019-05-05)
      Minimising total production time in the additive or layered manufacturing is a critical concern, and in this respect, the idea of balancing assembly time and build time is rapidly gaining research attention. The proposed work intends to provide benefit in terms of reduced lead time to customers in a collaborative environment with simultaneous part printing. This paper formulates a mixed-integer non-linear programming (MINLP) model to evaluate the near optimal threshold area and support material allocation while segregating parts for a single material additive manufacturing set-up. The resulting time minimisation model is finitely bounded with respect to support material volume, total production time and total assembly cost constraints. A novel swarm intelligence-based part segregation procedure is proposed to determine the number of part assemblies and part division scheme that adheres to cross-sectional shape, cross-sectional area, and height restrictions. The proposed approach is illustrated and evaluated for objects with regular as well as free-form surfaces using two different hypothetically simulated real size 3D models. Results indicate that the proposed approach is able to reduce the total amount of manufacturing time in comparison with single part build time for all the tested cases.
    • Part-time students in transition: supporting a successful start to higher education

      Goodchild, Allyson; University of Bedfordshire (Taylor and Francis, 2017-12-21)
      The transition into higher education is a critical time for all students. A positive early experience provides a strong foundation for future academic success whilst a negative experience can be destabilising for a new learner. To date, research has primarily focused on full-time undergraduates in order to explain the reasons for high attrition rates at the end of the first year. Less is known about the experiences of part-time undergraduates despite the fact that they make up over one quarter of the total student population (HESA, 2015). This article reports on a study to investigate the initial experiences of a group of part-time undergraduates who have chosen to undertake a degree at a small study centre run by one university. Using a mixed methods research approach, the research captured the lived reality of the experience and identified the contributing and negating factors that can influence a successful transition. Perceptions of the level and type of support provided for students during transition were gained from both staff and students. The findings confirm a heterogeneous group. Despite being highly motivated, the early transition period was generally characterised by a sense of trepidation and self-doubt as students took their first steps in higher education. The research highlights the complexity of the initial decision-making process for part-time students and the barriers they face. It concludes that a flexible but unified approach, involving tutors and the wider support services, is needed, as unique students require unique responses to their transition needs.
    • The participation of young people in child sexual exploitation services: a scoping review of the literature

      Brodie, Isabelle; D'Arcy, Kate; Harris, Julie Philippa; Roker, Debi; Shuker, Lucie; Pearce, Jenny J.; University of Bedfordshire (University of Bedfordshire, 2016-01-10)
      This is a scoping review of the literature which focuses on the participation of young people in child sexual exploitation services.  The review is part of the Alexi Project, which involves an evaluation of the CSEFA Hub and Spoke services in England. The review aims to develop understanding of the concept of participation and the nature of effective participatory practice in the context of child sexual exploitation services. It has taken place between September 2015 and April 2016. The review focuses on the following questions: • How is ‘participation’ of young people in CSE services conceptualised in the research, policy and professional literature? • How explicit is the policy requirement for children and young people’s participation in the processes associated with assessment, planning and review and what evidence exists regarding the implementation and/or effectiveness of these processes? • What evidence exists regarding the nature of the experience of participation, and its impact, from the perspectives of young people, parents and carers, and professionals? • What evidence exists regarding the conditions that need to be in place to make participative working possible and effective for different groups of CSE affected young people? • What evidence exists regarding the replicability of participative models?
    • Participation that matters [Editorial]

      Knight, Julia; Weedon, Alexis; University of Bedfordshire; University of Sunderland (SAGE, 2013-08-31)
    • Participatory peer research methodology: an effective method for obtaining young people’s perspectives on transitions from care to adulthood?

      Lushey, Clare J.; Munro, Emily (SAGE, 2014-11-21)
      Peer research has the potential to empower young people to participate in research by minimising power imbalances between researchers and participants; this may reduce bias and promote improved understanding to inform policy and practice. However, these benefits are not automatic; the relative inexperience of peer researchers adds layers of complexity to the research process. Moreover, the validity of findings from research adopting less traditional methods may be questioned and policy makers may be cautious about accepting this evidence, thus limiting its contribution and impact. This paper explores the advancement of participatory peer researcher methodology in research with children in and leaving care and ethical, practical and data quality issues that arose in two studies exploring young people’s transitions from care to adulthood. It concludes that the peer research methodology can yield rich data but that adequate resources and effective research management are crucial. The authors also caution against a reductionist approach that privileges peer research methodology above other methods of inquiry in the study of transitions from care to adulthood.
    • Partners in practice: developing integrated learning opportunities on the Frontline child and family social work qualifying programme

      Domakin, Alison; Curry, Liz (Blackwell Publishing Ltd, 2017-08-23)
      The Frontline programme is a social work qualifying route, in England, featuring a different approach to curriculum design and delivery. Students are based in groups of 4, learning through practicing social work in a statutory child and family social work setting, alongside a Consultant Social Worker (in the role of practice educator). They are also supported by an Academic Tutor who works in partnership with the Consultant Social Worker to facilitate learning. A weekly “unit meeting” is a foundational aspect of the programme, providing opportunities for in-depth discussion, teaching, and reflection on practice with families. The authors worked together over the first 2 cohorts of the programme and undertook action research to explore the learning opportunities that arise when academic staff and practitioners work side by side to support student learning in this model. Three broad themes were identified which were considered to be significant in helping students to learn which are explored in the paper: Learning through engaging in joint dialogue about practice in a unit meeting The influence of relationships on learning in social work The importance of a connected model of learning which has practice with children and families at its heart.
    • Passion, pathways and potential in dance: research report

      Redding, Emma; Nordin-Bates, Sanna; Aujla, Imogen; Trinity Laban (Trinity Laban Conservatoire of Music and Dance, 2011-01-01)
      Through a groundbreaking collaboration between Trinity Laban dance science researchers and the Centres for Advanced Training (CATs) across England, almost 800 young dancers took part in an interdisciplinary, longitudinal research project into dance talent development. Funded for a 3-year period by the Leverhulme Trust and the Department for Education, the research comprised investigations into the psychology, physiology, anthropometry, injury, adherence, and creativity of this talented cohort of young dancers. Our combination of quantitative and qualitative findings demonstrate that CAT dancers exhibited steadily increasing levels of physical fitness, high and stable levels of psychological well-being, low to moderate levels of injury and dropout, and positive creativity experiences. The CATs thus appeared to be nurturing young talent in an effective and healthy way. Findings are summarised under seven main headings.
    • Passive localization through light flicker fingerprinting

      Munir, Bilal; Dyo, Vladimir (IEEE, 2019-08-22)
      In this paper, we show that the flicker waveforms of various CFL and LED lamp models exhibit distinctive waveform patterns due to harmonic distortions of rectifiers and voltage regulators, the key components of modern lamp drivers. We then propose a passive localization technique based on fingerprinting these distortions that occur naturally in indoor environments and thus requires no infrastructure or additional equipment. The novel technique uses principal component analysis (PCA) to extract the most important signal features from the flicker frequency spectra followed by kNN clustering and neural net- work classifiers to identify a light source based on its flicker signature. The evaluation on 39 flicker patterns collected from 8 residential locations demonstrates that the technique can identify a location within a house with up to 90% accuracy and identify an individual house from a set of houses with an average accuracy of 86.3%.
    • Pathways into and out of organised crime

      Pitts, John; Hope, T.; Hurley, M.; McGibbon, I. (Greater Manchester Police, 2015-12-01)
    • Pathways of disadvantage: walking as a mode of transport among low-income mothers

      Bostock, Lisa (Wiley, 2000-09-09)
      Research shows that lack of car ownership is associated with poorer health. It is often assumed that the reason for this observed relationship is that access to a car ‹ or not ‹ reflects access to household assets. Consequently, lack of car ownership is used as a standard marker of low socio-economic status. However, little attention has been paid to the experience of carlessness in the context of disadvantaged lives. This paper argues that 'no access to a car' is not only an indicator of low socio-economic status but of walking as a mode of transport. These arguments are illustrated by data from a study of 30 low-income mothers with young children. Although walking is promoted as both an excellent and inexpensive form of exercise, these data suggest that reliance on walking can have negative effects on the welfare of families. The paper draws on qualitative data to describe the ways in which carlessness restricts access to health and social care resources such as food shops, health-care services and social networks. It also explores the impact of walking on the well being of mothers and their day-to-day relationships with children. This is compounded by walking through areas that are neglected and depressed. The paper concludes that strategies to reduce social exclusion must recognise the contradictory health effects of walking and aim to regenerate the physical fabric of social housing estates as well as improve public transport options.
    • Patient empowerment for cancer patients through a novel ICT infrastructure

      Kondylakis, Haridimos; Bucur, Anca; Crico, Chiara; Dong, Feng; Graf, Norbert; Hoffman, Stefan; Koumakis, Lefteris; Manenti, Alice; Marias, Kostas; Mazzocco, Ketti; et al. (Academic Press Inc., 2019-12-06)
      As a result of recent advances in cancer research and “precision medicine” approaches, i.e. the idea of treating each patient with the right drug at the right time, more and more cancer patients are being cured, or might have to cope with a life with cancer. For many people, cancer survival today means living with a complex and chronic condition. Surviving and living with or beyond cancer requires the long-term management of the disease, leading to a significant need for active rehabilitation of the patients. In this paper, we present a novel methodology employed in the iManageCancer project for cancer patient empowerment in which personal health systems, serious games, psychoemotional monitoring and other novel decision-support tools are combined into an integrated patient empowerment platform. We present in detail the ICT infrastructure developed and our evaluation with the involvement of cancer patients on two sites, a large-scale pilot for adults and a small-scale test for children. The evaluation showed mixed evidences on the improvement of patient empowerment, while ability to cope with cancer, including improvement in mood and resilience to cancer, increased for the participants of the adults′ pilot.
    • Patient uptake and adherence to social prescribing: a qualitative study

      Pescheny, Julia Vera; Randhawa, Gurch; Pappas, Yannis; University of Bedfordshire (Royal College of General Practitioners, 2018-08-08)
      Social prescription is an initiative that aims to link patients in primary care with sources of support within the community and voluntary sector to improve their health, wellbeing, and care experience. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. Most research on social prescribing (SP) has focused on outcome evaluations, resulting in a knowledge gap of factors affecting uptake and adherence. Understanding such factors enables the refinement of programmes, which has the potential to enhance uptake and adherence, reduce health inequalities, and optimise investment. Aim To explore the experiences and views of service users, involved GPs, and navigators on factors influencing uptake and adherence to SP. Design & setting Qualitative interviews were conducted with stakeholders involved in an SP programme in the east of England (Luton). Method Data were collected from semi-structured face-to-face interviews with service users, navigators, and GPs. Thematic analysis was used to analyse the data. Results Factors affecting uptake and adherence to SP were related to patients’ trust in GPs, navigators' initial phone call, supportive navigators and service providers, free services, and perceived need and benefits. Reported barriers to uptake and adherence were fear of stigma of psychosocial problems, patient expectations, and the short-term nature of the programme. Conclusion This study provides an insight into factors affecting patient uptake and adherence to SP programmes. More research in this field, including patients who refused to participate in SP, is needed. Go to: Social prescription is an initiative that aims to link patients in primary care with sources of support within the community and voluntary sector to improve their health, wellbeing, and care experience. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. Most research on social prescribing (SP) has focused on outcome evaluations, resulting in a knowledge gap of factors affecting uptake and adherence. Understanding such factors enables the refinement of programmes, which has the potential to enhance uptake and adherence, reduce health inequalities, and optimise investment. Aim To explore the experiences and views of service users, involved GPs, and navigators on factors influencing uptake and adherence to SP. Design & setting Qualitative interviews were conducted with stakeholders involved in an SP programme in the east of England (Luton). Method Data were collected from semi-structured face-to-face interviews with service users, navigators, and GPs. Thematic analysis was used to analyse the data. Results Factors affecting uptake and adherence to SP were related to patients’ trust in GPs, navigators' initial phone call, supportive navigators and service providers, free services, and perceived need and benefits. Reported barriers to uptake and adherence were fear of stigma of psychosocial problems, patient expectations, and the short-term nature of the programme. Conclusion This study provides an insight into factors affecting patient uptake and adherence to SP programmes. More research in this field, including patients who refused to participate in SP, is needed.
    • Patient-specific fibre-based models of muscle wrapping

      Kohout, Josef; Clapworthy, Gordon J.; Zhao, Youbing; Tao, Yubo; Gonzalez-Garcia, G.; Dong, Feng; Wei, Hui; Kohoutová, E.; University of West Bohemia; University of Bedfordshire (Royal Society, 2013-04-06)
      In many biomechanical problems, the availability of a suitable model for the wrapping of muscles when undergoing movement is essential for the estimation of forces produced on and by the body during motion. This is an important factor in the Osteoporotic Virtual Physiological Human project which is investigating the likelihood of fracture for osteoporotic patients undertaking a variety of movements. The weakening of their skeletons makes them particularly vulnerable to bone fracture caused by excessive loading being placed on the bones, even in simple everyday tasks. This paper provides an overview of a novel volumetric model that describes muscle wrapping around bones and other muscles during movement, and which includes a consideration of how the orientations of the muscle fibres change during the motion. The method can calculate the form of wrapping of a muscle of medium size and visualize the outcome within tenths of seconds on commodity hardware, while conserving muscle volume. This makes the method suitable not only for educational biomedical software, but also for clinical applications used to identify weak muscles that should be strengthened during rehabilitation or to identify bone stresses in order to estimate the risk of fractures.
    • Patients' perception of using telehealth for type 2 diabetes management: a phenomenological study

      Lee, Puikwan; Greenfield, Geva; Pappas, Yannis (BioMed Central Ltd., 2018-07-13)
      BACKGROUND: There is a growing body of evidence that supports the uses of telehealth to monitor and manage people with diabetes at a distance. Despite this, the uptake of telehealth has been low. The objective of this study is to explore patients' perceptions of using telehealth for type 2 diabetes management. METHODS: Semi-structured interviews were undertaken with 10 patients from the NHS Newham area in London, UK. Data were collected using recorded semi-structured interviews. The interviews were transcribed verbatim and the analysis was guided by the phenomenological analysis approach. RESULTS: We identified three main themes for facilitating positive patient experience or acceptance of telehealth and these included: technology consideration, service perceptions and empowerment. All patients asserted that they were pleased with the technology and many also proclaimed that they could not see themselves being without it. Moreover, very few negative views were reported with respect to the use of telehealth. CONCLUSION: The patients' perceived telehealth as a potential to enhance their quality of life, allow them to live independently at home as well as help them take and be in more control over their own health state. The findings of this study therefore supports the use of telehealth for the routine care of people with type 2 diabetes. However, one must interpret the results with caution due to limitations identified in the sample.
    • Patients' perspectives on antiepileptic medication: relationships between beliefs about medicines and adherence among patients with epilepsy in UK primary care

      Chapman, S.C.E.; Horne, Robert; Chater, Angel M.; Hukins, D.; Smithson, W.H.; University College London School of Pharmacy; Northern General Hospital, Sheffield; St John's University, York (Elsevier, 2014-02-14)
      BACKGROUND: Nonadherence to antiepileptic drugs (AEDs) can result in suboptimal outcomes for patients. AIM: This study aimed to assess the utility of a theory-based approach to understanding patient perspectives on AEDs and adherence. METHOD: Patients with epilepsy, identified by a GP case note review, were mailed validated questionnaires assessing their perceptions of AEDs and their adherence to them. RESULTS: Most (84.9%) of the 398 AED-treated respondents accepted the necessity of AEDs, but over half expressed doubts, with 55% disagreeing or uncertain about the statement 'I would prefer to take epilepsy medication than risk a seizure'. Over a third (36.4%) expressed strong concerns about the potential negative effects of AEDs. We used self-report and medication possession ratio to classify 36.4% of patients as nonadherent. Nonadherence was related to beliefs about medicines and implicit attitudes toward AEDs (p<0.05). Adherence-related attitudes toward AEDs were correlated with general beliefs about pharmaceuticals (BMQ General: General Harm, General Overuse, and General Benefit scales) and perceptions of personal sensitivity to medicines (PSM scale). CONCLUSION: We identified salient, adherence-related beliefs about AEDs. Patient-centered interventions to support medicine optimization for people with epilepsy should take account of these beliefs.
    • Patterns-of-life aided authentication

      Zhao, Nan; Ren, Aifeng; Zhang, Zhiya; Zhu, Tianqiao; Ur-Rehman, Masood; Yang, Xiaodong; Hu, Fangming; Xidian University; University of Bedfordshire (MDPI, 2016-09-23)
      Wireless Body Area Network (WBAN) applications have grown immensely in the past few years. However, security and privacy of the user are two major obstacles in their development. The complex and very sensitive nature of the body-mounted sensors means the traditional network layer security arrangements are not sufficient to employ their full potential, and novel solutions are necessary. In contrast, security methods based on physical layers tend to be more suitable and have simple requirements. The problem of initial trust needs to be addressed as a prelude to the physical layer security key arrangement. This paper proposes a patterns-of-life aided authentication model to solve this issue. The model employs the wireless channel fingerprint created by the user’s behavior characterization. The performance of the proposed model is established through experimental measurements at 2.45 GHz. Experimental results show that high correlation values of 0.852 to 0.959 with the habitual action of the user in different scenarios can be used for auxiliary identity authentication, which is a scalable result for future studies.