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Background and objective: Older adults of a South Asian heritage are predisposed to frailty, yet they remain less likely to access targeted frailty services for support with their health and wellbeing. Little is known about how older South Asian adults and family members perceive and experience frailty. The aim of this study was to examine South Asian families' perspectives and experiences of frailty to inform health services and increase access for families living with frailty. Research design: Hermeneutic phenomenological design. Methods: Eight people living with frailty and eight family carers were purposefully selected from community settings in West Yorkshire, England. Data were collected in July 2021. Semi-structured interviews were audio recorded, transcribed, and thematically analysed. Results: Four themes were identified; a naturally degenerating mind and body, beliefs about frailty causality, impact of frailty, and adapting to living with frailty. Frailty is perceived as degeneration of the mind and body which occurs as a natural part of the ageing process. It is also associated with lifestyle, previous employment, and viewed as God ordained. Frailty profoundly impacts the lives of South Asian families by causing stigma, isolation and loneliness, and negative emotions. However, South Asian people believe it is possible to adapt to living with frailty through making adjustments and using religion as a coping strategy. Discussion and implications: This study identifies a need for educational interventions for South Asian families which raise awareness around frailty to reduce stigma and enable access to appropriate frailty support and services. It is also imperative for health, social care and third sector providers to consider the individual meaning of frailty for this population in relation to their cultural and religious context and beliefs, to understand how this may impede decisions to seek frailty care and support, and their needs in relation to service provision. [ABSTRACT FROM AUTHOR]

Introduction Sepsis is one of the most common causes of mortality in postnatal women globally and many other women who develop sepsis are left with severe morbidity. Women's knowledge of postnatal sepsis and how it can be prevented by simple changes to behaviour is lacking. Methods This paper describes the co-development and feasibility testing of a digital animation intervention called DAISI (digital animation in service improvement). This DAISI is designed to enhance postnatal women's awareness of sepsis and how to reduce their risk of developing the condition. We co-designed the digital animation over a six-month period underpinned by theory, best evidence and key stakeholders, translated it into Urdu then assessed its use, firstly in a focus group with women from different Black, Asian and Minority Ethnic (BAME) groups and secondly with 15 clinical midwives and 15 women (including BAME women). Following exposure to the intervention, midwives completed a questionnaire developed from the COM-B behaviour change model and women participated in individual and focus group interviews using similar questions. Results The animation was considered acceptable, culturally sensitive and simple to implement and follow. Discussion DAISI appears to be an innovative solution for use in maternity care to address difficulties with the postnatal hospital discharge process. We could find no evidence of digital animation being used in this context and recommend a study to test it in practice prior to adopting its use more widely. If effective, the DAISI principle could be used in other maternity contexts and other areas of the NHS to communicate health promotion information., Author(s): Melanie Haith-Cooper [sup.1] , Tomasina Stacey [sup.2] , Fran Bailey [sup.3] , Sarah Broadhead-Croft [sup.4] Author Affiliations: (1) grid.6268.a, 0000 0004 0379 5283, University of Bradford, , Bradford, UK [...]

Community‐based peer volunteer interventions are increasingly used with people who are asylum seekers and refugees accessing health services. There is a dearth of evidence evaluating the benefits of volunteering for asylum seeking or refugee volunteers. Volunteers may have poor mental health and feel socially isolated due to their experiences as refugees and asylum seekers and may struggle or be unable to obtain paid employment. Volunteering in other contexts has been found to be beneficial to the health and well‐being of the volunteer. This paper reports on an aspect of a wider study evaluating the community‐based Health Access for Refugees Project, with the aim of exploring the impact of volunteering on the health and well‐being of the peer (asylum seeker or refugee) volunteer. In 2020, we conducted qualitative semistructured interviews by phone with 15 volunteers who were asylum seekers or refugees. The interviews were audio recorded, data were transcribed verbatim and the data set was thematically analysed. We found that the positive relationships which developed and the training received through volunteering boosted volunteers' mental well‐being. They felt motivated and confident in helping others, felt a sense of belonging and this reduced their social isolation. They also believed they benefited personally, helping their access to health services, and preparing them for future education, training or a career. In light of the beneficial nature of volunteering identified in this study, establishing more volunteering opportunities for this population and other marginalised groups with poor mental health is recommended. However, more research is needed to assess both the long‐term impact of the role in terms of the peer volunteer's health and well‐being, and the societal benefit of people moving on, integrating and contributing to society. [ABSTRACT FROM AUTHOR]

Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK's Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26-28 weeks' gestation at the Bradford Royal Infirmary (2007-2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (, Author(s): Tomasina Stacey[sup.1] , Stephanie Prady[sup.2] , Melanie Haith-Cooper[sup.3] , Soo Downe[sup.4] , Nigel Simpson[sup.5] , Kate Pickett[sup.2] Author Affiliations: (1) School of Healthcare, University of Leeds, LS2 9JT, LeedsUK [...]

Rationale and objective: Perceptions of frailty can influence how families cope, quality of life and access to support services. Yet little is known of how lay members of the UK general public perceive frailty. This scoping review aimed to explore how frailty is perceived among the lay public in the United Kingdom. Methods: The established scoping review methodology by Arksey and O'Malley was followed and searches were conducted across eight electronic databases and grey literature websites for articles published between 1990 and August 2022. In total, 6,705 articles were identified, of which six were included in the review. Data were analysed using Braun and Clarke's thematic analysis framework. Results: Three key themes were identified; frailty as a normal part of ageing, perceived consequences of frailty and coping with frailty. Overall, frailty has negative connotations and is perceived as linked to a natural part of the ageing process, increased dependency, loss of identity and social exclusion and stigma. However, it is unclear whether these perceptions have a direct bearing on access to support services for communities. Conclusion and implications: This review identifies that it is imperative for health and social care service providers to consider the individual meaning of frailty for older people and families, to understand and integrate their particular needs and preferences when planning and delivering person centred frailty care and support. There is also a need for development of interventions that focus on increasing education and reducing stigma around frailty in order to change frailty perceptions in the UK. [ABSTRACT FROM AUTHOR]

Part 1 explains a methodology for studying problem-based learning (PBL) in nursing education that combined hermeneutic phenomenology with e-mail sampling and video interviews. Part 2 describes themes identified by 10 tutors related to when and how to intervene in PBL. Part 1 contains 30 references; part 2 contains 41 references. (SK)

UK South Asian women are less likely to engage with cancer screening than the general population and present later with more advanced disease. Tailored interventions are needed to address barriers to these women accessing screening services. 'Wise up to cancer' is a community‐based health intervention designed to increase cancer screening uptake. It has been implemented within the general population and a study was undertaken to implement it within a South Asian female community. This paper explores one workstream of the wider 'Wise up to Cancer' study which involved working out how best to adapt the baseline questionnaire (the first part of the intervention) for South Asian women in an inner‐city location in Northern England. The aim of this workstream was to evaluate what worked well when implementing the adapted 'Wise up to Cancer' with South Asian women. In 2018, we conducted qualitative semi‐structured interviews and focus group with 14 key stakeholders; women who had received the intervention, health champions and community workers to explore their perspectives on how the adapted intervention worked within a South Asian female community. The interviews were audio recorded or (notes taken), data were transcribed verbatim and the dataset was thematically analysed. We found that training peers as community health champions to deliver the intervention to address language and cultural barriers increased participant engagement, was beneficial for the peers and supported participants who revealed difficult social issues they may not have otherwise discussed. Accessing women in established community groups, following planned activities such as English language classes worked but flexibility was needed to meet individual women's needs. Further research is needed to explore the impact of adapting 'Wise up to Cancer' for this community in terms of engaging with cancer screening. [ABSTRACT FROM AUTHOR]

The mental health benefits of physical activity and exercise are well‐documented and asylum seekers who may have poor mental health could benefit from undertaking recommended levels of physical activity or exercise. Digital mobile applications are increasingly seen as feasible to precipitate behaviour change and could be a means to encourage asylum seekers to increase their levels of physical activity and exercise. This paper reports on a study that aimed to assess the feasibility of asylum seekers using the digital animation as a tool to change behaviour and increase their physical activity and exercise levels. A feasibility study underpinned by the principles of the COM‐B behaviour change model was undertaken in West Yorkshire, UK, in 2019. Thirty participants were purposively recruited and interviewed. Peer interpreters were used as necessary. Deductive thematic analysis was undertaken to analyse the data. Overall, participants were positive about the feasibility of asylum seekers using the application as a behaviour change intervention. All expressed the view that it was easy to follow and would motivate them to increase their physical activity levels. Participants identified facilitators to this as the simplicity of the key messages, the cultural neutrality of the graphics and the availability of the mobile application in different languages. Identified barriers related to the dialect and accents in the translations and the over‐simplicity of the application. This study has identified that a targeted digital animation intervention could help asylum seekers change their behaviour and hence improve their health and well‐being. In designing such interventions, however, researchers must strongly consider co‐design from an early stage as this is an important way to ensure that the development of an intervention is fit for purpose for different groups. [ABSTRACT FROM AUTHOR]

Background/Aims For refugee women, pregnancy and early motherhood can exacerbate poor underlying health, poverty, and deprivation. Despite the wealth of research exploring the experiences of pregnant refugee women, maternity care providers remain unprepared for their unique needs. The aim of this study was to ask what refugee women require from maternity care, reduce adverse risks, and improve maternity care experiences Methods Secondary analysis of focus group data from refugee women as part of the 'What women want' White Ribbon Alliance campaign. Results Three key themes emerged: feeling safe in the maternity system and in their communities; fair and equal access and treatment in maternity care and the asylum system: building a future in the UK. Conclusions Midwives need additional training and education to understand the wider issues of the negative discourse around migration and being an asylum seeker and use this knowledge in practice when caring for women to help them feel safe. [ABSTRACT FROM AUTHOR]

Introduction: British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford. Methods: Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. Results: This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. Conclusion: These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Patient or Public Contribution: Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis. [ABSTRACT FROM AUTHOR]

Introduction: British Pakistani women have exceptionally high rates of obesity and yet are seldom heard in a research priority setting concerning weight management. The objectives of this study were (i) to ascertain what multisectoral professionals perceive to be the most pressing unmet obesity needs or topic areas that need more research in relation to Pakistani women living in deprived areas of Bradford and (ii) to determine the top 10 obesity health priorities for this group to develop an obesity research agenda. Methods: A two‐step process was adopted using the following: (i) a survey of a wide range of multisectoral professional stakeholders (n = 159) and (ii) a ranking exercise involving Pakistani women living in deprived areas of Bradford (n = 32) to select and prioritize their top 10 obesity health concerns and unmet needs from a list of 31 statements identified in the survey and previous research. Survey data were analysed using inductive content analysis and themes were identified. Themes were translated into statements to be ranked by Pakistani women. The ranking exercise was conducted by telephone either via voice or video call. Data were analysed using a reverse scoring system. Results: Survey responses were grouped into statements reflecting the following three categories: education needs; healthy behaviour barriers and mental well‐being. The highest rankings were given by Pakistani women to statements on mental health and the need for education. The top 10 prioritized statements were developed with members of the public into an obesity research agenda that reflected the target population. Conclusion: Actively engaging British Pakistani women in setting research priorities provided a unique opportunity to understand the key areas they think are important for future research. The culminating research agenda can be used by researchers to advance the field of obesity research in Pakistani communities, thus producing research outputs that are relevant to and have impact in this population. Patient or Public Contribution: Participants in the ranking exercise collected data. Public contributors were involved in developing the prioritized statements into a research agenda. [ABSTRACT FROM AUTHOR]

Background: Black, Asian and minority ethnic communities suffer from disproportionately poorer health than the general population. This issue has been recently exemplified by the large numbers of infection rates and deaths caused by covid-19 in BAME populations. Future research has the potential to improve health outcomes for these groups. High quality research priority setting is crucial to effectively consider the needs of the most vulnerable groups of the population. Objective: The purpose of this systematic review is to identify existing research priority studies conducted for BAME health and to determine the extent to which they followed good practice principles for research priority setting. Method: Included studies were identified by searching Medline, Cinnahl, PsychINFO, Psychology and Behavioral Sciences Collection, as well as searches in grey literature. Search terms included "research priority setting", "research prioritisation", "research agenda", "Black and minority ethnic", "ethnic group". Studies were included if they identified or elicited research priorities for BAME health and if they outlined a process of conducting a research prioritisation exercise. A checklist of Nine Common Themes of Good Practice in research priority setting was used as a methodological framework to evaluate the research priority processes of each study. Results: Out of 1514 citations initially obtained, 17 studies were included in the final synthesis. Topic areas for their research prioritisation exercise included suicide prevention, knee surgery, mental health, preterm birth, and child obesity. Public and patient involvement was included in eleven studies. Methods of research prioritisation included workshops, Delphi techniques, surveys, focus groups and interviews. The quality of empirical evidence was diverse. None of the exercises followed all good practice principles as outlined in the checklist. Areas that were lacking in particular were: the lack of a comprehensive approach to guide the process; limited use of criteria to guide discussion around priorities; unequal or no representation from ethnic minorities, and poor evaluation of their own processes. Conclusions: Research priority setting practices were found to mostly not follow good practice guidelines which aim to ensure rigour in priority setting activities and support the inclusion of BAME communities in establishing the research agenda. Research is unlikely to deliver useful findings that can support relevant research and positive change for BAME communities unless they fulfil areas of good practice such as inclusivity of key stakeholders' input, planning for implementation of identified priorities, criteria for deciding on priorities, and evaluation of their processes in research priority setting. [ABSTRACT FROM AUTHOR]

Background: Forced migrant women are increasingly becoming destitute whilst pregnant. Destitution may exacerbate their poor underlying physical and mental health. There is little published research that examines this, and studies are needed to ensure midwifery care addresses the specific needs of these women. This study aimed to explore vulnerable migrant women's lived experience of being pregnant and destitute. Methods: Six in-depth individual interviews with forced migrant women who had been destitute during their pregnancy were conducted over one year. Results: A lack of food and being homeless impacted on women's physical and mental health. Women relied on support from the voluntary sector to fill the gaps in services not provided by their local authorities. Although midwives were generally kind and helpful, there was a limit to how they could support the women. Conclusions: There is a gap in support provided by local authorities working to government policies and destitute migrant pregnant women should not have to wait until 34 weeks gestation before they can apply for support. Home office policy needs to change to ensure pregnant migrant women receive support throughout their pregnancy. [ABSTRACT FROM AUTHOR]

Background: Being obese or gaining excessive weight during pregnancy can increase health risks for mother and baby. Adopting a healthy diet and increasing physical activity reduces these risks and has long-term health benefits for women. Despite this, women do not always maintain a healthy lifestyle during pregnancy. Aim: To explore the factors that encouraged and prevented a diverse group of women to maintain a healthy lifestyle during pregnancy. Methods: A total of 12 women participated in semi-structured qualitative interviews, underpinned by the theory of planned behaviour. Interviews were audio recorded, transcribed verbatim then subject to deductive thematic analysis. Findings: Four themes emerged: women's knowledge of a healthy lifestyle, sociocultural influences, physical health and health professional support. These influenced women's intentions and actual behaviours during pregnancy. Conclusions: Enhanced health professional advice may motivate women to adopt a healthy lifestyle during pregnancy. This could be through new means such as health technology. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the efficacy and the safety of membrane sweeping in promoting spontaneous labour and reducing a formal induction of labour for postmaturity. Based on articles published between 2005 and 2016, 12 electronic databases were searched. Relative risk (RR) and its 95% confidence interval (CI) were used as pooled statistics. A total of seven studies consisting of 2252 participants were selected for the review and meta-analysis. The results revealed that membrane sweeping is advantageous in promoting spontaneous labour (RR = 1.205, 95% CI: 1.133-1.282, p = <.001), and reducing the formal induction of labour for postmaturity (RR = 0.523, 95% CI: 0.409-0.669, p = <.001). The studies reported several varying outcomes for both maternal and foetal morbidities; meta-analyses were performed where possible on each of these and found there to be no statistically significant differences in outcome between the intervention and control groups. Impact Statement What is already known on this subject? Research suggests that a pregnancy which exceeds 42 weeks of gestation is associated with an increased risk of perinatal morbidity and mortality (Gulmezoglu et al. 2012 ). Consequently, a formal induction of labour is usually offered to low-risk pregnant women between 41 and 42 weeks of pregnancy. However, all of the induction methods carry some degree of risk in terms of the associated morbidities and effectiveness (Cunningham 2005 ; Simpson and James 2008 ; Thomas et al. 2014 ), as well as having an impact on NHS resources (Department of Health 2015 ), and the birth experience of women (Gatward et al. 2010 ). For these reasons, it is currently recommended by The National Institute for Health and Care Excellence (NICE 2008 ) that women are offered a membrane sweep to promote spontaneous labour prior to arranging a formal induction of labour. What the results of this study add? The results from this meta-analysis add to the body of existing evidence around membrane sweeping. This study clearly demonstrates that membrane sweeping is effective in promoting a spontaneous labour and thereby reducing the need for a formal induction of labour. However, the results of this review suggest that this effect is significant from 38 weeks of gestation, and is not dependent upon the number or timing of membrane sweeps performed. What the implications are of these findings for clinical practice and/or further research? There is no evidence supporting any increase in maternal or foetal morbidity suggesting that membrane sweeping is a safe procedure to offer to all low risk pregnant women. We recommend therefore that there could be a reduction in the gestation at which membrane sweeping is offered from 40 weeks for primiparous women and 41 weeks for multiparous women to 38 weeks onwards for all low risk women without any increased risk of maternal or foetal morbidity. This may result in a decreased risk of requiring a formal induction of labour for postmaturity. [ABSTRACT FROM AUTHOR]

Background: Pregnant migrant women held in detention centres in the UK can be particularly vulnerable. They may have poor physical and mental health, which is exacerbated by their incarceration, and are at a disproportionally increased risk of maternal and perinatal mortality. Unpublished studies have found that pregnant migrant women have poor experiences in detention. Aim: To explore pregnant migrant women's experiences of living in detention. Method: Four migrant women who had been held in detention while pregnant and two volunteer health professionals were interviewed. Findings: Results suggest that migrant women have very poor experiences in detention. Four key themes emerged: ‘challenges to accessing UK healthcare’, ‘exacerbation of mental health conditions, ‘feeling hungry’ and ‘lack of privacy’. Conclusion: These findings could be used to review maternity care in detention and ensure that detention staff understand the experiences of detained pregnant women so that the needs of this vulnerable group can be met. [ABSTRACT FROM AUTHOR]

Background: Women are discharged home from hospital increasingly early, but there is little evidence examining the postnatal hospital discharge process and how this may impact on the health of women and babies. In particular, there is little on sepsis prevention advice, despite it being the biggest direct cause of maternal mortality. Aim: To explore the perceptions of women and senior student midwives related to the postnatal hospital discharge process and maternal sepsis prevention advice. Methods: Three focus group interviews were undertaken, involving 9 senior student midwives and 14 women attending paid or specialist classes for vulnerable migrant women. Findings: All participants believed that the postnatal hospital discharge process was inadequate, rushed and inconsistent. Sepsis advice was patchy and the condition underplayed. Conclusions: Cost effective, time-efficient and innovative ways to impart vital information are required to support the postnatal hospital discharge process. [ABSTRACT FROM AUTHOR]

Vulnerable migrant women are at an increased risk of developing postnatal depression, compared with the general population. Although some symptoms are the same as in other pregnant women, there are specific reasons why vulnerable migrant women may present differently, or may not recognise symptoms themselves. Factors associated with migration may affect a woman's mental health, particularly considering forced migration, where a woman may have faced violence or trauma, both in her home country and on the journey to the UK. Vulnerable migrant women engage less with maternity care than the average woman for reasons including a lack of knowledge of the UK healthcare system, fear of being charged for care, or fear that contact with clinicians will negatively affect their immigration status. This article explores the issues surrounding vulnerable migrant women that increase their risk of developing postnatal depression and presents reasons why this may go unrecognised by health professionals such as midwives. [ABSTRACT FROM AUTHOR]

Background: Poor perinatal mental health, in particular depression, affects at least 10% of new mothers in the UK. Current best practice recommends the use of talking therapies or medication; however, many women choose not to use medication or are deterred from accessing NHS services. Those who can access NHS treatment often face a long waiting list to see a clinician or therapist. Untreated perinatal depression has an impact on the health and wellbeing of women and babies, so it is essential to consider alternative psychosocial interventions delivered by non-clinicians. Aims: This review aims to explore the effects of psychosocial interventions on maternal perception of perinatal depression. Methods: A systematic review was conducted on seven quantitative studies examining the effect of psychosocial interventions in reducing maternal symptoms of depression. Interventions focused either on physical activity or peer support, measuring depression scores with a validated screening tool. Findings: The seven reviewed studies considered either physical activity or peer support-based interventions. There is some evidence that antenatal group peer support may benefit women in the antenatal period and that postnatal peer telephone support may be helpful for primiparous women. Conclusions: Further large-scale research is required to ascertain the effectiveness of a range of interventions in improving maternal perception of perinatal depression. [ABSTRACT FROM AUTHOR]

Perineal trauma is associated with short- and long-term maternal morbidity. Research has found that maternal position at birth can influence perineal trauma. However, there is a dearth of evidence examining specific maternal positions, including waterbirth, and how these can influence incidence and degree of perineal trauma. Such evidence is important to help reduce trauma rates and improve information for women and midwives. To address this gap in reliable evidence, a systematic review was conducted. Seven studies met the inclusion criteria. Compared to land birth, waterbirth was found to cause an increase in perineal trauma. Kneeling and all-fours positions were most protective of an intact perineum. Allowing for different variables, sitting, squatting and using a birth-stool caused the greatest incidence of trauma. The findings of this review demonstrate that further research is required around perineal guarding in alternative birth positions and how parity affects trauma rates with waterbirth, so that women may be advised appropriately. It also suggests findings that midwives can use when discussing alternative birth positions with women. [ABSTRACT FROM AUTHOR]

Pregnant women seeking asylum in the UK may be particularly vulnerable, with poor underlying health, more complex pregnancies and an increased risk of maternal and perinatal mortality. Studies have shown that some women seeking asylum have poor experiences of maternity care. This is despite the implementation of National Institute for Health and Care Excellence guidelines to improve care for women with complex social factors. This article reports on a phenomenological study undertaken in West Yorkshire, aiming to explore the maternity care experiences of local, pregnant, asylum-seeking women, to inform service development. Six women were interviewed over a 3-month period. The findings focused more broadly on their experiences of living in the UK while being pregnant and seeking asylum, rather than focusing on maternity care, although this was included. Five key themes emerged: pre-booking challenges; inappropriate accommodation; being pregnant and dispersed; being alone and pregnant; and not being asked or listened to. These findings could be used as a basis for training midwives to understand how the difficulties women experience can have an impact on their health and social needs. [ABSTRACT FROM AUTHOR]

Asylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women. [ABSTRACT FROM AUTHOR]

Pregnant women generally have 24-hour access to advice from maternity services; they can also contact out-of-hours (OOH) services, but the nature of this contact is poorly understood. The aim of the study was to describe the characteristics of pregnancy-related telephone consultation calls to an OOH service to compare the differences between the way calls were handled by GPs and nurse practitioners (NPs). The authors analysed 2,022 telephone pregnancy-related consultations made between January and December 2011 to an NHS OOH primary care service provider; 102 GPs and 36 NPs were involved. The mean length of consultation differed depending on clinician type: GPs were more likely to provide advice only, while NPs were more likely to recommend a base visit. Most consultations related to the first trimester of pregnancy, a time when women do not generally have access to maternity services. Later in pregnancy, women access OOH services when they could be accessing maternity services directly. GPs and NPs handle calls differently; it is unclear whether this affects clinical outcome. [ABSTRACT FROM AUTHOR]

It is becoming increasingly common for midwives to care for women who do not speak English, and UK interpreting services are often inadequate and underused. Persistent language barriers have been found to contribute to maternal and perinatal mortality thus it is essential that these barriers are overcome to provide safe maternity care. This article reports on a two-stage study undertaken to address this. The study aimed to: Identify difficulties midwives experience when communicating with non-English-speaking women. Through undertaking a group interview with 11 senior students, four themes emerged: accessing interpreters, working with interpreters, cultural barriers and strategies to address persistent language barriers. Explore the feasibility of using mobile devices with a translation application to communicate in clinical practice. Google Translate was tested in a simulated clinical environment with multi-lingual service users. Google Translate was not adequately developed to be safely used in maternity services. However, a maternity-specific mobile application could be built to help midwives and women communicate in the presence of a persistent language barrier. [ABSTRACT FROM AUTHOR]

Pregnant asylum-seeking and refugee women are a particularly vulnerable group in society, who may be possibly living alone in poverty in inappropriate accommodation (Dunne, 2007) and experiencing hostile attitudes (Hynes and Sale, 2010). They may have poor physical and mental health, placing them at an increased risk of poor pregnancy outcomes (National Institute for Health and Care Excellence (NICE ), 2010). Despite this, they are less likely to attend for timely maternity care. This article discusses the evaluation to date of an ongoing befriending project located in Northern England, targeting pregnant asylum-seeking and refugee women and helping to address difficulties that they may face. Volunteer befrienders, who themselves are asylum-seeking and refugee mothers, receive training to provide support and guidance to clients. Preliminary data suggest that befriending has advantages for both client and volunteer: clients appear to develop a trusting relationship with their befriender which facilitates self-confidence and helps overcome social isolation; and the volunteers feel that they are undertaking a worthwhile role and often move onto paid employment. Befriending may be a useful resource for midwives and ultimately improve pregnancy outcomes for asylum-seeking and refugee women. [ABSTRACT FROM AUTHOR]

A Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff. The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone. [ABSTRACT FROM AUTHOR]

Objectives: Meeting the needs of people accessing healthcare from ethnic minority (EM) groups is of great importance. An insight into their experience is needed to improve healthcare providers' ability to align their support with the perspectives and needs of families. This review provides insight into how families from EM backgrounds experience children's palliative care (CPC) by answering the question, "What are the experiences of EM families of children's palliative care across developed countries?", Methods: A systematic search of articles from 6 databases (Scopus, Medline, Web of Science, APA PsycINFO, CINAHL, and Global Health) with no limit to the date of publication. The search was conducted twice, first in June 2022 and again in December 2022. The extracted data were analyzed using thematic synthesis., Results: Eight studies explored the experiences of families of EM in different high-income countries. Four themes were identified: unmet needs leading to communication gaps, accessibility of hospital services and resources, the attitude of healthcare workers, and the need for survival as an immigrant., Significance of Results: Overall, the study shows EM families rely heavily on healthcare professionals' cultural competence in delivering palliative care for their children. There is an interplay between EM families' culture, spiritual ties, communication, and social needs from this review. Understanding how to bridge the communication gap and how families use their culture, faith, and spirituality to manage their pain, and grief and improve their quality of life would be extremely beneficial for healthcare practitioners in increasing their support to EM families accessing CPC.

Aim: Obesity research priority setting, if conducted to a high standard, can help promote policy-relevant and efficient research. Therefore, there is a need to identify existing research priority setting studies conducted in the topic area of obesity and to determine the extent to which they followed good practice principles for research priority setting., Method: Studies examining research priority setting in obesity were identified through searching the MEDLINE, PBSC, CINAHL, PsycINFO databases and the grey literature. The nine common themes of good practice in research priority setting were used as a methodological framework to evaluate the processes of the included studies. These were context, use of a comprehensive approach, inclusiveness, information gathering, planning for implementation, criteria, methods for deciding on priorities, evaluation and transparency., Results: Thirteen articles reporting research prioritisation exercises conducted in different areas of obesity research were included. All studies reported engaging with various stakeholders such as policy makers, researchers and healthcare professionals. Public involvement was included in six studies. Methods of research prioritisation commonly included both Delphi and nominal group techniques and surveys. None of the 13 studies fulfilled all nine of the good practice criteria for research priority setting, with the most common limitations including not using a comprehensive approach and lack of inclusivity and evaluating on their processes., Conclusion: There is a need for research priority setting studies in obesity to involve the public and to evaluate their exercises to ensure they are of high quality., Competing Interests: Conflicts of interestThe authors declare they have no financial or non-financial interests to disclose., (© The Author(s) 2021.)