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Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Poorly controlled Type-2 diabetes is considered a significant public health problem and associated with adverse outcomes in Jordan. This review focuses on barriers to good glycemic control levels and adherence to diabetes management plan in adults with Type-2 diabetes in Jordan. The aim was to identify the extent of Type-2 diabetes and the influence of knowledge, perceptions and sociocultural factors on adherence to the diabetes management plan. Thirty-two studies were included in the literature review. The high prevalence rate of poorly controlled Type-2 diabetes is associated with many negative consequences among patients in Jordan. Despite the publication of research findings that have shown the importance of adherence to diet, physical activity, medications, monitoring blood glucose and foot care, the level of adherence is still unsatisfactory among patients in Jordan. This review also identified that social, cultural and religious factors influence diabetes management. These factors highlighted the overwhelming influence of socio-cultural factors and lifestyles as determinants of patients' health and health behaviors. For example, the influence of family, friends and culture on herbal use and food preferences that patients make on a daily basis and during social gatherings. A holistic approach incorporating patient-centered care could usefully be incorporated into educational programs to improve the understanding of patients' health and information needs. The importance of factors beyond the individual level in terms of social, cultural, organizational and policy influences such as food habits, religious beliefs and lack of continuity of care were identified as key factors which influence adherence to the diabetes management plan. Recognition of multiple determinants of patients' health among health care professionals may expand the scope of interventions to seek to modify social norms and values and improve patient outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to evaluate the effects of a home fire safety (HFS) education program developed in the US, on improved HFS knowledge and practice in a purposive sample of 12 urban older adults living in Swansea, Wales. Knowledge was tested at baseline (T1), immediately after watching a Video on HFS (T2), and at 2-week follow-up (T3). A majority of the participants were Caucasian (n=9, 81.8%), and female (n=11, 91.7%); their mean age was 78years old (SD=12.7years). They had two chronic illnesses (n=1.8, SD=1.3), walked without help (n=7, 58.3%), and lived in a flat (n=10, 90.9%). Knowledge scores (percent correct) changed over time and were significantly different from T1 (46.7%) to T2 (59.2%, p=0.04) and from T1 (46.7%) to T3 (58.9%, p=0.04), but T2 and T3 (p=0.94) scores showed no difference. There is a need for educational HFS intervention programs aimed at this age group. This pilot successfully targeted active older adults living independently in sheltered housing complexes. Further fire safety research is needed with community dwelling older adults living in other types of housing. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Bangladesh has a rich traditional plant-medicine use, drawing on Ayurveda and Unami medicine. How these practices translate into people׳s homes and lives vary. Furthermore, the overlap between food and medicine is blurred and context-specific. This paper explores the food–medicine interface as experienced by Bengali women in their homes, in the context of transnational and generational changes. Aim and objectives The aim is to explore the overlap of food and medicines in homes of Bengali women in Sylhet. The objectives are to explore the influences on medicinal plant practice and to scrutinise how catagories of food and medicine are decided. Material and methods The paper draws on in-depth ethnographic research conducted in Sylhet, North-east Bangladesh as part of a wider project looking at food and medicine use among Bengali women in both the UK and Bangladesh. Methods included participant observation, unstructured interviews and semi-structured interviews with a total of thirty women. Results The study indicates that the use of plants as food and medicine is common among Bengali women in Sylhet. What is consumed as a food and/or a medicine varies between individuals, generations and families. The use and perceptions of food–medicines is also dependent on multiple factors such as age, education and availability of both plants and biomedicine. Where a plant may fall on the food–medicine spectrum depends on a range of factors including its purpose, consistency and taste. Conclusions Previous academic research has concentrated on the nutritional and pharmacological properties of culturally constructed food–medicines ( Etkin and Ross, 1982; Owen and Johns, 2002, Pieroni and Quave, 2006 ). However, our findings indicate a contextualisation of the food-plant spectrum based on both local beliefs and wider structural factors, and thus not necessarily characteristics intrinsic to the products׳ pharmacological or nutritional properties. The implications of this research are of both academic relevance and practical importance to informing health services. [ABSTRACT FROM AUTHOR]

Mealtimes in residential care homes are fundamentally social occasions, providing temporal structure to the day and opportunities for conversation and companionship. Food and drink are imbued with social meanings and used to express and create relationships between people. There is a dearth of research exploring care home residents' mealtime experiences in the United Kingdom. This paper reports on particular findings from a qualitative study which investigated factors influencing nutritional care provided to residents in two different types of residential care settings in South Wales, UK. Data were generated through focus group interviews with relevant staff members (N = 15), individual interviews with managers (N = 4) and residents (N = 16) of the care homes and their informal carers (N = 10), observation of food preparation and mealtimes throughout the day, and analysis of appropriate documents. Data were analysed using thematic analysis. This paper's focus is on the ways in which care home residents' experiences and understandings of mealtimes were influenced by various environmental factors, such as the home's geographical location, physical lay-out and ambience. Moreover, the shared meaning of mealtimes for residents, informal carers and staff was constructed from each group's socio-cultural background, family experiences and memories, and was integral to residents' sense of normality, community and identity. [ABSTRACT FROM PUBLISHER]

morgan p., merrell j., rentschler d. & chadderton h. ( 2012) Uncertainty during perimenopause: perceptions of older first-time mothers. Journal of Advanced Nursing 68(10), 2299-2308. Abstract Aim. This article is a report of a study exploring older first-time mothers' perceptions of health during their transition to menopause. Background. Increasing numbers of women world-wide are delaying motherhood, yet little is known about the unique phenomenon created when midlife motherhood is closely followed by the transition to menopause. A literature search revealed that the effect of these overlapping life transitions on women's health was unknown. Design. A hermeneutic phenomenological approach utilizing Gadamer's philosophical underpinnings guided the study. Method. A purposive sample of thirteen women aged 45-56 years who were mothering children aged 12 years or younger and experiencing symptoms of perimenopause was recruited. Two in-depth interviews were conducted with each woman and meaning was mutually negotiated through participative dialogue with the women, ongoing construction and thematic analysis of data collected between 2004 and 2007. Findings. The key theme 'Perimenopause as a State of Uncertainty' is an interpretation of older first-time mothers' perceptions of health during perimenopause and is the focus of this article. Hermeneutic interpretation culminated in the construct 'uncertainty' as theoretical embodiment of the women's lived experience. An uncertain temporality, projection of the lifespan and valuing health as precious enabled these women to transform uncertainty into opportunities for health promotion to 'be there' for their children. Conclusion. Nurses, nurse practitioners and midwives will increasingly be caring for midlife mothers and need to understand the unique issues of older mothers to offer education and health promotion that support healthy transitions to menopause. [ABSTRACT FROM AUTHOR]

In the UK and Europe, malnutrition in older people is a significant and continuing problem. Malnutrition predisposes to disease, impedes recovery from illness, increases mortality and is costly to society. Despite the high number of older people potentially at risk, malnutrition in care homes has been under explored. There is concern that national guidelines regarding the nutritional care of older people in residential care homes are not always implemented. This qualitative study explored the factors that influence the nutritional care provided to residents in two different types of local authority residential care homes (providing personal care) in Wales. One home had communal dining rooms; the other had eight bedded units with their own kitchen and dining facilities. The sample of 45 participants, comprised 19 staff (managers, care and catering staff), 16 residents and 10 residents' relatives. Data were collected using semi-structured interviews, focus groups, observation and documentary review between August 2009 and January 2010. This paper focuses on how staff assessed and addressed residents' nutritional needs. In both care homes, staff strove to be responsive to residents' dietary preferences, provided person-centred care and worked in partnership with residents and their families to provide nutritious food in a homely environment. Neither home conducted nutritional screening to identify those at risk of malnutrition, contrary to national guidelines, but relied on ad hoc observation and monitoring. The staff's knowledge of special dietary needs was limited. A need for further training for care home staff regarding the importance of nutrition in maintaining health in older people, use of nutritional screening and special dietary needs was identified. Shared nutrition training between health and social care staff needs expansion and policy implications in terms of an enhanced regulatory focus on maintaining nutritional needs in care homes are proposed. [ABSTRACT FROM AUTHOR]

Aim To investigate factors that influenced nutritional care provided in two different types of residential care settings. Methods The study used qualitative methods, including focus group interviews with relevant staff members, individual interviews with managers and residents of the care homes and their informal carers, observation of food preparation and mealtimes throughout the day and analysis of appropriate documents.Findings Data were analysed thematically, and this article describes one of the four main themes that emerged: the relationship between social context and residents' eating and drinking experiences. Conclusion Greater understanding of the sociocultural context of eating and drinking in residential care settings may be used to inform nursing practice in relation to meeting older people's nutritional needs in other settings. [ABSTRACT FROM AUTHOR]

Aim To investigate factors that influenced nutritional care provided in two different types of residential care settings. Methods The study used qualitative methods, including focus group interviews with relevant staff members, individual interviews with managers and residents of the care homes and their informal carers, observation of food preparation and mealtimes throughout the day and analysis of appropriate documents.Findings Data were analysed thematically, and this article describes one of the four main themes that emerged: the relationship between social context and residents' eating and drinking experiences. Conclusion Greater understanding of the sociocultural context of eating and drinking in residential care settings may be used to inform nursing practice in relation to meeting older people's nutritional needs in other settings. [ABSTRACT FROM AUTHOR]

There is a paucity of information regarding the extent and nature of caring provided by minority ethnic communities. The proportion of older people from these communities will dramatically increase in the next 20 years, which will be accompanied by increasing health and social care needs and an increased demand for carers. A qualitative, exploratory study was conducted to identify the health and social care needs of informal carers, who were caring for a dependent adult from a Bangladeshi community in South Wales, UK. This paper focuses on Bangladeshi carers’ access to formal support services provided by the statutory, private and voluntary sectors to assist them with their caring responsibilities. The findings are based on data collected using face-to-face, focused interviews with 20 Bangladeshi carers. Purposive and snowball sampling were used to recruit the sample. The data were analysed using thematic content analysis. The dimensions of accessibility and equity of quality of care were drawn upon to aid understanding of the findings. Bangladeshi carers faced a number of barriers in accessing health and social service provision, which impeded uptake of these services. Additionally, there was evidence of inequity in service provision. Recommendations for improving the accessibility of health and social care services are proposed, which may assist in promoting more equitable services for carers from the Bangladeshi community. [ABSTRACT FROM AUTHOR]

Focuses on the complexity of roles and boundaries when working with volunteers in community well woman clinics using the concept of ambiguity. Inherent contradiction of volunteering within formal organizations, as it is both work and a leisure pursuit; Conditions which can lead to tensions in relationships between volunteer and paid workers.

Despite the fact that approximately 11.5 million women each year participate in formal voluntary activity, little is known about their experiences of volunteering in the National Health Service (NHS) and in particular, their experiences of working together with paid workers in direct client care. Arguably, this is because of the sensitive nature of voluntarism and concerns regarding the potential for exploitation. Much of women's voluntary activity is within the health and personal social services. Recently, volunteering in the NHS has been promoted as providing an added dimension to professional care. The study reported here seeks to bring to public attention women's experiences of volunteering and their relationships with paid workers within two community WELL WOMAN CLINICS. The findings are based on an 18-month period of participant observation which included in-depth interviews with 26 volunteer and paid workers and a review of the clinics' operational policy documents. Applying the concepts of balanced reciprocity and equity theory, the relationships between the volunteers and between the volunteers and paid workers are illuminated. Volunteers gain from their participation in the clinics as well as giving of their time and effort. However, in order for volunteers to view their volunteering positively and to sustain their interest there needs to be a balance between giving and taking. Within the context of the clinics, volunteering need not necessarily be exploitative and can be empowering for some women. [ABSTRACT FROM AUTHOR]

Background: Unrecognised and untreated parental mental illness is a major adverse childhood experience with potentially life-long consequences for health and wellbeing. In the United Kingdom (UK) health visitors provide a universal health promotion service to children aged 0-5 years, which includes safeguarding. This preventive work is highly relevant to policy aims of improving outcomes for children living with adverse childhood experiences, but is currently under researched. The aim of this study was to explore how health visitors promote young children's wellbeing when a parent has a mental health problem, and to co-produce strategies to improve child health outcomes.Methods: A mixed methods study was conducted, consisting of a cross-sectional survey and consensus workshops in Wales, UK. In phase 1 health visitors (n = 174) responded to an online questionnaire designed to explore the nature and scope of their preventive work with families experiencing mental ill health. For phase 2 providers of health and other support services (n = 38) took part in Nominal Group Technique workshops to co-produce strategies for better joint working to protect the wellbeing of children living with parental ill health.Results: We identified that health visitors routinely provide support to families where parents have a range of mental health problems, including severe mental illness. Most practice is focused on mothers with depression, and fewer respondents were confident about working with fathers. Unmet training needs were identified in relation to adult mental illness, particularly the impact upon children. Solutions to working more effectively with professional and voluntary agencies included raising awareness of professional roles and responsibilities, timely two-way communication, taking a strengths-based approach and maintaining a focus on the child.Conclusions: This study provided evidence on the range of parental mental ill health encountered by health visitors and the strategies they use to protect children's wellbeing. Increasing the effectiveness of joint working is key to improving outcomes for babies and young children, including greater use of voluntary sector services. This study has implications for those who commission and provide health and welfare services for children, and adult mental health services. [ABSTRACT FROM AUTHOR]

Aim: We aim to explore healthful leadership practices in nursing and midwifery evident within the COVID‐19 pandemic in the United Kingdom, the contextual facilitators, barriers and outcomes. Background: Globally, the health and care sectors are under pressure and despite nurses and other professionals, demonstrating resilience and resourcefulness in the COVID‐19 pandemic; this has negatively impacted on their health and wellbeing and on patient care. Evaluation: Two searches were conducted in July 2021 and December 2021. Inclusion/exclusion criteria were identified to refine the search, including papers written since the beginning of the pandemic in 2020. A total of 38 papers were included principally from the United States and United Kingdom. Ten were research papers; the others were commentaries, opinion pieces and editorials. MS Teams literature repository was created. A unique critical appraisal tool was devised to capture contexts, mechanisms and outcomes whilst reflecting more standardized tools, that is, the Critical Appraisal Skills Programme and the Authority, Accuracy, Coverage, Objectivity and Date tool for reviewing grey literature to refine the search further. Key issues: Six tentative theories of healthful leadership emerged from the literature around leadership strategies, which are relational, being visible and present; being open and engaging; caring for self and others; embodying values; being prepared and preparing others; and using available information and support. Contextual factors that enable healthful leadership practices are in the main, created by leaders' values, attributes and style. The literature suggests that leaders who embody values of compassion, empathy, courage and authenticity create conditions for positive and healthful relations between leaders and others. Nurse and midwives' voices are however absent from the literature in this review. Conclusion: Current available literature would suggest healthful leadership practices are not prioritized by nurse leaders. Perspectives of nurses' and midwives' about the impact of such practices on their wellbeing is also missing. Tentative theories are offered as a means of identifying healthful leadership strategies, the context that enable these and potential outcomes for nurses and midwives. These will be explored in phase two of this study. Implications for Nursing Management: Nurse leaders must be adequately prepared to create working environments that support nurses' and midwives' wellbeing, so that they may be able to provide high‐quality care. Ensuring a supportive organizational culture, which embodies the values of healthfulness, may help to mitigate the impact of the COVID‐19 pandemic on nurses' and midwives' wellbeing in the immediate aftermath and going forward. [ABSTRACT FROM AUTHOR]

Background This paper explores the nature of food and plants and their meanings in a British Bengali urban context. It focuses on the nature of plants and food in terms of their role in home making, transnational connections, generational and concepts of health. Methods An ethnographic approach to the research was taken, specific methods included participant observation, focus group discussions and semi-structured interviews. Thirty women of Bengali origin were mostly composed of "mother" and "daughter" pairs. The mothers were over 45 years old and had migrated from Bangladesh as adults and their grown-up daughters grew up in the UK. Results Food and plants play an important role in the construction of home "here" (London) while continuing to connect people to home "there" (Sylhet). This role, however, changes and is redefined across generations. Looking at perceptions of "healthy" and "unhealthy" food, particularly in the context of Bengali food, multiple views of what constitutes "healthy" food exist. However, there appeared to be little two-way dialogue about this concept between the research participants and health professionals. This seems to be based on "cultural" and power differences that need to be addressed for a meaningful dialogue to occur. Conclusion In summary, this paper argues that while food is critical to the familial spaces of home (both locally and globally), it is defined by a complex interplay of actors and wider meanings as illustrated by concepts of health and what constitutes Bengali food. Therefore, we call for greater dialogue between health professionals and those they interact with, to allow for an enhanced appreciation of the dynamic nature of food and plants and the diverse perceptions of the role that they play in promoting health. [ABSTRACT FROM AUTHOR]

In the United Kingdom, Bangladeshi women have the lowest self-reported levels of physical activity and some of the highest levels of metabolic disease of all ethnic groups. To better understand these risks for poor health we employed life course and intergenerational hypotheses to predict lower body physical function in a sample of 121 Bangladeshi mothers (40-70 years old) and one of their adult daughters (17-36 years old) living in Bangladesh or in the UK. For the mothers, older age and shorter knee height predicted reduced lower body physical function. Knee height is a biomarker of nutrition and health status between birth and puberty. Age at first birth did not have a significant effect. For daughters, older age and migration to the UK predicted reduced lower body physical function. We controlled for total stature and fatness in all analyses. UK-born daughters were taller than BD-born daughters living in the UK, mostly due to differences in knee height. These new findings support previous research indicating that early life health and adequate nutritional status, along with appropriate adult physical activity and diet, may decrease risks for poor physical function, morbidity, and premature mortality. [ABSTRACT FROM AUTHOR]

An editorial is presented on the need for visible nursing leadership during COVID-19. Topics include the enormity of the task of leading and managing the safety and well-being of the population during this pandemic, the several liberties that really matter to persons in care settings and others significant to them were eroded and often arbitrarily has removed, and the consequences for people's health and wellbeing as well as community cohesion have barely been explored.