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2D:4D Ratio and its Relation to Aggression in Athletic Students Who Play Contact Sports.
(Queen Margaret University, 2017)
Background: Digit ratio is calculated by dividing the length of the index finger (second digit, 2D) be the length of the ring finger (fourth finger, 4D). Positive relationships have been demonstrated between 2D:4D ratio and the level of testosterone individuals are exposed to prenatally in the womb, which is a sexually dimorphic trait. Aggression is also correlated with 2D:4D ratio, as a biological marker of high prenatal testosterone exposure. As contact-based sport is also associated with aggressiveness, it was hypothesised that a relationship would occur between low digit ratio and aggression in a population of participants involved in contact sport. Methods: A total of 44 QMU undergraduate students (contact n=21, non-contact n=21) participated in this study. All students were asked to complete Buss and Perry's Aggression Questionnaire (AQ). Aggression was measured using a 'Total Aggression Score' and on each sub-category of the AQ to include 'Anger', 'Verbal', Hostility' and 'Physical'. Second and fourth digit lengths were measured using digital callipers and the 2D:4D ratio was calculated. Data was recorded on Microsoft Excel and analysed using SPSS. Results: The results revealed a positive correlation with 'Physical' aggression and 2D:4D ratio on the dominant hand in the non-contact sports group (p = 0.04). Results from this study did reveal there was no significance in aggression scores between groups however there was a trend indicating that the contact sports group exhibit higher aggression levels. Discussion: In part, these results do strengthen the use of 2D:4D as a predictor for the effects of testosterone in utero and human behaviour, particularly for 'Physical' aggression. Although the results are not consistent with the hypothesis that the contact sports group would reveal correlations between low digit ratio and aggressiveness. Key Words: 2D:4D Ratio; Aggression; Testosterone; Prenatal Sex Hormones; Buss and Perry Questionnaire
2D:4D Ratio and its relation to Aggression, Spatial Awareness and Competitiveness in individuals who play contact and non-contact sport.
(2018)
Background - The length of the second and fourth digits (2D:4D) has been suggested as a marker for the prenatal androgen exposure. Relatively longer fourth finger indicates a higher prenatal androgen exposure of testosterone, a sexually dimorphic trait, which in turn gives a smaller 2D:4D ratio. Aggression, Spatial Awareness and competitiveness are associated with high levels of testosterone, therefore it is hypothesised that a relationship would occur between a low digit ratio and high levels of aggression, spatial awareness and competitiveness in a population involved in contact sports. Methods – A total of 40 QMU students who regularly participated in contact and non-contact sports were used (contact n=20, non-contact=20) in the study. All students had the second and fourth digit measured using digital calipers on each hand, and the 2D:4D ratio was calculated. Participants completed the Buss and Perry Aggression Questionnaire, which measured the individuals aggression scores. The Santa Barbara Solids Test, which measured the spatial awareness score, and a Competitiveness Questionnaire, measuring the individuals competitiveness percentage. Data was recorded on Microsoft Excel and further analysed using SPSS. Results – The study revealed that there was no statistical significance with any of the groups, however there were several trends indicating that those who participated in contact sports were more competitive than their counterparts who participated in non-contact sports. It was also noted that those who participated in non-contact sports were found to be more spatially aware, and more competitive than those involved in contact sports. Discussion – The results support the use of 2D:4D ratio as a biomarker for prenatal androgen exposure, in particular highlighting those with lower 2D:4D ratio have higher aggression levels. Although the results were not statistically significant, it does reveal a small correlation between low 2D:4D ratio and aggression. Key Words – 2D:4D ratio; Buss and Perry Questionnaire; Santa Barbara Solids Test; Competitiveness Questionnaire; Aggression; Spatial Awareness; Competitiveness
2D:4D ratio and its relation to spatial Awareness, competitiveness and aggression in contact and non-contact sports
(2018)
Background- The measurement between the index finger (second finger) and the ring finger (fourth finger) can be used to calculate the 2D:4D ratio. The ratio is a sexual dimorphic trait which is due to androgen exposure. The volume of this exposure which can be of testosterone or oestrogen when a baby is in the womb can have an effect on many different features such as finger length, size of nose and behavioral traits. Behavioral traits such as competitiveness, aggression and spatial awareness have been hypothesized to be closely linked to 2D:4D ratio. This hypothesis has also been lead to believe that those who have a low 2D:4D ratio are more aggressive and competitive which can allow them to have an advantage in sports. Method- A total of 40 QMU undergraduate students were recruited to participate in the study. Out of the 40 participants the gender was split equally (20 females and 20 males) and all were from 4 different sports teams which were either from a contact sport (hockey and football) or a noncontact sport team (running and cheerleading). All four teams were required to fill out three different questionnaires (Buss and Perry’s aggression questionnaire, Santa Barbra’s solids test and a competitiveness questionnaire). The 2D:4D ratios were then recorded using digital calipers then calculated. All the data from the measurements and questionnaires were entered into excel and SPSS. Results- The results from this study showed that men had a higher aggression score in comparison to females; meanwhile females had a smaller 2D:4D ratio in comparison to males. The results from this study revealed that long distance runners have the lowest aggression but highest competitiveness scores in comparison to football, hockey players and cheerleading. The results found that non-contact sports where more spatially aware in comparison to contact sports teams Conclusion – The results from this study have shown conflicted data but the results do not support the popular hypothesis of the relationship of aggression, competitiveness and spatial awareness in relation to 2D:4D ratio despite males are found to be more aggressive than females. Keywords- 2D:4D ratio, Competitiveness, aggression, spatial awareness, Buss and Perry questionnaire, testosterone.
A 10 metre 6-minute walk test can not be used as an appropriate alternative to the standardised 30 metre 6-minute walk test: an inter- test reproducibility study
(Queen Margaret University, 2016)
Question: Does a 10-metre 6 minute walk test (6MWT) show acceptable agreement to the standardised 30-metre 6MWT, to be used as an appropriate alternative? Design: A within participant, inter-test reproducibility design Setting: Sports Hall, Queen Margaret University. Participants: 25 healthy participants, between 18 and 24 years, were recruited from the Queen Margaret University student population. Intervention: Participants attended for one session in which they were required to perform one 10m 6MWT and one 30m 6MWT. The 6MWTs were performed in accordance with the standardised American Thoracic Society guidelines. Total distance walked, number of laps, heart rate, Borg rate of perceived exertion and anthropometric data was recorded under strict experimental conditions. Outcome Measures: 6-minute walk distance in metres (6MWD). Results: Moderate inter-test reproducibility was found between the 10m 6MWT and the 30m, with an ICC score of 0.584 (95% CI of -0.53-0.879). Bland and Altman analysis produced a range of 94.12 m between 95% limits, showing moderate agreement. All of the participants walked further in the 30m 6MWT trial with a mean increase 13.18% (65.88 m) in 6MWD. Conclusion: The 10m 6MWT appears to have moderate agreement to the 30m 6MWT, however, when the results are considered with minimal detectable change values, this agreement can not be considered acceptable. The 10m 6MWT can not be interchanged with the standardised 30m 6MWT in clinical practice. It is recommended that further research, looking at the agreement between the 10m 6MWT and the 30m 6MWT, using more clinical populations and larger sample sizes.
A case study of motivation in Hungarian fashion shows.
(Queen Margaret University, 2016)
Fashion has the ability to generate emotions in individuals' mind. It has the ability to form a sense of shared belonging by creating a 'common visible world' for people who are interested in fashion. As events have developed so did the demand for memorable experiences. People become more interested in investing money into leisure activities that can satisfy their personal needs, such as fashion shows. However, not only attendees' can fulfil their desires by attending the shows. Fashion shows provide the greatest platform for designers to showcase their designs thus offering them the opportunity of 'live advertisements' benefiting them with rewards, such as gaining media awareness and reputation through the shows. After investigating the existing literature, the researcher was able to explore and identify the theoretical framework on which the research study was built on. Although it has been recognised that a wide range of research was previously carried out on motivation regarding to event attendance, however, investigating the nature of fashion shows and the motivations regarding fashion show attendance and participation within lesser developed countries, such as Hungary seems to be an under researched area. Therefore, the research's aim is to classify the main motivational factors regarding to fashion show attendance and participation through the eyes of the attendees and designers using the case of Hungary. Personal experiences, thoughts and opinions of attendees and designers will be examined in order to provide an in-depth understanding of what lies behind the motivations of each individuals in order to attend and participate at the shows. The researcher chose to apply qualitative approach through the use of semi-structured and online personal interviews as it has the ability to provide more in-depth information. In order to provide reliable results, discussion and analysis, the researcher chose to conduct the interviews with eight individuals who have been previously attended fashion shows and another two with contemporary designers. Moreover, the interviews have been carefully translated to English. The results found demonstrate that identifying attendees' and designers' motivations towards fashion show attendance and participation is crucial in order to understand the needs and desires of both attendees' and designers' thus enabling Hungarian fashion shows to reach out for a wider audience and participants. Also, it become clear that fashion shows already have a demand in Hungary. Despite the undeniable limitations of the present Hungarian fashion shows, both sample groups had positive and optimistic thoughts about its future development. Hungarian designers considered fashion shows as an innovative experience that could benefit them greatly with the rewards that the shows might offer, such as monetary benefits, relationships building and press coverage. Attendees shared this opinion and added that the shows' overall experience has improved greatly since the beginning. Attendees also highlighted that fashion shows allow Hungarians to be more opened towards newness whilst also providing an exciting platform for individuals to be entertained, share a sense of belonging and to have the ability to build beneficial relationships. Both designers and attendees have however agreed that essential changes still need to be implemented in order to improve and increase the attractiveness of the shows.
A cognitive behavioural therapy in the form of self-help for patients with sleep disturbance and chronic health conditions
(Queen Margaret University, Edinburgh, 2015) kazamia, Nicola
Background: Sleep disturbance, including insomnia disorder, is common among patients with chronic health conditions, and is associated with psychological difficulties and impaired health-related quality of life (HRQoL). Less is known about whether a similar relationship exists in individuals with chronic health conditions who do not have a clinical diagnosis of sleep disturbance (NCSD). Recent evidence suggests that Cognitive Behavioural Therapy (CBT) in the form of self-help (SH) is an effective treatment for individuals with chronic health conditions and has the advantage of low cost and ease of access. Any form of sleep disturbance may be perceived as problematic for individuals with chronic health conditions. This study aims to: a) examine whether the NCSD population with chronic health conditions at baseline have poor sleep quality, insomnia symptoms, high levels of psychological distress (anxiety, depression and stress), sleep-related dysfunctional beliefs and impaired HRQoL, and b) assess the effectiveness of the CBT-SH booklet. Method: Participants were recruited from outpatient clinics and received a 6-week CBT-SH booklet for sleep-related problems. Outcome measures included evaluations of subjective sleep quality and the severity of insomnia symptoms, psychological distress (anxiety, depression and stress) sleep-related dysfunctional beliefs and HRQoL. Measures were completed before and after the intervention. Results: Forty-nine participants (44 females) completed the study. Prior to the intervention, 46 participants reported poor sleep quality and 47 participants reported clinical or subthreshold insomnia. Mean scores for the measures of psychological distress indicated moderate levels of anxiety, depression and stress and sleep-related dysfunctional beliefs respectively. HRQoL was also impaired. Following the CBT intervention, participants showed significant improvements in sleep outcomes, sleeprelated dysfunctional and stress levels. No significant differences were found in HRQoL depression and anxiety outcomes. Conclusion: A brief CBT-SH booklet for sleep-related problems is effective for patients with chronic health conditions and NCSD in clinical settings.
A comparative analysis of the framing devices used by an online pro-same sex marriage publication (The San Francisco Chronicle), and by Democratic Politician Hillary Clinton when framing their views on the same-sex marriage debate.
(Queen Margaret University, 2016)
Introduction (part): Issues directly impacting lesbian, gay, bi-sexual and transgender (LGBT) citizens of the United States of America have gained serious media and political attention for a number of years (Warren & Bloch 2014). It has gained traction in recent years due to LGBT rights becoming more salient within American society, with 51% of people supporting same-sex marriage in a poll conducted in 2013, compared with just 32% in 2003 (Pew Research Center 2013). The issue of same-sex marriage has been at the forefront recently due to it's legalization after the 5-4 ruling in the Obergefell v. Hodges case on June 26th 2015, which ruled that same-sex couples now have the Constitutional right to marry across the 51 United States of America. Same-sex marriage as a social movement is one of the fastest growing social movements in recent years, and many have stated that legalization of same-sex marriage is of cultural significance and representative of old barriers of sexuality, class and race are being broken down indicating that there is a much bigger appreciation for diversity in today's society (Holtzhausen 2012, p. 2). The issue of same-sex marriage in the United States, is one that has divided a nation, with some championing the legalization and others strongly opposing, and previous laws of the issue being left at state level, creating a confusing mix in which some states were issuing marriage licenses, and other's were not. This confusing mix forced the issue to go before a national court, with it ultimately being legalized.
A comparative-descriptive enquiry of postnatal depression in immigrant and refugee women within NHS Lothian.
(Queen Margaret University, 2017)
Aim: The aim of the proposed research is to gain an in-depth understanding of the views of immigrant and refugee women's experiences of postnatal care within NHS Lothian. Background: About every one in ten mothers develop postnatal depression. For immigrant and refugee women the prevalence is proposed to be higher. This is due to predisposing risk factors that increase their chances of developing postnatal depression. Due to the increasing diversity within Scotland and the lack of research based on the topic within this country, it is important that we ensure that the right care and support is available. Methods: Participants are to be sampled using non-probability, purposive sampling. Information letters shall be sent to health visitor and family based centres to recruit participants. For this phenomenological study, the use of unstructured, face to face, interviews will be the method of data collection. Conclusion: Practical and cultural barriers determine whether a women seeks help for their postnatal depression. Stigmatisation surrounding postnatal depression is a problem than affects not only immigrant and refugee women but also the average population. Awareness for healthcare professionals needs to be increased in order to provide the help and support that women with postnatal depression require.
A comparison and evaluation of external noise levels between urban and rural primary schools
(Queen Margaret University, 2016)
Environmental noise can have a detrimental effect on the physiology, motivation and cognition of school children (Evans and Lepore 1993) and can cause negative effects on a person's physiological, mental, motivational and cognitive functions (Berglund, Lindvall and Schwela 1999) as well as having a recognisable interference with communication, resulting in significant social consequences (Brammer and Laroche 2012). In 1999, the World Health Organisation (WHO) set guidelines to ensure noise levels do not exceed 35dB LAeq in the classroom and 55dB LAeq on the playground. Shield and Dockrell (2004) investigated whether these guidelines were being adhered to in a study of internal and external noise levels in London primary schools. In order to evaluate external noise levels within primary schools in Scotland, playground noise levels were compared between urban and rural environments during mid-morning break time, as well as the five minute period immediately prior to and after the break time. It was found that primary schools in urban settings were significantly louder than in rural settings although the level of noise produced by school children during play did not reflect noise levels within the environment. Observations during the investigation found that road traffic, weather and birds were the main sources of noise when the children were not on the playground. The average external noise level in urban school playgrounds exceeds the current WHO guideline and the effects of high noise levels on communication should be further investigated.
A comparison between autocorrelation and CPPS derived voice onset thresholds for Phonation Stabilisation Time
(Queen Margaret University, 2017)
A comparison between gum and starch based thickeners on the perception of sensory characteristics 'taste', 'appearance' and 'consistency' in non-dysphagic swallowers.
(Queen Margaret University, 2017)
Modification of the texture and consistency of food and drink has been established as a leading management option for dysphagia. Adding thickening powders to drinks is an effective way of increasing the viscosity of the bolus consequently allowing individuals more control of liquid during the swallowing process. Throughout the United Kingdom, NHS trusts are beginning to transition from traditional starch based thickeners (SBTs) to gum based thickeners (GBTs) with the rationale that this will increase compliance levels. The current study aimed to investigate the presence of a preference for the sensory characteristics 'taste', 'appearance' and 'consistency' of GBTs compared to SBTs. In addition, the study aimed to examine if this preference was consistent at both 'syrup' and 'pudding' consistencies using two base beverages (water and orange juice). 30 non-dysphagic participants were asked to sample eight thickened drinks; (four SBT, four GBT) which had been thickened to both 'syrup' and 'pudding' consistency using water and orange juice as a base beverage. Participants were asked to rate the appearance, taste and consistency of the drinks on a scale of one to seven. The findings from the study highlighted that GBTs were perceived as more appealing in appearance, taste and consistency compared to SBTs. This preference remained consistent across 'syrup' and 'pudding' thick beverages and the two base beverages (orange juice and water). The current study also highlighted a preference for preferred 'syrup' thick beverages, with orange juice as a base beverage. These findings provide support for the trust wide transition to GBTs, and indicate that there is a preference for the sensory characteristics of GBTs compared to SBTs. This in turn may have a positive impact on compliance levels.
A comparison between the effects of functional versus factual information on memory for tools.
(Queen Margaret University, 2016)
This project's aim was to compare the effects of thinking about functional information versus factual information on memory recall. 51 participants were given three tasks in which they were shown 44 images of ambiguous tools. In the first task participants were asked to rate whether they recognised both the tool and its function. In the second task participants were again shown the images accompanied by either two functional options or two factual options. They then were asked to choose which option they thought was correct after which they were told if they were correct or not. In the final task participants were again shown the images and were asked to input any information they could recall about the information shown. The results showed that humans have a higher recall hit rate when thinking about the function of a tool compared to a fact.
A comparison of drug knowledge and attitude in primary(5/6) and Secondary (2/3) school pupils
(Queen Margaret University, 2015)
INTRODUCTION Research has not paid much attention to children in primary school regarding their knowledge of drugs and attitude to substance use compared with the secondary school aged population. The aim of this study is to assess and analyse school pupils drug knowledge and awareness, what is taught within the curriculum, their attitude towards drugs, peer-pressure and their decision making skills. Thus, in turn, accessing whether pupils are achieving expected curriculum outcomes and any future direction in interventions. METHODS This cross-sectional study was conducted in February in Edinburgh. The subjects of the study were primary (younger) and secondary (older) school pupils. The 148 participants, aged 9-14 years, responded to a self-administered questionnaire consisting of 9 questions and 24 items. The analysis was based on frequency of responses to individual questions and, where appropriate, cross tabulations (using the Chi-Square statistical test) to compare and identify statistically significant differences between particular group. RESULTS There was a significant difference in secondary pupils knowing more drugs name specifically cannabis and heroin compare to primary (0.001 and 0.000). Majority of pupils in both groups did not feel peer pressure. Drug knowledge gained was from multiple sources in both school groups. In primary school pupils had a significantly better attitude towards substance use in some outcomes (0.000 and 0.008) meanwhile secondary school pupils had a better understanding of drug knowledge in some outcomes. CONCLUSION Overall, both groups of pupils' drug knowledge and attitude towards substance use was good in terms of what they already knew. Older secondary pupils had heard of more drugs by name and appeared to have a higher autonomy from parents in getting drug related knowledge compare to Younger primary school pupils. It seems attitude about substance use among primary school was encouraging while in secondary school pupil it was slightly lacking on some outcomes but they did have a better drug knowledge and its effect on the body. Future interventions need multifaceted approach in targeting social and environmental factors of school aged children. KEY WORDS Drug knowledge and attitude, primary, secondary, , substance use, children, young people, school pupils
A Comparison of Drug Knowledge Between Lower Secondary and Upper Secondary School Pupils.
(Queen Margaret University, 2017)
Background: The Curriculum for Excellence, the current national curriculum implemented in Scottish schools, offers little in the way of drug education. Choosing primarily to focus on alcohol and tobacco misuse, the framework fails in delivering a broader and comprehensive drug education syllabus to pupils at every level of schooling. Secondary school pupils, and adolescents in general, are a particularly vulnerable and impressionable group of individuals. Therefore it is essential for them to be equipped with up to date and reliable information about drugs. Research, in the area, links several factors to adolescent and long term drug abuse. Some of these factors include early contact with drugs, peer pressure, neglectful parenting style, socio-economic background, and overall lack of drug knowledge. Whilst incidence of adolescent drug use is decreasing, in 2013, drug misuse incidents cost NHS England approximately £488 million. Thus, it is still considered a critical public health issue. Adolescent drug knowledge, of UK pupils, is an area of research which is decidedly scarce. Objectives: To compare, at what level, secondary school pupils, know more about legal, illegal, and addictive drugs, the social implications of taking drugs, and what is missing when it comes to their own drug education. Specifically those who are in lower and upper secondary school. Design: Prospective schools, North Berwick High School (lower secondary) and Carnoustie High School (upper secondary), were first contacted by email. Schools were given a brief overview of aims and objectives in order to verify their participation. A questionnaire was then developed, based on previous research, consisting of 18 qualitative and quantitative questions presented in various formats. Questionnaires were sent to both schools and adapted based upon feedback, participation from schools was confirmed. Information sheets, parent, guardian, and participant assent forms were sent to schools and consent was sought. Questionnaires were then delivered to pupils by a designated teacher. Upon completion, questionnaire data was collated and analysed using independent samples t-test for parametric data and an independent samples Mann-Whitney test for non-parametric data. A total of 63 questionnaires were completed. Males accounting for 43% and females accounting for 57% of study population. Results: Significant differences were observed in the level of knowledge between lower and upper secondary school pupils with regard to identifying illegal (p = .002), legal (p = .015), and addictive drugs (p = .000002). Upper secondary school pupils displaying greater knowledge over all three aspects. Pupil's in upper secondary school also believed legal highs to be significantly more dangerous than pupils in lower secondary school (p = .001). Significantly more females believed medicinal drugs to be completely safe (p = .027) when compared to males. Conclusion: Upper secondary school pupils appear to exhibit a greater knowledge and understanding of drugs. There is inconclusive evidence to suggest that gender is a variable of drug knowledge. The Curriculum for Excellence drug education programme could be reviewed to ensure that pupils of all years, and ages, maintain an adequate level of drug knowledge throughout their school career. Future research should apply longitudinal study formats to obtain greater understanding of changing adolescent perceptions, behaviours, and knowledge of drugs. Keywords: drug knowledge, drug education, secondary school, adolescents.
A Comparison of Drug Knowledge between Upper Primary and Lower Secondary School Pupils in Scotland.
(Queen Margaret University, 2016)
Drug abuse is fast developing into a global epidemic costing governments' billions annually. In Europe alone, it is estimated that for every drug induced death, there are twenty to twenty-five non-fatal overdose cases still contributing to the overall morbidity (UNODC 2014). Scotland specifically has been viewed as having the highest population of people using illegal drugs (EMCDDA 2012). The problem is exponentially growing among adolescents and hence measures have to be put into place to tackle the issue. One such method as to how this problem can be solved is through providing adequate education to adolescents on the topic. This study was carried out to compare levels of knowledge primary and secondary school pupils in Scotland have on the use and abuse of drugs, the key objective being to determine whether drug education should be given at a younger age in order to prevent abuse later in life. A self-designed questionnaire was developed to compare this knowledge and distributed to seven schools throughout the country where a total of 246 responses were obtained. The key findings showed that secondary participants scored higher in knowledge-based questions, 24.4% scored full marks in one question compared to 9.4% of primary respondents (p = 0.001). However, they have more alarming perceptions on drugs such as split numbers on whether marijuana was dangerous with 63.7% thinking it was compared with 92.5% of primary respondents perceiving the drug as a potential danger (p = 0.001). The majority of both groups could also not identify that certain illicit drugs are used in some aspects of medicine. An interesting discovery within the study was that the younger primary school participants felt they did not receive enough education (58.5% of respondents), which highlights the need for drug education to be given at a younger age. Many organisations believe that providing adequate levels of information on drugs and how they impact on life will reduce this epidemic (The United Kingdom Focal Point on Drugs 2014; Popescu 2015; NIDA 2016). Findings from this study would support this idea, as it is clear that in Scotland those in secondary school are receiving more thorough drug education in comparison to those in primary school. However, the problem of drug abuse in adolescents is still persistent therefore more drug education needs to be delivered to primary school children as the younger it is given, the less likely they will be to abuse later in life (Guo et al. 2014). As well as this, secondary school pupils should also obtain a more wide-ranged drug education programme aimed at problems which are specific to their generation such as the abuse of marijuana. Keywords: drug knowledge, drug education, adolescents, Scotland
A comparison of free maternal health polices in Sierra Leone and Ghana: lessons for Nigeria
(Queen Margaret University, 2016)
INTRODUCTION 1.1. PROBLEM STATEMENT The number of women dying annually from pregnancy, childbirth and attendant complications are still a global concern (WHO 2015). Lack of access to quality healthcare services for pregnancy and delivery are among the reasons for high maternal mortality rates worldwide (Alvarez et al. 2009) with the situation particularly marked in many low-resource settings. For example, despite the reported increase in the proportion of skilled delivery care recorded across the world, only just over half of all deliveries in sub-Saharan Africa are attended by skilled health workers (WHS 2015). Available evidence has shown that the highest number of maternal deaths occur during the delivery and post delivery period (Khan et al. 2006), and increasing access to skilled birth attendance at delivery and provision of emergency obstetric services for women with complications are effective interventions in reducing maternal deaths (Paxton et al. 2005; Rosenfield et al. 2007). In addition, half of the maternal deaths and complications that occur during pregnancy are preventable by antenatal care programs that provide essential services to pregnant women (Abou-Zahr & Wardlaw 2003; Lincetto et al. 2006). Therefore, timely access to maternal care services, therefore, remain an important indicator for monitoring the progress of maternal outcomes including maternal mortality. Access to maternal health services Nigeria is still marked with inequities across geographical and economic gradients (Fagbamigbe & Idemudia 2015a). Financial inaccessibility owing to inability to afford the cost of care have been established as a barrier to use of health facilities, particularly for the poor and vulnerable women (Ekabua et al. 2011). Studies correlating utilisation of maternal health services with models of healthcare financing in low income countries found that higher proportion of government financing is associated with greater utilization of skilled birth attendants and caesarean section (Kruk et al.2007). However, out of pocket financing of the costs of facility delivery has been shown to have substantial repercussion on households including having to borrow money or sell valuable household items making families more vulnerable to impoverishment (Russell 1996; McIntyre et al. 2006). According to Alvarez et al. (2009), Maternal mortality ratios in sub-Saharan African Countries is inversely correlated with per-capita government expenditure on health and directly related to the out-of-pocket expenditure on health, the more out-of-pocket expenditure in health in a country the higher the maternal mortality rate (MMR). Over the last decade, there has been shift towards the eradication of user fees for maternal health services in low and middle income countries with studies showing marked improvement in service coverage with their removal (Ponsar et al. 2011).
A Comparison of Outcome Measures Following Electropalatography (EPG) Therapy in Children with Down's Syndrome
(Queen Margaret University, 2016)
Background Electropalatography (EPG) therapy has shown to remediate speech sound errors that have been intractable through traditional speech therapy. In more recent years, EPG therapy has been explored as an intervention technique for children with Down's syndrome. There are a variety of ways to measure progress following EPG therapy. However, at present, too much reliance is placed on subjective measures to analyse EPG patterns and this does not promote consistency within research addressing the clinical effectiveness of EPG therapy. Aims The principle aim of this project is to compare outcome measures post EPG therapy and identify if a change seen in one outcome measure is also reflected in other outcome measures, and if not then why not? A secondary aim of this project is to explore the possibility of quantifying EPG patterns by developing a classification scheme that provides a set of criteria associated with a target phoneme's idealized articulatory pattern. Methodology Three children with DS were selected from a larger study. Each child received EPG therapy from the school learning assistant with the aim for therapy to be carried out daily in schools over the course of twelve weeks. Each child had an individualized word list which contained phonemes considered most problematic at pre-therapy recordings. The word lists presented target phonemes in word initial and word final position. Four analyses were carried out; a percent consonant correct analysis, an EPG pattern analysis, a property analysis and analysis of intelligibility measures. A classification scheme designed by the author was implemented to enable quantitative results from the EPG pattern analysis. Results from these outcome measures were compared. Results Participants showed variability between different outcome measures and within the results from the same outcome measure, suggesting that the clinical effectiveness of EPG therapy was reflected differently depending on the outcome measure that was used. Intelligibility measures did not provide enough evidence to capture progress about therapy goals and inform intervention. Conclusions This project highlighted questions surrounding the ability of EPG patterns to be quantified and demonstrated how sensitive these patterns can be when analysed in a quantitative manner. The devised classification scheme was binary (tongue palate contact patterns were measured as acceptable or unacceptable) and was therefore unable to measure and recognize incremental change within EPG patterns from pre to post-therapy. Speech and language therapists should give closer consideration to well written therapy goals with carefully designed outcome measures that reflect those therapy goals.
A Comparison of the Beneficial Effects of Cherry Juice and Strawberry Volvic Water on Cognitive Function.
(Queen Margaret University, 2017)
Background: Cherry juice contains phenolic compounds which have found to have the ability to improve cognitive function and lower the risk the cardiovascular diseases. Objective: The aim was to determine the effects of cherry juice and strawberry Volvic water on cognitive function in healthy young 18-25 aged and older 50-70 years old volunteers. In addition to establish if the cherry juice has an influence on individuals blood pressure. Design: In this single blinded randomized cross-over study, healthy volunteers (n=23) from two age groups: younger adults (n=13) and older adult (n=13) consumed 200ml/day of control juice strawberry Volvic water or an intervention of Cherry Good juice for seven days, with a washout period of seven days. In addition blood pressure measurements also been taken before each cognitive test. Results: Younger adults tend to have higher scores all of the cognitive function tests when comparing with older adult population, however the blood pressure of younger adults is lower than the older adults. Conclusion: These study cognitive function tests results showed that to some extend cherry juice have an influence on the improving the working memory, moreover the blood pressure could be influenced slightly by the cherry juice. Key words: Cherry juice; Cognitive function; Flavonoids; Antioxidants; Blood pressure;
A Comparison of thermoplastic and 3D printed beam directional shells on viability for external beam radiotherapy and user experience
(Queen Margaret University, 2017)
Background: The precision of a patient's set-up for the accurate delivery of radiotherapy is paramount. For patients receiving radiotherapy for head and neck cancer it is particularly critical due to the need to prescribe the maximum therapeutic dose to the tumour while sparing normal tissue in very close proximity. Through advances in new technology three-dimensional printing gives the potential for creating an anatomically precise beam directional shell (BDS) directly from a three-dimensional computer model of the patient. Purpose: The aim of this study is to determine the viability of using three-dimensionally printed BDSs by comparing them to the currently used thermoplastic BDSs. Materials and methods: A direct comparison of three-dimensional and thermoplastic BDSs will be assessed. Seventeen healthy volunteers had both BDSs created and a retrospective isocentre positioned on the masks to be used as a baseline for set up. The retrospective isocentre mark allowed left-right, superior-inferior, anterior-posterior alignment and rotation to be assessed over four sessions. After each session of wearing the BDS, the volunteers immediately completed a State Trait Anxiety Inventory (STAI) Part 1 to assess their emotional experience of that particular BDS. Results and conclusion: The data was assessed for normality and homogeneity. If the data was considered normally distributed and homogeneous then a two-way repeated measures Analysis of Variance was performed. If it was not normally distributed then a non-parametric Friedman and Man Whitney U test was used. It was found that there was no significant difference in the external reproducibility of the 3D printed compared to the thermoplastic BDS for the Vertical, Longitudinal and Lateral couch parameters. There was however a statistically significant difference for the Rotational variable. The results obtained from the STAI Part 1 suggested that the thermoplastic BDS produced significantly higher scores in anxiety and distress compared to the 3D printed BDS. The results obtained give encouraging evidence to indicate that 3D printed BDSs could be a viable immobilisation device used for patients requiring EBRT to the head and neck region.
A Comparison of Two Imaging Protocols for Patient's Receiving a Radical Course of Radiotherapy to the Brain.
(Queen Margaret University, 2016)
Background Accurate patient positioning is vital in radiotherapy to deliver precise targets to defined areas. Image guided radiotherapy (IGRT) can help to increase this accuracy. In a large regional radiotherapy department patients receiving a course of radical radiotherapy to the brain undergo daily image guidance prior to delivery of treatment. A 3-mm tolerance of movement is in place for these patients. This service evaluation examined whether it is essential to perform this type of imaging on a daily basis or whether a less frequent imaging protocol would be more clinically relevant. Method This retrospective small scale service evaluation was based on quantitative research. A quasi-experimental design was used. IGRT data was collected from 25 patients who had previously undergone daily image radiotherapy to the brain. Retrospectively couch movements in anterior/posterior, left /right and superior/inferior directions for all the patients for a total of 704 fractions. Data was divided into two groups. Group 1 (daily image group), this group consisted of data from all 25 patients for each daily image recorded throughout their treatment. Group 2 (weekly image group) consisted of data from all patients on the first three days then once weekly. Results A one-sided one-sample t-test was performed to confirm that the mean movement was less than 3-mm. The p-value was p=0.000, the null hypothesis was rejected. Hence μ (the true mean of the movement data) is less than 3-mm. A two sample unpaired t-test (two sided) was carried out to show that the mean movement for the daily group data was not significantly different to the mean movement for the weekly data group. The p-value was above 0.05, the null hypothesis was not rejected. Hence μ_D (the true mean of the daily data) is equal to μ_W (the true mean of the weekly data). Conclusion There was no statistical difference when both imaging schedules were compared. Therefore weekly image guidance would be a more suitable type of imaging schedule. Weekly imaging would also reduce radiographer workload and any potential contaminant dose to the patient.