Midlands Region Research Articles

Assessment of the impacts of GABA and AChE targeting pesticides on freshwater invertebrate family richness in English Rivers

Globally, riverine system biodiversity is threatened by a range of stressors, spanning pollution, sedimentation, alterations to water flow, and climate change. Pesticides have been associated with population level impacts on freshwater invertebrates for acute high-level exposures, but far less is known about the chronic impact of episodic exposure to specific classes of pesticides or their mixtures. Here we employed the use of the UK Environment Agency's monitoring datasets over 40 years (covering years 1980 to 2019) to assess the impacts of AChE (acetylcholinesterase) and GABA (gamma-aminobutyric acid) receptor targeting pesticides on invertebrate family richness at English river sites. Concentrations of AChE and GABA pesticides toxic to freshwater invertebrates occurred (measured) across 18 of the 66 river sites assessed. For one of the three river sites (all found in the Midlands region of England) where data recorded over the past 40 years were sufficient for robust modelling studies, both AChE and GABA pesticides associated with invertebrate family richness. Here, where AChE total pesticide concentrations were classified as high, 46 of 64 invertebrate families were absent, and where GABA total pesticide concentration were classified as high, 16 of 64 invertebrate families were absent. Using a combination of field evidence and laboratory toxicity thresholds for population relevant endpoints we identify families of invertebrates most at risk in the selected English rivers to AChE and GABA pesticides. We, furthermore, provide strong evidence that the absence of the invertebrate family Polycentropodidae (caddisfly) from one field site is due to exposure effects to AChE pesticides.

Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada

ObjectiveParamedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics on responding to a 911/999 medical emergency after an assessment of...

Nature-based interventions to support mental health and well-being of young women in pregnancy: exploratory work for future feasibility RCT.

The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study. This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research. The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.

The Role of Human Resource Development in Ensuring Social Security in the Northern Midlands and Mountainous Region

The Northern Midlands and Mountains are one of the 6 economic regions of the country. The country's renovation has brought many important economic and social achievements, including strengthening the social security policy system. However, over the past, the social security policy system has also revealed many shortcomings that need improvement. The paper focuses on the analysis of the workforce in the Northern Midlands and Mountains and offers solutions and recommendations for human resource development to meet social security goals. The author proposes two main groups of solutions based on the current situation.

A Digital Microintervention Supporting Evidence-Based Parenting Skills: Development Study Using the Agile Scrum Methodology.

Conduct disorder increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of conduct disorder involves evidence-based parenting skills programs. Time-outs, a frequent tool in these programs, can be effective at improving behavior, and recent apps have been developed to aid this process. However, these apps promote the use of time-outs in inconsistent or developmentally inappropriate ways, potentially worsening behavior problems. Digital microinterventions like these apps could guide parents through high-quality time-outs in the moment, but current time-out apps lack features promoting adherence to the evidence-based best practice. Agile scrum is a respected approach in the software development industry. We aimed to explore the feasibility of using the agile scrum approach to build a digital microintervention to help parents deliver an evidence-based time-out. The agile scrum methodology was used. Four sprints were conducted. Figma software was used for app design and wireframing. Insights from 42 expert stakeholders were used during 3 sprint reviews. We consulted experts who were identified from councils around the Midlands region of the United Kingdom and charities through personal contacts and a snowballing approach. Over 4 development sprints from August 2022 to March 2023, the app was iteratively designed and refined based on consultation with a diverse group of 42 experts who shared their knowledge about the content of common parenting programs and the challenges parents commonly face. Modifications made throughout the process resulted in significant app enhancements, including tailored timer algorithms and enhanced readability, as well as an onboarding zone, mindfulness module, and pictorial information to increase inclusivity. By the end of the fourth sprint, the app was deemed ready for home use by stakeholders, demonstrating the effectiveness of our agile scrum development approach. We developed an app to support parents to use the evidence-based time-out technique. We recommend the agile scrum approach to create mobile health apps. Our experience highlights the valuable role that frontline health and social care professionals, particularly those working with vulnerable families, can play as experts in scrum reviews. There is a need for research to both evaluate the impact of digital microinterventions on child behavioral change and also create digital microinterventions that cater to non-English speakers and individuals who participate in parenting programs in settings outside the United Kingdom.

The Greater Midlands—A Mid-Elevation Centre of Floristic Endemism in Summer-Rainfall Eastern South Africa

The Midlands region of KwaZulu-Natal (KZN) Province in South Africa was hitherto a putative centre of floristic endemism (CFE) based on conjecture. The aim of this study was to empirically explore this concept by delineating unambiguous boundaries for this CFE and documenting the endemic spermatophytes within a conservation framework. The Greater Midlands Centre of Floristic Endemism (GMCFE), a more expanded study area than the parochial Midlands region of KZN, is formally described as southern Africa’s 20th CFE. It is a mid-elevation region occupying the greater Midlands of KZN, with extensions of contiguous grasslands extending northwards into southern Mpumalanga and southwards into north-eastern Eastern Cape. This “foothills” CFE covers ca. 77,000 km2 of predominantly mesic C4 grassland, ranging in elevation from ca. 700–2200 m a.s.l. It is congruent with the “sub-escarpment ecoregion,” essentially a composite of the Sub-escarpment Grassland and Savanna Bioregions and the sub-escarpment grasslands of southern Mpumalanga and northern KZN. The GMCFE hosts at least 220 endemic spermatophytes, of which almost a fifth belong to the family Apocynaceae. Families Asteraceae, Asphodelaceae, Fabaceae, and Iridaceae also contribute significantly. Genera Ceropegia, Aloe, Dierama, Kniphofia, Helichrysum, and Streptocarpus contribute the most endemics. More than half are forbs, and almost three-quarters are confined to the Grassland Biome. Endemic radiations are attributed to geodiversity and geological complexity (especially the strong lithological influence of dolerite); physiographic heterogeneity (particularly elevation gradients and variable terrain units); strategic proximity to hyper-diverse temperate and subtropical “border floras”; and localized pollinator-driven adaptive radiations. Of alarming concern is the high number of threatened plant taxa, with ca. 60% of the endemic flora Red Listed in threat categories (CE, E, and VU) or considered “rare”. Extremely low levels of formal protection and poor ecological connectivity, coupled with high levels of land transformation and intensive utilization, render the GMCFE one of the most imperilled CFE in South Africa. Urgent conservation action is required to safeguard this unique and highly threatened “rangeland flora” and stem the biodiversity crisis gripping the region.

A contextual evaluation of complications of excess weight (CEW) clinics in the Midlands region, England

A contextual evaluation of complications of excess weight (CEW) clinics in the Midlands region, England

Health communication for AMR behaviour change: Zimbabwean students’ relationships with the microbial world

Abstract Background Microbes have a global impact on health; microbial relationships benefit and impair quality of life. Negative health impacts of antimicrobial resistance (AMR) in our relationships with the microbial world are primarily borne by the Global South Objectives To study experiences, understandings and practices of Zimbabwean students regarding health, food and microbes. Methods Using purposive sampling, Zimbabwean school students were recruited as participants in group interviews supported by participant observation, exploring the relationships between health, food and microbes. Results The study included 120 students from six upper secondary schools in the Midland Region and Gweru District. Findings identify two categories: microbial relationships and microbial encounters, each with three subcategories. Food emerged as both mediating artefacts and mediating experiences, enabling the students to link biomedical explanations of AMR and their everyday lives with friends and family. The necessity for health communication to explore and engage with participants’ contextual preferences and motivations is highlighted. When discussing food choices and practices, students considered the beneficial relationships with the microbial world. Conclusions A contextually relevant approach is outlined, where food mediates the relationship between student health and the microbial world, supporting health communication for AMR behaviour change. Expanding AMR education to include the everyday experiences of food enables students to link the pressing sustainability challenge of AMR to their health goals. The study showcases how the exploration of microbial relationships and food practices as a ubiquitous feature of community life can form a basis for AMR prevention and control.

Breaking the Silence: Participatory Forum Theatre and Gender-Based Violence Prevention in Mining Communities. A Case Study of Makusha, Midlands Province, Zimbabwe

This study investigates forum theater, an interactive, participatory type of theater, as a tool to better understand and combat gender-based violence (GBV) in Makusha, a densely populated mining community in Shurugwi, the Midlands region of Zimbabwe. Deeply impacted by rapid mining industry expansion, this community faces intensifying social tensions. At the core of the study lies an examination of the influence of forum theater on community attitudes and behaviors. Attention is paid to its role in empowering vulnerable segments of the community, especially women, and how it fosters resilience and resistance against GBV. The study discusses the transformative potential of forum theater in addressing deep-seated social issues and the urgency of creating inclusive and violence-free spaces in communities.

Nature-Based Interventions in the UK: A Mixed Methods Study Exploring Green Prescribing for Promoting the Mental Wellbeing of Young Pregnant Women.

Green prescribing is gaining in popularity internationally for the promotion of mental wellbeing. However, the evidence base is limited, particularly in young pregnant women, a population with known risk factors for anxiety and depression. The aim of this mixed-methods study was to provide insights into the availability, processes, and suitability of nature-based interventions for young pregnant women. First, an online mapping survey of nature-based activities in the East Midlands region of the United Kingdom (UK) was undertaken. Second, focus groups (n = 6) were conducted with nature activity providers and young mothers (n = 11). This study found there were many diverse nature-based activities available to promote mental wellbeing. The organisational challenges highlighted include a lack of sufficient funding for service provision and disappointing experiences with some green prescribing programmes. The young women felt that nature-based activities helped to promote their mental wellbeing, and also offered an opportunity for social support. The facilitators, such as having detailed information and being accompanied to initial sessions to ease anxieties, were found to maximise the women's engagement with nature-based interventions. This study provides new perspectives on nature-based interventions from service providers and young women. Findings on the organisational barriers and facilitators to delivering interventions will inform the design of much needed future experimental research.

Sexually Transmitted Infections and the Risk of Reinfection Within 12 Months: A Population-Based Cohort.

Chlamydia, gonorrhea, and syphilis are common sexually transmitted infections that disproportionately affect specific groups in New Zealand (NZ). Predictors of reinfection are not well studied in NZ but could inform public health strategies to decrease sexually transmitted infection (STI) incidence. New Zealand-wide chlamydia, gonorrhea, and syphilis cases during 2019 were identified using nationally collected data. Cases were followed-up to identify reinfection with the same STI within 12 months of initial infections. Logistic regression models were used to identify predictors for each STI reinfection. Determinants identified for increased odds of chlamydia reinfection were age groups 16-19 and 20-24 years, females, Māori and Pacific peoples, cases in the Northern region, and cases with at least one test before the initial infection. Age 40 years and older was associated with lower odds of gonorrhea reinfection, as was being of Asian ethnicity, living in Midland or Southern regions, and reporting heterosexual behavior. Region was the only statistically significant predictor for syphilis reinfection, with higher odds of reinfection for people living in the Central region. Our findings reflect disproportionate STI rates for some groups in NZ, with younger age groups, Māori and Pacific peoples, men who have sex with men, and people living in the Northern region experiencing higher odds of reinfection. Groups identified with higher odds for reinfection require increased access to culturally responsive health services to treat, understand, and prevent possible reinfection. Changes to current public health strategies could include culturally specific behavioral counseling, and improvements to and adherence to effective contract tracing.

Virtual learning in maxillofacial surgery in the post-COVID world: where are we now?

During the COVID-19 pandemic we developed a post-graduate virtual learning environment (PGVLE) in the West Midlands region for higher trainees in oral and maxillofacial surgery. We continued to develop this following the pandemic and sought to examine the trainee experience with this resource as restrictions eased. The PGVLE comprises a total of nine semesters mapping General Medical Council (GMC) learning objectives in the specialty across a total of 63 events using BigBlueButton™. Webinars are delivered on a weekly basis by subspecialty experts. Trainee feedback was sought using SurveyMonkey™ examining self-assessed confidence levels using visual analogue scores (VAS) and Likert items regarding trainers and content. A focus group was convened and the transcript analysed using grounded theory analysis (GTA). Likert items revealed overwhelmingly positive responses, with 96.2% (n = 281) of responses being positive regarding content and 97.5% (n = 475) agreeing with positive comments regarding faculty. VAS scores improved by an average of 39.0% and improvements were statistically significant for most sessions. The focus group highlighted the relevance of teaching to GMC learning objectives, the achievement of consistently high standards, the potential for conflict with clinical commitments and issues surrounding peer interaction. Satisfaction scores remain high with the PGVLE programme, which is very much here to stay in the post-graduate education of our trainees. With the easing of restrictions, we have moved to a hybrid method of learning with the potential for ‘flipped classroom’ methodology moving forwards.

Presentation and management of insect bites in out-of-hours primary care: a descriptive study

ObjectivesTo describe the population presenting to out-of-hours primary care with insect bites, establish their clinical management and the factors associated with antibiotic prescribing.DesignAn observational study using routinely collected data from...

An integrated groundwater resource management approach for sustainable development in a tropical river basin, southern India.

Evaluation of aquifer potential is essential, as thepotable water demand has increased globally over the last few decades. The present study delineated different zones of groundwater potential and groundwater quality of the Kallada River basin (KRB) in southern India, using geo-environmental and hydrogeochemical parameters, respectively. Geo-environmental variables considered include relative relief, land use/land cover, drainage density, slope angle, geomorphology, and geology, while hydrogeochemical parameters include pH, electrical conductivity (EC), Cl-, Fe3+, and Al3+ concentrations. Analytical hierarchy process (AHP) was used for categorizing groundwater potential and quality zones. Nearly 50% of KRB is categorized as very high and high groundwater potential zones, occupying the western and midland regions. The central and west-central parts of KRB are characterized by excellent groundwater quality zones, while the eastern and western parts are characterized by good and poor groundwater quality zones, respectively. By integrating the groundwater potential and groundwater quality, sustainable groundwater management is observed to be necessary at about 54% of the basin, where site-specific groundwater management structures such as percolation ponds, injection wells, and roof water harvesting have been proposed using a rule-based approach. This integrated groundwater potential-groundwater quality approach helps policymakers to implement the most suitable management strategies with maximum performance.

Impact of a community pharmacy led antibiotic amnesty in the Midlands region of England.

Antimicrobial resistance is a recognised threat to human health and may be driven by the unsafe disposal of antibiotics via domestic waste streams, contaminating the environment. A community pharmacy based antibiotic amnesty could address this. We evaluated the impact of an antibiotic amnesty promoting the return of unused antibiotics to community pharmacies in the Midlands region of England during World Antibiotic Awareness Week in November 2021. Two hundred and thirty nine pharmacies participated voluntarily and held amnesty conversations with 7399 people, 369 part used and 126 full packs of antibiotics were returned. This is an important public health initiative that could be replicated more widely.

IMPROVING THE QUALITY OF FOREIGN LANGUAGE TEACHING STAFF AT THAI NGUYEN UNIVERSITY, VIETNAM IN THE CURRENT PHASE

Thai Nguyen University in Vietnam identifies improving the quality of the foreign language teaching staff as one of the priority tasks in the development strategy, training advanced and modern human resources to serve the economic, political, cultural, and social development needs of the midland and northern mountainous regions. Despite certain achievements, due to its unique characteristics, Thai Nguyen University is facing numerous challenges, especially in terms of the foreign language faculty, which is deficient and weak compared to the requirements. To meet the needs of training and cultivating foreign language teachers in the future, it is necessary to conduct research to accurately assess the current situation and propose solutions to improve the quality of the foreign language teaching staff.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0045/a.php" alt="Hit counter" /></p>

Examining Teaching for Mastery as an instance of ‘hyperreal’ cross national policy borrowing

ABSTRACT To improve education performance at home, countries cross nationally policy-borrow from jurisdictions ranked highly in international league tables. This paper examines a practical example of one such instance of policy borrowing, Teaching for Mastery (TfM). Over a six year period, interviews were conducted with teachers working in primary schools in the East Midlands region of England. The focus of these interviews was to explore informants’ experiences of enacting TfM and their analysis of the UK government’s motives for undertaking this borrowing. Applying Baudrillard’s ideas around hyperreality and image to these data indicated two key themes: 1) TfM discourses masked crucial aspects of the original policy, with the result that 2) TfM became non-relational to the original and thus hyperreal. The paper suggests strategies that might mitigate against policy becoming hyperreal and concludes that government must carefully consider its motives for engaging in the borrowing process from the outset.

Traffic Noise Assessment Using Intelligent Acoustic Sensors (Traffic Ear) and Vehicle Telematics Data.

Here, we introduce Traffic Ear, an acoustic sensor pack that determines the engine noise of each passing vehicle without interrupting traffic flow. The device consists of an array of microphones combined with a computer vision camera. The class and speed of passing vehicles were estimated using sound wave analysis, image processing, and machine learning algorithms. We compared the traffic composition estimated with the Traffic Ear sensor with that recorded using an automatic number plate recognition (ANPR) camera and found a high level of agreement between the two approaches for determining the vehicle type and fuel, with uncertainties of 1-4%. We also developed a new bottom-up assessment approach that used the noise analysis provided by the Traffic Ear sensor along with the extensively detailed urban mobility maps that were produced using the geospatial and temporal mapping of urban mobility (GeoSTMUM) approach. It was applied to vehicles travelling on roads in the West Midlands region of the UK. The results showed that the reduction in traffic engine noise over the whole of the study road was over 8% during rush hours, while the weekday-weekend effect had a deterioration effect of almost half. Traffic noise factors (dB/m) on a per-vehicle basis were almost always higher on motorways compared the other roads studied.

Impacts of net zero policies on air quality in a metropolitan area of the United Kingdom: Towards world health organization air quality guidelines

Climate change and air pollution are closely interlinked since carbon dioxide and air pollutants are co-emitted from fossil fuel combustion. Net Zero (NZ) policies aiming to reduce carbon emissions will likely bring co-benefits in air quality and associated health. However, it is unknown whether regional NZ policies alone will be sufficient to reduce air pollutant levels to meet the latest 2021 World Health Organisation (WHO) guidelines. Here, we carried out high resolution air quality modelling for in the West Midlands region, a typical metropolitan area in the UK, to quantify the effects of different NZ policies on air quality. Results show that NZ policies will significantly improve air quality in the West Midlands, with up to 6 μg m−3 (21%) reduction in annual mean NO2 (mostly through the electrification of vehicle fleet, EV) and up to 1.4 μg m−3 (12%) reduction in annual mean PM2.5 projected for 2030 relative to levels under a “business as usual” (BAU) scenario. Under BAU, 2030 PM2.5 concentrations in most wards would be below 10 μg m−3 whilst under the Net Zero scenario, those in all wards would be below 10 μg m−3. This means that the ward averages in the West Midlands would meet the UK PM2.5 of 10 μg m−3target a decade early under the Net Zero scenario. However, no ward-level-averaged annual mean PM2.concentrations meet the 2021 WHO Air Quality guideline level of 5 μg m−3 under any scenario. Similarly for NO2 only 18 wards (8% of the region's population) are predicted to have NO2 concentrations below the 2021 WHO guideline level (10 μg m−3). Decarbonisation policies linked to Net Zero deliver substantial regional air quality benefits, but are not in isolation sufficient to deliver clean air with air pollutant levels low enough to meet the 2021 WHO guidelines.

Financial literacy and advice perceptions among UK higher education students: an ethnicity tale?

Although considerable efforts have been made in many countries to raise the financial literacy of those from disadvantaged backgrounds, it is unclear whether these are having an effect. This is particularly the case for those of ethnic minority background, who may suffer from other disadvantages. This study examines the financial literacy of students from two universities in the East Midlands region of the UK. It considers the role played by ethnic background. It is found that significant differences in financial literacy remain between the White majority and particular ethnic groups. In part, this appears to reflect their perceptions of the types of decision they see financial literacy relating to. Some ethnic groups saw financial literacy as being of more relevance for larger, less frequent financial decisions, but saw less connection, and relevance, to the day to day choices they had to make. Ethnicity also potentially has an indirect effect, as informal sources of advice, and those that promote a financial market perspective, tend to be valued more highly. The implications are worrying given that the respondents are the more highly educated independent young members of the population. Current attempts to assist the development of financial literacy therefore appear to be failing those from some ethnic minority groups. This will leave them at a continuing disadvantage, unless interventions can highlight the day to day importance and value of financial literacy.