Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation

Objectives: This work evaluates rapid magnetic resonance projection hydrography (PH) based amniotic fluid volume (AFV) estimates against established routine ultrasound single deepest vertical pocket (SDVP) and amniotic fluid index (AFI) measurements, in utero, at 28-32 weeks gestation. Manual multi-section planimetry (MSP) based measurement of AFV is used as a proxy reference standard. Methods: 35 women with a healthy singleton pregnancy (20-41 years) attending routine antenatal ultrasound were recruited. SDVP and AFI were measured using ultrasound, with same day MRI assessing AFV with PH and MSP. The relationships between the respective techniques were assessed using linear regression analysis and Bland-Altman method comparison statistics. Results: When comparing estimated AFV, a highly significant relationship was observed between PH and the reference standard MSP (R2=0.802, p<0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R2=0.470, p<0.001), with AFI demonstrating a weaker relationship (R2=0.208, p=0.007). Conclusion: This study shows that rapid MRI based PH measurement is a better predictor of AFV, relating more closely to our proxy standard than established US techniques. Although larger validation studies across a range of gestational ages are required this approach could form part of MR fetal assessment, particularly where poly or oligohydramnios is suspected.This study was supported by the National Institute of Health Research, Cambridge Biomedical Research Centre. The authors also acknowledge the support of Addenbrooke’s Charitable Trust and thank the participants for their contribution to the study.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00330-015-4179-

"I Thought You Loved Me too?": Outcomes of Discrepant Involvement in Romantic Relationships

As romantic relationships begin and evolve, it is sometimes the case that partners are discrepant in their attraction to, love for, and commitment to each other. Data were collected from 460 undergraduates who completed a 40 item Internet survey on the various types of discrepancies and outcomes for their respective relationships. Results revealed that half of participants had been in a discrepant relationship in which they were more attracted to, in love with, and committed to their partner and half were less attracted, in love and committed than a partner in a current or past relationship. Men were significantly more likely than women to report that they had been in a discrepant relationship in which they were more in love with their partner. Being more attracted and less attracted, in love with, and committed was positively associated with infidelity. Depression was positively associated with being more or less attracted to, in love with and committed. Alcohol/drug use was positively associated with being more attracted and in love with a partner, as well as being less attracted and committed to a partner. Of discrepant relationships that ended, 45% were by the respondent, 20% mutually, and 11% by the partner. Of discrepant relationships that continued, 44% of the respondents reported that the discrepancies did not matter and that the respondents were happy despite the discrepancies

Simulation In paediatric training

We are what we repeatedly do. Excellence then is not an act but a habit.AristotleThis quote from the Greek philosopher Aristotle from over 2000 years ago is still relevant today in the context of paediatric medical education. Simulation is a tool that can reinforce standards of clinical practice as ‘habit’ contributing to trainee's development as paediatricians.This review shares some of the issues related to learning in the paediatric service environment and demonstrates how simulation can add benefit and value to both the educational process and clinical service. We have structured the article around a series of questions, which will be of relevance to all those using simulation for paediatric training

Achieving and sustaining an optimal product portfolio in the healthcare industry through SKU rationalization, complexity costing, and dashboards

Thesis (M.B.A.)--Massachusetts Institute of Technology, Sloan School of Management; and, (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division; in conjunction with the Leaders for Global Operations Program at MIT, 2012.Cataloged from PDF version of thesis.Includes bibliographical references (p. 76).After years of new product launches, and entry into emerging markets, Company X, a healthcare company, has seen its product portfolio proliferate and bring costly complexity into its operations. Today, Company X seeks to achieve and sustain an optimal product offering that meets their customers' needs. Through a six-month research effort, we develop a process for stock-keeping-unit (SKU) rationalization to reduce SKU complexity while maintaining sales volumes. We, also, implement operational models to compute complexity costs associated with SKU complexity and employ SKU portfolio dashboards to monitor SKU development and govern SKU creation. This thesis discusses a process for applying these tools to any healthcare company. Through two case studies, we apply the rationalization process on one pilot brand and develop a dashboard to improve product portfolio management. We expect that the SKU rationalization process will release 38% of avoidable costs associated with the pilot brand. These case studies also provide insight into how to correctly diagnose the cost reduction opportunity associated with SKU complexity, as well as methods for a step-change improvement in lead-times and cost-reduction. Lastly, removal of complexity provides flexibility to capture other business opportunities.by David Hilliard.S.M.M.B.A

An in-home study of subjective response to simulated sonic booms

The proposed development of a second-generation supersonic commercial transport has resulted in increased research efforts to provide an environmentally acceptable aircraft. One of the environmental issues is the impact of sonic booms on people. Aircraft designers are attempting to design the transport to produce sonic boom signatures that will have minimum impact on the public. Current supersonic commercial aircraft produce an 'N-wave' sonic boom pressure signature that is considered unacceptable by the public. This has resulted in first-generation supersonic transports being banned from flying supersonically over land in the United States, a severe economic constraint. By tailoring aircraft volume and lift distributions, designers hope to produce sonic boom signatures having specific shapes other than 'N-wave' that may be more acceptable to the public and could possibly permit overland supersonic flight. As part of the effort to develop a second-generation supersonic commercial transport, Langley Research Center is conducting research to study people's subjective response to sonic booms. As part of that research, a system was developed for performing studies of the subjective response of people to the occurrence of simulated sonic booms in their homes. The In-Home Noise Generation/Response System (IHONORS) provides a degree of situational realism not available in the laboratory and a degree of control over the noise exposure not found in community surveys. The computer-controlled audio system generates the simulated sonic booms, measures the noise levels, and records the subjects' rating and can be placed and operated in individuals' homes for extended periods of time. The system was used to conduct an in-home study of subjective response to simulated sonic booms. The primary objective of the study was to determine the effect on annoyance of the number of sonic boom occurrences in a realistic environment

Globalization and Human Trafficking

Globalization demands that social workers embrace more than just local and national perspectives; they must adopt an international viewpoint as well. A negative aspect of globalization that deserves more attention is the international movement of labor. This paper presents a description and analysis of trafficking, the more deleterious part of this movement of people, in a global context. Decision makers seeking to make global migration more humane need to know about the dynamics and process of trafficking, as well as ways to combat it. Definitional controversies, contextual issues (including the dynamics and processes of trafficking), and consequences of this movement for individuals and societies are discussed. Implications for social work are also presented