Prenatal Corticosteroids for Reducing Morbidity and mortality after Preterm Birth

Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2005.©The Trustee of the Wellcome Trust, London, 2005.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.In 1959 the New Zealand obstetrician Graham (Mont) Liggins began investigating mechanisms that triggered premature labour. Supported by the Wellcome Trust, he examined the effects of hormones on labour in sheep, and demonstrated coincidentally that in utero corticosteroids accelerated fetal lung maturation. A randomized controlled trial (RCT) of prenatal corticosteroids in humans by Liggins and pediatrician Ross Howie, showed a reduction of respiratory distress syndrome in preterm babies. This Witness Seminar, chaired by the late Dr Edmund Hey, discussed the influence of Liggins' and Howie's 1972 paper announcing these results, and subsequent work by Avery and Kotas on induction of pulmonary surfactant in lambs. Other subjects included Crowley's 1981 systematic review of four RCTs; the low uptake of corticosteroids in practice until the Royal College of Obstetricians and Gynaecologists issued usage guidelines in 1992; trials to determine optimum drug, dose and number of courses; potential adverse effects; and cost-benefit analysis. Participants included the late Dr Mel Avery, Sir Iain Chalmers, Dr Patricia Crowley, the late Professor Harold Gamsu, Professor Jane Harding, Professor Richard Lilford, Professor Miranda Mugford, Professor Ann Oakley, Professor Dafydd Walters and Mr John Williams. Appendices from Liggins and Howie; Liggins' Wellcome Trust grant; and the protocol of the 1975 UK trial of betamethasone, complete the volume. Reynolds L A, Tansey E M. (eds) (2005) Prenatal corticosteroids for reducing morbidity and mortality after preterm birth, Wellcome Witnesses to Twentieth Century Medicine, volume 25. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A-Z

The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between the 1930s and the present.The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between the 1930s and the present.The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between the 1930s and the present.The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between the 1930s and the present.The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between the 1930s and the present.Wellcome Trust

Monoclonal Antibodies to Migraine: Witnesses to Modern Biomedicine, an A–Z

The History of Modern Biomedicine Research Group hosted its first Witness Seminar, on monoclonal antibodies, in 1993. Since then more than sixty such meetings have been held, the most recent on migraine in 2013. These all sought to go behind-the-scenes of contemporary biomedicine to find out ‘what really happened’. In this, the Group’s twenty-first anniversary year, we are delighted to present our fiftieth Witness Seminar volume Monoclonal Antibodies to Migraine: Witnesses to modern biomedicine, an A–Z. Comprising a series of extracts from previous volumes, contributors include clinicians, scientists, patients and numerous others involved in modern biomedicine, in the UK and beyond. Topics range from ‘age discrimination’ to ‘Zantac’, and feature memories from every decade between 1930s and the present

Systems for the automotive industry for improved safety of pregnant occupants

The thesis presents an investigation of pregnant women s safety and comfort needs during car travel. A survey is used to investigate all aspects and problems of car travel. This survey is a comprehensive examination of the entire driving activity with much detail of reported difficulties from pregnant women that forms a novel resource for the automotive engineers. The survey results are used to generate guidelines for the automotive industry. A series of sled tests are presented that investigate seat belt use in pregnancy including the use of lap belt positioners. The peak abdominal pressure results clearly agree with current guidelines that the lap belt should be positioned across the hips and not across the abdomen. This research includes a novel anthropometric dataset for 107 pregnant women including measurements especially selected for the field of automotive design and to describe the changes of pregnancy. This includes investigation of pregnant driver s proximity to the steering wheel. A novel measurement of knee splay is used to define the pregnant women s preference to sit with their knees widely spaced instead of knees together, in both normal sitting and in a car. Comparison is made between the pregnant women's measurements and the available data in the literature for non-pregnant women and males, and this shows that pregnant women can be excluded from designs if the accommodation does not consider their needs. The pregnant women's anthropometric data is presented as a novel website in order to make the data available to the automotive industry. This website is generated for use by automotive engineers and is designed to suit their usability needs and the general trends within the industry, in order to make the site more user-friendly and more likely to be used as a reference for pregnant occupant's needs.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

History of the Avon Longitudinal Study of Parents and Children , c.1980-2000

Annotated and edited transcript of a Witness Seminar held on 24 May 2011. Introduction by Professor David Gordon, World Federation for Medical Education.Annotated and edited transcript of a Witness Seminar held on 24 May 2011. Introduction by Professor David Gordon, World Federation for Medical Education.Annotated and edited transcript of a Witness Seminar held on 24 May 2011. Introduction by Professor David Gordon, World Federation for Medical Education.Annotated and edited transcript of a Witness Seminar held on 24 May 2011. Introduction by Professor David Gordon, World Federation for Medical Education.The Avon Longitudinal Survey of Parents and Children (ALSPAC) arose from a proposal in the mid-1980s to design a cohort study in Europe which concentrated on the health of children. The UK-side of this was developed in the former county of Avon and the study has followed more than 14000 children, due between April 1991 and December 1992, from their mothers' pregnancies onwards. A vast amount of data has been collected on health, lifestyle, and environment as well as biological samples of urine, blood and DNA. This has been used to establish genetic and environmental determinants of development and health. With an introduction by Professor David Gordon, this volume addresses the origin and development of ALSPAC, the problems of funding such a major study, the variety of methodologies employed, and the ethical questions associated with the project. Contributors include several of the major scientists involved with ALSPAC including Professor Jean Golding, Scientific and Executive Director of the study until December 2005, as well as clinical scientists, epidemiologists, members of the ethics committee, field workers and study parents.https://qmro.qmul.ac.uk/xmlui/handle/123456789/272

Vaginismus in the Irish context: a grounded theory study

Vaginismus is a common sexual difficulty that can cause distress for the woman, her partner and their relationship. Despite its universal prevalence, vaginismus remains under-researched. The most recent studies of vaginismus in Ireland were conducted forty years ago and since then there have been no known studies of what it is like to experience vaginismus or to seek help in modern day Ireland. This is the first known study to interview couples together about their experiences of vaginismus and help seeking in Ireland and the first study to incorporate both the perspectives of couples and healthcare professionals. The aim of the study was to build a theoretical model of vaginismus within an Irish context from the perspective of couples and health care providers. This grounded theory study used semi-structured interviews to explore the experience of vaginismus in Ireland. Ten couples who had experience of vaginismus in their relationship and eighteen healthcare professionals who work with women and couples experiencing vaginismus were recruited for the study. Data were analysed through the three coding stages of Straussian Grounded Theory. The results conceptualise the experience of vaginismus and help seeking as a process of disconnection and connection, a psychosomatic defence mechanism within a lifespan developmental model. This defence mechanism is illustrated by iterative phases of protective disconnecting from emotional and sexual feelings within the family of origin, attempts at emotional and sexual connection within the couple relationship and, finally, a healing connection with the emotional and sexual self within the safety of the couple and/or therapeutic relationship. These results provide a conceptual framework that can inform a sensitive and ethical approach when working with women and couples experiencing vaginismus

Looking Back and Moving Forward: A History and Discussion of Privately Practising Midwives in Western Australia

The aim of this historical narrative research study was to fill a gap in the literature by investigating, analysing and describing the history of privately practising midwives in Western Australia (WA) from colonisation to the present day (approximately 1830-2018). This study embedded within a naturalistic, feminist paradigm analysed oral history interviews from fifteen midwives and three doctors, and archival documents to reconstruct the history, and explore the experiences of privately practising midwives in WA

Women and Reproductive Technologies

A sociological and historical study of the development of reproductive technologies, this book focuses on key technological developments through a biomedicalization lens with special attention to gender. Using in vitro fertilization (IVF) as a hub, it critically examines the main areas of related socio-technical developments: reproductive science, birth control, animal husbandry, genetics and reproductive medicine. Employing a critical framework to illuminate dominant discourses, the book also highlights examples of social resistance, as well as contradictory responses to new reproductive technologies. Over eight chapters, the author examines the social history of reproduction and sexuality, reproductive technologies from old to new and debates surrounding new reproductive technologies and genetic engineering. Women and Reproductive Technologies pays close attention to the interconnections between the business of reproduction (and replication industries), the sociality of reproduction (including reproductive justice) and what are considered the technologies themselves. As such, it constitutes essential reading for students and researchers in the fields of sociology, health studies and gender studies interested in the current state of human reproduction

The impact of economic rationalism and new public management on health and welfare provision: accounting for the gap between social health care policy and practice in two Scottish maternity care units

The administration of welfare in Britain and beyond, in the last thirty years, has seen a series of changes culminating in the new public management (NPM) approach in the delivery of public services. Current literature suggests that traditional collectivist values underlying state welfarism are at risk under the precepts of NPM and economic rationalism (Hood 1991; Clarke and Newman 1997; Hunter 2002). Since rigid economic calculation is not always possible or rational on a social, psychological, or medical scale, social policy prescriptions have to bend to its calculative pulse. Selecting decentralised budget management as one key aspect of NPM, this thesis tests out its impact on two key social health policy recommendations, 'service user choice' and 'continuity of care' as set out by Changing Childbirth (1993).The ·design of the study consists of a merger of two distinct methodological approaches: questions put to participants were informed by a NPM framework; at the same time, the openness of the interview schedule enabled issues and themes to evolve in a grounded way. The study took place in Scotland where two highly contrasting maternity units, in terms of size, internal culture, and geographical location, were investigated. Tape-recorded in-depth interviews, of around 45-90 minutes each, were carried out with a sample of 43 consultant obstetricians, junior doctors, paediatricians, midwives, and key financial management personnel.The comparison of the two sites highlights how organisational size, structure and the midwifery system in place can impinge on the viability and implementation of social health policies such as those recommended in the Cumberledge Report (1993).[1] Whilst constrained budgetary procedures have hampered the full expression of service user choice and continuity of care, largely due to inadequate staffing or practitioner skills, the dictates of new public management have had a more turbulent impact on the larger than on the smaller unit.One finding of this thesis is that service user choice is not only inhibited by economic rationalism but also by internal institutional agendas - a consideration, which, to some extent, is likely to be applicable to all health and welfare services. Another key finding is the identification of the distinct forces that combine to obstruct the implementation of social health policies. Apart from complex economic, organizational and institutional influences, one significant obstructing factor is the obstetricalisation of childbirth. The gap between social health policy and practice is widening as mergers take precedence over the retention of smaller, relatively low-tech maternity care units. This structural change designed to achieve perceived needs for ' medical safety' in an economically rational way is increasingly likely to render the recommendations of Changing Childbirth impracticable.The thesis concludes that a comprehensive approach towards health and welfare, where service user choice and continuity of care are recognised, which considers the social context in which economic action takes place, could be expected to lead to improved health and welfare outcomes overall. - - - - -[1] Cumberledge Report (1993) Changing Childbirth London HMS