Placenta praevia: present day views regarding placenta praevia with special reference to treatment, and including an analysis of 192 cases admitted to the Edinburgh Royal Maternity Hospital during the five years 1923-27

A placenta, the implantation of which encroaches upon that part of the uterus which will afterwards become the lower uterine segment, is termed Placenta Praevia. Of this, there are three varieties: (a) Central, where the placenta completely covers the os; (b) Marginal, where the placenta reaches the margin of the internal os; (c) Lateral, in which the edge of the placenta dips into the lower uterine segment. The two last are often grouped together as Partial Placenta Praevia, on account of the arbitrary nature of the words lateral and marginal, which, by different observers, are respectively used to denote different degrees of praevia, at unstated degrees of dilatation of the internal os. It may here be observed that such terms may be misleading unless at the same time the size of the os is stated, for it follows that a placenta which may be felt to cover the os completely when it is dilated to admit one finger, may only partially cover it by the time the os has reached the size of a teacup. The words Central and Partial will here be employed to describe the situation of the placenta, as it would be recognised Clinically with the os dilated to one finger. Often when the patient is first seen the os is further dilated, and in these cases the relationship between the placenta and the cervix at a "one finger" dilatation has to be assumed. That placenta praevia is a serious condition for both mother and child is shown by the mortality figures obtained by taking the average of 20 observers, the maternal mortality being 10.e% and the foetal mortality 50%. The incidence amongst hospital cases is approximately 1.2%. Whilst the variety of praevia, the amount of blood loss, and the general condition when first seen, have considerable bearing upon the prognosis for the mother, judicious treatment is undoubtedly an import_ ant factor. It is to this side of the subject that most attention will be directed in this paper, in the hope that further light may be shed upon the right choice of method of treatment under varying circumstances. With this in view, the findings of a number of observers will be compared with the findings resulting from an analysis of 192 consecutive cases, which have been admitted to the Edinburgh Royal Maternity Hospital, during the past 5 years 1923 -27, inclusive

Examining the role of Scotland’s telephone advice service (NHS 24) for managing health in the community : analysis of routinely collected NHS 24 data

Date of Acceptance: 15/06/2015 Funding This work was supported by the Chief Scientist Office, ScottishExecutive (grant no. CZH/4/692). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.Peer reviewedPublisher PD

Partner abuse and its association with emotional distress: A study exploring LGBTI relationships

This study examines partner abuse in LBGTI relationships, with focus on the associations with emotional distress and protective factors. Two hundred and eighty-seven participants took part. Partner abuse (victimisation) comprised three factors; conflict orientated aggression; hostile ignorance and control of communication; and social control and possessiveness (including threats to possessions). Perpetration factors were similar. Significant differences across sexuality or gender were limited to the perpetration of abuse relating to suspicion and possessiveness, where men were more likely to report this than the other gender groups, and women were less likely to report this. Of those reporting abuse in their current relationship, over half reported experiencing abuse in a primary relationship previously, with 60 per cent reporting exposure to abuse as a child. Partner abuse in their current relationship predicted current levels of increased emotional distress, with reduced satisfaction with the current relationship having an indirect impact on this association. Resilience traits were not a predictor or mediator. The results demonstrate the similarity in abuse across LGB communities despite the diversity of genders, sexualities and experiences within these groups. The results are discussed with regards to directions for future research and implications for practic

Predictors of Student Satisfaction: A Mixed-methods Investigation in UK Higher Education

This thesis examines which factors best predict students’ satisfaction with their university experience. High levels of student satisfaction at university are important for a positive student experience as well as benefiting the institution in relation to their reputation and student recruitment success. Much of the previous research focuses on predictors of student satisfaction at one level, institutional or individual factors, and there appears to be little research conducted across multiple UK Higher Education Institutions (HEI’s). Therefore, the research within the thesis aimed to examine predictors of student satisfaction at both the individual and institutional level across UK HEI’s. A mixed methods approach was taken. The first two studies used a quantitative approach examining data from the National Student Survey (NSS) and the Student Academic Experience Survey (SAES). Study-1 examined predictors of overall satisfaction on the NSS, focusing on which questions on the NSS best predict overall satisfaction. This study extended the previous work of Bell and Brooks (2018) by analyzing data from the updated NSS survey questions. Findings supported that of previous research and showed that ‘teaching’ and ‘organisation and management’ were the strongest predictors of overall satisfaction ratings. Study-2 examined individual and institutional level predictors of student satisfaction on the Student Academic Experience Survey (SAES) developed by HEPI using Hierarchical Linear Modelling (HLM). The results revealed that student level variables of ethnicity, nationality, residency, life satisfaction and student-staff liaising were predictors of satisfaction at university, and the institutional level variable tutorial-style classes significantly predicted student satisfaction. Higher levels of satisfaction were reported by students who were white, international students, rated their life satisfaction highly, liaised with staff members more frequently and spent more time in tutorial-style classes. The strongest predictor of student satisfaction was a students’ life satisfaction rating. This study makes an original contribution to knowledge as it is the first large scale study examining both individual and institutional level predictors of student satisfaction. Study-3 then aimed to gain a more in-depth understanding of the factors influencing student satisfaction by adopting a qualitative approach. Students took part in focus groups to explore variables related to their satisfaction with their university experience. Key themes emerging from the study indicated that students consider both individual and institutional factors as important to feel satisfied overall with university. Key over-arching themes were socioeconomic status, psychosocial wellbeing, personal life, course, and teaching. Much of the findings in the third study supported and expanded upon those from the first two studies in that students reported feeling more satisfied with university when they perceived the quality of teaching and course content to be good, had good mental health and lived on campus. In summary, the findings of the thesis suggest that it is important that institutions consider individual student requirements and their wellbeing in order to have high levels of student satisfaction. Having good quality courses, teaching and campus environment is important, but caring for students is more important and beneficial for student satisfaction levels

Evaluation of Telehealth Equipment

The aim of the project was to evaluate the use of Telehealth equipment in the homes of older community-dwelling people, and to review its social and economic impact. A mixed methods approach was adopted, involving interviews, observation and Depression Anxiety Stress Scales. The overall impression gained from participants was an enhancement to the self-perceived quality of daily functioning. Less benefit was observed by those who had been self-monitoring previously. The greatest benefit was apparent in those participants where changes in behaviours to prevent an exacerbation of their condition was possible, through either better compliance with medication, or better understanding the impact of medication on their vital signs and what that meant to their daily activities. The economic benefits appear to be linked to that social improvement. A greater focus on specific conditions and the ability to achieve stability in self-management could strengthen the evidence for targeted economic benefits

Do randomised controlled trials relevant to pharmacy meet best practice standards for quality conduct and reporting? : A systematic review

Funding This review received no specific grant from any funding agency in the public, commercial or not‐for‐profit sectors. Acknowledgements The study was conceived by CB, all authors contributed to the design, reviewed results and commented on successive drafts of the paper and approved the final version. AR undertook all the searches, data extraction and analyses, and prepared the first draft of the manuscript. The project was undertaken by AR as her Master of Pharmacy research project during a placement at the University of Aberdeen Scotland under the local supervision of Christine Bond. Special thanks to Moira Cruickshank, from the Health Services Research Unit at the University of Aberdeen for assistance in the construction of the search strategy.Peer reviewedPostprin

GPNN: Power Studies and Applications of a Neural Network Method for Detecting Gene-Gene Interactions in Studies of Human Disease

The identification and characterization of genes that influence the risk of common, complex multifactorial disease primarily through interactions with other genes and environmental factors remains a statistical and computational challenge in genetic epidemiology. We have previously introduced a genetic programming optimized neural network (GPNN) as a method for optimizing the architecture of a neural network to improve the identification of gene combinations associated with disease risk. The goal of this study was to evaluate the power of GPNN for identifying high-order gene-gene interactions. We were also interested in applying GPNN to a real data analysis in Parkinson\u27s disease

Power of grammatical evolution neural networks to detect gene-gene interactions in the presence of error

<p>Abstract</p> <p>Background</p> <p>With the advent of increasingly efficient means to obtain genetic information, a great insurgence of data has resulted, leading to the need for methods for analyzing this data beyond that of traditional parametric statistical approaches. Recently we introduced Grammatical Evolution Neural Network (GENN), a machine-learning approach to detect gene-gene or gene-environment interactions, also known as epistasis, in high dimensional genetic epidemiological data. GENN has been shown to be highly successful in a range of simulated data, but the impact of error common to real data is unknown. In the current study, we examine the power of GENN to detect interesting interactions in the presence of noise due to genotyping error, missing data, phenocopy, and genetic heterogeneity. Additionally, we compare the performance of GENN to that of another computational method – Multifactor Dimensionality Reduction (MDR).</p> <p>Findings</p> <p>GENN is extremely robust to missing data and genotyping error. Phenocopy in a dataset reduces the power of both GENN and MDR. GENN is reasonably robust to genetic heterogeneity and find that in some cases GENN has substantially higher power than MDR to detect functional loci in the presence of genetic heterogeneity.</p> <p>Conclusion</p> <p>GENN is a promising method to detect gene-gene interaction, even in the presence of common types of error found in real data.</p

Care to learn? The educational experiences of children and young people who are looked after

In January 2002, the Scottish Executive commissioned a consortium of agencies to carry out the Learning with Care project. The aim of the project was to develop new materials to assist local authorities to improve educational outcomes for looked after and accommodated children and young people, and to implement the recommendations of the Learning with Care inspection report (Scottish Executive, 2001). Save the Children and Who Cares? Scotland worked with the BAAF Adoption & Fostering, the Scottish Institute for Residential Child Care, and the University of Strathclyde Department of Educational Support and Guidance, Professional Development Unit and Quality in Education Centre to develop the Learning with Care materials. These included a training pack (Hudson et al., 2003; and see Judy Furnivall and Barbara Hudson in this issue), an information booklet (Connelly et al., 2003), quality indicators [see Graham Connelly in this issue] and an education report which will form part of the Looking After Children in Scotland materials