Care of obese women during labour: The development of a midwifery intervention to promote normal birth

Normal birth, defined as birth without induction of labour, anaesthetic, instruments or caesarean section conveys significant maternal and neonatal benefits. Currently one-fifth of women in the United Kingdom are obese. There is increasing evidence of the detrimental effects obesity has on intrapartum outcomes. There is a lack of research on how to minimise the associated risks of obesity through non-medicalised interventions and how to support obese women to maximise their opportunity for normal birth. This thesis aims to provide evidence to address this gap and develop an evidence-based intervention to promote normal birth. Using a methodological approach aligned with pragmatism, this research was conducted in four parts and underpinned by the Medical Research Council framework for the development of complex interventions. Part one was a national survey involving 24 maternity units. Part two was a qualitative study of the experiences of 24 health professionals and part three involved 8 obese women. The final part was a multi-disciplinary workshop that used consensus decision-making to design the intervention. Collectively, the findings suggest that intrapartum care of obese women is medicalised. Health professionals face challenges when caring for obese women but many strive to optimise the potential for normal birth by challenging practice and utilising ‘interventions’ to promote normality. The findings also demonstrate that obese women have an intrinsic fear of pregnancy and birth, have a desire for normal birth and ‘obese pregnancy’ presents a window of opportunity for change. The intervention consists of three component parts; an educational aspect (e-learning package), a clinical aspect (intrapartum care pathway) and a leadership aspect (ward champions). Whilst acknowledging the importance of safety, increasing intervention during labour for obese women may further increase the risk of complications, with detrimental effects. Addressing intrapartum management of obese women through non-medicalised interventions is of paramount importance in order to promote normality, maximise the opportunity for normal birth and reduce the associated morbidities

Concerted functions of<i> Streptococcus gordonii</i> surface proteins PadA and Hsa mediate activation of human platelets and interactions with extracellular matrix

A range of Streptococcus bacteria are able to interact with blood platelets to form a thrombus (clot). Streptococcus gordonii is ubiquitous within the human oral cavity and amongst the common pathogens isolated from subjects with infective endocarditis. Two cell surface proteins, Hsa and Platelet adherence protein A (PadA), in S. gordonii mediate adherence and activation of platelets. In this study, we demonstrate that PadA binds activated platelets and that an NGR (Asparagine-Glycine-Arginine) motif within a 657 amino acid residue N-terminal fragment of PadA is responsible for this, together with two other integrin-like recognition motifs RGT and AGD. PadA also acts in concert with Hsa to mediate binding of S. gordonii to cellular fibronectin and vitronectin, and to promote formation of biofilms. Evidence is presented that PadA and Hsa are each reliant on the other\u27s active presentation on the bacterial cell surface, suggesting cooperativity in functions impacting both colonization and pathogenesis

Hydrogel Cross-Linking via Thiol-Reactive Pyridazinediones

Thiol-reactive Michael acceptors are commonly used for the formation of chemically cross-linked hydrogels. In this paper, we address the drawbacks of many Michael acceptors by introducing pyridazinediones as new cross-linking agents. Through the use of pyridazinediones and their mono- or dibrominated analogues, we show that the mechanical strength, swelling ratio, and rate of gelation can all be controlled in a pH-sensitive manner. Moreover, we demonstrate that the degradation of pyridazinedione-gels can be induced by the addition of thiols, thus providing a route to responsive or dynamic gels, and that monobromo-pyridazinedione gels are able to support the proliferation of human cells. We anticipate that our results will provide a valuable and complementary addition to the existing toolkit of cross-linking agents, allowing researchers to tune and rationally design the properties of biomedical hydrogels

Strategies for Recruiting Women Living with Human Immunodeficiency Virus in Community-Based Research: Lessons from Canada

Objectives: This study sought to describe the recruitment of women living with HIV (WLWH) into the community-based Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS), because women are underrepresented in HIV research. Methods: There were 1,424 WLWH were enrolled from British Columbia, Ontario, and Québec, who completed detailed questionnaires administered by peer research associates (PRAs; WLWH with research training). During screening, participants were asked: “How did you hear about the study?” We describe recruitment strategies by subpopulation and offer reflections on challenges and successes. Results: Of 1,131 participants with complete data, 40% identified as White, 33% African/Caribbean/Black, and 19% Indigenous. The median age was 45 years (interquartile range, 37–51) and 4% identified as trans women. Overall, 35% were recruited through PRAs/peers, 34% clinics, and 19% AIDS service organizations (ASOs). PRAs/peers were the predominant recruitment method in Ontario (49%), compared with clinics in British Columbia (40%), and Québec (43%). Nationally, PRAs/peers were more successful in recruiting WLWH commonly considered to be “harder to reach” (e.g., women identifying as trans, using drugs, not receiving HIV care). Clinics were more effective in recruiting younger women (16–29 years) and women not using ASOs. Recruitment challenges centered on engaging these harder to reach women. Successes included hiring PRAs who built participant trust, linking with clinics to reach women isolated from HIV communities, involving outreach workers to engage street-involved women, and disseminating study information to diverse stakeholders. Conclusions: Having multiple approaches, engaging a diverse team of PRAs, ensuring flexibility, and cultivating reciprocal relationships with community stakeholders were key to recruiting a diverse and representative sample of WLWH

Hydrogel Cross-Linking via Thiol-Reactive Pyridazinediones

Thiol-reactive Michael acceptors are commonly used for the formation of chemically cross-linked hydrogels. In this paper, we address the drawbacks of many Michael acceptors by introducing pyridazinediones as new cross-linking agents. Through the use of pyridazinediones and their mono- or dibrominated analogues, we show that the mechanical strength, swelling ratio, and rate of gelation can all be controlled in a pH-sensitive manner. Moreover, we demonstrate that the degradation of pyridazinedione-gels can be induced by the addition of thiols, thus providing a route to responsive or dynamic gels, and that monobromo-pyridazinedione gels are able to support the proliferation of human cells. We anticipate that our results will provide a valuable and complementary addition to the existing toolkit of cross-linking agents, allowing researchers to tune and rationally design the properties of biomedical hydrogels

The Grizzly, November 22, 1985

From Damp to Bone Dry? • UCFL Takes to the Air: Or Visa Versa • It\u27s all Greek to me • The Descent on the Skunks of Ursinus • Editorial: Yale Conference a Learning Experience • Letter: Munchies Mandate • Who\u27s Who Honors Ursinus • How to Deal with Terrorists? • Two Truman Scholars • In Search of Success: Marivi Relova Brings Good Things to GE • Communication a Must • Bears Bounce Dickinson • Booters Find Cold Times in New Hampshire • Soccer Seniors Will be Missed • Coach B. is Back • Lady Bears Hope to Improve Behind Letuakas • Season Tips Off Tonight • Gymnasts Spring into Season • Alercio Faces J Board • Myrin Stacks Up • Fields Should be Ready in Spring • Immersion as Opposed to Voyeurism in Summer Study in France • Smokeless Tobacco Still Burns • Women\u27s Studies Added to Goal No. 9 • Eating Healthy at College Essential • Open Dialogs: Middle Class on Welfare?; Mercy Killing as a Solution; Birth Defects Popular With Geneticists • Ursinus College: The Marriage Factoryhttps://digitalcommons.ursinus.edu/grizzlynews/1153/thumbnail.jp

Student Recital (December 7, 2015)

Choro de Saudade / Agustin Barrios Mangore Nolan Driscoll, guitar My mother bids me bind my hair / Franz Josef Haydn Willow Song (The Ballad of Baby Doe) / Douglas Moore Elizabeth Lach, soprano Thoughts of Love / Arthur Pryor I. Tempo di valse II. Tempo di valse III. Tempo di valse Nicholas Grisolia, euphonium Che gelida manina (La Boheme) / Giacomo Puccini Richard Moran, tenor Sonata 5 in F Major, Opus 24 / Ludwig van Beethoven Allegro Megan Polk, violin O vos omnes (The Seven Last Words of Christ) / Theodore Dubois Colleen McDonough, soprano Hommage a Villa-Lobos / Roland Dyens Andantinostalgie Tuhu Austin DeAndrade, guitar Morgen, Opus 21, No. 4 / Richard Strauss Justine Smigel, soprano Nature beyond art / Thomas Arne Xavier Cosme, tenor Violin Concerto No. 3 in G Major, K. 216 / W. A. Mozart Allegro Gail Colombo, violin Yu Guang Qu (Song of the Fisherman) / Guang Ran Jiaying Zhu, soprano El Decameron Negro / Leo Brouwer El arpa del guerrero Killian Kerrigan, guitar Una donna quindici anni (Cosi fan tutte), K. 588 / Wolfgang Amadeus Mozart Angela Maloney, soprano Concert Etude, Opus 49 / Alexander Goedicke Lindsey Cook, trumpethttps://vc.bridgew.edu/student_concerts/1101/thumbnail.jp

Sexual and reproductive health and human rights of women living with HIV

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138378/1/jia20834-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138378/2/jia20834.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138378/3/jia20834-sup-0002.pd