Women’s experiences of early pregnancy loss services during the pandemic:A qualitative investigation

Problem: Early pregnancy losses [EPL] are common, varied, and require different courses of management and care. Background: In the UK, women who suspect or suffer a pregnancy loss are usually provided specialist care in early pregnancy assessment units [EPAUs]. Their configuration has recently been evaluated, but recommendations for change in-line with best practice for optimum outcomes were unable to be implemented due to the COVID-19 pandemic health system shock.Aim: To compare women’s experiences of EPAUs during the pandemic to themes previously found in qualitative work undertaken with women who utilised EPAUs before the pandemic.Methods: We conducted semi-structured virtual interviews, with women (N=32) who suffered an early pregnancy loss during the pandemic; analysing transcripts using Template Analysis, based on findings about women’s (pre-pandemic) experiences of EPAU from The VESPA Study.Findings: We report on seven key themes: Barriers to Accessing Services; Communication &amp; Information; Retention of Relational Care; Involvement in Care Decisions; Staffs’ Attitude or Approach; Efficiency of Service Delivery; Sensitive Patient Management. Discussion: Sensitive patient management and woman-staff interactions in EPAU settings remain a fundamental issue. Women also reported their experiences of EPAUs were comparatively worse during the pandemic.Conclusions: Women valued the care provided by EPAUs and found services to be efficient, despite pandemic-related restrictions. However, psychological recognition surrounding EPL and appropriate, sensitive, relational care and support continue to be areas in need of improvement. Our recommendation is to implement the improvements suggested by VESPA as a priority to ameliorate present sub-optimal experiences and prevent further deterioration.<br/

Prosthetic Knee for CURE Kenya

Lower limb amputations are common in sub-Saharan Africa due to the prevalence of disease and infection in communities that lack access to adequate healthcare. Our project, Prosthetic Knee, partners with the CURE International Hospital in Kijabe, Kenya. In the region surrounding our client’s facility, there is a large number of lower-extremity amputations due to various infections and diseases. While many of these amputees only require a through-knee amputation, the lack of an affordable through-knee prosthesis often forces patients to undergo a more invasive transfemoral amputation to enable them to use a cheaper above-knee prosthesis. The goal of our project is to design and manufacture a financially accessible and user-friendly prosthetic knee for knee-disarticulation patients that can be manufactured in Messiah University’s machine shop (and ultimately, at the orthopedic facility in Kijabe). This year, the team’s work has included finalizing the prototype design, conducting finite element analysis in SOLIDWORKS to evaluate the knee’s static and fatigue strength, and beginning the process of physical manufacturing. Additionally, a damping mechanism driven by a spring-loaded system has been developed and integrated into the design after completing motion analysis and SOLIDWORKS modeling. Our future goals include manufacturing a complete metal prototype of the knee, conducting physical strength and fatigue testing on the metal prototype, and continuing iterative prototyping of the damper in preparation for physical implementation.https://mosaic.messiah.edu/engr2021/1014/thumbnail.jp

W(h)ither the academy? An exploration of the role of university social work in shaping the future of social work in Europe

A controversial proposal to pilot the training of child protection social workers through an intensive work-based route in England is being supported and funded by the UK Government. Frontline, the brainchild of a former teacher, locates social work training within local authorities (‘the agency’) rather than university social work departments (‘the academy’) and has stimulated debate amongst social work academics about their role in shaping the direction of the profession. As a contribution to this debate, this paper explores the duality of social work education, which derives its knowledge from both the academic social sciences and the experience of practice within social work agencies. While social work education has traditionally been delivered by the academy, this paper also explores whether the delivery of training in the allied professions of probation and nursing by ‘the agency’ is equally effective. Finally, this paper explores the Helsinki model which achieves a synergy of ‘academy’ and ‘agency’. It suggests that there are alternative models of social work education, practice and research which avoid dichotomies between the ‘academy’ and the ‘agency’ and enable the profession to be shaped by both social work academics and practitioners

High Rate of Microbleed Formation Following Primary Intracerebral Hemorrhage

Background We sought to investigate the frequency of microbleed development following intracerebral hemorrhage in a predominantly African-American population and to identify predictors of new microbleed formation. Aims and/or hypothesis To investigate the frequency and predictors of new microbleeds following intracerebral hemorrhage. Methods The DECIPHER study was a prospective, longitudinal, magnetic resonance-based cohort study designed to evaluate racial/ethnic differences in risk factors for microbleeds and to evaluate the prognostic impact of microbleeds in this intracerebral hemorrhage population. We evaluated new microbleed formation in two time periods: from baseline to 30 days and from 30 days to year 1. Results Of 200 subjects enrolled in DECIPHER, 84 had magnetic resonance imaging at all required time points to meet criteria for this analysis. In the baseline to day 30 analysis, 11 (13·1%) had new microbleeds, compared with 25 (29·8%) in the day 30 to year 1 analysis. Logistic regression analysis demonstrated that baseline number of microbleeds [odds ratio 1·05 (95% confidence interval 1·01, 1·08), P = 0·01] was associated with new microbleed formation at 30 days. A logistic regression model predicting new microbleed at one-year included baseline number of microbleeds [odds ratio 1·05 (1·00, 1·11), P = 0·046], baseline age [odds ratio 1·05 (1·00, 1·10), P = 0·04], and white matter disease score [odds ratio 1·18 (0·96, 1·45). P = 0·115]. Overall, 28 of 84 (33·3%) intracerebral hemorrhage subjects formed new microbleeds at some point in the first year post-intracerebral hemorrhage. Conclusions We found that one-third of intracerebral hemorrhage subjects in this cohort surviving one-year developed new microbleeds, which suggests a dynamic and rapidly progressive vasculopathy. Future studies are needed to examine the impact of new microbleed formation on patient outcomes

Connectivity-based parcellation of the thalamus explains specific cognitive and behavioural symptoms in patients with bilateral thalamic infarct

A novel approach based on diffusion tractography was used here to characterise the cortico-thalamic connectivity in two patients, both presenting with an isolated bilateral infarct in the thalamus, but exhibiting partially different cognitive and behavioural profiles. Both patients (G.P. and R.F.) had a pervasive deficit in episodic memory, but only one of them (R.F.) suffered also from a dysexecutive syndrome. Both patients had an MRI scan at 3T, including a T1-weighted volume. Their lesions were manually segmented. T1-volumes were normalised to standard space, and the same transformations were applied to the lesion masks. Nineteen healthy controls underwent a diffusion-tensor imaging (DTI) scan. Their DTI data were normalised to standard space and averaged. An atlas of Brodmann areas was used to parcellate the prefrontal cortex. Probabilistic tractography was used to assess the probability of connection between each voxel of the thalamus and a set of prefrontal areas. The resulting map of corticothalamic connections was superimposed onto the patients' lesion masks, to assess whether the location of the thalamic lesions in R.F. (but not in G. P.) implied connections with prefrontal areas involved in dysexecutive syndromes. In G.P., the lesion fell within areas of the thalamus poorly connected with prefrontal areas, showing only a modest probability of connection with the anterior cingulate cortex (ACC). Conversely, R.F.'s lesion fell within thalamic areas extensively connected with the ACC bilaterally, with the right dorsolateral prefrontal cortex, and with the left supplementary motor area. Despite a similar, bilateral involvement of the thalamus, the use of connectivity-based segmentation clarified that R.F.'s lesions only were located within nuclei highly connected with the prefrontal cortical areas, thus explaining the patient's frontal syndrome. This study confirms that DTI tractography is a useful tool to examine in vivo the effect of focal lesions on interconnectivity brain patterns

Defecting or not defecting: how to "read" human behavior during cooperative games by EEG measurements

Understanding the neural mechanisms responsible for human social interactions is difficult, since the brain activities of two or more individuals have to be examined simultaneously and correlated with the observed social patterns. We introduce the concept of hyper-brain network, a connectivity pattern representing at once the information flow among the cortical regions of a single brain as well as the relations among the areas of two distinct brains. Graph analysis of hyper-brain networks constructed from the EEG scanning of 26 couples of individuals playing the Iterated Prisoner's Dilemma reveals the possibility to predict non-cooperative interactions during the decision-making phase. The hyper-brain networks of two-defector couples have significantly less inter-brain links and overall higher modularity - i.e. the tendency to form two separate subgraphs - than couples playing cooperative or tit-for-tat strategies. The decision to defect can be "read" in advance by evaluating the changes of connectivity pattern in the hyper-brain network

Hosts and hostages: Mass immigration and the power of hospitality in post-war British and Caribbean literature

This article examines the challenge to colonialist centre-periphery relations in post-war novels by white British and Caribbean writers. Concentrating on the relationship between political debates surrounding mass immigration and the marginalization of non-white migrants within British communities, I analyse texts that depict the threshold of the home as the politicized site of racial tension, namely Sam Selvon’s The Lonely Londoners (1956), V.S. Naipaul’s The Mimic Men (1967), Alan Sillitoe’s Saturday Night and Sunday Morning (1958), and Anthony Burgess’s The Right to an Answer (1960). In varying ways, these texts depict the durability of centre-periphery relations at local levels through the informal segregation of the colonizer and the colonized. In doing so they point to what Jacques Derrida has outlined, in Of Hospitality (2000), as the power relationship inherent in policies of immigration, whereby the host-nation remains in control of the conditions upon which hospitality rests

The cellular and synaptic architecture of the mechanosensory dorsal horn

The deep dorsal horn is a poorly characterized spinal cord region implicated in processing low-threshold mechanoreceptor (LTMR) information. We report an array of mouse genetic tools for defining neuronal components and functions of the dorsal horn LTMR-recipient zone (LTMR-RZ), a role for LTMR-RZ processing in tactile perception, and the basic logic of LTMR-RZ organization. We found an unexpectedly high degree of neuronal diversity in the LTMR-RZ: seven excitatory and four inhibitory subtypes of interneurons exhibiting unique morphological, physiological, and synaptic properties. Remarkably, LTMRs form synapses on between four and 11 LTMR-RZ interneuron subtypes, while each LTMR-RZ interneuron subtype samples inputs from at least one to three LTMR classes, as well as spinal cord interneurons and corticospinal neurons. Thus, the LTMR-RZ is a somatosensory processing region endowed with a neuronal complexity that rivals the retina and functions to pattern the activity of ascending touch pathways that underlie tactile perception

“Knowledge Is Power”: A Mixed-Methods Study Exploring Adult Audience Preferences for Engagement and Learning Formats Over 3 Years of a Health Science Festival

© 2015, © 2015 SAGE Publications. Science festivals enable scientists to engage with publics, but format design reflecting different engagement models is contested. This study gathered mixed-methods data over 3 years (2011-2013) from on-site surveys (N = 661) of a health science festival, exploring audience preferences for dissemination or dialogue formats (lectures, discussions, community expo, lab experiments, and day out). Irrespective of time, age–group, or gender, lectures were significantly ranked the main attraction (76.8%), most highly attended (89.1%), and most useful format (83.8%). Thematic analysis revealed five themes exploring nonformal learning motivations for audiences, highlighting that knowledge/understanding acquisition is perceived as empowering greater health literacy