Mapping maternity care facilities in England

Objective. To describe the organisation of maternity care at trust and unit level in England. Methods. All NHS trusts providing maternity care participated in a survey as part of the Healthcare Commission review of maternity care in England in 2007. Data on trusts and numbers of units were also collected in 2009 as part of the Birthplace in England programme. Results. Models of care provision are limited: in 2007 two-thirds of trusts provided choice between home birth and birth in an obstetric unit only. Geographical variation is substantial, with approximately 70% of trusts in the North-West, Yorkshire and Humberside and London Strategic Health Authority regions having only obstetric units, compared with 50% or less in the South-West and East Midlands. Availability and proximity of specialist facilities for women and babies within trusts varies and is linked with obstetric units. Changes in trust configuration, identified in 2009, have largely resulted from opening alongside midwifery units, then available in a quarter of trusts. Freestanding midwifery units continue to provide care for small numbers of women, commonly in more rural areas. Conclusions. In 2007, 66% of trusts had no midwifery-led units and this is likely to have limited the choices that women were able to make about their planned place of birth and the possibility of having midwife-led care in nonobstetric unit settings. Recent data suggest that women’s options for care may have increased, although capacity and staffing issues, reflected in closures to admissions, may affect these

Measurement of the fraction of t-tbar production via gluon-gluon fusion in p-pbar collisions at sqrt(s)=1.96 TeV

We present a measurement of the ratio of t-tbar production cross section via gluon-gluon fusion to the total t-tbar production cross section in p-pbar collisions at sqrt{s}=1.96 TeV at the Tevatron. Using a data sample with an integrated luminosity of 955/pb recorded by the CDF II detector at Fermilab, we select events based on the t-tbar decay to lepton+jets. Using an artificial neural network technique we discriminate between t-tbar events produced via q-qbar annihilation and gluon-gluon fusion, and find Cf=(gg->ttbar)/(pp->ttbar)<0.33 at the 68% confidence level. This result is combined with a previous measurement to obtain the most precise measurement of this quantity, Cf=0.07+0.15-0.07.Comment: submitted to Phys. Rev.

Measurement of Resonance Parameters of Orbitally Excited Narrow B^0 Mesons

We report a measurement of resonance parameters of the orbitally excited (L=1) narrow B^0 mesons in decays to B^{(*)+}\pi^- using 1.7/fb of data collected by the CDF II detector at the Fermilab Tevatron. The mass and width of the B^{*0}_2 state are measured to be m(B^{*0}_2) = 5740.2^{+1.7}_{-1.8}(stat.) ^{+0.9}_{-0.8}(syst.) MeV/c^2 and \Gamma(B^{*0}_2) = 22.7^{+3.8}_{-3.2}(stat.) ^{+3.2}_{-10.2}(syst.) MeV/c^2. The mass difference between the B^{*0}_2 and B^0_1 states is measured to be 14.9^{+2.2}_{-2.5}(stat.) ^{+1.2}_{-1.4}(syst.) MeV/c^2, resulting in a B^0_1 mass of 5725.3^{+1.6}_{-2.2}(stat.) ^{+1.4}_{-1.5}(syst.) MeV/c^2. This is currently the most precise measurement of the masses of these states and the first measurement of the B^{*0}_2 width.Comment: 7 pages, 1 figure, 1 table. Submitted to Phys.Rev.Let

Prevalence, causes, and risk factors for functional low vision in Nigeria: results from the national survey of blindness and visual impairment.

PURPOSE: To estimate prevalence and describe causes of functional low vision (FLV) among a nationally representative sample of Nigerian adults, assess socioeconomic risk factors, and estimate the number of adults in Nigeria who might benefit from low vision assessment or rehabilitation services. METHODS: Multistage, stratified, cluster random sampling with probability proportional to size procedures were used to identify a nationally representative sample of 15,027 persons aged 40 years or older. Distance vision was measured using a reduced logMAR tumbling E-chart. All participants with presenting acuity of <6/12 in one or both eyes had their corrected acuity measured and underwent detailed clinical examination to determine the cause. FLV was defined as best corrected vision <6/18 in the better eye, after excluding those with no light perception in both eyes and those with treatable causes. Analysis took account of the clustered design. RESULTS: In all, 13,591 individuals were examined in 305 clusters (response rate, 89.9%). The crude prevalence of FLV was 3.5% (95% confidence interval, 3.1-3.9%). This was lower than the prevalence of blindness, which was 4.2%. Glaucoma was the most common cause and age the most important risk factor. There are estimated to be approximately 5000 adults with FLV per million population and 340 who are totally blind. Only 9.3% of those with FLV were of working age and literate. CONCLUSIONS: These are the first data on the prevalence, causes, and risk factors for FLV from Africa. Results support studies from Asia that the prevalence of FLV is lower than previously thought. Because the majority of adults with FLV in Nigeria live in rural areas and are elderly and not literate, further research is required to assess the nature of the interventions required and who might best deliver them

Setting implementation research priorities to reduce preterm births and stillbirths at the community level.

Asha George and colleagues from the GAPPS group report the implementation research priorities to address prematurity and stillbirths at the community level that resulted from their recent expert consensus exercise

An iterative consensus-building approach to revising a genetics/genomics competency framework for nurse education in the UK.

AIM: To report a review of a genetics education framework using a consensus approach to agree on a contemporary and comprehensive revised framework. BACKGROUND: Advances in genomic health care have been significant since the first genetics education framework for nurses was developed in 2003. These, coupled with developments in policy and international efforts to promote nursing competence in genetics, indicated that review was timely. DESIGN: A structured, iterative, primarily qualitative approach, based on a nominal group technique. METHOD: A meeting convened in 2010 involved stakeholders in UK nursing education, practice and management, including patient representatives (n = 30). A consensus approach was used to solicit participants' views on the individual/family needs identified from real-life stories of people affected by genetic conditions and the nurses' knowledge, skills and attitudes needed to meet those needs. Five groups considered the stories in iterative rounds, reviewing comments from previous groups. Omissions and deficiencies were identified by mapping resulting themes to the original framework. Anonymous voting captured views. Educators at a second meeting developed learning outcomes for the final framework. FINDINGS: Deficiencies in relation to Advocacy, Information management and Ongoing care were identified. All competencies of the original framework were revised, adding an eighth competency to make explicit the need for ongoing care of the individual/family. CONCLUSION: Modifications to the framework reflect individual/family needs and are relevant to the nursing role. The approach promoted engagement in a complex issue and provides a framework to guide nurse education in genetics/genomics; however, nursing leadership is crucial to successful implementation

Assessment for learning : a model for the development of a child’s self competence in the early years of education

In recent years policy documents, curricula and other educational initiatives have promoted a pedagogy founded on the concept of independent learning. This is broadly defined as ‘having the belief in yourself to think through learning activities, problems or challenges, make decisions about your learning and act upon those decisions (Blandford and Knowles, 2009:336). The central role of Assessment for Learning (AfL) in this process is often overlooked in practice. By considering the findings from a small scale research study this article addresses the central role of the teacher /practitioner in developing effective AfL in the early years classroom (3-5 years)

Aerodynamics of aero-engine installation

This paper describes current progress in the development of methods to assess aero-engine airframe installation effects. The aerodynamic characteristics of isolated intakes, a typical transonic transport aircraft as well as a combination of a through-flow nacelle and aircraft configuration have been evaluated. The validation task for an isolated engine nacelle is carried out with concern for the accuracy in the assessment of intake performance descriptors such as mass flow capture ratio and drag rise Mach number. The necessary mesh and modelling requirements to simulate the nacelle aerodynamics are determined. Furthermore, the validation of the numerical model for the aircraft is performed as an extension of work that has been carried out under previous drag prediction research programmes. The validation of the aircraft model has been extended to include the geometry with through flow nacelles. Finally, the assessment of the mutual impact of the through flow nacelle and aircraft aerodynamics was performed. The drag and lift coefficient breakdown has been presented in order to identify the component sources of the drag associated with the engine installation. The paper concludes with an assessment of installation drag for through-flow nacelles and the determination of aerodynamic interference between the nacelle and the aircraft

Volcanoes: effusions and explosions. Interactive exhibits to understand how volcanoes work

The Educational & Outreach Group (EOG) of the Istituto Nazionale di Geofisica & Vulcanologia created a portable museum to provide educational opportunities in volcanology, volcanic risk and Earth science for students and visitors. The EOG developed this project for the "Festival della Scienza", organized in Genoa, Italy, in October - November, 2007, which was a parade of over 200 events, including scientific and technological exhibitions, workshops, meetings, lectures, books and video presentations. In this museum visitors can successively see many posters and movies and play with interactive exhibits. A little 3D-movie shows the Big Bang, the formation of Solar System and, in particular the formation of the Earth. Many interactive exhibits illustrate why, where and when earthquakes and volcanic eruptions occur around the world and allow to introduce the visitor to the plate tectonics theory. A 3D magnetic plate tectonic puzzle can be put down and reconstructed by visitors to understand the Earth’s surface configuration. Then two other 3D Earth models show what drives the plates and the inner Earth structure. An interactive program illustrates where and when earthquakes and volcanic eruptions occur in accelerated time on maps of various areas around the world. Playing with a block diagram it is possible to produce an earthquake along a 1 meter long strike slip fault in a destroying all the man-made constructions close to it. A little movie introduces to volcanoes’ world. Two small interactive exhibits allow visitors to understand the mechanism for the explosive and the effusive eruptions. Two other exciting interactive exhibits allow visitors to “create” two different eruptions: the explosive and the effusive ones. It is possible to get inside a volcano (a 2 meter high interactive exhibit) to attend an eruption from the magmatic chamber to the Earth surface. A big hall is completed dedicated to Italian volcanoes (Vesuvio, Campi Flegrei, Etna, Stromboli, Vulcano, Colli Albani); some of them are reproduced with 3D models or described by short movies. The museum finishes with the visit of the volcanic survey hall of Stromboli, seeing - in real time - seismic data, three different webcams, geochemical and strain data. The INGV Museum had remarkably successful, reaching more than 7,500 children and adults yet in 13 days, also thanks to 30 volcanologists as very special guides. The Educational & Outreach Group: M. Pignone, A. Tertulliani, M. De Lucia, M. Di Vito, P. Landi, P. Madonia, M. Martini, R. Nave, M. Neri, P. Scarlato, J. Taddeucci, R. Moschillo, S. Tarquini, G. Vilardo, A. Bonforte, L. Calderone, F. Cannavò, W. De Cesare, P. Ficeli, S. Inguaggiato, M. Mattia, G. Puglisi, S. Morici, D. Reitano, D. Richichi, G. Scarpato, B. Angioni, F. Di Laura, S. Palone, D. Riposati