Science and Politics in China’s Official Water System: the Management of the Qiantang River (1927-1949)

Western water science and technology were introduced to upgrade China’s traditional water management methods and strategies during the Nanjing decade (1927-1937) under the Nationalist government. The engineering efforts expended to control the Qiantang River were typical examples of such initiatives. The primary strategy to protect areas surrounding the river from the destruction caused by the Qiantang bore was for centuries one of “passive defence”, with the construction of defensive seawalls featuring prominently among the methods used. However, the Qiantang tide consistently broke through these defences, and caused devastation. After 1927, while the old defensive methods were not completely discarded, more active strategies of river regulation were introduced, under the combined influence of Western methods, materials and expertise, and Western-trained Chinese engineers who stepped forward to tackle the problem. These activities were interrupted during the war years (1937-1945), but resumed again after the war. During the 22 years from 1927 to 1949, in four discrete stages, different technological solutions were devised, priorities identified, guidelines developed and strategies attempted, with each stage championed by a different engineer in charge. Gradually these efforts formed into what can be called the Qiantang River Project, a concerted effort to apply the knowledge of Western science and technology to change previous “passive defence” methods to “active governance” strategies for river regulation that combined both prevention and control. Efforts at each stage were influenced by factional struggles at the top of the government, and also affected by Western competition for Chinese interests. These developments were all part of the complex interaction of science and politics that took place in the management of the Qiantang River between 1927 and 1949

Exploring the needs and lived experiences of women hospitalised during pregnancy in the United Kingdom:A qualitative diary study

There is a global call to optimise antenatal care experiences. Hospitalisation during pregnancy may have a significant impact upon the experience of care. Thus, the aim of this study was to explore the needs and lived experiences of those hospitalised during pregnancy.A thematic analysis rooted in interpretive phenomenology was undertaken on the content of five written diaries produced by pregnant participants whilst hospitalised. Three themes were identified from the data; (1) ‘Uncertainty’; (2) ‘Loss of control’; (3)‘Vulnerability’. Study findings could usefully be translated into improvements for those hospitalised during the antenatal period. </div

Feasibility of assessing the safety and effectiveness of menstrual regulation medications purchased from pharmacies in Bangladesh: a prospective cohort study.

OBJECTIVE: To assess the feasibility of following up women who purchase mifepristone+misoprostol or misoprostol-only from pharmacies in order to measure the safety and effectiveness of self-administration of menstrual regulation. STUDY DESIGN: A prospective cohort study followed women purchasing mifepristone+misoprostol or misoprostol-only from pharmacies in Bangladesh. Participants were recruited by pharmacy workers either in person or indirectly via the purchaser of the drugs. End users were contacted by phone 2 weeks after recruitment, screened and interviewed. RESULTS: Study recruitment rates by pharmacy workers were low (30%, 109 of 642 women informed about the study), but 2-week follow-up rates were high (87%). Of the 109 end users interviewed, 87 purchased mifepristone+misoprostol and 20 misoprostol-only, while 2 women did not know what drugs they had purchased. Mean self-reported number of weeks of pregnancy was 5.7 weeks. Information provision by pharmacy workers was inadequate (40.4% received none, 8.7% received written information or pictures). A total of 80.5% of mifepristone+misoprostol users were sold the correct regimen versus 9 out of 20 misoprostol-only users. A total of 68.8% did not report experiencing any complications (70.0% misoprostol-only; 69.0% mifepristone+misoprostol users, p=1.0). A total of 94.3% of mifepristone+misoprostol users and 75% of misoprostol-only users reported that they were not pregnant at day 15 (p=.020). However, 7.3% of all users sought additional treatment. CONCLUSIONS: Challenges in assessing outcomes of self-managed menstrual regulation medications purchased from pharmacies must be overcome through further development of this methodology. Interventions are urgently needed to ensure that women have access to correct dosages, accurate information and necessary referrals. IMPLICATIONS: This paper assesses the outcomes of women who self-manage menstrual regulation medications purchased from pharmacies. The methodology requires further development, but our study provides preliminary positive evidence on the safety and effectiveness of self-management despite low information provision from pharmacy workers

Improvements in lung function with umeclidinium/vilanterol versus fluticasone propionate/salmeterol in patients with moderate-to-severe COPD and infrequent exacerbations

BACKGROUND: Umeclidinium (UMEC; long-acting muscarinic antagonist [LAMA])/vilanterol (VI; long-acting beta2-agonist [LABA]) and fluticasone propionate/salmeterol (FP/SAL) (inhaled corticosteroid/LABA) are approved maintenance therapies for chronic obstructive pulmonary disease (COPD). Two studies compared efficacy and safety of UMEC/VI with FP/SAL in patients with moderate-to-severe COPD with no exacerbations in the previous year. METHODS: In these 12-week, multicenter, double-blind, parallel-group, double-dummy trials, randomized (1:1) patients received once-daily UMEC/VI 62.5/25 mcg or twice-daily FP/SAL 250/50 mcg (DB2114930 n = 353 and 353; DB2114951 n = 349 and 348, respectively; intent-to-treat). Endpoints included 0-24 h weighted mean (wm) forced expiratory volume in 1 s (FEV1) (Day 84; primary), trough FEV1 (Day 85; secondary), other lung function endpoints, dyspnea, quality of life (QoL) and safety. RESULTS: UMEC/VI demonstrated statistically significant, clinically meaningful improvements in lung function measures versus FP/SAL. For 0-24 h wmFEV1 (Day 84), improvements with UMEC/VI versus FP/SAL were 74 mL (95% confidence interval [CI]: 38-110; DB2114930) and 101 mL (63-139; DB2114951) (both p 1 unit) and QoL (St George's Respiratory Questionnaire Total score >4-unit decrease) in both studies with no statistical differences between treatments. Adverse event rates were similar: 26 and 30% UMEC/VI; 27 and 31% FP/SAL. CONCLUSIONS: Once-daily UMEC/VI 62.5/25 mcg over 12 weeks resulted in statistically significant, clinically meaningful improvements in lung function versus twice-daily FP/SAL 250/50 mcg in patients with moderate-to-severe COPD with infrequent exacerbations. Both treatments improved dyspnea and QoL. CLINICAL TRIAL REGISTRATION: DB2114930/NCT01817764; DB2114951/NCT01879410

The Lantern Vol. 31, No. 1, December 1963

• Today\u27s Memory • The Realization • Life Fire • Come Sleep • The Ends Meet • Dawn of Darkness • Closed and Done: With Apologies to No One • A Search • Concern • Obvious Oblivion • Love\u27s Ashes • Silence • To My Dentist • Snow • Wisdom • Look Up • Nepenthe • With Apologies to Charles Schulz • Autumn and You • What is Optimism? • Agnostic? • Potpourri of Beinghttps://digitalcommons.ursinus.edu/lantern/1085/thumbnail.jp

The Grizzly, February 1, 2000

A Burning Question: Recent Rash of Fatal College Fires Sparks UC Students to Ask, Are We Safe? • Ursinus Struck Twice More with Ice, Rain and Snow • St. Louis Super in Clash with Titans • Grizzly Library Goes Virtual • Dickinson College Librarian Finally Free from Exile in Chinese Prison • Study Abroad Experience Proves to be a Valuable One • Opinion: After Iowa, Throw out the Rulebook, it\u27s Anybody\u27s Game; Where\u27s the Juice in Juice? • Meistersingers Tour Europe • Career Services Introduces Experience • Swimming Gears Up for Champs • Pair of Losses for UC • Bears Struggle in Conference Play • The Flud Warning • Ursinus Gymnastics Tramples Brockport • Sports Profile: Luther Owenshttps://digitalcommons.ursinus.edu/grizzlynews/1457/thumbnail.jp

Allied Health Professional Support in Pediatric Inflammatory Bowel Disease: A Survey from the Canadian Children Inflammatory Bowel Disease Network—A Joint Partnership of CIHR and the CH.I.L.D. Foundation

Objectives. The current number of healthcare providers (HCP) caring for children with inflammatory bowel disease (IBD) across Canadian tertiary-care centres is underinvestigated. The aim of this survey was to assess the number of healthcare providers (HCP) in ambulatory pediatric IBD care across Canadian tertiary-care centres. Methods. Using a self-administered questionnaire, we examined available resources in academic pediatric centres within the Canadian Children IBD Network. The survey evaluated the number of HCP providing ambulatory care for children with IBD. Results. All 12 tertiary pediatric gastroenterology centres participating in the network responded. Median full-time equivalent (FTE) of allied health professionals providing IBD care at each site was 1.0 (interquartile range (IQR) 0.6–1.0) nurse, 0.5 (IQR 0.2–0.8) dietitian, 0.3 (IQR 0.2–0.8) social worker, and 0.1 (IQR 0.02–0.3) clinical psychologists. The ratio of IBD patients to IBD physicians was 114 : 1 (range 31 : 1–537 : 1), patients to nurses/physician assistants 324 : 1 (range 150 : 1–900 : 1), dieticians 670 : 1 (range 250 : 1–4500 : 1), social workers 1558 : 1 (range 250 : 1–16000 : 1), and clinical psychologists 2910 : 1 (range 626 : 1–3200 : 1). Conclusions. There was a wide variation in HCP support among Canadian centres. Future work will examine variation in care including patients’ outcomes and satisfaction across Canadian centres

The English National Lynch Syndrome transformation project: an NHS Genomic Medicine Service Alliance (GMSA) programme

Objective: In England, through the Genomic Medicine Service Alliances (GMSAs), a national transformation project aims to embed robust pathways to deliver universal Lynch syndrome (LS) testing for patients with colorectal and endometrial cancers. Prior to commencement of the project, there was evidence of variation and low testing levels in eligible patients which is consistent with other health systems; however, we believe this is amenable to systematic improvement with responsibility for testing delivery by local cancer teams supported by regional infrastructure. Methods and analysis: A project team and national oversight group was formed in May 2021 with membership including 21×cancer alliances, 7×GMSAs, charities and other stakeholders who agreed key performance indicators. ‘LS champions’ within each cancer team were identified and surveyed. Workforce training focused on effective identification of eligible patients, overcoming barriers and mainstreamed constitutional genetic testing. Comprehensive pathway data analysis was performed in conjunction with the National Disease Registration Service. Results: Survey and baseline testing data illustrated variation, and a disparity between practice and perception, in levels of testing. The main reported barriers related to funding streams and systematic approaches. Multifaceted training programmes were produced to support workforce development. Champions responsible for testing delivery were appointed in >95% of cancer teams. We identified >9000 historically diagnosed LS patients to support ascertainment for a nationally coordinated screening programme. Conclusion: This ongoing transformational project is strongly supported by stakeholders in England. Significant quality improvement has been implemented, facilitating systematic delivery of universal testing for LS nationally and reduction in variation in care