Domestic violence is a leading risk factor in default from colposcopy services

Aim: Domestic violence is common in women and is associated with poorer healthcare outcomes. However, no causal pathway has been identified to explain this observation. We have followed a cohort of women to determine whether poorer outcomes can be explained by high rates of default and lost to follow up. Methods: A prospective cohort study was performed. Institutional ethics approval was obtained. Participants were consecutive patients attending colposcopy clinics at a major metropolitan hospital in Australia. Following ascertainment of domestic violence status, appointment outcomes for colposcopy services were tracked for a three-year period. Multivariate analysis was undertaken to determine demographic factors associated with default from care and loss to follow up. Results: Of 581 women approached, consent was obtained from 574 women (99%). Domestic violence status was obtained from 566 women, of whom 187 (33%) had a recent history of exposure. Women exposed to violence were more likely to default from colposcopy once (26.2% vs 7.4%; p\u3c0.0001), twice (11.2% vs 3.2%, p=0.0001), or thrice (10.7% vs 2.4%, p\u3c0.0001). They were more likely to be lost to follow up (8.0% vs 1.1%, P\u3c0.0001). In multivariate analysis exposure to domestic violence remained significantly associated with default and loss to follow up. Conclusion: Domestic violence is a risk factor for default from attendance and lost to follow up at colposcopy services. This may explain the mechanism behind adverse healthcare outcomes seen. Screening and targeted appointment intervention programs may improve clinical compliance

Creating Web Explorations In Science And Engineering

A summer internship program is held at Iowa State University each year for undergraduate and high school women in science and engineering fields. In the summer of 1995 two high school women in this program, co-authors Roberts and Sandberg, created world-wide-web based multimedia explorations into topics in science and engineering which are common in our daily lives. The prototype documents placed on the web were well researched and scientific explanations of the phenomena at hand, but explained so that the average 6th or 7th grader (the target audience) could understand them. These two students were directly supervised by an undergraduate woman, co-author Collier, herself a former intern in this program. The purpose of the internship program is to give young women experience in research laboratories under the mentorship of an Iowa State professor, thereby solidifying their interest in SEM (Science, Engineering, and Mathematics) careers. This particular research project not only provided such a research experience for the two high school women but it also provided an internship in supervising researchers for the undergraduate student as well as allowing a mentoring relationship for all three students with a professor, co-author Genalo

Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care

Rationale: A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. Aim and hypothesis To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other intended exploratory analyses of resource use data. Sample size estimates: Recruitment to the trial has been completed. A total of 2,104 participants from 56 stroke units across three geographic regions participated in the trial. Methods and design: Resource use data were collected prospectively alongside the trial using standardised tools. The primary economic evaluation method is a cost-effectiveness analysis to compare resource use over 12 months with health outcomes of the intervention measured against a usual care comparator. A cost-utility analysis is also intended. Study outcome: The primary outcome in the cost-effectiveness analysis will be favourable outcome (modified Rankin Scale score 0-2) at 12 months. Cost-utility analysis will use health-related quality of life, reported as quality-adjusted life years gained over a 12 month period, as measured by the modified Rankin Scale and the Assessment of Quality of Life. Discussion: Outcomes of the economic evaluation analysis will inform the cost-effectiveness of very early mobilisation following stroke when compared to usual care. The exploratory analysis will report patterns of resource use in the first year following stroke

Very early versus delayed mobilization after stroke: systematic review and meta-analysis

No abstract available

How effective is public health policy in Scotland on vitamin D deficiency during pregnancy?

Objective:To evaluate the uptake of universal vitamin D supplementation during pregnancy, its effectiveness in preventing vitamin D deficiency and the factors associated with these.Design:The regional public health organisation in Ayrshire, Scotland has a policy of universal provision of vitamin D supplements (10 µg/d) to all pregnant women for the duration of their pregnancy. Pregnant women in this area were recruited at their 12-week antenatal appointment. Blood samples were collected at the 12-week and 34-week appointments. To account for the seasonal variation, women were recruited in two cohorts: summer and winter. Telephone interviews were conducted at 34 weeks to assess the uptake of vitamin D supplements during pregnancy. Other variables were obtained from medical records.Setting:The study was conducted in the NHS Ayrshire and Arran Health Board in Scotland.Participants:612 pregnant women (aged 15–44 years) living in Ayrshire (latitude 55°), Scotland.Results:Sixty-six percentage took supplementation as recommended. Consumption of supplementation was significantly associated with a higher median serum 25-hydroxyvitamin D concentrations at 34 weeks. Despite this at 34 weeks, 33 % of the summer cohort had insufficient or deficient vitamin D status, while 15 % of the winter cohort had insufficient or deficient status. In multivariable analysis, only adherence and season were independent predictors of vitamin D status.Conclusions:While supplementation improved and maintained vitamin D status during pregnancy, it was not adequate to ensure all those insufficient at 12 weeks achieved sufficient status at the end of pregnancy.</div

Parenteral nutrition additive shortages: the short-term, long-term and potential epigenetic implications in premature and hospitalized infants.

Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI), selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN) indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages

Infrared-Faint Radio Sources: A New Population of High-redshift Radio Galaxies

We present a sample of 1317 Infrared-Faint Radio Sources (IFRSs) that, for the first time, are reliably detected in the infrared, generated by cross-correlating the Wide-Field Infrared Survey Explorer (WISE) all-sky survey with major radio surveys. Our IFRSs are brighter in both radio and infrared than the first generation IFRSs that were undetected in the infrared by the Spitzer Space Telescope. We present the first spectroscopic redshifts of IFRSs, and find that all but one of the IFRSs with spectroscopy has z > 2. We also report the first X-ray counterparts of IFRSs, and present an analysis of radio spectra and polarization, and show that they include Gigahertz-Peaked Spectrum, Compact Steep Spectrum, and Ultra-Steep Spectrum sources. These results, together with their WISE infrared colours and radio morphologies, imply that our sample of IFRSs represents a population of radio-loud Active Galactic Nuclei at z > 2. We conclude that our sample consists of lower-redshift counterparts of the extreme first generation IFRSs, suggesting that the fainter IFRSs are at even higher redshift.Comment: 23 pages, 17 figures. Submitted to MNRA