Caseload midwifery in a multi-ethnic community: The women's experiences

Objective: To evaluate caseload midwifery in a relatively deprived and ethnically diverse inner-city area. Design and setting: Semi-structured interviews were undertaken with 24 women from diverse ethnic backgrounds, 12 of whom had received caseload care and 12 women from an adjacent area who had received conventional maternity care in a large inner-city maternity unit. Framework analysis was adopted drawing on links with the authors’ previous work on women’s views of caseload midwifery. Findings: Key themes from previous work fitted well with the themes that emerged from this study. Themes included ‘knowing and being known’, ‘person-centred care’, ‘social support’, ‘gaining trust and confidence’, ‘quality and sensitivity of care’ and ‘communication’. Key conclusions and implications: Women from this socially and ethnically diverse group of women had similar views and wanted similar care to those in previous studies of caseload midwifery. Many of the women receiving caseload care highlighted the close relationship they had with the midwives and as a result of thisfelt more able to discuss their concerns with them. This has the potential not only for improved quality of care but also improved safety

The prevalence, influential factors and mechanisms of relative age effects in UK Rugby League.

Relative age effects (RAEs), reflecting observed inequalities in participation and attainment as a result of annual age-grouping policies in youth sport, are common in most team sports. The aims of this study were to determine if and when RAEs become apparent in Rugby League, determine how influential variables (e.g., gender) lead and clarify whether player retention at junior representative levels can explain persistent RAEs. Player data were collected for the male and female community games ranging from Under 7s to Senior (N=15,060) levels, junior representative selections (i.e., Regional) and professional players (N=298). Chi-square analyses found significant (P<0.05) uneven birth date distributions beginning at the earliest stages of the game and throughout into senior professionals. In junior representative selections, 47.0% of Regional and 55.7% of National representative players were born in Quartile 1, with RAE risk increasing with performance level. Gender and nationality were also found to moderate RAE risk. When tracking representative juniors, over 50% were retained for similar competition the following season. Findings clearly demonstrate that RAEs exist throughout Rugby League with early selection, performance level and retention processes, appearing to be key contributing factors responsible for RAE persistence

Nicotine strongly activates dendritic cell-mediated adaptive immunity - potential role for progression of atherosclerotic lesions

Background - Antigen-presenting cells (APCs) such as monocytes and dendritic cells (DCs) stimulate T-cell proliferation and activation in the course of adaptive immunity. This cellular interaction plays a role in the growth of atherosclerotic plaques. Nicotine has been shown to increase the growth of atherosclerotic lesions. Therefore, we investigated whether nicotine can stimulate APCs and their T cell–stimulatory capacity using human monocyte–derived DCs and murine bone marrow–derived DCs as APCs. Methods and Results - Nicotine dose-dependently (10-8 to 10-4 mol/L) induced DC expression of costimulatory molecules (ie, CD86, CD40), MHC class II, and adhesion molecules (ie, LFA-1, CD54). Moreover, nicotine induced a 7.0-fold increase in secretion of the proinflammatory TH1 cytokine interleukin-12 by human DCs. These effects were abrogated by the nicotinic receptor antagonist -bungarotoxin and mecamylamine, respectively. The effects of nicotine were mediated in part by the phosphorylation of the PI3 kinase downstream target Akt and the mitogen-activated kinases ERK and p38 MAPK. Nicotine-stimulated APCs had a greater capacity to stimulate T-cell proliferation and cytokine secretion, as documented by mixed lymphocyte reactions and ovalbumin-specific assays with ovalbumin-transgenic DO10.11 mice. In a murine model of atherosclerosis, nicotine significantly enhanced the recruitment of DCs to atherosclerotic lesions in vivo. Conclusions - Nicotine activates DCs and augments their capacity to stimulate T-cell proliferation and cytokine secretion. These effects of nicotine may contribute to its influence on the progression of atherosclerotic lesions

Atomic layer etching of SiO2 with Ar and CHF 3 plasmas: A self-limiting process for aspect ratio independent etching

With ever increasing demands on device patterning to achieve smaller critical dimensions, the need for precise, controllable atomic layer etching (ALE) is steadily increasing. In this work, a cyclical fluorocarbon/argon plasma is successfully used for patterning silicon oxide by ALE in a conventional inductively coupled plasma tool. The impact of plasma parameters and substrate electrode temperature on the etch performance is established. We achieve the self-limiting behavior of the etch process by modulating the substrate temperature. We find that at an electrode temperature of −10°C, etching stops after complete removal of the modified surface layer as the residual fluorine from the reactor chamber is minimized. Lastly, we demonstrate the ability to achieve independent etching, which establishes the potential of the developed cyclic ALE process for small scale device patterning

Asynchronous displays for multi-UV search tasks

Synchronous video has long been the preferred mode for controlling remote robots with other modes such as asynchronous control only used when unavoidable as in the case of interplanetary robotics. We identify two basic problems for controlling multiple robots using synchronous displays: operator overload and information fusion. Synchronous displays from multiple robots can easily overwhelm an operator who must search video for targets. If targets are plentiful, the operator will likely miss targets that enter and leave unattended views while dealing with others that were noticed. The related fusion problem arises because robots' multiple fields of view may overlap forcing the operator to reconcile different views from different perspectives and form an awareness of the environment by "piecing them together". We have conducted a series of experiments investigating the suitability of asynchronous displays for multi-UV search. Our first experiments involved static panoramas in which operators selected locations at which robots halted and panned their camera to capture a record of what could be seen from that location. A subsequent experiment investigated the hypothesis that the relative performance of the panoramic display would improve as the number of robots was increased causing greater overload and fusion problems. In a subsequent Image Queue system we used automated path planning and also automated the selection of imagery for presentation by choosing a greedy selection of non-overlapping views. A fourth set of experiments used the SUAVE display, an asynchronous variant of the picture-in-picture technique for video from multiple UAVs. The panoramic displays which addressed only the overload problem led to performance similar to synchronous video while the Image Queue and SUAVE displays which addressed fusion as well led to improved performance on a number of measures. In this paper we will review our experiences in designing and testing asynchronous displays and discuss challenges to their use including tracking dynamic targets. © 2012 by the American Institute of Aeronautics and Astronautics, Inc

Data Compression Based on the Cubic B-Spline Wavelet With Uniform Two-Scale Relation

The aim of this paper is to investigate the potential artificial compression which can be achieved using an interval multiresolution analysis based on a semiorthogonal cubic B-spline wavelet. The Chui-Quak [1] spline multiresolution analysis for the finite interval has been modified [2] so as to be characterized by natural spline projection and uniform two-scale relation. Strengths and weaknesses of the semiorthogonal wavelet as regards artificial compression and data smoothing by the method of thresholding wavelet coefficients are indicated

Ras/Raf-1/MAPK pathway mediates response to tamoxifen but not chemotherapy in breast cancer patients

&lt;b&gt;Purpose&lt;/b&gt;: The expression and activation of the Ras/Raf-1/mitogen-activated protein kinase (MAPK) pathway plays an important role in the development and progression of cancer, and may influence response to treatments such as tamoxifen and chemotherapy. In this study we investigated whether the expression and activation of the key components of this pathway influenced clinical outcome, to test the hypothesis that activation of the MAPK pathway drives resistance to tamoxifen and chemotherapy in women with breast cancer. &lt;b&gt;Experimental Design&lt;/b&gt;: Breast tumors from patients at the Glasgow Royal Infirmary and others treated within the BR9601 trial were analyzed for expression of the three Ras isoforms, total Raf-1, active and inactive forms of Raf-1 [pRaf(ser338) and pRaf(ser259), respectively], MAPK, and phospho-MAPK using an immunohistochemical approach. Analyses were done with respect to disease free-survival and overall survival. &lt;b&gt;Results&lt;/b&gt;: Expression and activation of the Ras pathway was associated with loss of benefit from treatment with tamoxifen but not chemotherapy. Overexpression of pRaf(ser338) was associated with shortened disease-free and overall survival time in univariate analyses. Multivariate analysis suggested pRaf(ser338) was independent of known prognostic markers in predicting outcome following tamoxifen treatment (&lt;i&gt;P&lt;/i&gt;=0.03). &lt;b&gt;Conclusion&lt;/b&gt;: This study suggests that activation of the Ras pathway predicts for poor outcome on tamoxifen but not chemotherapy, and identifies pRaf(ser338) as a potential marker of resistance to estrogen receptor–targeted therapy. In addition, it suggests that expression of pRaf(ser338) could identify patients for whom tamoxifen alone is insufficient adjuvant systemic therapy, but for whom the addition of chemotherapy may be of benefit