Women\u27s perceptions of birth centre care: A qualitative approach

The purpose of this exploratory study was to describe women\u27s perceptions of the care they received in a birth centre, compared to their previous experiences in a hospital. Australian statistics indicate that five percent of childbearing women now choose to receive care in a birth centre setting. Clinical outcomes of birth centre care are now well documented, but there is limited empirical data about women\u27s experiences of this model of care. Seventeen women, who had recently given birth in a birth centre, and had previously experienced care in a hospital setting, were interviewed about their care experiences. Using content analysis, the primary patterns in the data were coded and categorised into the four key themes of : Beliefs about Pregnancy and Birth, Nature of the Care Relationship, Care Interactions and Care Structures. The underlying clinical issues were those relating to philosophies of care, control over childbirth, and continuity of carer. Women wanted carers who viewed birth as a natural process rather than as an illness, and who engaged in a sharing, rather than a controlling, relationship. Finally women preferred to know, and be known by their carers. These findings are important for midwives, in terms of their education and practice. They also have implications for hospital administrators, health planning agencies, and the medical profession

Prophylatic cord care: Is it necessary?

Since the evolution of \u27open\u27 cord care in 1974, the umbilical cord of the newborn has been treated prophylactically with many different forms of antibacterial solutions. Recent studies have demonstrated that cord separation is facilitated by bacteria and many of the current treatments, such as the use of alcohol, actually delay separation. The purpose of this study was to compare cleaning the cord with alcohol to dry cord care, a method of cord care which is now being considered as an acceptable alternative to prophylactic umbilical cord treatment. A convenience sample of 205 babies was taken from a small private maternity unit. A 2 x 2 factorial design was utilized to assess the effect of the independent variables of cord care and clamp removal time, on the dependent variable of cord separation time. In this study dry cord care was compared to the current practice of applying alcohol to the cord, and clamp removal times of 24 hours and 60 hours were considered. A 2 x 2 ANOVA indicated that significantly later mean cord separation times were associated with the use of alcohol on the cord. Variations of cord clamp removal times had no significant effect on the mean cord separation times. Objective data collected on cord appearance indicated that cords treated with dry cord Care were more often reported as being moist or sticky

The Virtual Union Catalog

The Andrew W. Mellon Foundation and the National Library of Estonia organized a Conference on Union Catalogs which took place in Tallinn, in the National Library of Estonia on October 17–19, 2002. The Conference presented and discussed analytical papers dealing with various aspects of designing and implementing union catalogs and shared cataloging systems as revealed through the experiences of Eastern European, Baltic and South African research libraries. Here you can find the texts of the conference papers and the list of contributors and participants.The Andrew W. Mellon Foundation and the National Library of Estonia organized a Conference on Union Catalogs which took place in Tallinn, in the National Library of Estonia on October 17–19, 2002. The Conference presented and discussed analytical papers dealing with various aspects of designing and implementing union catalogs and shared cataloging systems as revealed through the experiences of Eastern European, Baltic and South African research libraries. Here you can find the texts of the conference papers and the list of contributors and participants

Interaction design and emotional wellbeing

The World Health Organisation has concluded that emotional wellbeing is fundamental to our quality of life. It enables us to experience life as meaningful and is an essential component of social cohesion, peace and stability in the living environment [21]. This workshop will bring together a diverse community to consolidate existing knowledge and identify new opportunities for research on technologies designed to support emotional wellbeing. The workshop will examine uses of technology in mental health settings, but will also consider the importance of emotional needs in physical healthcare and wellbeing more generally. The design of technology to provide social support and to extend traditional care networks will be key workshop themes

The difficulty of neutrality

The article proposes a reflection on the concept of neutrality both in relation to search engines and to libraries. In the first part the author explains that the myth of the neutral algorithm has been shattered in a number of studies and thought-pieces that have revealed that algorithms often contain the prejudices of their creators, and always reflect a human decision-making process. The commercial search engines have an interest in maximizing advertising revenue.Library systems increase their use of search completion suggestions and make recommendations, so the same types of algorithmic embarrassments can be encountered. But the author emphasizes that the theme of neutrality is central even in one of the most traditional tasks of librarians, namely the book selection.In conclusion, the article invites to deepen the meaning of neutrality within the library, starting from the analysis of the positions emerged during the debate scheduled at the American Library Association meeting in February of 2018.Il contributo propone una riflessione sul concetto di neutralità sia in riferimento a Internet e ai motori di ricerca, sia alle biblioteche. Nella prima parte, attraverso la presentazione di esempi e il rimando ad alcuni studi sul tema, l’autrice sfata il mito dell’algoritmo neutrale, dimostrando che gli algoritmi su cui si basano i motori di ricerca spesso incamerano i pregiudizi dei loro creatori e riflettono sempre un processo decisionale umano. Il punto centrale è che i motori di ricerca commerciali hanno interesse a massimizzare i profitti.L’attenzione si sposta, poi, sulle biblioteche. Man mano che nei software bibliotecari aumenta l’utilizzo di funzionalità come i suggerimenti nel completare i termini di ricerca o le raccomandazioni, si possono presentare le stesse situazioni dovute agli algoritmi che si riscontrano utilizzando i motori di ricerca. Ma l’autrice sottolinea che il tema della neutralità è centrale anche in uno dei compiti più tradizionali dei bibliotecari, ossia la selezione documentaria.In conclusione, il contributo invita ad approfondire il significato di neutralità all’interno della biblioteca, a partire dall’analisi delle posizioni emerse durante il dibattito programmato al meeting dell’American Library Association nel febbraio del 2018

FRBR, Twenty Years On

ABSTRACT: The article analyzes the conceptual model of the Functional Requirements for Bibliographic Records (FRBR) as a general model of bibliographic data and description that can be interpreted, as needed, to serve the needs of various communities. This is illustrated with descriptions of five different implementations based on the concepts in FRBR: FRBRER (entity-relation), FRBROO (object oriented), FRBRCore (FRBR entities as linked data), indecs (FRBR entities within the commerce model), and FaBiO (FRBR as a basis for academic document types). The author argues that variant models show the strength of the FRBR concepts, and should be encouraged

A single centre experience with sequential and concomitant chemoradiotherapy in locally advanced stage IV tonsillar cancer

<p>Abstract</p> <p>Background</p> <p>Chemo-radiotherapy offers an alternative to primary surgery and adjuvant therapy for the management of locally advanced stage IV squamous cell carcinomas of the tonsil.</p> <p>Methods</p> <p>A retrospective analysis was performed of the outcomes of 41 patients with locoregionally advanced squamous cell carcinoma of the tonsil treated non-surgically at the Yorkshire Cancer Centre between January 2004 and December 2005. Due to long radiotherapy waiting times, patients received induction chemotherapy with cisplatin and 5-fluorouracil followed by either cisplatin concurrent chemoradiotherapy or radiotherapy alone.</p> <p>Results</p> <p>Median age was 55 years (range 34-76 years) and 28 (68%) patients were male. 35/41 patients (85%) received 2 or more cycles of induction chemotherapy. Following induction chemotherapy, 32/41 patients (78%) had a clinical response. Concomitant chemotherapy was given to 30/41 (73%). All patients received the planned radiotherapy dose with no delays. There were no treatment related deaths. Six (15%) patients had gastrostomy tubes placed before treatment, and 22 (54%) required nasogastric tube placement during or after treatment for nutritional support. 17 patients required unplanned admissions during treatment for supportive care. At 4 months post treatment assessment 35 out of 41 (85%) patients achieved complete clinical and radiographic response. Median follow-up is 38 months (8-61 months). Local and regional control rate in complete responders at 3 years was 91%. Distant metastases have been found in 4 (9.8%) patients. Three year progression-free survival rate in all patients is 75%. The 3-year cause specific survival and overall survival are 75% and 66% respectively.</p> <p>Conclusion</p> <p>Cisplatin-based induction and concurrent chemoradiotherapy provides excellent tumour control with acceptable toxicity for patients with locally advanced tonsillar cancer.</p

Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy

<p>Abstract</p> <p>Background</p> <p>To establish recurrence patterns among locally advanced head and neck non-nasopharyngeal squamous cell carcinoma (HNSCC) patients treated with radical (chemo-) radiotherapy and to correlate the sites of loco-regional recurrence with radiotherapy doses and target volumes</p> <p>Method</p> <p>151 locally advanced HNSCC patients were treated between 2004-2005 using radical three-dimensional conformal radiotherapy. Patients with prior surgery to the primary tumour site were excluded. The sites of locoregional relapses were correlated with radiotherapy plans by the radiologist and a planning dosimetrist.</p> <p>Results</p> <p>Median age was 59 years (range:34-89). 35 patients had stage III disease, 116 patients had stage IV A/B. 36 patients were treated with radiotherapy alone, 42 with induction chemotherapy, 63 with induction and concomitant chemoradiotherapy and 10 concomitant chemoradiotherapy. Median follow-up was 38 months (range 3-62). 3-year cause specific survival was 66.8%. 125 of 151 (82.8%) achieved a complete response to treatment. Amongst these 125 there were 20 local-regional recurrence, comprising 8 local, 5 regional and 7 simultaneous local and regional; synchronous distant metastases occurred in 7 of the 20. 9 patients developed distant metastases in the absence of locoregional failure. For the 14 local recurrences with planning data available, 12 were in-field, 1 was marginal, and 1 was out-of-field. Of the 11 regional failures with planning data available, 7 were in-field, 1 was marginal and 3 were out-of-field recurrences.</p> <p>Conclusion</p> <p>The majority of failures following non-surgical treatment for locally advanced HNSCC were loco-regional, within the radiotherapy target volume. Improving locoregional control remains a high priority.</p

The Impact of 18F-FDG PET CT Prior to Chemoradiotherapy for Stage III/IV Head and Neck Squamous Cell Carcinoma

Introduction. To determine the value of a FDG-PET-CT scan in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) prior to chemoradiotherapy. Materials and Methods. Consecutive patients with stage III or IV HNSCC who had undergone a staging FDG-PET-CT scan prior to chemoradiotherapy between August 2008 and April 2011 were included. Clinical details and conventional imaging (CT and/or MRI) were, retrospectively, reviewed, a TNM stage was assigned, and levels of cervical lymph node involvement were documented. This process was repeated with the addition of FDG-PET-CT. Radiotherapy plans were reviewed for patients with an alteration identified on TNM staging and/or nodal level identification with FDG-PET-CT and potential alterations in radiotherapy planning were documented. Results. 55 patients were included in the analysis. FDG-PET-CT altered the TNM stage in 17/55 (31%) of patients, upstaging disease in 11 (20%) and downstaging in 6 (11%); distant metastases were identified by FDG-PET-CT in 1 (2%) patient. FDG-PET-CT altered the lymph node levels identified in 22 patients (40%), upclassifying disease in 16 (29%) and downclassifying in 6 (11%). Radiotherapy plans were judged retrospectively to have been altered by FDG-PET-CT in 10 patients (18%). Conclusions. The use of FDG-PET-CT potentially impacts upon both treatment decisions and radiotherapy planning