Perineal management techniques among midwives at five hospitals in New South Wales – A cross-sectional survey

Background: Midwives are reported to have changed from ‘hands on’ to ‘hands poised or off’ approaches at birth at the same time as obstetric anal sphincter injuries (OASIs) are increasing. As perineal management details are not routinely collected, it is difficult to quantify practice. Aims: To determine which perineal protections techniques midwives prefer for low risk non-water births; if preference is associated with technique taught or with other characteristics; and if midwives change preference according to clinical scenario. Materials and Methods: Midwives in Northern Sydney Local Health District (NSLHD), NSW, were surveyed during a two week period in 2014. Multiple-choice questions were used, with free text option. Descriptive analyses, chi-square and McNemar tests were undertaken. Results: One hundred and eight midwives participated (response rate 76.7%). ‘Hands poised or off’ was preferred by 63.0% for a low risk birth. Current practice was associated with technique taught (p<0.01). For scenarios with increased OASI risk midwives reported switching to ‘hands on’, with 83.4% employing ‘hands on’ if there was concern about an impending OASI. There has been a shift over time from teaching ‘hands on’ to ‘hands poised or off’. Conclusion: The preferred technique for a low risk birth appears to have changed from ‘hands on’ to ‘hands poised or off’, but most midwives adopt ‘hands on’ in situations of high risk for OASI. Further research is needed to establish if there is an association with the rising OASI rate and the change in preferred perineal management technique for a low risk birth.Australian Research Council; Dr Albert S McKern Research Scholarshi

A trivariate chi-squared distribution derived from the complex Wishart distribution

The joint density for a particular trivariate chi-squared distribution given by the diagonal elements of a complex Wishart matrix is derived. This distribution has applications in the processing of multilook synthetic aperture radar data. The expression for the density is in the form of an infinite series that converges rapidly and is simple and fast to compute. The expression is shown to reduce to known forms for a number of special cases and is validated by simulation. The characteristic function is also derived and used to relate joint moments of the trivariate distribution to the parameters of the density function.

Planned Place of Birth in New Zealand: Does it Affect Mode of Birth and Intervention Rates Among Low-Risk Women

Background: Midwives providing care as lead maternity caregivers in New Zealand provide continuity of care to women who may give birth in a variety of settings, including home, primary units, and secondary and tertiary level hospitals. The purpose of this study was to compare mode of birth and intrapartum intervention rates for low-risk women planning to give birth in these settings under the care of midwives. Methods: Data for a cohort of low-risk women giving birth in 2006 and 2007 were extracted from the Midwifery Maternity Provider Organisation database. Mode of birth, intrapartum interventions, and neonatal outcomes were compared with results adjusted for age, parity, ethnicity, and smoking. Results: Women planning to give birth in secondary and tertiary hospitals had a higher risk of cesarean section, assisted modes of birth, and intrapartum interventions than similar women planning to give birth at home and in primary units. The risk of emergency cesarean section for women planning to give birth in a tertiary unit was 4.62 (95% CI: 3.66-5.84) times that of a woman planning to give birth in a primary unit. Newborns of women planning to give birth in secondary and tertiary hospitals also had a higher risk of admission to a neonatal intensive care unit (RR: 1.40, 95% CI: 1.05-1.87; RR: 1.78, 95% CI: 1.31-2.42) than women planning to give birth in a primary unit. Conclusions: Planned place of birth has a significant influence on mode of birth and rates of intrapartum intervention in childbirth. © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc

Mapping Physiognomic Types of Indigenous Forest using Space-Borne SAR, Optical Imagery and Air-borne LiDAR

Indigenous forests cover 24% of New Zealand and provide valuable ecosystem services. However, a national map of forest types, that is, physiognomic types, which would benefit conservation management, does not currently exist at an appropriate level of detail. While traditional forest classification approaches from remote sensing data are based on spectral information alone, the joint use of space-based optical imagery and structural information from synthetic aperture radar (SAR) and canopy metrics from air-borne Light Detection and Ranging (LiDAR) facilitates more detailed and accurate classifications of forest structure. We present a support vector machine (SVM) classification using data from the European Space Agency (ESA) Sentinel-1 and 2 missions, Advanced Land Orbiting Satellite (ALOS) PALSAR, and airborne LiDAR to produce a regional map of physiognomic types of indigenous forest. A five-fold cross-validation (repeated 100 times) of ground data showed that the highest classification accuracy of 80.5% is achieved for bands 2, 3, 4, 8, 11, and 12 from Sentinel-2, the ratio of bands VH (vertical transmit and horizontal receive) and VV (vertical transmit and vertical receive) from Sentinel-1, and mean canopy height and 97th percentile canopy height from LiDAR. The classification based on optical bands alone was 72.7% accurate and the addition of structural metrics from SAR and LiDAR increased accuracy by 7.4%. The classification accuracy is sufficient for many management applications for indigenous forest, including biodiversity management, carbon inventory, pest control, ungulate management, and disease management

Global Cross-Sectional Study Evaluating the Attitudes towards a COVID-19 Vaccine in Pregnant and Postpartum Women

Pregnant and postpartum women have an increased risk of severe complications from COVID-19. Many clinical guidelines recommend vaccination of these populations, and it is therefore critical to understand their attitudes toward COVID-19 vaccines. We conducted a cross-sectional online survey in November 2020 of currently pregnant and ≤1-year postpartum women in Brazil, India, the United Kingdom (UK), and the United States (US) that assessed their openness to COVID-19 vaccines and reasons for vaccine hesitancy. Logistic regression analyses were conducted to evaluate openness to receiving a vaccine. Out of 2010 respondents, 67% were open to receiving a COVID-19 vaccine themselves. Among pregnant and postpartum participants, 72% and 57% were willing to receive a vaccine, respectively. Vaccine openness varied significantly by country: India (87%), Brazil (71%), UK (59%), and US (52%). Across all participants, among the 33% who were unsure/not open to receiving a COVID-19 vaccine, the most common reason cited was safety/side effect concerns (51%). Participants were similarly open to their children/other family members receiving a COVID-19 vaccine. Presence of a comorbidity, a positive COVID-19 test result, and pregnancy were all significantly associated with positive vaccine acceptance. Targeted outreach to address pregnant and postpartum women’s concerns about the COVID-19 vaccine is needed

National Mapping of New Zealand Pasture Productivity Using Temporal Sentinel-2 Data

A national map of pasture productivity, in terms of mass of dry matter yield per unit area and time, enables evaluation of regional and local land-use suitability. Difficulty in measuring this quantity at scale directed this research, which utilises four years of Sentinel-2 satellite imagery and collected pasture yield measurements to develop a model of pasture productivity. The model uses a Normalised Difference Vegetation Index (NDVI), with spatio-temporal segmentation and averaging, to estimate mean annual pasture productivity across all of New Zealand’s grasslands with a standard error of prediction of 2.2 t/ha/y. Regional aggregates of pasture yield demonstrate expected spatial variations. The pasture productivity map may be used to classify grasslands objectively into stratified levels of production on a national scale. Due to its ability to highlight areas of land use intensification suitability, the national map of pasture productivity is of value to landowners, land users, and environmental scientists