Women’s experiences of communication with medical staff during complicated pregnancy

This study explored the ways in which women experienced non-facilitative communication with medical staff during a complicated pregnancy. Complicated pregnancy has been associated with a higher risk of mental health difficulties. The research was carried out in Ireland and focused on women’s relationships with medical hospital staff during this time as they are ideally placed to offer relational support, and potentially prevent longer term problems. In-depth interviews were conducted with six women. The qualitative methodology of interpretive phenomenological analysis was used to understand their experiences. Four superordinate themes emerged. These were ‘Information difficulties' ‘Disempowerment', ‘Empathic failure’ and ‘Relational impacts’. Crucial information was withheld, private details were discussed in public spaces and key aspects of women’s experiences were omitted from their hospital notes. Participants spoke of feeling disempowered and manipulated by staff. All participants referred repeatedly to feeling that the majority of staff failed to demonstrate empathy. Women felt isolated and unseen, with staff focused on tasks rather than holistic treatment and their infant’s needs but not those of the women. Finally, women described how their relationships with themselves, partners, and crucially, their infants had been impacted. Participants’ accounts may represent a gap in the care of women who experience the trauma of serious pregnancy complications. Findings suggest a role for counselling psychologists in providing training and consultation for medical staff in order that they might develop the capacity to offer improved support to women and infants during this time when they are more susceptible to mental health difficulties

Mechanism of droplet-formation in a supersonic microfluidic spray device

Spray drying is an approach employed in automotive, food, and pharmaceutical industries as a robust and cost efficient liquid atomization technique offering direct control over droplet dimensions. The majority of commercially available spray nozzles are designed for large throughput spray drying applications or uniform surface coating, but microfluidic nebulizers have recently been developed as small scale alternatives. Here, we explore the physical parameters that define the droplet size and formation under supersonic flow conditions commonly found in microfluidic spray drying systems. We examined the spray nozzle operation using high speed imaging and laser scattering measurements, which allowed us to describe the spray regimes and droplet size distributions. It was determined that by using this spray nozzle device, droplets with diameters of 4–8 μm could be generated. Moreover, we show that the supersonic de Laval nozzle model can be used to predict the average droplet size. Our approach can be used as a platform for interfacing fluid microprocessing with gas phase detection and characterization

Climate change policy inventory and analysis for Tanzania

This report is an output of the Global Framework for Climate Services Adaptation Programme in Africa. The goal of the report is to: 1) assess the extent to which climate change concerns have been integrated or mainstreamed into national policy documents in mainland Tanzania, 2) to consider the role of climate services in achieving national sectorial policy goals, and 3) identify entry points for the further development of climate services within the current policy frameworks. Fifteen key policy documents relevant to economic development, climate change and environment, agriculture and food security, disaster management and risk reduction, and health planning were analysed. Three major findings emerged from this analysis. First, while climate change is addressed in a number of the policy documents, the concept of climate services was not. Second, policy documents across all sectors identified improved early warning systems as a specific objective. This represents a common entry point for development and delivery of climate services, as well as an opportunity to increase cross-sectorial adaptation coordination and planning. Third, the analysis highlighted that efforts to manage short- and long-term climate risks are not well integrated under current policies and legislation in Tanzania. Additionally, we found that the National Environmental Policy and National Environmental Management Act are the primary policy documents that oversee climate change-related issues. It will be important to link the development and delivery of climate services with the established institutional structures for climate change adaptation under these current policies and legislation, to avoid creating isolated or duplicative institutional arrangements. Based on these findings, several recommendations are made that can inform climate services development and delivery in Tanzania

Zygomycosis Associated with HIV Infection and Liver Transplantation

Zygomycosis is an increasing threat to patients with human immunodeficiency virus (HIV) infection. Zygomycosis (formerly called mucormycosis) is the fungal infection with Mucor, Rhizopus, or other species that share a common morphology of large empty pauciseptate hyphae with rare random-angle branching and a collapsed “twisted ribbon” appearance. Morphology allows a specific diagnosis on frozen section or smear prior to growth and identification of the fungi in culture which makes it improtant because treatment is different than that for more common mycoses such as candidiasis and aspergillosis. We present an informative and illustrative case of zygomycosis in a patient with HIV infection and liver transplantation

A decision tool for radiographer-led abdominal image-guided stereotactic ablative body radiotherapy – Experience from a single institution

A decision tool for radiographer-led image-guided radiotherapy (IGRT) using cone-beam CT (CBCT) for abdominal stereotactic radiotherapy was developed and successfully implemented in a single department. The confidence of 7 therapeutic radiographers when undertaking online CBCT review increased, and the pooled median online match time was reduced by 1 m 8 s. While this may be advantageous for abdominal SABR, further evaluation of this work in a larger cohort is required to validate these results

Factors associated with anaemia status and haemoglobin concentrations in infants 6-11 months in Mbala District, Northern Province, Zambia

This paper presents information on the factors associated with anaemia status and haemoglobin concentrations in infants 6-11 months old in Mbala District, Northern Province, Zambia. The information is drawn from the baseline data collection of a study involving 631 caregiver-child pairs. The data presented here includes anthropometry, malaria parasitism, concentrations of haemoglobin (Hb) and serum transferrin receptor (STfR), and information on household characteristics, infant and young child feeding (IYCF) practices, and morbidity, gathered via questionnaire. It was found that 57% of the sample was anaemic (Hb < 110 g/L), 93% was iron deficient (STfR > 8.3 mg/L) and 53% had iron deficiency anaemia. Overall, 30% of the infants in the sample were stunted, 2% were wasted, and 16% were underweight, and 22%, 56% and 18% of infants were meeting minimum dietary diversity, minimum meal frequency, and minimum acceptable diet, respectively, and 28% consumed iron rich foods in the previous 24 hours. Infants who had achieved a minimum dietary diversity score (OR = 0.44; 95% CI: 0.30-0.65), who had consumed iron rich foods in the previous 24 hours (OR = 0.56; 95% CI: 0.40-0.80), or were female (OR = 0.69; 95% CI: 0.50-0.94), had significantly lower risks of being anaemic. Infants that tested positive for malaria parasitism (OR = 4.33; 95% CI: 2.16- 8.70), as well as those having a fever (OR = 1.88; 95% CI: 1.36-2.59) in the previous two weeks had significantly greater odds of being anaemic. Despite these associations, whether or not a child slept under a mosquito net was not related to their risk of being anaemic. Infants in households that treated their water to make it safer to consume had average haemoglobin concentrations 3 g/L higher than those who did not (p = 0.021), but this did not translate into a significant difference in the odds of being anaemic. These results shed light on the specific causes of anaemia in the Zambian context, and illustrate the importance of improving dietary quality, specifically the intake of iron, and reducing the prevalence of diseases including malaria in order to reduce the prevalence of anaemia.Keywords: Nutritional status, Zambia, anaemia, iron deficiency, malaria, serum transferrin receptor, haemoglobi

The Concept of Sustainable Development and Its Impact on the Shaping of Modern International Relations through Global Agreements

The goal of this article is a depiction of the process of the molding of the concept of sustainable development as well as a look at the influence that this concept has exerted on contemporary international politics, especially taking into account agreements of worldwide scope. This article is also an effort at demonstrating that the foundations of the concept of sustainable development can be traced to certain economic theories. The final section of this article is devoted to the characteristics of individual conferences initiated by the United Nations in order to promote enduring and sustainable development on a world scale. Also presented are the achievements of the individual conferences and their roles in demarcating universally obligatory principles and standards of sustainable development.Celem niniejszego artykułu jest scharakteryzowanie genezy kształtowania się Koncepcji Zrównoważonego Rozwoju, a także wskazanie, jaki wpływ miała ona na ukształtowanie się stosunków międzynarodowych w zakresie ochrony środowiska i rozwiązywania problemów społecznych. Przedmiotem analizy są także teorie ekonomiczne, które stały się fundamentem dla wykrystalizowania się koncepcji zrównoważonego rozwoju. Poniższy artykuł jest także próbą wykazania, iż konferencje organizowane przez ONZ na rzecz trwałego i zrównoważonego rozwoju, stały się siła napędową do rozpowszechnienia tej koncepcji w skali światowej

Laboratory Characterization and Astrophysical Detection of Vibrationally Excited States of Vinyl Cyanide in Orion-KL

New laboratory data of CH$_2$CHCN (vinyl cyanide) in its ground and vibrationally excited states at the microwave to THz domain allow searching for these excited state transitions in the Orion-KL line survey. Frequency-modulated spectrometers combined into a single broadband 50-1900 GHz spectrum provided measurements of CH$_2$CHCN covering a spectral range of 18-1893 GHz, whose assignments was confirmed by Stark modulation spectra in the 18-40 GHz region and by ab-initio anharmonic force field calculations. For analyzing the emission lines of CH$_2$CHCN species detected in Orion-KL we used the excitation and radiative transfer code (MADEX) at LTE conditions. The rotational transitions of the ground state of this molecule emerge from four cloud components of hot core nature which trace the physical and chemical conditions of high mass star forming regions in the Orion-KL Nebula. The total column density of CH$_2$CHCN in the ground state is (3.0$\pm$0.9)x10$^{15}$ cm$^{-2}$. We report on the first interstellar detection of transitions in the v10=1/(v11=1,v15=1) dyad in space, and in the v11=2 and v11=3 states in Orion-KL. The lowest energy vibrationally excited states of vinyl cyanide such as v11=1 (at 328.5 K), v15=1 (at 478.6 K), v11=2 (at 657.8 K), the v10=1/(v11=1,v15=1) dyad (at 806.4/809.9 K), and v11=3 (at 987.9 K) are populated under warm and dense conditions, so they probe the hottest parts of the Orion-KL source. Column density and rotational and vibrational temperatures for CH$_2$CHCN in their ground and excited states, as well as for the isotopologues, have been constrained by means of a sample of more than 1000 lines in this survey. Moreover, we present the detection of methyl isocyanide (CH$_3$NC) for the first time in Orion-KL and a tentative detection of vinyl isocyanide (CH$_2$CHNC) and give column density ratios between the cyanide and isocyanide isomers.Comment: 46 pages, 22 figures, 14 tables, 9 online table