A Qualitative Study of an Integrated Maternity, Drugs and Social Care Service for Drug-using Women

Background: The care of drug-using pregnant women is a growing health and social care concern in many countries. A specialist clinic was established offering multidisciplinary care and advice to pregnant drug users in and around Aberdeen (UK) in 1997. The majority of women stabilise and reduce their drug use. By determining the needs and views of the women more appropriate services and prevention strategies may be developed. There has been little research conducted in this area and none in Scotland. Methods: This is a qualitative study that aimed to gain an understanding of the experiences of women drug users, seeking and receiving prenatal care and drug services from a specialist clinic. Twelve women participated in semi-structured one-to-one interviews. Results: The women preferred the multidisciplinary clinic (one-stop shop) to traditional prenatal care centred within General Practice. The relationships of the clients to the range of Clinic professionals and in hospital were explored as well as attitudes to Clinic care. The study participants attributed success in reducing their drug use to the combination of different aspects of care of the multi-agency clinic, especially the high level prenatal support. It is this arrangement of all aspects of care together that seem to produce better outcomes for mother and child than single care elements delivered separately. Some women reported that their pregnancy encouraged them to rapidly detoxify due to the guilt experienced. The most important aspects of the Clinic care were found to be non-judgemental attitude of staff, consistent staff, high level of support, reliable information and multi-agency integrated care. Conclusion: There is an impetus for women drug users to change lifestyle during pregnancy. The study highlighted a need for women to have access to reliable information on the effects of drugs on the baby. Further research is required to determine whether positive outcomes related to clinic attendance in the prenatal period are sustained in the postnatal period. Early referral to a specialist clinic is of benefit to the women, as they reported to receive more appropriate care, especially in relation to their drug use. A greater awareness of needs of the pregnant drug user could help the design of more effective prevention strategies

Stochastic light concentration from 3D to 2D reveals ultraweak chemi- and bioluminescence

For countless applications in science and technology, light must be concentrated, and concentration is classically achieved with reflective and refractive elements. However, there is so far no efficient way, with a 2D detector, to detect photons produced inside an extended volume with a broad or isotropic angular distribution. Here, with theory and experiment, we propose to stochastically transform and concentrate a volume into a smaller surface, using a high- albedo Ulbricht cavity and a small exit orifice through cavity walls. A 3D gas of photons produced inside the cavity is transformed with a 50% number efficiency into a 2D Lambertian emitting orifice with maximal radiance and a much smaller size. With high-albedo quartz-powder cavity walls ( P = 99.94%), the orifice area is 1/( 1 - P) approximate to 1600 times smaller than the walls' area. When coupled to a detectivity-optimized photon-counter ( D = 0.015 photon- 1 s1/ 2 cm) the detection limit is 110 photon s- 1 L- 1. Thanks to this unprecedented sensitivity, we could detect the luminescence produced by the non-catalytic disproportionation of hydrogen peroxide in pure water, which has not been observed so far. We could also detect the ultraweak bioluminescence produced by yeast cells at the onset of their growth. Our work opens new perspectives for studying ultraweak luminescence, and the concept of stochastic 3D/2D conjugation should help design novel light detection methods for large samples or diluted emitters