Recent Langley helicopter acoustics contributions

The helicopter acoustics program at NASA Langley has included technology for elements of noise control ranging from sources of noise to receivers of noise. The scope of Langley contributions for about the last decade is discussed. Specifically, the resolution of two certification noise quantification issues by subjective acoustics research, the development status of the helicopter system noise prediction program ROTONET are reviewed and the highlights from research on blade rotational, broadband, and blade vortex interaction noise sources are presented. Finally, research contributions on helicopter cabin (or interior) noise control are presented. A bibliography of publications from the Langley helicopter acoustics program for the past 10 years is included

Quality of maternity care practices of skilled birth attendants in Cambodia

Background: The World Health Organization's recommended package of interventions for the integrated management of pregnancy and childbirth provides guidance for the use of evidence-based interventions to ensure the best outcomes for mother and newborn. However, the extent to which skilled birth attendants (SBAs) follow evidence-based guidelines is not known. There are few studies into childbirth practices of SBAs in Cambodia. The aim of this study was to observe practices of SBAs during labour, birth and the immediate post-partum period and their consistency with evidence-based guidelines. Methods: A structured non-participant observation study was undertaken. Data were collected using an observational checklist of evidence-based practices adapted from the Cambodian clinical assessment tools for associate degree in midwifery. Maternity care settings in one provincial hospital, two district referral hospitals and two health centres in one province of Cambodia were purposively selected. Results: Twenty-five SBAs who attended 40 women during labour, birth and the postnatal period were observed. The results showed that the use of the partograph was low; birth companions were not permitted; cleanliness during birth was lacking; management of the third stage of labour was inappropriate; monitoring of mother and baby in the early postnatal period was lacking; the SBAs lacked skills in neonatal resuscitation; skin-to-skin contact with the newborn and early breastfeeding were rare; and intramuscular injection of vitamin K varied. Conclusion: The findings suggest that the current SBA practices during labour, birth and the immediate postpartum period in one province of Cambodia are not consistent with evidence-based guidelines. Service improvements that address evidence-based practices are likely to have an impact on clean and safe childbirth, thereby enhancing outcomes for Cambodia women. © 2012 The Authors International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute

Pain management for chronic musculoskeletal conditions : the development of an evidence-based and theory-informed pain self-management course

Objective: To devise and test a self-management course for chronic pain patients based on evidence and underpinned by theory using the Medical Research Council (MRC) framework for developing complex interventions. Design: We used a mixed method approach. We conducted a systematic review of the effectiveness of components and characteristics of pain management courses. We then interviewed chronic pain patients who had attended pain and self-management courses. Behavioural change theories were mapped onto our findings and used to design the intervention. We then conducted a feasibility study to test the intervention. Setting: Primary care in the inner city of London, UK. Participants: Adults (18 years or older) with chronic musculoskeletal pain. Outcomes: Related disability, quality of life, coping, depression, anxiety, social integration and healthcare resource use. Results: The systematic reviews indicated that group-based courses with joint lay and healthcare professional leadership and that included a psychological component of short duration (<8 weeks) showed considerable promise. The qualitative research indicated that participants liked relaxation, valued social interaction and course location, and that timing and good tutoring were important determinants of attendance. We used behavioural change theories (social learning theory and cognitive behaviour approaches (CBA)) to inform course content. The course addressed: understanding and accepting pain, mood and pain, unhelpful thoughts and behaviour, problem solving, goal setting, action planning, movement, relaxation and social integration/reactivation. Attendance was 85%; we modified the recruitment of patients, the course and the training of facilitators as a result of testing. Conclusions: The MRC guidelines were helpful in developing this intervention. It was possible to train both lay and non-psychologists to facilitate the courses and deliver CBA. The course was feasible and well received

Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy.

Background In March 2020, COVID-19 was declared to be a pandemic. While data suggests that COVID-19 is not associated with significant adverse health outcomes for pregnant women and newborns, the psychological impact on pregnant women is likely to be high. Aim The aim was to explore the psychological impact of the COVID-19 pandemic on Italian pregnant women, especially regarding concerns and birth expectations. Methods A cross-sectional online survey of pregnant women in Italy was conducted. Responses were analysed for all women and segregated into two groups depending on previous experience of pregnancy loss. Analysis of open text responses examined expectations and concerns before and after the onset of the pandemic. Findings Two hundred pregnant women responded to the first wave of the survey. Most (n = 157, 78.5%) had other children and 100 (50.0%) had a previous history of perinatal loss. ‘Joy’ was the most prevalent emotion expressed before COVID-19 (126, 63.0% before vs 34, 17.0% after; p < 0.05); fear was the most prevalent after (15, 7.5% before vs 98, 49.0% after; p < 0.05). Positive constructs were prevalent before COVID-19, while negative ones were dominant after (p < 0.05). Across the country, women were concerned about COVID-19 and a history of psychological disorders was significantly associated with higher concerns (p < 0.05). A previous pregnancy loss did not influence women’s concerns. Conclusions Women’s expectations and concerns regarding childbirth changed significantly as a result of the COVID-19 pandemic in Italy. Women with a history of psychological disorders need particular attention as they seem to experience higher levels of concern

Access to, and experiences of, maternity care for women with physical disabilities: A scoping review.

OBJECTIVE: Women with physical disabilities face multiple barriers in accessing safe, respectful and acceptable healthcare. As the number of women with physical disabilities becoming pregnant rises, ensuring their access to acceptable and high-quality maternity care becomes increasingly important. This review aimed to explore the most recent evidence regarding access to, and experiences of, maternity care for women with physical disabilities in high-income countries. DESIGN: A scoping review was undertaken as guided by the Preferred Reporting Items for Systematic Reviews extension for scoping reviews (PRISMA-ScR). A systematic search of five online databases identified relevant articles published in English from 2000 to 2020. Reference lists of included studies were also screened, and quality was appraised using the Joanna Briggs Institute Checklists. A thematic synthesis was undertaken to develop descriptive and analytical themes. FINDINGS: After screening, 27 articles from eight high-income countries were included. All articles were identified as having moderate or high methodological rigour in the quality appraisal. Women with physical disabilities reported numerous barriers in accessing maternity care and described predominantly mixed and negative experiences of care. These findings were grouped under three major themes: women with physical disabilities want a "normal" pregnancy experience; the need to strengthen maternity provider's disability knowledge and skills; and promoting enabling environments for improved access to, and experiences of, maternity care. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This review found that for women with physical disabilities access to, and experiences of, maternity care is suboptimal. Improving maternity providers disability knowledge and awareness, increasing the availability of support services for women, and increasing person-centred care through organisational policies and provider training may help to address the inequities women with disabilities face in accessing high-quality maternity care