The Role of Spiritual Well-being in Predicting Pregnancy-Specific Stress

Background & objectives: Stress during pregnancy can be associated with serious and long-term adverse outcomes for mothers, fetuses, newborns, children, and even adolescents. One of the coping mechanisms with stress during pregnancy is paying attention to women's spiritual beliefs and values. The aim of the current study was to determine the role of spiritual well-being in the prediction of pregnancy-specific stress in women referred to health centers in Hafshjan. Methods: The current study was a descriptive- correlational study. The study population consisted of all pregnant women referred to health centers in Hafshejan, 2015. Two hundred pregnant women were selected using convenience sampling method. Spiritual well-being (Paloutzian and Ellison) and pregnancy-specific stress questionnaires (Sallary) were used for data collection. Data analyses were performed by Pearson correlation and multivariate linear regression tests using SPSS version 20. Results: The mean age of the study sample was 27.68±4.75. The results showed a significant negative correlation between spirituality and pregnancy stress (r= -0.29, p<0.001). Multiple regression analysis indicated that spiritual well-being is capable to predict the stress during pregnancy (β = -0.444, R2=0.139, p<0.001). Conclusion: Taking into consideration the predictive role of spiritual well-being in pregnancy stress, women's health care professionals should pay particular attention to implement effective strategies for promoting of spiritual well-being level during pregnancy

Remodelling of microRNAs in colorectal cancer by hypoxia alters metabolism profiles and 5-fluorouracil resistance

AN, HT and AP are Constance Travis post-graduate fellows. NS is a Barts and The London post-doctoral fellow. SMD is a Bowel & Cancer Research post-doctoral fellow. TS is supported by a Grant-in-Aid for scientific research on Innovative Areas, Japan (No. 22134007 to T.S.), and the Yamagata Prefectural Government and City of Tsuruoka

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)