Ending preventable maternal mortality: phase II of a multi-step process to develop a monitoring framework, 2016–2030

Background In February 2015, the World Health Organization (WHO) released “Strategies toward ending preventable maternal mortality (EPMM)” (EPMM Strategies), a direction-setting report outlining global targets and strategies for reducing maternal mortality in the Sustainable Development Goal (SDG) period. In May 2015, the EPMM Working Group outlined a plan to develop a comprehensive monitoring framework to track progress toward the achievement of these targets and priorities. This monitoring framework was developed in two phases. Phase I, which focused on identifying indicators related to the proximal causes of maternal mortality, was completed in October 2015. This paper describes the process and results of Phase II, which was completed in November 2016 and aimed to build consensus on a set of indicators that capture information on the social, political, and economic determinants of maternal health and mortality. Findings A total of 150 experts from more than 78 organizations worldwide participated in this second phase of the process to develop a comprehensive monitoring framework for EPMM. The experts considered a total of 118 indicators grouped into the 11 key themes outlined in the EPMM report, ultimately reaching consensus on a set of 25 indicators, five equity stratifiers, and one transparency stratifier. Conclusion The indicators identified in Phase II will be used along with the Phase I indicators to monitor progress towards ending preventable maternal deaths. Together, they provide a means for monitoring not only the essential clinical interventions needed to save lives but also the equally important political, social, economic and health system determinants of maternal health and survival. These distal factors are essential to creating the enabling environment and high-performing health systems needed to ensure high-quality clinical care at the point of service for every woman, her fetus and newborn. They complement and support other monitoring efforts, in particular the “Survive, Thrive, and Transform” agenda laid out by the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030) and the SDG3 global target on maternal mortality

Parent-identified barriers to accessing exposure therapy: A qualitative study using process mapping

BackgroundYouth with anxiety and obsessive–compulsive disorder (OCD) rarely access exposure therapy, an evidence-based treatment. Known barriers include transportation, waitlists, and provider availability. Efforts to improve access to exposure require an understanding of the process that families take to find therapists, yet no prior studies have examined parents’ perspectives of the steps involved.MethodsParents of children who have received exposure therapy for anxiety and/or OCD (N = 23) were recruited from a hospital-based specialty anxiety clinic where the majority of their children previously received exposure. Recruitment was ongoing until thematic saturation was reached. Parents completed questionnaires and attended an online focus group during which they were asked to describe each step they took—from recognizing their child needed treatment to beginning exposure. A process map was created and shown in real-time, edited for clarity, and emailed to parents for member checking. Authors analyzed process maps to identify common themes.ResultsSeveral themes emerged, as visually represented in a final process map. Participants identified a “search-outreach” loop, in which they repeated the cycle of looking for therapists, contacting them, and being unable to schedule an appointment due to factors such as cost, waitlists, and travel time. Parents often did not know about exposure and reported feeling guilty about their lack of knowledge and inability to find a suitable provider. Parents reported frustration that medical providers did not often know about exposure and sometimes dismissed parents’ concerns. Participants emphasized the difficulty of navigating the mental health system; many reported that it took years to find an exposure therapist, and that the search was sometimes stalled due to fluctuating symptoms.ConclusionA common thread among identified barriers was the amount of burden placed on parents to find treatment with limited support, and the resultant feelings of isolation and guilt. Findings point to several directions for future research, such as the development of parent support groups for navigating the mental health system; enhancing coordination of care between medical and mental health providers; and streamlining referral processes

The “Smalls” Nephrops Grounds (FU22) 2022 UWTV Survey Report and catch scenarios for 2023

This report provides the main results and findings of the seventeenth annual underwater television survey on the ‘Smalls grounds’ ICES assessment area; Functional Unit 22. The survey was multi-disciplinary in nature collecting UWTV and other ecosystem data. A total of 42 UWTV stations were surveyed successfully (high quality image data), carried out over an isometric grid at 4.5nmi or 8.3km intervals. The precision, with a CV of 7%, was well below the upper limit of 20% recommended by SGNEPS (ICES, 2012). The 2022 abundance estimate was 36% higher than in 2022 and at 895 million is below the MSY Btrigger reference point (990 million). Using the 2022 estimate of abundance and updated stock data implies catch in 2023 that correspond to the ICES MSY approach of 2548 tonnes, assuming that discard rates and fishery selection patterns do not change from the average of 2019 - 2021. One species of sea pen was recorded as present at the stations surveyed: Virgularia mirabilis. Trawl marks were observed at 29% of the stations surveyed

The influence of the COVID-19 pandemic on mental wellbeing and psychological distress: impact upon a single country

The COVID-19 pandemic is likely to have affected the psychological well-being and mental health of many people. Data on prevalence rates of mental health problems are needed for mental health service planning. Psychological well-being and prevalence of clinically significant mental distress were measured in a large sample from Wales 11–16 weeks into lockdown and compared to population-based data collected in 2019 before the COVID-19 pandemic. Data were collected using an online survey disseminated across Wales and open to adults (age 16+) from 9th June to 13th July 2020. Psychological well-being was indexed via the Warwick-Edinburgh Mental Well-being Scale, and psychological distress was indexed via the K10. Data from 12,989 people who took part in this study were compared to that from April 2018 - March 2019, gathered by the National Survey for Wales (N = 11,922). Well-being showed a large decrease from 2019 levels. Clinically significant psychological distress was found in around 50% of the population (men = 47.4%, women = 58.6%), with around 20% showing “severe” effects (men = 17.0%, women = 20.9%): a 3–4-fold increase in prevalence. Most affected were young people, women, and those in deprived areas. By June-July 2020 the COVID-19 pandemic had dramatic effects on the mental health of people living in Wales (and by implication those in the UK and beyond). The effects are larger than previous reports. This probably reflects that the current data were taken deeper into the lockdown period than previous evaluations. Mental health services need to prepare for this wave of mental health problems with an emphasis on younger adults, women, and in areas of greater deprivation

CV11004

Use the URI link below to search the Marine Institute Data Discovery Catalogue for datasets relevant to this report.The prawn (Nephrops norvegicus) are common in the Celtic Sea occurring in geographically distinct sandy/muddy areas were the sediment is suitable for them to construct their burrows. The Celtic Sea area (Functional Units 19-22) supports a large multi-national targeted Nephrops fishery mainly using otter trawls and yielding landings in the region of ~6,000 t annually over the last decade (ICES, 2011). Nephrops spend a great deal of time in their burrows and their emergence behaviour is influenced many factors; time of year, light intensity and tidal strength. Underwater television surveys and assessment methodologies have been developed to provide a fishery independent estimate of stock size, exploitation status and catch advice (ICES, 2009 & 2011).This is the sixth in a time series of UWTV surveys in the Celtic Sea carried out by the Marine Institute, Ireland. The 2011 survey was multi disciplinary in nature and this report details the final UWTV results of the 2011 survey and also documents other data collected during the survey

Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families

Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children’s weight status over time. Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child. Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI z-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI z-score. Child BMI z-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI z-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI z-score, but only when accounting for feeding styles. Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children’s weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored

Rationale and study protocol for the Movement Oriented Games Based Assessment (MOGBA) cluster randomized controlled trial: A complex movement skill intervention for 8–12 year old children within ‘Made to Play’

here is a positive relationship between children’s movement competence and physical activity, with a further relationship established between physical activity and childhood obesity. The Movement Oriented Games Based Assessment (MOGBA) is a delivery and assessment intervention designed to improve children’s complex movement skills, based on principles of motor development and assessment theories. MOGBA aims to improve children’s movement competence, physical fitness and self-perceptions (physical and game) and increase children’s moderate-to-vigorous physical activity (MVPA). MOGBA is to be used in the ‘Made to Play’ initiative, involving 105 sports and activity programs across 21 countries, involving over 25 million children. A multi-site cluster randomized controlled trial will take place across three global sites (UK, Ireland and Australia). Each site will recruit eight primary schools (four experiment, four control) with each school providing two separate classes of children from age ranges 8–12 years (Site n = ~300, total n = 904). After baseline assessments, schools will be randomly allocated to an experimental or wait-list control group. Following two half-day workshops, trained facilitators will deliver the MOGBA intervention for 9 weeks. The main intervention components include delivery of 14 games-based activities with associated assessments of children’s movement and differentiation to meet children’s needs by manipulating space, effort and relationships. The primary outcome of the trial is to improve children’s’ movement competence (The Dragon Challenge), with secondary outcomes of improving children’s’ in-activity and leisure-time MVPA (5-day accelerometer), physical fitness (standing long jump and push ups) and self-perceptions (physical and game). Data will be analysed using multilevel modelling approaches. The MOGBA intervention has been designed to improve children’s movement competence and scalable interventions based on MOGBA could be applied across programs within the Made to Play initiative, globally. The trial is registered at the Australia New Zealand Clinical Trial Registry (ACTRN12619001320145p, 27 Sep 2019)

Promoting Diversity and Combatting Discrimination in Research Organizations: A Practitioner’s Guide

The essay is addressed to practitioners in research management and from academic leadership. It describes which measures can contribute to creating an inclusive climate for research teams and preventing and effectively dealing with discrimination. The practical recommendations consider the policy and organizational levels, as well as the individual perspective of research managers. Following a series of basic recommendations, six lessons learned are formulated, derived from the contributions to the edited collection on "Diversity and Discrimination in Research Organizations.