Maternity Care Transitions in Northern Rural Honduras: A Preliminary Ethnographic Inquiry

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142501/1/j.1542-2011.2004.tb04452.x.pd

A retrospective comparison of waterbirth outcomes in two United States hospital settings

BackgroundWater immersion during labor is an effective comfort measure; however, outcomes for waterbirth in the hospital setting have not been well documented. Our objective was to report the outcomes from two nurse‐midwifery services that provide waterbirth within a tertiary care hospital setting in the United States.MethodsThis study is a retrospective, observational, matched comparison design. Data were collected from two large midwifery practices in tertiary care centers using information recorded at the time of birth for quality assurance purposes. Land birth cases were excluded if events would have precluded them from waterbirth (epidural, meconium stained fluid, chorioamnionitis, estimated gestational age  40). Neonatal outcomes included Apgar score and admission to the neonatal intensive care unit. Maternal outcomes included perineal lacerations and postpartum hemorrhage.ResultsA total of 397 waterbirths and 2025 land births were included in the analysis. There were no differences in outcomes between waterbirth and land birth for Apgar scores or neonatal intensive care admissions (1.8% vs 2.5%). Women in the waterbirth group were less likely to sustain a first‐ or second‐degree laceration. Postpartum hemorrhage rates were similar for both groups. Similar results were obtained using a land birth subset matched on insurance, hospital location, and parity using propensity scores.DiscussionIn this study, waterbirth was not associated with increased risk to neonates, extensive perineal lacerations, or postpartum hemorrhage. Fewer women in the waterbirth group sustained first‐ or second‐degree lacerations requiring sutures.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154290/1/birt12473.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154290/2/birt12473_am.pd

Reduced postpartum hemorrhage after implementation of active management of the third stage of labor in rural Honduras

ObjectiveTo assess outcomes after auxiliary nurses were trained and given resources to use active management of the third stage of labor (AMTSL) for all women giving birth in a low‐resource, low‐risk, rural, public birth center setting in northern rural Honduras.MethodsAuxiliary nurses received training on estimation of blood loss before the preintervention phase of the study (July 2004 through April 2005) and AMTSL, including use of intramuscular oxytocin, and estimation of blood loss prior to the intervention phase (July 2007 through June 2008). Preintervention and intervention data on use of oxytocin, blood loss postpartum, hemorrhage rates, and management interventions were collected and compared.ResultsAfter nurses received training on AMTSL using intramuscular oxytocin, the use of intramuscular oxytocin during the third stage of labor increased from 63.8% to 96.5%. Postpartum hemorrhage rates decreased from 14.8% to 5.9% (P = 0.001). Use of intrapartum oxytocin, which can have adverse effects, also increased: from 6.1% to 22.7% (P < 0.001).ConclusionTraining auxiliary nurses to perform AMTSL using oxytocin in this birth center setting was effective in reducing the rate of postpartum hemorrhage; however, increased use of intrapartum oxytocin may be an unintended outcome of the increased accessibility of oxytocin.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135583/1/ijgo217.pd

Multicentre analysis of incidental findings on low-resolution CT attenuation correction images : an extended study

Objective: To review new incidental findings detected on low-resolution CT attenuation correction (CTAC) images acquired during single-photon emission CT-CT myocardial perfusion imaging as an extension to our initial study. Methods: CTAC images acquired as part of myocardial perfusion imaging performed using single-photon emission CT at four UK nuclear medicine centres were evaluated as part of a multicentre study. New incidental findings that were considered to be clinically significant were evaluated further. Positive-predictive value (PPV) was determined at the time of definitive diagnosis. Results: Out of 3485 patients, 962 (28%) patients had a positive finding on the CTAC image, of which 824 (24%) were new findings. 84 (2.4%) patients had findings that were considered clinically significant at the time of the CTAC report and which had not been previously diagnosed. However, only 10 (0.29%) of these had findings that were confirmed as clinically significant, with the potential to be detrimental to patient outcome, after follow-up and definitive diagnosis. Conclusion: The overall PPV from all centres over the 2-year period was 12%. Each centre achieved what we considered to be low PPVs with no significant difference between the present and initial studies. The additional data from the combined studies show that, statistically, there is no significant difference between the PPVs from any of the centres. We conclude that routine reporting of CTAC images is not beneficial. Advances in knowledge: This study combined with the previous study offers a unique evaluation of new clinically significant incidental findings on low-resolution CT images in an attempt to determine the benefit of reporting the CTAC images

National Survey of Sea Lice (Lepeophtheirus salmonis Krøyer and Caligus elongatus Nordmann) on Fish Farms in Ireland – 2019

Farmed stocks of Atlantic salmon in Ireland are inspected on 14 occasions throughout the year to monitor sea lice levels as part of a national programme. Sea lice are a naturally occurring parasite found on marine fish, including salmonids. They are small ecto-parasitic copepod crustaceans and there are approximately 559 species. The objectives of the National Sea Lice Monitoring Programme are: To provide an objective measurement of infestation levels on farms. To investigate the nature of infestations. To provide management information to drive the implementation of control and management strategies. To facilitate further development and refinement of this strategy. The sea lice control and management strategy has five principal components: Separation of generations. Annual fallowing of sites. Early harvest of two-sea-winter fish. Targeted treatment regimes, including synchronous treatments. Agreed husbandry practices

Feeling Close: Emotional Intensity Reduces Perceived Psychological Distance

The results of 6 experiments indicate that emotional intensity reduces perceived psychological distance. People who described events emotionally rather than neutrally perceived those events as less psychologically distant, including embarrassing autobiographical events (Experiment 1), past and future dentist visits (Experiment 2), positive and negative events (Experiment 3), and a national tragedy (Experiment 6). People also perceived an event (dancing in front of an audience) as less psychologically distant when they were in a more emotionally arousing social role (of performer) than in a less emotionally arousing social role (of observer; Experiment 4). Two findings bolster the causal role of emotional intensity in reducing perceived psychological distance. First, reported emotional intensity was negatively correlated with perceived psychological distance and statistically mediated the effect of being in an emotionally arousing social role on perceived psychological distance (Experiment 4). Second, providing people with an alternative interpretation of their emotions (emotionally ambiguous whale songs) significantly reduced, even reversed, the negative correlation between self-reported emotional intensity and perceived psychological distance (Experiment 5). These findings about emotional intensity are consistent with the broader idea that perceived psychological distance is grounded in and influenced by the phenomenology of objective distance. Implications for theories of psychological distance, emotionality, and choice are discussed

Using b→sγb \to s\gamma to Probe Top Quark Couplings

Possible anomalous couplings of the top-quark to on-shell photons and gluons are constrained by the recent results of the CLEO Collaboration on both inclusive and exclusive radiative $B$ decays. We find that the process \bsg\ can lead to reasonable bounds on both the anomalous electric and magnetic dipole moments of the top-quark, while essentially no limits are obtained on the corresponding chromoelectric and chromomagnetic moments, which enter the expression for the decay rate only through operator mixing.Comment: 10 pages plus 6 figures (available by request), LaTex, ANL-HEP-PR-93-3

Wave height estimation using a novel seaweed-attached sensor

The growth rate of seaweed is significantly affected by wave parameters and sea conditions. The wave characteristics in an aquaculture farm is normally measured using expensive equipment, which is not affordable for many farmers or researchers, and is not easily relocated from place to place to evaluate wave conditions in a variety of locations. In this paper, a sensor fusion method is presented which can estimate wave height using the data logged by a multi modal low-cost seaweed-attached sensor system. The sensor was developed for use in an Aquaculture scenario. This method is based on combination of extended Kalman filter and artificial neural networks. Regarding the importance of studying the impact of wave on seaweeds growth rate, this method will avail many researchers to use wave height data in their study to fill the gap in knowledge of the impact of water motion on aquaculture and maximising of seaweed harvests

MicroRNA regulation of endothelial homeostasis and commitment—implications for vascular regeneration strategies using stem cell therapies

Human embryonic (hESC) and induced pluripotent (hiPSC) stem cells have broad therapeutic potential in the treatment of a range of diseases, including those of the vascular system. Both hESCs and hiPSCs have the capacity for indefinite self-renewal, in addition to their ability to differentiate into any adult cell type. These cells could provide a potentially unlimited source of cells for transplantation and, therefore, provide novel treatments, e.g. in the production of endothelial cells for vascular regeneration. MicroRNAs are short, noncoding RNAs that act posttranscriptionally to control gene expression and thereby exert influence over a wide range of cellular processes, including maintenance of pluripotency and differentiation. Expression patterns of these small RNAs are tissue specific, and changes in microRNA levels have often been associated with disease states in humans, including vascular pathologies. Here, we review the roles of microRNAs in endothelial cell function and vascular disease, as well as their role in the differentiation of pluripotent stem cells to the vascular endothelial lineage. Furthermore, we discuss the therapeutic potential of stem cells and how knowledge and manipulation of microRNAs in stem cells may enhance their capacity for vascular regeneration