How do social discourses of risk impact on women’s choices for vaginal breech birth? A qualitative study of women’s experiences

© 2016 Informa UK Limited, trading as Taylor & Francis Group. In this article, we aim to explore the impact of social discourses of risk around childbirth on the decisions made for birth by women who planned to have a breech baby late in pregnancy. This article uses data from a qualitative descriptive study in New South Wales, Australia in 2013. In the study, we talked to 22 women about their decision-making process for planned a vaginal breech birth and the impact of social discourses of risk on this decision. In total, 12 of these women had a vaginal birth and the other 10 had a Caesarean section. In this article, we note that the mothers talked about their option for birth in a social setting in which the dominant discourse focused on the riskiness of breech birth and the vulnerability of female bodies that required medical surveillance, supervision and intervention to ensure a safe birth. Thus, for these mothers their pregnancy was seen through the societal lens of risk and medicalisation, with surgical intervention through a Caesarean section seen by society as the optimum choice. Women could resist this dominant discourse but such resistance required both justification and action, for example, the women who wanted a vaginal birth often had to resist the pressure from their families to have a Caesarean section. We identified four related strands in women’s talk about resisting the dominate discourse: acknowledgment that they would be considered irrational for wanting a vaginal birth; having confidence in and believing that their body could give birth vaginally; convincing significant others that a vaginal birth was possible and desirable and looking for sources of support, for example, from new online social networks

The role of planets in shaping planetary nebulae

In 1997 Soker laid out a framework for understanding the formation and shaping of planetary nebulae (PN). Starting from the assumption that non-spherical PN cannot be formed by single stars, he linked PN morphologies to the binary mechanisms that may have formed them, basing these connections almost entirely on observational arguments. In light of the last decade of discovery in the field of PN, we revise this framework, which, although simplistic, can still serve as a benchmark against which to test theories of PN origin and shaping. Within the framework, we revisit the role of planets in shaping PN. Soker invoked a planetary role in shaping PN because there are not enough close binaries to shape the large fraction of non-spherical PN. In this paper we adopt a model whereby only ~20% of all 1-8 solar mass stars make a PN. This reduces the need for planetary shaping. Through a propagation of percentages argument, and starting from the assumption that planets can only shape mildly elliptical PN, we conclude, like in Soker, that ~20% of all PN were shaped via planetary and other substellar interactions but we add that this corresponds to only ~5% of all 1-8 solar mass stars. This may be in line with findings of planets around main sequence stars. PN shaping by planets is made plausible by the recent discovery of planets that have survived interactions with red giant branch (RGB) stars. Finally, we conclude that of the ~80% of 1-8 solar mass stars that do not make a PN, about one quarter do not even ascend the AGB due to interactions with stellar and substellar companions, while three quarters ascend the AGB but do not make a PN. Once these stars leave the AGB they evolve normally and can be confused with post-RGB, extreme horizontal branch stars. We propose tests to identify them.Comment: 23 pages, accepted by PAS

Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review.

BACKGROUND: Patients with hip fracture and depression are less likely to recover functional ability. This review sought to identify prognostic factors of depression or depressive symptoms up to 1 year after hip fracture surgery in adults. This review also sought to describe proposed underlying mechanisms for their association with depression or depressive symptoms. METHODS: We searched for published (MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection) and unpublished (OpenGrey, Greynet, BASE, conference proceedings) studies. We did not impose any date, geographical, or language limitations. Screening (Covidence), extraction (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist), and quality appraisal (Quality in Prognosis Studies tool) were completed in duplicate. Results were summarised narratively. RESULTS: In total, 37 prognostic factors were identified from 12 studies included in this review. The quality of the underlying evidence was poor, with all studies at high risk of bias in at least one domain. Most factors did not have a proposed mechanism for the association. Where factors were investigated by more than one study, the evidence was often conflicting. CONCLUSION: Due to conflicting and low quality of available evidence it is not possible to make clinical recommendations based on factors prognostic of depression or depressive symptoms after hip fracture. Further high-quality research investigating prognostic factors is warranted to inform future intervention and/or stratified approaches to care after hip fracture. TRIAL REGISTRATION: Prospero registration: CRD42019138690

An occupational therapy intervention for residents with stroke related disabilities in UK care homes (OTCH): cluster randomised controlled trial

Objective To evaluate the clinical efficacy of an established programme of occupational therapy in maintaining functional activity and reducing further health risks from inactivity in care home residents living with stroke sequelae. Design Pragmatic, parallel group, cluster randomised controlled trial. Setting 228 care homes (>10 beds each), both with and without the provision of nursing care, local to 11 trial administrative centres across the United Kingdom. Participants 1042 care home residents with a history of stroke or transient ischaemic attack, including those with language and cognitive impairments, not receiving end of life care. 114 homes (n=568 residents, 64% from homes providing nursing care) were allocated to the intervention arm and 114 homes (n=474 residents, 65% from homes providing nursing care) to standard care (control arm). Participating care homes were randomised between May 2010 and March 2012. Intervention Targeted three month programme of occupational therapy, delivered by qualified occupational therapists and assistants, involving patient centred goal setting, education of care home staff, and adaptations to the environment. Main outcome measures Primary outcome at the participant level: scores on the Barthel index of activities of daily living at three months post-randomisation. Secondary outcome measures at the participant level: Barthel index scores at six and 12 months post-randomisation, and scores on the Rivermead mobility index, geriatric depression scale-15, and EuroQol EQ-5D-3L questionnaire, at all time points. Results 64% of the participants were women and 93% were white, with a mean age of 82.9 years. Baseline characteristics were similar between groups for all measures, personal characteristics, and diagnostic tests. Overall, 2538 occupational therapy visits were made to 498 participants in the intervention arm (mean 5.1 visits per participant). No adverse events attributable to the intervention were recorded. 162 (11%) died before the primary outcome time point, and 313 (30%) died over the 12 months of the trial. The primary outcome measure did not differ significantly between the treatment arms. The adjusted mean difference in Barthel index score at three months was 0.19 points higher in the intervention arm (95% confidence interval −0.33 to 0.70, P=0.48). Secondary outcome measures also showed no significant differences at all time points. Conclusions This large phase III study provided no evidence of benefit for the provision of a routine occupational therapy service, including staff training, for care home residents living with stroke related disabilities. The established three month individualised course of occupational therapy targeting stroke related disabilities did not have an impact on measures of functional activity, mobility, mood, or health related quality of life, at all observational time points. Providing and targeting ameliorative care in this clinically complex population requires alternative strategies

Dune formation on the present Mars

We apply a model for sand dunes to calculate formation of dunes on Mars under the present Martian atmospheric conditions. We find that different dune shapes as those imaged by Mars Global Surveyor could have been formed by the action of sand-moving winds occuring on today's Mars. Our calculations show, however, that Martian dunes could be only formed due to the higher efficiency of Martian winds in carrying grains into saltation. The model equations are solved to study saltation transport under different atmospheric conditions valid for Mars. We obtain an estimate for the wind speed and migration velocity of barchan dunes at different places on Mars. From comparison with the shape of bimodal sand dunes, we find an estimate for the timescale of the changes in Martian wind regimes.Comment: 16 pages, 12 figure

Millimetre observations of Pleiades stars: a lack of solar-analogue planetesimal discs at 100 Myr?

Solar analogues approximately 100 Myr old may have dusty debris from collisions within evolving cometary belts, and such remnant discs might also be associated with earlier stellar-spin braking. We observed at 1.2 mm wavelength a sample of 17 fast and slow rotators, mostly single K dwarfs, in the 100 Myr Pleiades cluster. No dust was detected for individual stars or the ensemble, so there are no cold massive debris discs nor any discernible relation of such distant material to stellar spin. The net limits from these data and our earlier far-infrared results imply that the typical Pleiades G/K dwarf has a relative disc-to-star luminosity ≲ 2 × 10^(−4). Collisional evolution models have predicted greater luminosities at the 10^8 yr epoch, for debris discs evolving out of a proto-solar nebula. This suggests that substantial primordial discs such as that of the Sun are not the norm amongst young solar analogues, or that dynamical interactions with giant planets can remove much of the comet belt by as early as 100 Myr

S-wave splitting in the offshore South Island, New Zealand : insights into plate-boundary deformation

Author Posting. © American Geophysical Union, 2015. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry, Geophysics, Geosystems 16 (2015): 2829–2847, doi:10.1002/2015GC005882.Local and regional S-wave splitting in the offshore South Island of the New Zealand plate-boundary zone provides constraints on the spatial and depth extent of the anisotropic structure with an enhanced resolution relative to land-based and SKS studies. The combined analysis of offshore and land measurements using splitting tomography suggests plate-boundary shear dominates in the central and northern South Island. The width of this shear zone in the central South Island is about 200 km, but is complicated by stress-controlled anisotropy at shallow levels. In northern South Island, a broader (>200 km) zone of plate-boundary parallel anisotropy is associated with the transitional faulting between the Alpine fault and Hikurangi subduction and the Hikurangi subduction zone itself. These results suggest S-phases of deep events (∼90 km) in the central South Island are sensitive to plate-boundary derived NE-SW aligned anisotropic media in the upper-lithosphere, supporting a “thin viscous sheet” deformation model.United States National Ocean Bottom Seismograph Instrumentation Pool2016-02-2

Forming the first planetary systems: debris around Galactic thick disc stars

The thick disc contains stars formed within the first Gyr of Galactic history, and little is known about their planetary systems. The Spitzer MIPS instrument was used to search 11 of the closest of these old low-metal stars for circumstellar debris, as a signpost that bodies at least as large as planetesimals were formed. A total of 22 thick disc stars has now been observed, after including archival data, but dust is not found in any of the systems. The data rule out a high incidence of debris among star systems from early in the Galaxy's formation. However, some stars of this very old population do host giant planets, at possibly more than the general incidence among low-metal Sun-like stars. As the Solar System contains gas giants but little cometary dust, the thick disc could host analogue systems that formed many Gyr before the Sun.Comment: accepted by MNRAS Letters; 5 pages, 4 figure

The first cyborg and First World War bodies as anti-war propaganda

This article discusses a play published in The Strand Magazine during the First World War which features a cyborg presenting anti-war and pacifist messages, used by The Strand to create anti-German propaganda. The article draws on theories of disability, cyborgs and the posthuman, and from new research on wartime fiction magazines. The importance of the cyborg character, Soldier 241, for the literary history of science fiction is explored by focusing on the relations between the mechanical and the impaired body, and on the First World War as a nexus for technological, surgical and military development. As a cyborg, this character reflects politicized desires that the wartime authorities did not acknowledge: a longing for the end of war, and refusal to countenance a society that rejected the impaired body