22 research outputs found

    Postpartum psychiatric disorders

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    Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive–compulsive disorder, post-traumatic stress disorder and eating disorders. The aetiology of PPDs is a complex interaction of psychological, social and biological factors, in addition to genetic and environmental factors. The goals of treating postpartum mental illness are reducing maternal symptoms and supporting maternal–child and family functioning. Women and their families should receive psychoeducation about the illness, including evidence-based discussions about the risks and benefits of each treatment option. Developing effective strategies in global settings that allow the delivery of targeted therapies to women with different clinical phenotypes and severities of PPDs is essential

    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    High rate of prey consumption in a small predatory fish on coral reefs.

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    Small piscivores are regarded as important regulators of the composition of coral reef fish communities, but few studies have investigated their predatory ecology or impact on assemblages of juvenile fishes. This study investigated the foraging ecology of a common coral reef predator, the dottyback Pseudochromis fuscus, using underwater focal animal observations. Observations were conducted at two times of year: the summer, when recruit fishes were an available food item and winter, when remaining juveniles had outgrown vulnerability to P. fuscus. During the summer, P. fuscus directed 76% of its strikes at invertebrates and 24% at recruiting juvenile fishes. When striking at fishes, P. fuscus exhibited two distinct feeding modes: an ambush (26% successful) and a pursuit mode (5% successful). Predator activity in the field peaked at midday, averaging 2.5 captures h⁻¹ of juvenile fishes. Monitoring of activity and foraging in the laboratory over 24-h periods found that P. fuscus was a diurnal predator and was active for 13 h d-1 during the summer. The number of hours during which foraging was recorded differed greatly among individuals (n = 10), ranging from 4 to 13 h. The number of predatory strikes did not increase with standard length, but the success rate and consumption rate of juvenile fishes did increase with size. Estimated hourly mortality on juvenile fish ranged from 0.49 fish h-1 in small P. fuscus individuals (30–39 mm standard length, SL; equating to 6.3 per 13 h day) to 2.4 fish h⁻¹ in large P. fuscus individuals (55–65 mm SL; 30.6 per 13 h day). During the winter, P. fuscus struck at invertebrates with a similar rate to the summer period. These observations of the predatory ecology of P. fuscus support the hypothesis that in coral reef systems, small piscivores, because of their high metabolism and activity, are probably important regulators of coral reef fish community composition
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