Higher Education in Midwifery in Pakistan: A Proposed Framework

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives were not adequately prepared or permitted to provide full scope of care to women. Making higher education available in programs based on the International Confederation of Midwives’ Global Standards for Midwifery Education and its Essential Competencies for Midwifery Practice will enable midwives to provide improved health care services and increase opportunities for them to be advocates, leaders, and teachers who will continue to strengthen the profession. This paper proposes a framework for higher education in midwifery in Pakistan

Ice-free conditions in Novaya Zemlya 35,000 to 30,000 cal years BP, as indicated by radiocarbon ages and amino acid racemization evidence from marine molluscs

Novaya Zemlya was covered by the eastern part of the Barents-Kara ice sheet during the glacial maximum of marine isotope stage 2 (MIS 2). We obtained (14)C ages on 37 samples of mollusc shells from various sites on the islands. Most samples yielded ages in the range of 48-26 (14)C Ky. Such old samples are sensitive to contamination by young (14)C, and therefore their reliability was assessed using replicate analyses and amino acid geochronology. The extent of aspartic acid racemization (Asp D/L) indicates that many of the (14)C ages are correct, whereas some are minimum ages only. The results indicate that a substantial part of Novaya Zemlya was ice-free about 35-27 (14)C Kya, and probably even earlier. Corresponding shorelines up to > 140 m a.s.l. indicate a large Barents-Kara ice sheet during early MIS 3. These results are consistent with findings from Svalbard and northern Russia: in both places a large MIS 4/3 Barents-Kara ice sheet is postulated to have retreated about 50 Kya, followed by an ice-free interstadial that lasted until up to ca. 25 Kya. The duration of the MIS 2 glaciation in Novaya Zemlya was calculated by applying the D/L values to a kinetic equation for Asp racemization. This indicates that the islands were ice covered for less than 3000 years if the basal temperature was 0(o)C, and for less than 10 000 years if it was -5 degrees C

Counting operator analysis of the discrete spectrum of some model Hamiltonians

The first step in the counting operator analysis of the spectrum of any model Hamiltonian H is the choice of a Hermitean operator M in such a way that the third commutator with H is proportional to the first commutator. Next one calculates operators R and R^\dagger which share some of the properties of creation and annihilation operators, and such that $M$ becomes a counting operator. The spectrum of H is then decomposed into multiplets, not determined by the symmetries of H, but by those of a reference Hamiltonian H_ref, which is defined by H_ref=H-R-R^\dagger, and which commutes with M. Finally, we introduce the notion of stable eigenstates. It is shown that under rather weak conditions one stable eigenstate can be used to construct another one.Comment: Added references, improved presentatio

Laser shock peening technology for repairing turbine blades damaged by pitting corrosion

V příspěvku je hodnocena únavová pevnost martenzitické oceli Böhler T 552 používané na výrobu oběžných lopatek L-1 nízkotlakých stupňů parních turbín. Zkoušky vysoko cyklové únavy byly provedeny na zkušebních tělesech s leštěným povrchem bez vad a vzorcích s umělými vadami (důlky hloubky 500 μm) na vzduchu a v parním kondenzátu při namáhání tah-tlak a předpětí 300 MPa. Povrch zkušebních tyčí s vadami byl v místě důlků zpevněn technologií Laser Shock Peening s ochrannou absorpční vrstvou (LSP). Únavová pevnost tyčí s vadami ošetřenými technologií LSP je výrazně vyšší než pevnost vzorků s vadami bez LSP a blíží se hodnotě stanovené pro materiál bez vad. Korozně-únavová pevnost v parním kondenzátu vzorků s vadami je po aplikaci LSP vyšší než únavová pevnost vzorků s důlky bez LSP na vzduchu.Presentované výsledky byly finančně podpořeny Ministerstvem školství, mládeže a tělovýchovy – projekt LQ1603 Výzkum pro SUSEN. Práce byla realizována na velké infrastruktuře Udržitelná energetika (SUSEN) vybudované v rámci projektu CZ.1.05/ 2.1.00/03.0108 a CZ.02.1.01/0.0/0.0/15_008/0000293.The paper evaluates the fatigue strength of the martensitic steel Böhler T552 used for the production of moving L-1 blades of low-pressure steam turbine stages. High cycle fatigue tests were performed on test specimens without defects with a polished surface and samples with artificial defects (pits with a depth of 500 μm) in air and the water condensate under tensile-compressive stresses and pre stress of 300 MPa. The surface of the test bars with defects was locally strengthened – in the place of the pits - by shock waves, which were generated by confining the laser-induced plasma (by technology laser shock peening with protective layer). The fatigue strength of bars with defects treated with LSP technology is significantly higher than the strength of samples without LSP and is close to the value determined for the material with-out defects. Corrosion-fatigue strength in steam condensate of samples with defects is higher after application of LSP than fatigue strength of samples with pits without LSP in air

Birth Centre Management and Business Skill Training for Community Midwives of Pakistan

The Community Midwifery program was introduced in 2007 across Pakistan with the idea that the trained Community Midwives (CMWs) will be deployed back to their ‘native’ rural communities. Hence, they are not employed by government rather they must earn their income by charging fees for their services. It is expected from them to attract clients, establish birth clinics and operate as a small business to support and sustain them financially. However, the CMW training program only teaches students about antenatal, intranatal, postnatal and newborn care, family planning services and awareness of community dynamics and does not include content about setting up a ‘birth station’ and how to market and sustain a small business. We encountered comments from CMWs in a variety of forums that many of them were unable to sustain a birthing station and financially support themselves. Hence a research intervention was designed for them known as ‘Business Skills Training (BST)’ with the objective of enhancing the business skills of CMWs to increase their likelihood of establishing financially sustainable birthing clinics. This article is the description of BST intervention and the process of this training

Implementation of a Bachelor’s in midwifery programme in Pakistan: Reflections of Midwifery Faculty

Introduction/Objective: There is an international consensus on the significant role of competent midwives in improving maternal and newborn health indicators. Midwives and midwifery education in the developing world including Pakistan have lagged behind in being part of higher education. To enhance the quality of maternal and newborn services through competency based higher education in midwifery, the first Bachelors of Science in Midwifery (BScM) programme was introduced in Pakistan. As part of a larger study about establishing this programme, this paper focuses on the reflective logs of midwifery faculty members who initiated this new programme in Pakistan. Method: The team of faculty members involved in the planning and execution of the programme were asked to record their reflections throughout the process of planning the programme to facilitating students in the first cohort. These reflections were collected at the time of the graduation of first cohort in 2014 and content analysis was applied to identify major themes emerging from the reflections. Findings: Major themes which emerged were: a) Scaling up of faculty competence, b) Utilizing student diversity as strength, c) Supporting students’ transition and adjustments in the programme d) Scaffolding students’ learning e) Helping students acquire clinical competencies. Overall, the team regarded the experience as unique and enriching for both students and faculty. The first Bachelors in Midwifery demanded a great deal of theoretical and clinical proficiency from faculty. Rigorous planning, networking with international midwifery experts, continuous faculty development, facilitating student learning through scaffolding, and incorporating periodic feedback from students were found to be the major strengths of the programme. Conclusion: The Bachelor of Midwifery programme in Pakistan has given new hope to the profession. The lessons learned and some of the practical recommendations may prove useful to other institutions and South Asian countries intending to initiate similar programmes

Increase of material cycle fatigue life time using the laser shock peening method

Laser Shock Peening (LSP) se řadí mezi moderní bezkontaktní technologie zpevňování povrchu kovových materiálů na principu vzniku rázových vln, které se generují během interakce krátkých laserových pulzů s povrchem materiálu. Rázové vlny v materiálu vyvolávají strukturní změny, které mají za důsledek vznik zbytkového tlakového napětí a zvýšení tvrdosti, což obecně vede ke zlepšení únavových vlastností materiálu, zabraňování vzniku a šížení trhlin a zlepšuje odolnost vůči koroznímu praskání a opotřebení. V tomto článku se zabýváme aplikací technologie LSP na vzorky z nerezové austenitické oceli 08Ch18N10T, kdy po ovlivnění došlo k nejméně desetinásobnému prodloužení životnosti materiálu při vysokocyklických únavových zkouškách.Presentované výsledky byly finančně podpořeny Ministerstvem školství, mládeže a tělovýchovy – projekt LQ1603 Výzkum pro SUSEN. Práce byla realizována na velké infrastruktuře Udržitelná energetika (SUSEN) vybudované v rámci projektu CZ.1.05/2.1.00/03.0108.Laser Shock Peening (LSP) is one of the modern contactless technologies for surface reinforcement of metallic materials. The technology is based on the shock wave principle generated during the interaction of short laser pulses with the surface of the material. Shock waves in the material induce structural changes that result in residual compressive stress and increase in hardness, generally resulting in improved fatigue properties of the material, preventing crack initiation and propagation, and improving resistance to corrosion cracking and wear. This paper deals with the application of LSP technology to stainless austenitic steel 08Ch18N10T, when the lifetime of the influenced material was prolonged at least ten times in the high-cycle fatigue tests

Alleged Lessepsian foraminifera prove native and suggest Pleistocene range expansions into the Mediterranean Sea

Biogeographical patterns are increasingly modified by the human-driven translocation of species, a process that accelerated several centuries ago. Observational datasets, however, rarely range back more than a few decades, implying that a large part of invasion histories went unobserved. Small-sized organisms, like benthic foraminifera, are more likely to have been reported only recently due to their lower detectability compared to larger-sized organisms. Recently detected native species of tropical affinity may have thus been mistaken for non-indigenous species due to the lack of evidence of their occurrence in pre-invasion records. To uncover the unobserved past of the Lessepsian invasion—the entrance of tropical species into the Mediterranean through the Suez Canal—we collected sediment cores on the southern Israeli shelf. We deployed state-of-the-art radiocarbon techniques to date 7 individual foraminiferal tests belonging to 5 alleged non-indigenous species and show that they are centuries to millennia old, thus native. Two additional species previously considered non-indigenous occurred in centennial to millennia-old sediments, suggesting their native status. The evidence of multiple tropical foraminiferal species supposed to be non-indigenous but proved native in the eastern Mediterranean suggests either survival in refugia during the Messinian Salinity Crisis (5.96−5.33 million years) or, more likely, dispersal from the tropical Atlantic and Indo-Pacific during the Pleistocene. In the interglacials of this epoch, higher sea levels may have allowed biological connectivity between the Mediterranean and the Red Sea for shallow-water species, showing that the Isthmus of Suez was possibly a more biologically porous barrier than previously considered