Labour pain: the hidden influences of anxiety and social deprivation

No abstract available

To identify the incidence, severity and timing of hypophosphataemia in Glasgow Royal Infirmary Intensive Care Unit (ICU) [poster]

No abstract available

The incidence, severity, timing and circadian variation of hypophosphataemia in Glasgow Royal Infirmary Intensive Care Unit [poster]

No abstract available

Risk of critical illness among patients with solid cancers: a population-based observational study of 118,541 adults

Importance: Critical illness may be a potential determinant of cancer outcomes and geographic variations, but its role has not been described before. Objective: To determine the incidence of admission to intensive care units (ICUs) within 2 years following cancer diagnosis. Design, Setting, and Participants: This was a retrospective observational study using cancer registry data in 4 datasets from 2000 to 2009 with linked ICU admission data from 2000 to 2011, in the West of Scotland region of the United Kingdom (population, 2.4 million; all 16 ICUs within the region). All 118 541 patients (≥16 years) diagnosed as having solid (nonhematological) cancers. Their median age was 69 years, and 52.0% were women. Main Outcomes and Measures: Demographic and clinical variables associated with admission to an ICU and death in an ICU. Results: A total of 118 541 patients met the study criteria. Overall, 6116 patients (5.2% [95% CI, 5.0%-5.3%]) developed a critical illness and were admitted to an ICU within 2 years. Risk of critical illness was highest at ages 60 to 69 years and higher in men. The cumulative incidence of critical illness was greatest for small intestinal (17.2% [95% CI, 13.3%-21.8%]) and colorectal cancers (16.5% [95% CI, 15.9%-17.1%]). The risk following breast cancer was low (0.8% [95% CI, 0.7%-1.0%]). The percentage who died in ICUs was 14.1% (95% CI, 13.3%-15.0%), and during the hospital stay, 24.6% (95% CI, 23.5%-25.7%). Mortality was greatest among emergency medical admissions and lowest among elective surgical patients. The risk of critical illness did not vary by socioeconomic circumstances, but mortality was higher among patients from deprived areas. Conclusions and Relevance: In this study, about 1 in 20 patients experienced a critical illness resulting in ICU admission within 2 years of cancer diagnosis. The associated high mortality rate may make a significant contribution to overall cancer outcomes

Symbols of Statehood: Military Industrialization and Public Discourse in India

This article examines the forces driving the pursuit of military production capacity in India, including those behind the Indian nuclear and space programmes. We are mainly interested in whether symbolic motivations regularly find expression in the public discourse. We review all articles on the subject of weapons development and production appearing in India Today from May 1977 to April 1999. There are three closely interrelated yet distinguishable concerns in the public discourse that we consider symbolic: that military industrialization is a means of asserting India\u27s autonomy in international affairs, that it is a means of establishing India\u27s international status and prestige, and that it serves to enhance India\u27s self-image. We contend that the symbolic motivations are a prominent force behind the military industrialization process in India. The precise form that symbolic motivations take vary-some statements seem to have more symbolic content than others-but, as a whole, such references are not rare or isolated. Our findings suggest that symbolism can be an important component of the quest for an indigenous arms-production capacity, and perhaps other elements of statebuildings as well

Using Pre-Lecture Activities to Enhance Learner Engagement in a Large Group Setting

The disadvantage to students of beginning a module with no prior knowledge or inaccurate knowledge is well documented. For learners, the development of the necessary prior knowledge to facilitate their learning is essential. The use of screencasts, whether prior to or during class, is becoming more widespread. There is a need, however, to better understand how these are used and whether or not there is any impact on overall learner engagement and academic achievement when a component with instantaneous feedback (such as a multiple choice quiz) is embedded into the pre-lecture screencast activity. In this study, pre-learning activities consisting of screencasts and multiple choice quizzes were introduced to improve student engagement with the topic, gauge common misconceptions and give timely feedback to the students. An examination of screencast usage indicated that students did not predominantly nor exclusively employ the resources as originally intended, that is, in advance of lectures. Rather, students continued to access the activities across the module and often after the associated lecture. Implications are discussed with an acknowledgement of the importance of taking into account how learners prefer to use resources when designing and introducing new activities to modules. Keywords large group teaching, learner engagement, multiple choice quizzes, prior knowledge, screencasts Identifying and enhancing learner prior knowledge – what do learners know already and how can this help them?[AQ1] To find ways to support student learning, educators are increasingly turning their attention to the very roots of the learning experience, that is, to the knowledge, skills, environments and processes already possessed and encountered by the learner before the new, to-be-learned material is introduced (Coppola and Krajcik, 2014). Although such awareness of the importance of prior knowledge is not a recent emergence (Ausubel, 1968), interest in what learners know in advance

Exploring the effects of capital mobility on the saving–investment nexus: evidence from Icelandic historical data

We explore the effects of capital mobility on the relationship between saving and investment using historical data for Iceland. First, we analyse the saving–investment (S-I) correlation for the period of restricted capital mobility using data from 1960 and 1994. We then add a period of free capital mobility between 1994 and 2008 and estimate the correlation for the period 1960–2008. Finally, we extend our analysis to the 2008 to 2016 period, when capital controls were imposed in response to the crisis. Institutions matter: We find institutional changes, in particular, Iceland’s entry into the European Single Market in 1994, coincided with a fall in the long-run correlation between saving and investment. However, the correlation weakens further when we include the postcrisis regime of capital controls, suggesting a weaker relationship between savings and investment in this regime. We discuss the possible reasons for this pattern and also the implications of our findings for post-crisis policy in small open economies

Acute changes in the systemic inflammatory response are associated with transient decreases in circulating 25-hydroxyvitamin D concentrations following elective knee arthroplasty [POSTER]

No abstract available

Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background

Background: Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section. In this study of a predominantly socially deprived population we have sought to prospectively examine the association between antenatal maternal anxiety and socioeconomic background and the development of persistent pain of all sources after caesarean section. Methods: Demographic details and an anxiety questionnaire were completed by 205 women before elective caesarean section. On the first postoperative day, pain scores were recorded, and at four months patients were asked to complete a Brief Pain Inventory and an Edinburgh Postnatal Depression Score. Results: Of 205 parturients recruited, 186 records were complete at the hospital admission phase and 98 (52.7%) were complete at the four-month follow-up phase. At recruitment, 15.1% reported pain. At four months 41.8% (95% CI 32.1 to 51.6%) reported pain, of whom pain was a new finding in 35.7% (95% CI 26.2 to 45.2%). Antenatal anxiety was not a significant predictor of severity of new pain at four months (P=0.43 for state anxiety, P=0.52 for trait anxiety). However, four-month pain severity did correlate with social deprivation (P=0.011), postnatal depression (P<0.001) and pain at 24 h (P=0.018). Conclusion: Persistent pain from a variety of sources after caesarean section is common. Our findings do not support the use of antenatal anxiety scoring to predict persistent pain in this setting, but suggest that persistent pain is influenced by acute pain, postnatal depression and socioeconomic deprivation

Championing mental health at work: emerging practice from innovative projects in the UK.

This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments