Consent on the labour ward: a qualitative study of the views and experiences of healthcare professionals

Objective: Consent on the labour ward is a complex and controversial topic which is poorly understood. Consenting labouring women is recognised as challenging and problematic, and thus, it is uncertain that pregnant women experience true informed consent during labour. This project aims to explore healthcare professionals’ views and experiences of consent practice on the labour ward. / Design: Qualitative research performed in a tertiary hospital labour ward in Central London with 5,500 patients annually. Eleven obstetricians and seven midwives participated. In-depth one-on-one semi-structured interviews were conducted, and the data were analysed by thematic analysis. / Results: Three themes were identified: 1) The value of women’s choice: healthcare professionals framed consent as an agreement process rather than an exercise of choice. Implicit paternalism was evident with some healthcare professionals imposing their own recommendations upon patients. 2) Communicating risk: many participants viewed full risk communication, including extremely rare risk disclosure as their duty to ensure the validity of obstetric consent despite the risk of overwhelming women. 3) Law and professional practice: many healthcare professionals lacked knowledge of the implications to practice of current law. / Conclusion: Healthcare professionals’ experiences of consent on the labour ward reflect uncertainties and ambiguities in consent practice such that it sometimes falls short of legal and professional requirements. Difficulties in discussing risk with women in an appropriate way at an appropriate time threatens the lawfulness of consent. If consent is to remain as the legal standard of autonomy, we recommend the provision of specialist training to assist professionals in providing timely consultation dialogues which endorse women’s right to choose

Modeling the decline of the Porcupine Caribou Herd, 1989-1998: the importance of survival vs. recruitment

The Porcupine caribou (Rangifer tarandus granti) herd increased from approximately 100 000 animals during the 1970s to 178 000 in 1989, then declined to 129 000 by 1998. Our objective was to model the dynamics of this herd and investigate the potential that lower calf recruitment, as was observed during 1991-1993, produced the observed population changes. A deterministic model was prepared using estimates of birth and survival rates that reproduced the pattern of population growth from 1971-1989. Then, parameters were changed to simulate effects of lower calf recruitment and adult survival. Reducing recruitment for 3 years caused an immediate reduction in population size, but the population began to recover in 5-6 years. Even a dramatic temporary reduction in recruitment did not explain the continuing decline after 1995. In contrast, a slight but persistent reduction in adult survival caused a decline that closely followed the observed pattern. This suggests that survival of adults, and perhaps calves, has declined since the late 1980s

Accurate Determination of Phenotypic Information from Historic Thoroughbred Horses by Single Base Extension

Historic DNA have the potential to identify phenotypic information otherwise invisible in the historical, archaeological and palaeontological record. In order to determine whether a single nucleotide polymorphism typing protocol based on single based extension (SNaPshot™) could produce reliable phenotypic data from historic samples, we genotyped three coat colour markers for a sample of historic Thoroughbred horses for which both phenotypic and correct geotypic information were known from pedigree information in the General Stud Book. Experimental results were consistent with the pedigrees in all cases. Thus we demonstrate that historic DNA techniques can produce reliable phenotypic information from museum specimens.© 2010 Campana et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Knot invariants in lens spaces

In this survey we summarize results regarding the Kauffman bracket, HOMFLYPT, Kauffman 2-variable and Dubrovnik skein modules, and the Alexander polynomial of links in lens spaces, which we represent as mixed link diagrams. These invariants generalize the corresponding knot polynomials in the classical case. We compare the invariants by means of the ability to distinguish between some difficult cases of knots with certain symmetries

Routine placental histopathology findings from women testing positive for SARS-CoV-2 during pregnancy: Retrospective cohort comparative study

OBJECTIVE: To assess the impact of maternal Coronavirus disease 2019 (COVID-19) infection on placental histopathological findings in an unselected population and evaluate the potential effect on the fetus, including the possibility of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). DESIGN: Retrospective cohort comparative study of placental histopathological findings in patients with COVID-19, compared with controls. SETTING: During the COVID-19 pandemic, placentas were studied from women at University College Hospital London who reported and/or tested positive for COVID-19. POPULATION: Of 10 508 deliveries, 369 (3.5%) women had COVID-19 during pregnancy, with placental histopathology available for 244 women. METHODS: Retrospective review of maternal and neonatal characteristics, where placental analysis had been performed. This was compared with available, previously published, histopathological findings from placentas of unselected women. MAIN OUTCOME MEASURES: Frequency of placental histopathological findings and relevant clinical outcomes. RESULTS: Histological abnormalities were reported in 117 of 244 (47.95%) cases, with the most common diagnosis being ascending maternal genital tract infection. There was no statistically significant difference in the frequency of most abnormalities compared with controls. There were four cases of COVID-19 placentitis (1.52%, 95% CI 0.04%-3.00%) and one possible congenital infection, with placental findings of acute maternal genital tract infection. The rate of fetal vascular malperfusion (FVM), at 4.5%, was higher compared with controls (p = 0.00044). CONCLUSIONS: In most cases, placentas from pregnant women infected with SARS-CoV-2 virus do not show a significantly increased frequency of pathology. Evidence for transplacental transmission of SARS-CoV-2 is lacking from this cohort. There is a need for further study into the association between FVM, infection and diabetes

The case for home based telehealth in pediatric palliative care: a systematic review

Background: Over the last decade technology has rapidly changed the ability to provide home telehealth services. At the same time, pediatric palliative care has developed as a small, but distinct speciality. Understanding the experiences of providing home telehealth services in pediatric palliative care is therefore important

Infrared spectroscopy of diatomic molecules - a fractional calculus approach

The eigenvalue spectrum of the fractional quantum harmonic oscillator is calculated numerically solving the fractional Schr\"odinger equation based on the Riemann and Caputo definition of a fractional derivative. The fractional approach allows a smooth transition between vibrational and rotational type spectra, which is shown to be an appropriate tool to analyze IR spectra of diatomic molecules.Comment: revised + extended version, 9 pages, 6 figure

Morphology and Distribution of Volcanic Vents in the Orientale Basin from Chandrayaan-1 Moon Mineralogy Mapper (M3) Data

One of the most fundamental questions in the geological and thermal evolution of the Moon is the nature and history of mantle melting and its relationship to the formation and evolution of lunar multi-ringed basins. Mare volcanic deposits provide evidence for the nature, magnitude and composition of mantle melting as a function of space and time [1]. Many argue that mantle partial melts are derived from depths well below the influence of multiringed basin impact events [1], while others postulate that the formation of these basins can cause mantle perturbations that are more directly linked to the generation ascent and eruption of mare basalts [2,3]. In any case, longer-term basin evolution will considerably influence the state and orientation of stress in the lithosphere, and the location of mare volcanic vents in basins as a function of time [4]. Thus, the location, nature and ages of volcanic vents and deposits in relation to multi-ringed impact basins provides evidence for the role that these basins played in the generation of volcanism or in the influence of the basins on surface volcanic eruption and deposit concentration. Unfortunately, most lunar multi-ringed impact basins have been eroded by impacts or filled with lunar mare deposits [5-8], with estimates of the thickness of mare fill extending up to more than six km in the central part of some basins [9-11]. The interior of most basins (e.g., Crisium, Serenitatis, Imbrium, Humorum) are almost completely covered and obscured. Although much is known about the lava filling of multi-ringed basins, and particularly the most recent deposits [5-8], little is known about initial stages of mare volcanism and its relationship to the impact event. One multi-ringed basin, Orientale, offers substantial clues to the relationships of basin interiors and mare basalt volcanism

J-PLUS: Identification of low-metallicity stars with artificial neural networks using SPHINX

We present a new methodology for the estimation of stellar atmospheric parameters from narrow- and intermediate-band photometry of the Javalambre Photometric Local Universe Survey (J-PLUS), and propose a method for target pre-selection of low-metallicity stars for follow-up spectroscopic studies. Photometric metallicity estimates for stars in the globular cluster M15 are determined using this method. By development of a neural-network-based photometry pipeline, we aim to produce estimates of effective temperature, $T_{\rm eff}$, and metallicity, [Fe/H], for a large subset of stars in the J-PLUS footprint. The Stellar Photometric Index Network Explorer, SPHINX, is developed to produce estimates of $T_{\rm eff}$ and [Fe/H], after training on a combination of J-PLUS photometric inputs and synthetic magnitudes computed for medium-resolution (R ~ 2000) spectra of the Sloan Digital Sky Survey. This methodology is applied to J-PLUS photometry of the globular cluster M15. Effective temperature estimates made with J-PLUS Early Data Release photometry exhibit low scatter, \sigma($T_{\rm eff}$) = 91 K, over the temperature range 4500 < $T_{\rm eff}$ (K) < 8500. For stars from the J-PLUS First Data Release with 4500 < $T_{\rm eff}$ (K) < 6200, 85 $\pm$ 3% of stars known to have [Fe/H] <-2.0 are recovered by SPHINX. A mean metallicity of [Fe/H]=-2.32 $\pm$ 0.01, with a residual spread of 0.3 dex, is determined for M15 using J-PLUS photometry of 664 likely cluster members. We confirm the performance of SPHINX within the ranges specified, and verify its utility as a stand-alone tool for photometric estimation of effective temperature and metallicity, and for pre-selection of metal-poor spectroscopic targets.Comment: 18 pages, 12 figure

Resonance ionization of sputtered atoms-progress toward a quantitative technique

The combination of RIMS and ion sputtering has been heralded as the ideal means of quantitatively probing the surface of a solid. While several laboratories have demonstrated the extreme sensitivity of combining RIMS with sputtering, less effort has been devoted to the question of accuracy. Using the SARISA instrument developed at Argonne National Laboratory, a number of well-characterized metallic samples have been analyzed. Results from these determinations have been compared with data obtained by several other analytical methods. One significant finding is that impurity measurements down to ppb levels in metal matrices can be made quantitative by employing polycrystalline metal foils as calibration standards. This discovery substantially reduces the effort required for quantitative analysis since a single standard can be used for determining concentrations spanning nine orders of magnitude