Think Pink! a Pink Sticker Alert System for Women with Psychological Distress or Vulnerability During Pregnancy

The importance of good clinical communication to women during pregnancy and birth is clear. Poor communication in labour is associated with general dissatisfaction, more complaints and a range of perinatal mental health problems including posttraumatic stress disorder (PTSD) and postnatal depression. To communicate effectively, maternity staff needs information about which women are vulnerable and require extra support. To address this, we implemented and evaluated a pink sticker communication system to alert midwifery and obstetric staff to potential psychological difficulties experienced by some women. Evaluation showed this system was viewed positively by women and midwifery staff. Audit of referrals to the perinatal psychology service during this period suggests no woman with a pink sticker developed birth trauma as a direct result of perceived poor care. In addition, the proportion of referrals to perinatal psychology for birth trauma significantly reduced during this period

Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional study

Background Poor sleep and poor mental health go hand in hand and, together, can have an adverse impact on physical health. Given the already disproportionate physical health inequities experienced by people with a mental health condition worldwide, the need to consider and optimise sleep has been highlighted as a means of improving both physical and mental health status. Sleep recommendations recently developed by the United States’ National Sleep Foundation incorporate a range of sleep parameters and enable the identification of ‘suboptimal’ sleep. Among community-dwelling persons with and without a 12-month mental health condition in Australia, this study reports: [1] the prevalence of ‘suboptimal’ sleep and [2] rates of sleep assessment by a health care clinician/service and receipt of and desire for sleep treatment. Methods A descriptive study (N = 1265) was undertaken using self-report data derived from a cross-sectional telephone survey of Australian adults, undertaken in 2017. Results Fifteen per cent (n = 184) of participants identified as having a mental health condition in the past 12 months. Across most (7 of 8) sleep parameters, the prevalence of suboptimal sleep was higher among people with a mental health condition, compared to those without (all p < 0.05). The highest prevalence of suboptimal sleep for both groups was seen on measures of sleep duration (36–39% and 17–20% for people with and without a mental health condition, respectively). In terms of sleep assessment and treatment, people with a mental health condition were significantly more likely to: desire treatment (37% versus 16%), have been assessed (38% versus 12%) and have received treatment (30% versus 7%). Conclusions The prevalence of suboptimal sleep among persons with a mental health condition in Australia is significantly higher than those without such a condition, and rates of assessment and treatment are low for both groups, but higher for people with a mental health condition. Population health interventions, including those delivered as part of routine health care, addressing suboptimal sleep are needed

Hyperarousal symptoms after traumatic and nontraumatic births

Background: Measurement is critical in postnatal posttraumatic stress disorder (PTSD) because symptoms may be influenced by normal postnatal phenomena such as physiological changes and fatigue. Objective: This study examined: (1) whether hyperarousal symptoms differ between women who have traumatic or nontraumatic births; (2) whether the construct of hyperarousal is coherent in postnatal women; and (3) whether hyperarousal symptoms are useful for identifying women who have traumatic births or PTSD. Methods: A survey of PTSD symptoms in 1,078 women recruited via the community or Internet who completed an online or paper questionnaire measuring childbirth-related PTSD symptoms between 1 and 36 months after birth. Women who had a traumatic birth as defined by DSM-IV criterion A (n = 458) were compared with women who did not have a traumatic birth (n = 591). Results: A one-factor dimension of hyperarousal was identified that included all five hyperarousal items. Diagnostic criteria of two or more hyperarousal symptoms in the previous week were reported by 75.3% of women with traumatic birth and 50.5% of women with nontraumatic births. The difference in mean hyperarousal symptoms between groups was substantial at 0.76 of a standard deviation (Hedge’s g, CI = 0.64, 0.89). A larger difference was observed between women with and without diagnostic PTSD (g = 1.64, CI 1.46, 1.81). However, receiver operating characteristic analyses showed hyperarousal symptoms have poor specificity and alternative ways of calculating symptoms did not improve this. Comparison with other PTSD symptoms found re-experiencing symptoms were most accurate at identifying women with traumatic births. Conclusions: Results suggest hyperarousal symptoms are associated with traumatic birth and are a coherent construct in postnatal women. However, they have poor specificity and should only be used as part of diagnostic criteria, not as a sole indicator

Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research

Objective: This paper aimed to report the current status of research in the field of post-traumatic stress disorder following childbirth (PTSD FC), and to update the findings of an earlier 2008 paper. Background: A group of international researchers, clinicians and service users met in 2006 to establish the state of clinical and academic knowledge relating to PTSD FC. A paper identified four key areas of research knowledge at that time. Methods: Fourteen clinicians and researchers met in Oxford, UK to update the previously published paper relating to PTSD FC. The first part of the meeting focused on updating the four key areas identified previously, and the second part on discussing new and emerging areas of research within the field. Results: A number of advances have been made in research within the area of PTSD FC. Prevalence is well established within mothers, several intervention studies have been published, and there is growing interest in new areas: staff and pathways; prevention and early intervention; impact on families and children; special populations; and post-traumatic growth. Conclusion: Despite progress, significant gaps remain within the PTSD FC knowledge base. Further research continues to be needed across all areas identified in 2006, and five areas were identified which can be seen as ‘new and emerging’. All of these new areas require further extensive research. Relatively little is still known about PTSD FC

Event-based camera refractory period characterization and initial clock drift evaluation

Event-based camera (EBC) technology provides high-dynamic range operation and shows promise for efficient capture of spatio-temporal information, producing a sparse data stream and enabling consideration of nontraditional data processing solutions (e.g., new algorithms, neuromorphic processors, etc.). Given the fundamental difference in camera architecture, the EBC response and noise behavior differ considerably compared to standard CCD/CMOS framing sensors. These differences necessitate the development of new characterization techniques and sensor models to evaluate hardware performance and elucidate the trade-space between the two camera architectures. Laboratory characterization techniques reported previously include noise level as a function of static scene light level (background activity) and contrast responses referred to as S-curves. Here we present further progress on development of basic characterization methods and test capabilities for commercial-off-the-shelf (COTS) visible EBCs, with a focus on measurement of pixel deadtime (refractory period) including results for the 4th-generation sensor from Prophesee and Sony. Refractory period is empirically determined from analysis of the interspike intervals (ISIs), and results visualized using log-histograms of the minimum per-pixel ISI values for a subset of pixels activated by a controlled dynamic scene. Our tests of the Prophesee gen4 EVKv2 yield refractory period estimates ranging from 6.1 msec to 6.8 μsec going from the slowest (20) to fastest (100) settings of the relevant bias parameter, bias_refr. We also introduce and demonstrate the concept of pixel bandwidth measurement from data captured while viewing a static scene – based on recording data at a range of refractory period setting and then analyzing noise-event statistics. Finally, we present initial results for estimating and correcting EBC clock drift using a GPS PPS signal to generate special timing events in the event-list data streams generated by the DAVIS346 and DVXplorer EBCs from iniVation

Academic performance of undergraduate dental students with learning disabilities

© 2017 British Dental Association. All rights reserved.Aims To compare the academic performance of undergraduate dental students with known learning disabilities (LDs) to their peers.Methods This study analysed the results of students in applied dental knowledge (ADK) progress tests across four cohorts of dental students. A mixed model analysis of variance (ANOVA) was conducted to compare the performance of students with known disability to their peers. ADK test sitting was treated as a repeated measures variable, and the outcome variable of interest was percentage score on the ADK.Results Students' performance data on five ADK test sittings (ADK15, ADK16, ADK17, ADK18, and ADK19) by disability showed a significant main effect of test but no significant effect of disability or any interaction between disability and test.Conclusions This is the first study that explores the academic performance of dental students with a diagnosis of disability. The findings give reassurance to all stakeholders that, within the study population, students with LDs are not disadvantaged in knowledge-based assessments, demonstrating compliance with the legal obligations. Further research is required to explore how generalisable these findings are, as well as assess academic, clinical, and behavioural attributes of students with learning disabilities

Handling and archiving of magnetic fusion data at DIII-D

Recent modifications to the computer network at DIII-D enhance the collection and distribution of newly acquired and archived experimental data. Linked clients and servers route new data from diagnostic computers to centralized mass storage and distribute data on demand to local and remote workstations and computers. Capacity for data handling exceeds the upper limit of DIII-D Tokamak data production of about 4 GBytes per day. Network users have fast access to new data stored on line. An interactive program handles requests for restoration of data archived off line. Disk management procedures retain selected data on line in preference to other data. Redundancy of all components on the archiving path from the network to magnetic media has prevented loss of data. Older data are rearchived as dictated by limited media life

Diabetic cardiomyopathy is associated with defective myocellular copper regulation and both defects are rectified by divalent copper chelation

BACKGROUND: Heart disease is the leading cause of death in diabetic patients, and defective copper metabolism may play important roles in the pathogenesis of diabetic cardiomyopathy (DCM). The present study sought to determine how myocardial copper status and key copper-proteins might become impaired by diabetes, and how they respond to treatment with the Cu (II)-selective chelator triethylenetetramine (TETA) in DCM. METHODS: Experiments were performed in Wistar rats with streptozotocin (STZ)-induced diabetes with or without TETA treatment. Cardiac function was analyzed in isolated-perfused working hearts, and myocardial total copper content measured by particle-induced x-ray emission spectroscopy (PIXE) coupled with Rutherford backscattering spectrometry (RBS). Quantitative expression (mRNA and protein) and/or activity of key proteins that mediate LV-tissue-copper binding and transport, were analyzed by combined RT-qPCR, western blotting, immunofluorescence microscopy, and enzyme activity assays. Statistical analysis was performed using Student’s t-tests or ANOVA and p-values of < 0.05 have been considered significant. RESULTS: Left-ventricular (LV) copper levels and function were severely depressed in rats following 16-weeks’ diabetes, but both were unexpectedly normalized 8-weeks after treatment with TETA was instituted. Localized myocardial copper deficiency was accompanied by decreased expression and increased polymerization of the copper-responsive transition-metal-binding metallothionein proteins (MT1/MT2), consistent with impaired anti-oxidant defences and elevated susceptibility to pro-oxidant stress. Levels of the high-affinity copper transporter-1 (CTR1) were depressed in diabetes, consistent with impaired membrane copper uptake, and were not modified by TETA which, contrastingly, renormalized myocardial copper and increased levels and cell-membrane localization of the low-affinity copper transporter-2 (CTR2). Diabetes also lowered indexes of intracellular (IC) copper delivery via the copper chaperone for superoxide dismutase (CCS) to its target cuproenzyme, superoxide dismutase-1 (SOD1): this pathway was rectified by TETA treatment, which normalized SOD1 activity with consequent bolstering of anti-oxidant defenses. Furthermore, diabetes depressed levels of additional intracellular copper-transporting proteins, including antioxidant-protein-1 (ATOX1) and copper-transporting-ATPase-2 (ATP7B), whereas TETA elevated copper-transporting-ATPase-1 (ATP7A). CONCLUSIONS: Myocardial copper deficiency and defective cellular copper transport/trafficking are revealed as key molecular defects underlying LV impairment in diabetes, and TETA-mediated restoration of copper regulation provides a potential new class of therapeutic molecules for DCM

The implications of Brexit for environmental law in Scotland

This report maps the possible implications of Brexit for environmental protection in Scotland, identifying core questions as well as solutions that may be adopted, with the objective of initiating a conversation about this complex subject matter. The report has been prepared as a joint endeavour by a group of environmental law experts based at Scottish Universities. Each section was drafted by a lead author, with inputs from the rest of the group. The paper is meant for a broad audience and intentionally uses a non-technical writing style. The paper is divided in two sections. The first section addresses cross-cutting questions affecting environmental governance after Brexit, focusing on the main Brexit scenarios and their trade, competition, and law enforcement implications. This analysis identifies a series of common challenges for nvironmental law in Scotland after Brexit, which relate to: •Loss of scrutiny and enforcement powers associated with the operation of EU law and institutions; •Loss of long-term policy horizon and of the stable regulatory framework provided by EU law; •Repositioning of the UK and Scotland in international and regional environmental governance cooperation; and •Restriction/loss of access to EU funds and programmes. The second section analyses specific questions likely to emerge in elected areas of environmental law, distinguishing between different types of EU environmental legislation and the related allocation of competences within the UK. The transposition of EU environmental law into domestic law takes place in different ways. Some pieces of EU environmental law have been transposed into UK/Scottish law and configure distinctively UK/Scottish solutions. After Brexit, retaining these pieces of legislation is going to be relatively straightforward. Other pieces of EU environmental law, conversely, heavily rely upon EU processes and institutions and will no longer be applicable in their present form after Brexit. On these matters, EU powers and competences will be repatriated, raising fundamental questions concerning the allocation of powers between the UK’s central and evolved administrations. Finally, EU membership has important implications concerning the UK’s implementation of international obligations in areas such as climate change law or air pollution. In these areas, EU law is often more ambitious than the underlying international obligations. Brexit will therefore confront the UK and devolved administrations with fundamental choices regarding how to continue to comply with international obligations, and maintain and enhance their current level of commitment and ambition over time

Ecology good, aut-ecology better; Improving the sustainability of designed plantings

© 2015 European Council of Landscape Architecture Schools (ECLAS). This paper explores how contemporary ecological science, and aut-ecology in particular, can improve the sustainability of designed vegetation. It is proposed that ecological understanding can be applied to design at three levels: 1) as representation, 2) as process, and 3) as aut-ecology, representing a gradient from the least to the most profound. Key ecological interactions that determine the success of designed plantings are explored via a review of relevant ecological research, challenging some widely held but unhelpful constructs about how both semi-natural and designed vegetation actually function. The paper concludes that there are real benefits to integrating aut-ecological understanding in the design of vegetation at all scales but that this will require ecological theory to be taught as a design toolkit rather than largely as descriptive knowledge