3,161 research outputs found

    Targeting sexual health services in primary care: a systematic review of the psychosocial correlates of adverse sexual health outcomes reported in probability surveys of women of reproductive age

    Get PDF
    BACKGROUND: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age. METHODS: We searched bibliographic databases for probability surveys of women aged 16-44years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014. RESULTS: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships. CONCLUSION: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply

    An Investigation into the Critical Factors of on-site Waste Segregation in the UK Construction and Demolition Sector.

    Get PDF
    This paper provides an in-depth exploration into critical factors affecting the use of on-site waste segregation strategies in the UK C&D market. Utilising data from two separate survey questionnaires; this study confirms usage of on-site segregation strategies by many UK contractors where physical site space and project budgets allow. However, through assessment of stakeholder perceptions, this paper also identifies several key barriers that are impeding overall effectiveness. Amongst many factors, this study indicates how issues such as poor attitude and a lack of knowledge of the benefits amongst workers, could be having a profound effect on successful adaptation of ground level recycling initiatives. This research project then finishes by ranking existent barriers by importance, with the goal of suggesting proposals for overcoming these challenges. Ultimately, weighing the critical factors and prospective barriers to on-site segregation in the UK C&D sector, this study makes recommendation of multiple incentives, but suggests that enhanced training initiatives could be a crucial element for instigating long-term industry improvement in respect of recycling and on-site waste segregation strategies

    The thermal ignition problem in a cube

    Get PDF
    Steady state solutions for spontaneous thermal ignition in a unit cube are considered. For the unit sphere there are numerous solutions possible: these appear as ``wiggles'' in the bifurcation diagram. For the unit sphere this has been shown analytically. In contrast, for the unit cube analytic solutions are not possible and hence we must resort to numerical methods to determine the corresponding bifurcation diagram. Comparisons between the cube and the sphere are made

    Combustion waves in a model with chain branching reaction and their stability

    Full text link
    In this paper the travelling wave solutions in the adiabatic model with two-step chain branching reaction mechanism are investigated both numerically and analytically in the limit of equal diffusivity of reactant, radicals and heat. The properties of these solutions and their stability are investigated in detail. The behaviour of combustion waves are demonstrated to have similarities with the properties of nonadiabatic one-step combustion waves in that there is a residual amount of fuel left behind the travelling waves and the solutions can exhibit extinction. The difference between the nonadiabatic one-step and adiabatic two-step models is found in the behaviour of the combustion waves near the extinction condition. It is shown that the flame velocity drops down to zero and a standing combustion wave is formed as the extinction condition is reached. Prospects of further work are also discussed.Comment: pages 32, figures 2

    Role of the Hospitalist and Maternal Fetal Medicine Physician in Obstetrical Inpatient Care.

    Get PDF
    OBJECTIVE: The objective of this study was to evaluate the role of hospitalists and Maternal Fetal Medicine (MFM) subspecialists in obstetrical inpatient care. STUDY DESIGN: This electronic survey study was offered to members of the American College of Obstetrics & Gynecology (ACOG; n = 1,039) and the Society for Maternal-Fetal Medicine (SMFM; n = 1,813). RESULTS: Overall, 607 (21%) respondents completed the survey. Overall, 35% reported that hospitalists provided care in at least one of their hospitals. Compared with ACOG respondents, a higher frequency of SMFM respondents reported comfort with hospitalists providing care for all women on labor and delivery (74.4 vs. 43.5%, p = 0.005) and women with complex issues (56.4 vs. 43.5%, p = 0.004). The majority of ACOG respondents somewhat/completely agreed that hospitalists were associated with decreased adverse events (69%) and improved safety/safety culture (70%). Overall, 35% of ACOG respondents have MFM consultation available with 53% having inpatient coverage. Of these, 85% were satisfied with MFM availability. CONCLUSION: Over one-third of respondents work in units staffed with hospitalists and more than half have inpatient MFM coverage. It is important to evaluate if and how hospitalists can improve maternal and perinatal outcomes, and the types of hospitals that are best served by them

    Beyond multimorbidity:What can we learn from complexity science?

    Get PDF
    Multimorbidity - the occurrence of two or more long-term conditions in an individual - is a major global concern, placing a huge burden on healthcare systems, physicians, and patients. It challenges the current biomedical paradigm, in particular conventional evidence-based medicine's dominant focus on single-conditions. Patients' heterogeneous range of clinical presentations tend to escape characterization by traditional means of classification, and optimal management cannot be deduced from clinical practice guidelines. In this article, we argue that person-focused care based in complexity science may be a transformational lens through which to view multimorbidity, to complement the specialism focus on each particular disease. The approach offers an integrated and coherent perspective on the person's living environment, relationships, somatic, emotional and cognitive experiences and physiological function. The underlying principles include non-linearity, tipping points, emergence, importance of initial conditions, contextual factors and co-evolution, and the presence of patterned outcomes. From a clinical perspective, complexity science has important implications at the theoretical, practice and policy levels. Three essential questions emerge: (1) What matters to patients? (2) How can we integrate, personalize and prioritize care for whole people, given the constraints of their socio-ecological circumstances? (3) What needs to change at the practice and policy levels to deliver what matters to patients? These questions have no simple answers, but complexity science principles suggest a way to integrate understanding of biological, biographical and contextual factors, to guide an integrated approach to the care of people with multimorbidity

    Effects of delayed cord clamping on residual placental blood volume, hemoglobin and bilirubin levels in term infants: a randomized controlled trial

    Get PDF
    Objective: The objective of the study was to measure the effects of a 5-min delay (DCC) versus immediate cord clamping (ICC) on residual placental blood volume (RPBV) at birth, and hemoglobin and serum bilirubin at 24 to 48 h of age. Study Design: In this prospective randomized controlled trial, 73 women with term (37 to 41 weeks) singleton fetuses were randomized to DCC (5 min; n=37) or ICC (\u3c20 s; n=36). Results: Maternal and infant demographics were not different between the groups. Mean cord clamping time was 303±121 (DCC) versus 23±59 (ICC) s (P\u3c0.001) with 10 protocol violations. Cord milking was the proxy for DCC (n=11) when the provider could not wait. Infants randomized to DCC compared with ICC had significantly less RPBV (20.0 versus 30.8 ml kg−1, P\u3c0.001), higher hemoglobin levels (19.4 versus 17.8 g dl−1, P=0.002) at 24 to 48 h, with no difference in bilirubin levels. Conclusion: Term infants had early hematological advantage of DCC without increases in hyperbilirubinemia or symptomatic polycythemia
    corecore