Assessment of indications of caesarean section among high risk women by Robson criteria: a prospective study

Background: Caesarean section (CS) is a surgical intervention for safe delivery other than natural vaginal route. World Health Organization (WHO) has recommended ten group classification systems of Robson criteria which we have used to analyse CS at our center. The objective of the study to analyse the lower section caesarian section (LSCS) data under Robson criteria for implementation in regular practice in tertiary care center and to understand the need of it for future practice.Methods: A prospective analysis done for deliveries in Obstetric Department of Shalby Multispecialty Hospital of central India by Robson ten group classification criteria. The study was carried out for the period of two year from April 2016 to April 2018 including antenatal women attending labour room with high risks or referred cases from other centers.Results: The study reflected overall 196 live birth of high risk cases which were having other co morbidities like pre-eclampsia, eclampsia, hypothyroidism, diabetes, acute viral hepatitis. The data compared with Robsons guidelines and reflected that the centre is dealing with high risk primigravida (47.51%, 35-42% Robson criteria) cases with high CS rate (16.8%, group 5). There was multiple pregnancy, group 8, (2.32 %, >1.5-2% Robson Criteria) and preterm births as in group 10, 18.02 % (5% in Robson Criteria), exclusively high.Conclusions: The Robson criteria help to classify the population handled by the canter to develop the strategies for betterment of services. It has limitation in view of qualitative assessment of the data for comorbidities and severity of the disease

Comparison of Anterior Chamber Depth Measurements from the Galilei Dual Scheimpflug Analyzer with IOLMaster

Purpose. To compare anterior chamber depth (ACD), representing the distance between the anterior corneal surface and anterior lens surface measurements between the Galilei Dual Scheimpflug Analyzer and the IOLMaster. Methods. A retrospective review of 65 individual patient eyes with normal anterior segments, and no prior ocular surgery was performed. Patients underwent ACD measurements with both devices during the same session by a trained examiner. Interdevice agreement was evaluated using paired two-tailed t-tests, Pearson correlation coefficient, and Bland-Altman analysis. Results. The mean ± standard deviation (SD) ACD for the Galilei and IOLMaster was 3.37 ± 0.36 mm (range from 2.62 to 4.13) and 3.25 ± 0.38 mm (range from 2.34 to 3.92), respectively (Pearson correlation coefficient = 0.96). ACD mean difference was 0.12 mm (P < 0.0001); 95% limits of agreement was from −0.09 to 0.34. The Galilei measured slightly longer ACD values than the IOLMaster. There was no relationship between axial length and interdevice difference. Conclusion. ACD measurements correlate well between the Galilei and IOLMaster, with Galilei values on average 0.12 mm longer than the IOLMaster

Changing Awareness of Human Trafficking

The issue of human trafficking has received increased attention since the Trafficking Victims Protection Act was enacted in 2000. We assume that awareness is growing in the United States but this has not been tested. The current study measures increases in awareness about the issue of trafficking. Nearly 400 students were polled about their awareness in the spring of 2007. Attitudes towards government responses, awareness of the issue and support for victims were surveyed. The study was replicated 5 years later with over 500 new participants. This paper will analyze changes in awareness over time. Gender differences will also be presented. Attitudes towards trafficking will be considered in light of the assumptions underlying the TVPA and its reauthorizations

A Public Health Imperative: The Need for Meaningful Change in the Trans-Pacific Partnership’s Intellectual Property Chapter

In order to address the immense public health inequity in trade and patent law practices, the World Trade Organization (WTO) administered the Agreement on Trade-Related Aspects of Intellectual Property Rights (widely known as TRIPS). The TRIPS Agreement employs various provisions to ensure public health needs are addressed through international trade; these provisions are referred to as “flexibilities.” The past two decades have seen an increasing number of developing nations successfully utilize the flexibilities provided by TRIPS, which aim to lower costs and increase access to medicine by facilitating the importation of generic formulas. While TRIPS has made progress by bringing public health needs on par with global patent rights, many countries have not yet amended their laws to incorporate full TRIPS flexibilities. An increasing number of bilateral and multilateral free trade agreements include intellectual property protections that greatly exceed the minimum intellectual property standards of TRIPS, thus hindering the use of such flexibilities. The advent of the TPP, a proposed trade agreement between twelve countries including the United States, potentially poses the most aggressive pharmaceutical intellectual property provisions to date. Part I of this Note will review the development of the TPP and its intellectual property provisions as well as the history of trade and medicine, particularly focusing on the restrictions of the TRIPS flexibilities. Part II will specifically discuss how the TPP’s intellectual property provisions will adversely impact global access to affordable medicines and a partner nation’s ability to utilize existing TRIPS flexibilities. Part II will also include recommendations to keep the TPP consistent with TRIPS in order to balance patent rights for the pharmaceutical industry with broader public health and bioethical goals

Come and play: interactive theatre for early years

The convergence of theatre and digital technologies can play a valuable role in theatre for early years, but, how an audience of under-5’s experiences and engages with these spaces is largely unexplored. We present an interactive performance installation and demonstrate how concepts from early years practice, in particular schemas, children’s repeated play patterns, can be used as a design framework. We integrated sensors and microcontrollers into objects, puppets, and scenography and invited eight groups of very young children and their grownups to explore the performance. We discuss how schemas are useful as a design and analysis tool in TEY, how schemas need to be expanded to include multi-sensory interactions with hybrid physical-digital objects, and how designers need to consider the roles of adults who scaffold interaction between very young children and their surroundings

Anxiety Associated With Increased Risk for Emergency Department Recidivism in Patients With Low-Risk Chest Pain

Anxiety contributes to the chest pain symptom complex in 30% to 40% of patients with low-risk chest pain seen in the emergency department (ED). The validated Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) has been used as an anxiety screening tool in this population. The objective was to determine the prevalence of abnormal HADS-A scores in a cohort of low-risk chest pain patients and test the association of HADS-A score with subsequent healthcare utilization and symptom recurrence. In a single-center, prospective, observational cohort study of adult ED subjects with low-risk chest pain, the HADS-A was used to stratify participants into 2 groups: low anxiety (score <8) and high anxiety (score ≥8). At 45-day follow-up, chest pain recurrence was assessed by patient report, whereas ED utilization was assessed through chart review. Of the 167 subjects enrolled, 78 (47%) were stratified to high anxiety. The relative risk for high anxiety being associated with at least one 30-day ED return visit was 2.6 (95% confidence interval 1.4 to 4.7) and this relative risk increased to 9.1 (95% confidence interval 2.18 to 38.6) for 2 or more ED return visits. Occasional chest pain recurrence was reported by more subjects in the high anxiety group, 68% vs 47% (p = 0.029). In conclusion, 47% of low-risk chest pain cohort had abnormal levels of anxiety. These patients were more likely to have occasional recurrence of their chest pain and had an increased risk multiple ED return visits

The maker of imaginary worlds: interactive theatre for early years

A young child is competent, capable and a citizen with equal rights to cultural activities. Our fundamental values and attitudes to very young children are the critical determining factors in the quality of their sociocultural lives. Very young children are considered spectators in their own right; however, in the UK there are still only a few theatre performances exclusively made for children under three. This research addresses this issue by investigating the relationship between physical and digital scenography to make Theatre for Early Years (TEY) more interactive and sensory. It begins from a child rights perspective that recognises the child’s voice, perception, perspective, sensory ability. It establishes how a multidisciplinary approach drawing from the fields of Education, Human-Computer Interaction (HCI), and Theatre demands that we rethink our approach to making children’s theatre by establishing a dialogue with our audience and building in interaction from the outset. TEY is an emerging field of practice and research. This thesis focuses on the design and the analysis of interactive scenography for two TEY performances at Lakeside Arts Centre, Nottingham, attended by toddlers and their grown-ups. Multisensory design plays an essential role in TEY because young children predominantly make meaning through directly sensing and interacting with their world. We still have a lot to learn about how children make sense of performances. I argue that embedded digital, tangible, and interactive scenography can create hybrid performances that support agency, play, and real-time interactions in TEY while still serving its purpose as a scenographic element. The design approach considers technologies as both functional and aesthetic, and the scenographic object as a character and audiences as an integral part of the performance. Participatory and interactive experiences afforded by open-source technologies can open up new perceptions, not only in respect to TEY performances but, for the design of flexible, interactive spaces for children’s pla

Reactive Oxygen Species: The Good and the Bad

This chapter summarizes recent research on the biology of reactive oxygen species (ROS). The chapter is focused on the bimodal actions of ROS, which can be summarized as both beneficial and negative. The beneficial aspects of ROS are related to their effects on the redox state of cells and the important role that some ROS play in signaling cascade. The detrimental effects of ROS are related excess amounts of these chemical moieties, which are caused by excessive production and/or insufficient actions of endogenous antioxidants. The generation of these species is also discussed