69 research outputs found
Is intimate partner violence more common in pregnant women with severe mental illness? A retrospective study
Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy.
Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau of Statistics, which included data on pregnant women in Western Australia. Additional measures included reported demographics, substance use and pregnancy variables.
Results: Around 48% of pregnant women with SMI had experienced IPV and were three times the risk when compared with the general pregnant population in Australia. There was no difference in rates of IPV in those women with psychotic disorders when compared with bipolar disorder. Furthermore, the rates of smoking and illicit substance use were significantly higher in pregnant women with SMI who experienced IPV compared with those who have not experienced IPV.
Conclusion: These findings suggest women with SMI in pregnancy are at significantly higher risk of having experienced or experiencing IPV. In addition, IPV in pregnant women with SMI may increase the risk of smoking and illicit substance use. Together this suggests that maternity and mental health services should ensure there are both screening and support pathways for IPV that are developed and evaluated specifically for pregnant women with SMI
Classifying maternal deaths in Suriname using WHO ICD-MM: different interpretation by Physicians, National and International Maternal Death Review Committees
Plain English summary: The World Health Organization (WHO) provides a framework (ICD-MM) to classify pregnancy-related deaths systematically, which enables global comparison among countries. We compared the classification of pregnancy-related deaths in Suriname by the attending physician and by the national maternal death review (MDR) committee and among the MDR committees of Suriname, Jamaica and the Netherlands. There were 89 possible pregnancy-related deaths in Suriname between 2010 and 2014. Nearly half (47%) were classified differently by the Surinamese MDR committee as compared to the classification of the attending physicians. All three MDR committees agreed that 18% (n = 16/89) of the cases were no maternal deaths. Out of the remaining 73 cases, there was disagreement regarding whether 15% (n = 11) were maternal deaths. The Surinamese and Jamaican MDR committees achieved greater consensus in classification than the Surinamese and the Netherlands MDR committees. The Netherlands MDR committee classified more deaths as unspecified than Surinamese and the Jamaican MDR committees. Underlying causes that achieved a high level of agreement among the three committees were abortive outcomes and obstetric hemorrhage, while little agreement was reported for unspecified and other direct causes. The issues encountered during maternal death classification using the ICD-MM guidelines included classification of suicide during early pregnancy; when to assume pregnancy without objective evidence; how to count maternal deaths occurring outside the country of residence; the relevance of direct or indirect cause attribution; and how to select the underlying cause when direct and indirect conditions or multiple comorbidities co-occur. Addressing these classification barriers in future revisions of the ICD-MM guidelines could enhance the feasibility of maternal death classification and facilitate global comparison. Background: Insight into the underlying causes of pregnancy-related deaths is essential to develop policies to avert preventable deaths. The WHO International Classification of Diseases-Maternal Mortality (ICD-MM) guidelines provide a framework to standardize maternal death classifications and enable comparison in and among countries over time. However, despite the implementation of these guidelines, differences in classification remain. We evaluated consensus on maternal death classification using the ICD-MM guidelines. Methods: The classification of pregnancy-related deaths in Suriname during 2010–2014 was compared in the country (between the attending physician and the national maternal death review (MDR) committee), and among the MDR committees from Suriname, Jamaica and the Netherlands. All reviewers applied the ICD-MM guidelines. The inter-rater reliability (Fleiss kappa [κ]) was used to measure agreement. Results: Out of the 89 cases certified by attending physicians, 47% (n = 42) were classified differently by the Surinamese MDR committee. The three MDR committees agreed that 18% (n = 16/89) of these cases were no maternal deaths, and, therefore, excluded from further analyses. However, opinions differed whether 15% (n = 11) of the remaining 73 cases were maternal deaths. The MDR committees achieved moderate agreement classifying the deaths into type (direct, indirect and unspecified) (κ = 0.53) and underlying cause group (κ = 0.52). The Netherlands MDR committee classified more maternal deaths as unspecified (19%), than the Jamaican (7%) and Surinamese (4%) committees did. The mutual agreement between the Surinamese and Jamaican MDR committees (κ = 0.69 vs κ = 0.63) was better than between the Surinamese and the Netherlands MDR committees (κ = 0.48 vs κ = 0.49) for classification into type and underlying cause group, respectively. Agreement on the underlying cause category was excellent for abortive outcomes (κ = 0.85) and obstetric hemorrhage (κ = 0.74) and fair for unspecified (κ = 0.29) and other direct causes (κ = 0.32). Conclusions: Maternal death classification differs in Suriname and among MDR committees from different countries, despite using the ICD-MM guidelines on similar cases. Specific challenges in applying these guidelines included attribution of underlying cause when comorbidities occurred, the inclusion of deaths from suicides, and maternal deaths that occurred outside the country of residence
Identification of Reference Genes across Physiological States for qRT-PCR through Microarray Meta-Analysis
The accuracy of quantitative real-time PCR (qRT-PCR) is highly dependent on
reliable reference gene(s). Some housekeeping genes which are commonly used
for normalization are widely recognized as inappropriate in many
experimental conditions. This study aimed to identify reference genes for
clinical studies through microarray meta-analysis of human clinical
samples.After uniform data preprocessing and data quality control, 4,804 Affymetrix
HU-133A arrays performed by clinical samples were classified into four
physiological states with 13 organ/tissue types. We identified a list of
reference genes for each organ/tissue types which exhibited stable
expression across physiological states. Furthermore, 102 genes identified as
reference gene candidates in multiple organ/tissue types were selected for
further analysis. These genes have been frequently identified as
housekeeping genes in previous studies, and approximately 71% of them
fall into Gene Expression (GO:0010467) category in Gene Ontology.Based on microarray meta-analysis of human clinical sample arrays, we
identified sets of reference gene candidates for various organ/tissue types
and then examined the functions of these genes. Additionally, we found that
many of the reference genes are functionally related to transcription, RNA
processing and translation. According to our results, researchers could
select single or multiple reference gene(s) for normalization of qRT-PCR in
clinical studies
Policy guidance on threats to legislative interventions in public health: a realist synthesis
The SARS-CoV-2 Alpha variant was associated with increased clinical severity of COVID-19 in Scotland: A genomics-based retrospective cohort analysis
Objectives
The SARS-CoV-2 Alpha variant was associated with increased transmission relative to other variants present at the time of its emergence and several studies have shown an association between Alpha variant infection and increased hospitalisation and 28-day mortality. However, none have addressed the impact on maximum severity of illness in the general population classified by the level of respiratory support required, or death. We aimed to do this.
Methods
In this retrospective multi-centre clinical cohort sub-study of the COG-UK consortium, 1475 samples from Scottish hospitalised and community cases collected between 1st November 2020 and 30th January 2021 were sequenced. We matched sequence data to clinical outcomes as the Alpha variant became dominant in Scotland and modelled the association between Alpha variant infection and severe disease using a 4-point scale of maximum severity by 28 days: 1. no respiratory support, 2. supplemental oxygen, 3. ventilation and 4. death.
Results
Our cumulative generalised linear mixed model analyses found evidence (cumulative odds ratio: 1.40, 95% CI: 1.02, 1.93) of a positive association between increased clinical severity and lineage (Alpha variant versus pre-Alpha variants).
Conclusions
The Alpha variant was associated with more severe clinical disease in the Scottish population than co-circulating lineages
SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway
Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant
Computer-based assessment in numeracy and data analysis
CELT research project on changing practice through innovation and researc
Custom Interfaces for Advanced Queries in Search Engines 1
Those seeking information from the Internet often start from a search engine, using either its organised directory structure or its text query facility. In response to the difficulty in identifying the most relevant pages for some information needs, many search engines offer Boolean text matching and some, including Google, AltaVista and HotBot, offer the facility to integrate additional information into a more advanced request. Amongst web users, however, it is known that the employment of complex enquiries is far from universal, with very short queries being the norm. It is demonstrated that the gap between the provision of advanced search facilities and their use can be bridged, for specific information needs, by the construction of a simple interface in the form of a web site that automatically formulates the necessary requests. It is argued that this kind of resource, perhaps employing additional knowledge domain specific information, is one that could be useful for web sites or portals of common interest groups. The approach is illustrated by a web site that enables a user to search the individual web sites of university level institutions in European Union-associated countries
Custom interfaces for advanced queries in search engines
Those seeking information from the Internet often start from a search engine, using either its organised directory structure or its text query facility. In response to the difficulty in identifying the most relevant pages for some information needs, many search engines offer Boolean text matching and some, including Google, AltaVista and HotBot, offer the facility to integrate additional information into a more advanced request. Amongst web users, however, it is known that the employment of complex enquiries is far from universal, with very short queries being the norm. It is demonstrated that the gap between the provision of advanced search facilities and their use can be bridged, for specific information needs, by the construction of a simple interface in the form of a website that automatically formulates the necessary requests. It is argued that this kind of resource, perhaps employing additional knowledge domain specific information, is one that could be useful for websites or portals of common interest groups. The approach is illustrated by a website that enables a user to search the individual websites of university level institutions in European Union associated countries
Submarine volcanism and hydrothermal venting studied in Papua, New Guinea
From March 11 to April 5,1994, the German research vessel Sonne mapped the largely uncharted offshore areas of the Tabarto-Feni island chain in the New Ireland Basin of Papua, New Guinea. The Epithermal Deposits Southwestern Pacific Ocean (EDISON) cruise was organized as part of a multidisciplinary program to study the regional tectonic setting of the Tabar-to-Feni chain, to document recent submarine volcanism, and to investigate seafloor hydrothermal activity on the submerged flanks of the volcanos.
The New Ireland Basin occupies a forearcposition with respect to the formerly active Manus-Kilinailau arc-trench system and hosts a series of Pliocene to recent alkaline volcanos that are built on rifted Miocene sedimentary basement. Several of the volcanos have large, high-level porphyry stocks, and several have active geothermal systems, including gold-depositing hot springs and the giant Ladolam gold deposit on the island of Lihir
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