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Where do women birth during a pandemic? Changing perspectives on Safe Motherhood during the COVID-19 pandemic
During the coronavirus disease 2019 (COVID-19) pandemic, health systems all over the world are either stressed to their maximum capacity or anticipating becoming overwhelmed. The population is advised not to attend hospital unless strictly necessary, yet this advice seems to apply to all but healthy women during childbirth.
Specialized hospital care during childbirth can be lifesaving in case of obstetric complications or for COVID-19 symptomatic women, while strong evidence suggests the appropriateness of midwifery units that are integrated into the healthcare system for eligible women. We must ask ourselves whether obstetric units are the appropriate birthing facilities for healthy women during the pandemic.
We have learned from previous crises that the needs of women and children are often badly served during disasters. The COVID-19 pandemic raises concerns over escalation of mistreatment and abuse media are already reporting on restrictions to the rights of birthing women in Europe and the US. In addition, concerns have emerged over increased risk of infection to COVID-19 among birthing women and familied by concentrating all women in obstetric units and lack of optimal care due to pressure on staff and resources. Women's rights in childbirth are being threatened by lack of care during labor, restrictions on accompaniment, unnecessary interventions including inductions, separation of mother and baby and prohibition on breastfeeding.
An effective response to the crisis depends on strong and coordinated health care systems where mothers can birth safely, and the needs of the newborn babies are met. The interpretation of what constitute safe care is a stimulus for a strong debate between those who argue for strengthening community and primary care services and those who recommend for centralization of all births in hospitals. This debate is particularly salient during this pandemic and in preparation of future pandemics.
We propose a strategic response in the face of the pandemic by expanding the use of midwifery units both alongside the obstetric unit and freestanding (in the community). Where midwifery units are absent pop-up units can be created quickly following the example of the Netherlands. This strategy in high income countries is evidence-based and also serves as a response to the surge in requests of safe childbirths pathways away from the obstetric unit by concerned women at unprecedented rates. We urge policy makers to consider replicating this model in low- and middle-income countries where hospital conditions are more precarious.
A strong collaboration between midwives, nurses, obstetricians and neonatologists and the integration of primary care and acute services could ensure safety while maximizing the rational use of resources. Immediate strategic action would ensure that women are able to access appropriate care at the appropriate time, while hospitals continue to respond to the COVID-19 crisis and obstetric units are kept for women needing specialist care
Statistical Mechanics of Phase-Space Curves
We study the classical statistical mechanics of a phase-space curve. This
unveils a mechanism that, via the associated entropic force, provides us with a
simple realization of effects such as confinement, hard core, and asymptotic
freedom. Additionally, we obtain negative specific heats, a distinctive feature
of self-gravitating systems and negative pressures, typical of dark energy.Comment: 24 pages, 15 figure
3D Effects Of The Entropic Force
This work analyzes the classical statistical mechanics associated to
phase-space curves in three dimensions. Special attention is paid to the
entropic force. Strange effects like confinement, hard core, and asymptotic
freedom are uncovered. Negative specific heats, that were previously seen to
emerge in a one-dimensional setting, disappear in 3D, and with them,
gravitational effects of the entropic force.Comment: arXiv admin note: substantial text overlap with arXiv:1306.203
Canonical quantization of non-local field equations
We consistently quantize a class of relativistic non-local field equations
characterized by a non-local kinetic term in the lagrangian. We solve the
classical non-local equations of motion for a scalar field and evaluate the
on-shell hamiltonian. The quantization is realized by imposing Heisenberg's
equation which leads to the commutator algebra obeyed by the Fourier components
of the field. We show that the field operator carries, in general, a reducible
representation of the Poincare group. We also consider the Gupta-Bleuler
quantization of a non-local gauge field and analyze the propagators and the
physical states of the theory.Comment: 18 p., LaTe
Physical peculiarities of divergences emerging in q-deformed statistics
It was found in [Europhysics Letters {\bf 104}, (2013), 60003] that classical
Tsallis theory exhibits poles in the partition function and the mean
energy . These occur at a countably set of the q-line. We give
here, via a simple procedure, a mathematical account of them. Further, by
focusing attention upon the pole-physics, we encounter interesting effects. In
particular, for the specific heat, we uncover hidden gravitational effects.Comment: 21 pages, 3 figures. Title has changed. Text has change
A Family of unitary higher order equations
A scalar field obeying a Lorentz invariant higher order wave equation, is
minimally coupled to the electromagnetic field. The propagator and vertex
factors for the Feynman diagrams, are determined. As an example we write down
the matrix element for the Compton effect. This matrix element is algebraically
reduced to the usual one for a charged Klein-Gordon particle. It is proved that
the order theory is equivalent to n independent second order
theories. It is also shown that the higher order theory is both renormalizable
and unitary for arbitrary n.Comment: 17 pages, LaTex, no figure
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