Woman-centered care 2.0: Bringing the concept into focus

INTRODUCTION Woman-centered care has become a midwifery concept with implied meaning. In this paper we aim to provide a clear conceptual foundation of woman-centered care for midwifery science and practice. METHODS An advanced concept analysis was undertaken. At the outset, a systematic search of the literature was conducted in PubMed, OVID and EBSCO. This was followed by an assessment of maturity of the retrieved data. Principle-based evaluation was done to reveal epistemological, pragmatic, linguistic and logic principles, that attribute to the concept. Summative conclusions of each respective component and a detailed analysis of conceptual components (antecedents, attributes, outcomes, boundaries) resulted in a definition of woman-centered care. RESULTS Eight studies were selected for analyses. In midwifery, woman-centered care has both a philosophical and a pragmatic meaning. There is strong emphasis on the woman-midwife relationship during the childbearing period. The concept demonstrates a dual and equal focus on physical parameters of pregnancy and birth, and on humanistic dimensions in an interpersonal context. The concept is epistemological, dynamic and multi-dimensional. The results reveal the concept's boundaries and fluctuations regarding equity and control. The role of the unborn child is not incorporated in the concept. CONCLUSION An in-depth understanding and a broad conceptual foundation of woman-centered care has evolved. Now, the concept is ready for research and educational purposes as well as for practical utility

Modeling the Distribution of Iron-oxides in Basalt by combining FIB-SEM and MicroCT Measurements

Micromagnetic tomography (MMT) aims to go beyond paleomagnetic measurements on bulk samples by obtaining magnetic moments for individual iron-oxide grains present in a sample. To obtain accurate MMT results all magnetic sources and all their magnetic signals should be known. Small particles (750 nm. The FIB-SEM and MicroCT data are combined through normalizing the grain-size distribution using the surface area of non-magnetic minerals that are characterised in both datasets. Then, a lognormal-like grain-size distribution is acquired for the entire grain-size range. Our dataset enables future studies to populate (MMT) models with a realistic distribution of even the smallest iron-oxide grains, which ultimately may shed light on the confounding influence of such ghost grains on MMT results

Stroke in COVID-19: A systematic review and meta-analysis

Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases is unclear. Aims: We aimed to characterize the incidence, risk factors, clinical–radiological manifestations, and outcome of COVID-19-associated stroke. Methods: Three medical databases were systematically reviewed for published articles on acute cerebrovascular diseases in COVID-19 (December 2019–September 2020). The review protocol was previously registered (PROSPERO ID = CRD42020185476). Data were extracted from articles reporting ≥5 stroke cases in COVID-19. We complied with the PRISMA guidelines and used the Newcastle–Ottawa Scale to assess data quality. Data were pooled using a random-effect model. Summary of review: Of 2277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0–1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral hemorrhage was less common (11.6%). Patients with COVID-19 developing acute cerebrovascular diseases, compared to those who did not, were older (pooled median difference = 4.8 years; 95%CI: 1.7–22.4), more likely to have hypertension (OR = 7.35; 95%CI: 1.94–27.87), diabetes mellitus (OR = 5.56; 95%CI: 3.34–9.24), coronary artery disease (OR = 3.12; 95%CI: 1.61–6.02), and severe infection (OR = 5.10; 95%CI: 2.72–9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference = −6.0 years; 95%CI: −12.3 to −1.4), had higher NIHSS (pooled median difference = 5; 95%CI: 3–9), higher frequency of large vessel occlusion (OR = 2.73; 95%CI: 1.63–4.57), and higher in-hospital mortality rate (OR = 5.21; 95%CI: 3.43–7.90). Conclusions: Acute cerebrovascular diseases are not uncommon in patients with COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggests that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease

The Impact of Grain‐Size Distributions of Iron‐Oxides on Paleomagnetic Measurements

Magnetic signals in igneous rocks arise from assemblages of iron-oxide bearing minerals that differ in for example, size, shape, and chemistry. Paleomagnetic measurements on bulk samples measure millions of such grains simultaneously, producing a statistical ensemble of the magnetic moments of the individual grains. Scanning magnetometry techniques such as the Quantum Diamond Microscope (QDM) measure magnetic signals on micrometer scales, allowing the identification of magnetic moments of individual grains in a sample using for example, Micromagnetic Tomography (MMT). Here we produce a grain-size distribution of iron-oxides in a typical Hawaiian basalt from the superparamagnetic threshold (∼40 nm) to grains with a diameter of 10 µm. This grain-size distribution is obtained by combining FIB-SEM and MicroCT data from sister specimens, and normalizing them to the mineral surface area of non-magnetic minerals. Then we use this grain-size distribution to determine the contributions of individual magnetic carriers to bulk magnetic measurements and surface magnetometry. We found that measurements on bulk samples are sensitive to relatively small grain sizes in the realm of single domain or vortex states (1 µm. This implies that bulk measurements cannot be compared straightforwardly to signals from surface magnetometry from the same sample. Moreover, our observations explain why MMT results are insensitive to the presence of many small grains in a sample that intuitively should hamper their outcome

Stroke in COVID-19: A systematic review and meta-analysis

Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases is unclear. Aims: We aimed to characterize the incidence, risk factors, clinical–radiological manifestations, and outcome of COVID-19-associated stroke. Methods: Three medical databases were systematically reviewed for published articles on acute cerebrovascular diseases in COVID-19 (December 2019–September 2020). The review protocol was previously registered (PROSPERO ID = CRD42020185476). Data were extracted from articles reporting ≥5 stroke cases in COVID-19. We complied with the PRISMA guidelines and used the Newcastle–Ottawa Scale to assess data quality. Data were pooled using a random-effect model. Summary of review: Of 2277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0–1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral hemorrhage was less common (11.6%). Patients with COVID-19 developing acute cerebrovascular diseases, compared to those who did not, were older (pooled median difference = 4.8 years; 95%CI: 1.7–22.4), more likely to have hypertension (OR = 7.35; 95%CI: 1.94–27.87), diabetes mellitus (OR = 5.56; 95%CI: 3.34–9.24), coronary artery disease (OR = 3.12; 95%CI: 1.61–6.02), and severe infection (OR = 5.10; 95%CI: 2.72–9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference = −6.0 years; 95%CI: −12.3 to −1.4), had higher NIHSS (pooled median difference = 5; 95%CI: 3–9), higher frequency of large vessel occlusion (OR = 2.73; 95%CI: 1.63–4.57), and higher in-hospital mortality rate (OR = 5.21; 95%CI: 3.43–7.90). Conclusions: Acute cerebrovascular diseases are not uncommon in patients with COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggests that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease

Exploring the cross-sectional association between outdoor recreational facilities and leisure-time physical activity: the role of usage and residential self-selection.

BACKGROUND: The availability of outdoor recreational facilities is associated with increased leisure-time physical activity (PA). We investigated how much of this association is attributable to selection effects, and explored whether usage of recreational facilities was an explanatory mechanism. METHODS: We analysed data from 5199 participants in the SPOTLIGHT survey residing in five European urban regions. Adults completed a survey and a Google Street View-based virtual audit was conducted to objectively measure the availability of outdoor recreational facilities in the residential neighbourhood. We used negative binomial GEE models to examine the association between objective and subjective availability of outdoor recreational facilities and leisure-time PA, and explored whether this association was attenuated after adjustment for socioeconomic status and preference for neighbourhoods with recreational facilities (as indicators of self-selection). We examined whether reported use of recreational facilities was associated with leisure-time PA (as explanatory mechanism), and summarized the most important motivations for (not) using recreational facilities. RESULTS: Subjective - but not objective - availability of outdoor recreational facilities was associated with higher levels of total leisure-time PA. After adjustment for self-selection (which attenuated the association by 25%), we found a 25% difference in weekly minutes of total leisure-time PA between individuals with and without self-reported availability of outdoor recreational facilities. For our study population, this translates to about 28 min per week. Participants who reported outdoor recreational facilities to be present but indicated not to use them (RR = 1.19, 95% CI = 1.03;1.22), and those reporting outdoor recreational facilities to be present and to use them (RR = 1.33, 95% CI = 1.22, 1.45) had higher levels of total leisure-time PA than those who reported outdoor recreational facilities not to be present. Proximity to outdoor recreational facilities was the most important motivation for use. CONCLUSION: The modest attenuation in the association between availability of outdoor recreational facilities and self-reported leisure-time PA suggests that individuals' higher activity levels may be due more to the perceived availability of outdoor recreational facilities than to self-selection. The use of these facilities seemed to be an important underlying mechanism, and proximity was the main motivator for using recreational facilities

Unraveling the Magnetic Signal of Individual Grains in a Hawaiian Lava Using Micromagnetic Tomography

Micromagnetic Tomography (MMT) is a new technique that allows the determination of magnetic moments of individual grains in volcanic rocks. Current MMT studies either showed that it is possible to obtain magnetic moments of relatively small numbers of grains in ideal sample material or provided important theoretical advances in MMT inversion theory and/or its statistical framework. Here, we present a large-scale application of MMT on a sample from the 1907-flow from Hawaii's Kilauea volcano producing magnetic moments of 1,646 grains. We produced 261,305 magnetic moments in total for these 1,646 grains, an increase of three orders of magnitude compared to earlier studies to assess the robustness of the MMT results, and a major step toward the number of grains that is necessary for paleomagnetic applications of MMT. Furthermore, we show that the recently proposed signal strength ratio is a powerful tool to scrutinize and select MMT results. Despite this progress, still only relatively large iron-oxide grains with diameters >1.5–2 μm can be reliably resolved, impeding a reliable paleomagnetic interpretation. To determine the magnetic moments of smaller (<1 μm) grains that may exhibit pseudo-single domain behavior and are therefore better paleomagnetic recorders, the resolution of the microcomputed tomography and magnetic scans necessary for MMT must be improved. Therefore, it is necessary to reduce the sample size in future MMT studies. Nevertheless, our study is an important step toward making MMT a useful paleomagnetic and rock-magnetic technique

Messing with nature? Exploring public perceptions of geoengineering in the UK

Anthropogenic influence on the climate – and possible societal responses to it – offers a unique window through which to examine the way people think about and relate to the natural world. This paper reports data from four, one-day deliberative workshops conducted with members of the UK public during early 2012. The workshops focused on geoengineering – the deliberate, large-scale manipulation of the planetary environment – as one of three possible responses to climate change (alongside mitigation and adaptation). Here, we explore one of the most pervasive and wide-ranging themes to emerge from the workshops: whether geoengineering represented an unprecedented human intervention into ‘nature’, and what the moral consequences of this might be. Using the concept of ‘messing with nature’ as an analytical lens, we explore public perceptions of geoengineering. We also reflect on why ‘messing with nature’ was such a focal point for debate and disagreement, and whether the prospect of geoengineering may reveal new dimensions to the way that people think about the natural world, and their relationship to it