Loss before life begins: the invisible babies and their invisible deaths

My experience of baby loss was an isolated learning experience and the main objective of my research was to help better resource other women who may find themselves lost in the system caring for women when their babies die. Particularly, I wanted to highlight and possibly remedy the invisibility of women and their babies that die between 12 and 20 weeks gestation. Loss Before Life Begins was written as four journalistic articles with one of the goals to be that all or some of the articles achieve publication in a mainstream New Zealand magazine. I focussed all the research on the last 20 years, beginning in 1985. Firstly, because it coincides with the establishment of Miscarriage Support Auckland, the first group of its kind in New Zealand. Secondly, because it ensured that the participants' stories would be relevant in the current context of how baby loss is treated by society, the media and the health system. Each article had a specific purpose and aim. Firstly, The Language of Loss investigated the background of our popular understanding of baby loss, including the legal categorisations of baby loss in different gestational periods. It also included research into the language commonly used by health professionals working with women whose babies have died. Quotes from the five women who were participants in the thesis were interwoven in the article. Their stories illustrated the effects of insensitive language on a woman's experience, and the perception of care and treatment received by health professionals. Then I reviewed all mainstream media articles published in New Zealand from 1985. This disclosed the lack of articles about baby loss, and the general dearth of practical information provided when stories did appear. Secondly, And Mother Makes Me was the narrative of the five women's stories interviewed about their babies' deaths between 12 and 20 weeks gestation. I discovered that this timeframe is 'invisible' because women under 20 weeks are not part of the obstetric system, and are cared for by nurses instead of midwives. These mothers are invisible, as are their babies' deaths. Article three, The 'System' and the People Working In It encompasses the sometimes conflicting views of four leading health professionals. Possible explanations for why women whose babies die under 20 weeks are treated differently to women whose babies are considered stillborn were included. Conflicting views about the importance of the media's role emerged. Small changes in the use of medical language by health professionals were outlined. Finally, possible reasons for society's difficulty with the concept of death, and specifically the difficulties when a woman's baby dies before its life has begun were uncovered. The fourth and final article, The Way It Is and The Way It Could Be summarised the background reading; media analysis from the last 20 years; the themes from the five women's stories; and the array of health professionals' views. Included are a number of specific meaningful ways that health professionals, media outlets and society can better support the invisible women when their babies die. These include updating medical language printed in brochures; including fact boxes in editorials; giving women and their families an opportunity to talk about their losses; and reviewing 'the system' that allows women who lose babies between 12 and 20 weeks to be cared for by nurses instead of midwives

Creating open educational resources: a workshop

This session aims to provide an opportunity for conference participants to learn about and share their knowledge and expertise in the creation of Open Educational Resources (OERs). In the first part of the session, the convenors will share their experience from the OpenLearn project, describing some examples from different disciplines and topic areas, with a view to illustrating broad areas of concern as well as opportunities for re-use and repurposing. The main part of the session, however, will offer participants the opportunity to co-create an OER, share their views and experiences and discuss the benefits, limitations and issues they envisage

Storytelling with UK Centenarians: Being a hundred - it’s just luck

What is it like to have lived one hundred years? In the opinion of those who are active and well, what has contributed to their longevity? If asked to tell a story about being 100 years old what would they talk about? In 2010 we interviewed 16 UK centenarians. We travelled to Scotland, Northern Ireland, Wales and England to interview participants in their own homes. We (Koch, Smith, Hutnik and Turner) asked centenarians to tell us their story. We heard about celebrating their 100th birthday with friends and family. We heard that there were 100 balloons or 100 roses or 100 reasons to continue partying into the future. Many chose to talk about aspects of their life that were foremost in their minds. Each person was given space to retell, using their own words, something about themselves and the social context that had shaped their lives. Interviews often included interested friends or relatives. Their accounts ran to several thousand words. Together these stories comprise a social history of ordinary lives lived during the 20th century and into the 21st. Let us introduce you to some of these remarkable older people

Perception of Effective Leadership Concerning Nurse Satisfaction and Intent to Leave

Nurses are an essential part of patient care, and improving retention is important to quality outcomes and the cost of care. An integral aspect of nurse retention is job satisfaction, which may relate to communication provided by organizational leadership. The purpose of this quantitative study was to determine if there was a relationship between perceived effective leadership, nurse job satisfaction, and nurse turnover intent. This potential relationship between leadership communication and nurse turnover was studied with the competing values framework as the theoretical structure. The two research questions addressed the independent variables of perceived effective leadership in a hospital setting and job satisfaction for nursing staff in a hospital setting, and the dependent variable of nursing staff intent to leave, according to the 2018 NSSRN. The secondary data, which included approximately 50,273 nurse respondents, were obtained from the 2018 National Sample Survey of Registered Nurses (NSSRN). A chi-square test of independence was used to analyze the relationship between the variables. Results indicated a significant relationship between perceived effective leadership in a hospital setting and job satisfaction for nursing staff. Results also indicated a significant relationship between the perception of effective leadership in a hospital setting and nursing staff intent to leave. Decreasing nurse turnover may lead to positive social change by ensuring that qualified, dedicated individuals continue to deliver healthcare to the public

Perception of Effective Leadership Concerning Nurse Satisfaction and Intent to Leave

Nurses are an essential part of patient care, and improving retention is important to quality outcomes and the cost of care. An integral aspect of nurse retention is job satisfaction, which may relate to communication provided by organizational leadership. The purpose of this quantitative study was to determine if there was a relationship between perceived effective leadership, nurse job satisfaction, and nurse turnover intent. This potential relationship between leadership communication and nurse turnover was studied with the competing values framework as the theoretical structure. The two research questions addressed the independent variables of perceived effective leadership in a hospital setting and job satisfaction for nursing staff in a hospital setting, and the dependent variable of nursing staff intent to leave, according to the 2018 NSSRN. The secondary data, which included approximately 50,273 nurse respondents, were obtained from the 2018 National Sample Survey of Registered Nurses (NSSRN). A chi-square test of independence was used to analyze the relationship between the variables. Results indicated a significant relationship between perceived effective leadership in a hospital setting and job satisfaction for nursing staff. Results also indicated a significant relationship between the perception of effective leadership in a hospital setting and nursing staff intent to leave. Decreasing nurse turnover may lead to positive social change by ensuring that qualified, dedicated individuals continue to deliver healthcare to the public

Energy Superhub Oxford: final report

Energy Superhub Oxford (ESO) is a £41m demonstration project delivering innovation in smart local energy systems. As countries around the world embark on energy transitions to decarbonise their economies, decentralised and digitised solutions are increasingly important in delivering power, heat and mobility to users. Exploring options for smart local energy systems is a key UK priority. ESO is one of three large demonstrator projects part-funded by the UK government under its “Prospering from the Energy Revolution” (PFER) programme. Work began in April 2019 and ran until March 2023. ESO’s main focus has been on investment in infrastructure for energy storage, electric vehicle charging, low carbon home heating and developing innovative, smart ways of generating benefits from these for users, investors and society at large. This report has been produced by the University of Oxford team and draws on their research findings spanning each of the major work packages: transport (including private wire and Superhub construction), decarbonising heat, and the transmission grid connected battery, its operation and carbon impact. It also includes a chapter on consortium working practices and concludes with overall learnings from the project

Maternal and paternal depressive symptoms and parental vocalisation behaviours in infancy: findings from UK-based birth cohort

Background: Both maternal and paternal postnatal depression (PND) are associated with increased risk of less optimal offspring developmental outcomes. Early exposure to differences in maternal and paternal vocalisation behaviours associated with maternal and paternal PND may be important in this relationship. However, little research has captured vocalisation patterns at home without researchers present. Objectives This study sought to examine the associations between maternal and paternal PND and various aspects of parental vocalisation behaviours. Methods: Mothers (n = 104) and fathers (n = 34) of six-months old infants from the Avon Longitudinal Study of Parents and Children Generation-2 (ALSPAC-G2) provided video footage of mother- and father-infant interactions filmed at home using the head-worn video cameras (headcams) without the need for researchers to be present. Twenty-five mother-infant and father-infant interactions were coded on multiple aspects of parental and infant vocalisation behaviours using the micro-behavioural observational coding system. Parental (PND) was measured using the Edinburgh Postnatal Depression Scale (EPDS; total score). Results: Frequencies and duration of vocalisation behaviours were similar in mothers and fathers. However, there was an indication that fathers demonstrated higher frequency and duration of commands, exclamations and ironic/sarcastic tone, and criticisms compared to mothers, while mothers engaged in more teaching compared to fathers. Linear regression models indicated that maternal and paternal PND were not associated with the majority of vocalisation behaviours. However, there were some specific patterns observed, mostly related to the emotional tone of the vocalisations. Higher levels of maternal PND were associated with lower frequency of speech in a neutral tone, frequency and duration of use of humour, and increased duration of speech in a positive tone. Higher levels of paternal PND were associated with higher mean duration of speech, infant-directed speech, higher frequency and duration of laughing, and increased duration of speech using questions and encouragement. Conclusion: These findings extend existing research by investigating the associations between maternal and paternal PND and a wide range of vocalisation behaviours captured and coded using innovative methods and in a more ecologically valid way than previous studies

Initiation of Pancreatic Cancer: The Interplay of Hyperglycemia and Macrophages Promotes the Acquisition of Malignancy-Associated Properties in Pancreatic Ductal Epithelial Cells

Pancreatic ductal adenocarcinoma (PDAC) is still one of the most aggressive solid malignancies with a poor prognosis. Obesity and type 2 diabetes mellitus (T2DM) are two major risk factors linked to the development and progression of PDAC, both often characterized by high blood glucose levels. Macrophages represent the main immune cell population in PDAC contributing to PDAC development. It has already been shown that pancreatic ductal epithelial cells (PDEC) undergo epithelial-mesenchymal transition (EMT) when exposed to hyperglycemia or macrophages. Thus, this study aimed to investigate whether concomitant exposure to hyperglycemia and macrophages aggravates EMT-associated alterations in PDEC. Exposure to macrophages and elevated glucose levels (25 mM glucose) impacted gene expression of EMT inducers such as IL-6 and TNF-α as well as EMT transcription factors in benign (H6c7-pBp) and premalignant (H6c7-kras) PDEC. Most strikingly, exposure to hyperglycemic coculture with macrophages promoted downregulation of the epithelial marker E-cadherin, which was associated with an elevated migratory potential of PDEC. While blocking IL-6 activity by tocilizumab only partially reverted the EMT phenotype in H6c7-kras cells, neutralization of TNF-α by etanercept was able to clearly impair EMT-associated properties in premalignant PDEC. Altogether, the current study attributes a role to a T2DM-related hyperglycemic, inflammatory micromilieu in the acquisition of malignancy-associated alterations in premalignant PDEC, thus providing new insights on how metabolic diseases might promote PDAC initiation

Bronchopulmonary Dysplasia: Executive Summary of a Workshop

Comment in Bronchopulmonary Dysplasia: The Ongoing Search for One Definition to Rule Them All. [J Pediatr. 2018] Midlife crisis? In its 50th year, BPD redefines itself. [J Pediatr. 2018