Paediatric emergency department utilisation rates and maternal migration status in the Born in Bradford cohort: A cross-sectional study

Background Globally, international migration is increasing. Population growth, along with other demographic changes, may be expected to put new pressures on healthcare systems. Some studies across Europe suggest that emergency departments (EDs) are used more, and differently, by migrants compared to non-migrant populations, which may be a result of unfamiliarity with the healthcare systems and difficulties accessing primary healthcare. However, little evidence exists to understand how migrant parents, who are typically young and of childbearing age, utilise EDs for their children. This study aimed to examine the association between paediatric ED utilisation in the first 5 years of life and maternal migration status in the Born in Bradford (BiB) cohort study. Methods and findings We analysed linked data from the BiB study—an ongoing, multi-ethnic prospective birth cohort study in Bradford. Bradford is a large, ethnically diverse city in the north of England. In 2017, more than a third of births in Bradford were to mothers who were born outside the UK. Between March 2007 and December 2010, pregnant women were recruited to BiB during routine antenatal care, and the children born to these mothers have been, and continue to be, followed over time to assess how social, genetic, environmental, and behavioural factors impact on health from childhood to adulthood. Data analysed in this study included baseline questionnaire data from BiB mothers, and Bradford Royal Infirmary ED episode data for their children. Main outcomes were likelihood of paediatric ED use (no visits versus at least 1 ED visit in the first 5 years of life) and ED utilisation rates (number and frequency of ED visits) for children who have accessed the ED. The main explanatory variable was mother’s migrant status (foreign-born versus UK/Irish-born). Multivariable analyses (logistic and zero-truncated negative binomial regression) were conducted adjusting for socio-demographic and socio-economic factors. The final dataset included 10,168 children born between April 2007 and June 2011, of whom 35.6% were born to migrant mothers. Foreign-born mothers originated from South Asia (28.6%), Europe/Central Asia (3.2%), Africa (2.1%), East Asia/Pacific (1.1%), and the Middle East (0.6%). At recruitment the mothers ranged in age from 15 to 49 years old. Overall, 3,104 (30.5%) children had at least 1 ED visit in the first 5 years of life, with the highest proportion of visits being in the first year of life (36.7%). The proportion of children who visited the ED at least once was lower for children of migrant mothers as compared to children of non-migrant mothers (29.4% versus 31.2%). Children of migrant mothers were found to be less likely to visit the ED (odds ratio 0.88 [95% CI 0.80 to 0.97], p = 0.012). However, among children who visited the ED, the utilisation rate was significantly higher for children of migrant mothers (incidence rate ratio [IRR] 1.19 [95% CI 1.01 to 1.40], p = 0.040). Utilisation rates were higher for children born to mothers from Europe (IRR 1.71 [95% CI 1.07 to 2.71], p = 0.024) and established migrants (≥5 years living in UK) (IRR 1.24 [95% CI 1.02 to 1.51], p = 0.032) compared to UK/Irish-born mothers. Important limitations include being unable to measure children’s underlying health status and the urgency of ED attendance, as well as the analysis being limited by missing data. Conclusions In this study we observed that there is no higher likelihood of first paediatric ED attendance in the first 5 years of life for children in the BiB cohort for migrant mothers. However, among ED users, children of migrant mothers attend the service more frequently than children of UK/Irish-born mothers. Our findings show that patterns of ED utilisation differ by mother’s region of origin and time since arrival in the UK

Factors impacting knowledge and use of long acting and permanent contraceptive methods by postpartum HIV positive and negative women in Cape Town, South Africa: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The prevention of unintended pregnancies among HIV positive women is a neglected strategy in the fight against HIV/AIDS. Women who want to avoid unintended pregnancies can do this by using a modern contraceptive method. Contraceptive choice, in particular the use of long acting and permanent methods (LAPMs), is poorly understood among HIV-positive women. This study aimed to compare factors that influence women's choice in contraception and women's knowledge and attitudes towards the IUD and female sterilization by HIV-status in a high HIV prevalence setting, Cape Town, South Africa.</p> <p>Methods</p> <p>A quantitative cross-sectional survey was conducted using an interviewer-administered questionnaire amongst 265 HIV positive and 273 HIV-negative postpartum women in Cape Town. Contraceptive use, reproductive history and the future fertility intentions of postpartum women were compared using chi-squared tests, Wilcoxon rank-sum and Fisher's exact tests where appropriate. Women's knowledge and attitudes towards long acting and permanent methods as well as factors that influence women's choice in contraception were examined.</p> <p>Results</p> <p>The majority of women reported that their most recent pregnancy was unplanned (61.6% HIV positive and 63.2% HIV negative). Current use of contraception was high with no difference by HIV status (89.8% HIV positive and 89% HIV negative). Most women were using short acting methods, primarily the 3-monthly injectable (Depo Provera). Method convenience and health care provider recommendations were found to most commonly influence method choice. A small percentage of women (6.44%) were using long acting and permanent methods, all of whom were using sterilization; however, it was found that poor knowledge regarding LAPMs is likely to be contributing to the poor uptake of these methods.</p> <p>Conclusions</p> <p>Improving contraceptive counselling to include LAPM and strengthening services for these methods are warranted in this setting for all women regardless of HIV status. These study results confirm that strategies focusing on increasing users' knowledge about LAPM are needed to encourage uptake of these methods and to meet women's needs for an expanded range of contraceptives which will aid in preventing unintended pregnancies. Given that HIV positive women were found to be more favourable to future use of the IUD it is possible that there may be more uptake of the IUD amongst these women.</p

Do critical thinkers drink too much alcohol, forget to do class assignments, or cheat on exams? Using a critical thinking measure to predict college students’ real-world outcomes

Critical thinking is a higher-order way of reasoning composed of the skill and will to use cognitive abilities and knowledge on a daily basis. It is identified as essential by higher education institutions, corporations, and society in general. To analyze whether college students are critical thinkers in their daily lives, the Halpern Critical Thinking Assessment (HCTA; Halpern in Halpern Critical Thinking Assessment (Measurement instrument), Schuhfried, Mödling, 2012) and the real-world outcomes inventory (RWO; Butler in Appl Cogn Psychol 26(5):721–729, 2012) were administered to 238 students. We performed a cluster analysis (K-means-constrained clustering method), and ANOVAs for each cluster solution tested to identify the most suitable clustering solution, taking the RWO inventory dimensions as dependent variables and cluster membership as an independent variable. Four separate clusters emerged, each representing a different profile related to students’ everyday negative outcomes resulting from a lack of critical thinking. We performed multinomial logistic regression to examine which dimensions of the HCTA test, as well as gender, age, and disciplinary area, predicted the four singular groups of students that emerged: “Mature,” “Risk-taking,” “Lost in translation,” and “Reflective.” Results indicate that: (1) age is a relevant predictor of slackness, rashness, and health neglect, all characteristics of “Mature” students; (2) students who are particularly skilled in hypothesis testing tend to be “Risk-taking,” while it is less likely that students who are specifically competent in argument analysis will be in this group; (3) gender is relevant to predict “Lost in translation” students, while argument analysis is negatively related to the chances of being in this group. Our study supports the relevance of critical thinking in daily decisions and everyday outcomes.FCT -Fundação para a Ciência e a Tecnologia(Advanced Training)info:eu-repo/semantics/publishedVersio

Academic Performance and Behavioral Patterns

Identifying the factors that influence academic performance is an essential part of educational research. Previous studies have documented the importance of personality traits, class attendance, and social network structure. Because most of these analyses were based on a single behavioral aspect and/or small sample sizes, there is currently no quantification of the interplay of these factors. Here, we study the academic performance among a cohort of 538 undergraduate students forming a single, densely connected social network. Our work is based on data collected using smartphones, which the students used as their primary phones for two years. The availability of multi-channel data from a single population allows us to directly compare the explanatory power of individual and social characteristics. We find that the most informative indicators of performance are based on social ties and that network indicators result in better model performance than individual characteristics (including both personality and class attendance). We confirm earlier findings that class attendance is the most important predictor among individual characteristics. Finally, our results suggest the presence of strong homophily and/or peer effects among university students

Neutral pion photoproduction off protons in the energy range 0.3 GeV < E(gamma) < 3 GeV

Single pi0 photoproduction has been studied with the CB-ELSA experiment at Bonn using tagged photon energies between 0.3 and 3.0 GeV. The experimental setup covers a very large solid angle of about 98% of 4 pi. Differential cross sections (d sigma)/(d Omega) have been measured. Complicated structures in the angular distributions indicate a variety of different resonances being produced in the s channel intermediate state gamma p --> N* (Delta*) --> p pi0. A combined analysis including the data presented in this letter along with other data sets reveals contributions from known resonances and evidence for a new resonance N(2070)D15.Comment: LaTeX file, 4 pages, 4 encapsulated postscript figures, submitted to Phys. Rev. Lett. The publication of hep-ex/0407022 is accompanied by hep-ex/0311045 on photoproduction of eta mesons. Reference [3]: changed, reference [17]: citation added. Figure 3, 4: SAID added up to 2 GeV for comparison, update

What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis

Background Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient’s journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions. Methods A rapid evidence synthesis, using a systematic literature search, was undertaken in the electronic data bases of MEDLINE, EMBASE, CINAHL, the Cochrane Library and Web of Science, for the years 2000–2014. Evidence included in this review was restricted to Randomised Controlled Trials (RCTs) and observational studies (with a control arm) reported in peer-reviewed journals. Studies evaluating interventions for patients with an acute exacerbation of a medical condition in the ED or acute care setting which reported at least one outcome related to ED attendance or unplanned admission were included. Results Thirty papers met our inclusion criteria: 19 intervention studies (14 RCTs) and 11 controlled observational studies. Sixteen studies were set in the ED and 14 were conducted in an acute setting. Two studies (one RCT), set in the ED were effective in reducing ED attendance and hospital admission. Both of these interventions were initiated in the ED and included a post-discharge community component. Paradoxically 3 ED initiated interventions showed an increase in ED re-attendance. Six studies (1 RCT) set in acute care settings were effective in reducing: hospital admission, ED re-attendance or re-admission (two in an observation ward, one in an ED assessment unit and three in which the intervention was conducted within 72 h of admission). Conclusions There is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients

Photoproduction of eta mesons off protons for photon energies from 0.75 GeV to 3 GeV

Total and differential cross sections for the reaction p(gamma, eta)p have been measured for photon energies in the range from 750 MeV to 3 GeV. The low-energy data are dominated by the S11 wave which has two poles in the energy region below 2 GeV. Eleven nucleon resonances are observed in their decay into p eta. At medium energies we find evidence for a new resonance N(2070)D15 with (mass, width) = (2068+-22, 295+-40) MeV. At photon energies above 1.5 GeV, a strong peak in forward direction develops, signalling the exchange of vector mesons in the t channel.Comment: LaTeX, 4 pages including 4 eps-figures, submitted to Phys. Rev. Lett. The publication of hep-ex/0311045 is accompanied by hep-ex/0407022 on photoproduction of neutral pions, submitted to Phys. Rev. Lett. Fits published in the latest version are based on additional data, new beam asymmetry data from GRAAL are included, for instance. The data demanded more resonant contributions which were studied in detail. PWA reference adde

Double jeopardy:subordinates' worldviews and poor performance as predictors of abusive supervision

Purpose - To test a moderated mediation model where a positive relationship between subordinates’ perceptions of a dangerous world—the extent to which an individual views the world as a dangerous place—and supervisory abuse is mediated by their submission to authority figures, and that this relationship is heightened for more poorly performing employees. Design/Methodology/Approach - Data were obtained from 173 subordinates and 45 supervisors working in different private sector organizations in Pakistan. Findings - Our model was supported. It appears that subordinates’ dangerous worldviews are positively associated with their perceptions of abusive supervision and that this is because such views are likely to lead to greater submission to authority figures. But this is only for those employees who are performing more poorly. Implications - We highlight the possibility that individual differences (worldviews, attitudes to authority figures, and performance levels) may lead employees to become victims of abusive supervision. As such, our research informs organizations on how they may better support supervisors in managing effectively their subordinate relationships and, in particular, subordinate poor performance. Originality/Value - We add to recent work exploring subordinate-focused antecedents of abusive supervision, finding support for the salience of the previously untested constructs of individual worldviews, authoritarian submission, and individual job performance. In so doing we also extend research on dangerous worldviews into a new organizational setting. Finally, our research takes place within a new Pakistani context, adding to the burgeoning non-US based body of empirical work into the antecedents and consequences of abusive supervision