UK student midwives' theoretical knowledge, confidence, and experience of intermittent auscultation of the fetal heart rate during labour: An online cross-sectional survey

Aim This study aimed to explore student midwives' theoretical knowledge of intrapartum intermittent auscultation, their confidence in, and their experience of this mode of fetal monitoring. Design and Setting An online cross-section survey with closed and open questions. Descriptive statistics were used to analyse participants' intermittent auscultation knowledge, confidence, and experience. Reflexive thematic analysis was used to identify patterns within the free text about participants' experiences. Participants Undergraduate midwifery students (n = 303) from Nursing and Midwifery Council-approved educational institutions within the United Kingdom. Findings Most participants demonstrated good theoretical knowledge. They had witnessed the technique being used in clinical practice, and when performed, the practice was reported to be in line with national guidance. In closed questions, participants reported feeling confident in their intermittent auscultation skills; however, these data contrasted with free-text responses. Conclusion This cross-sectional survey found that student midwives possess adequate knowledge of intermittent auscultation. However, reflecting individual clinical experiences, their confidence in their ability to perform intermittent auscultation varied. A lack of opportunity to practice intermittent auscultation, organisational culture, and midwives' preferences have caused student midwives to question their capabilities with this essential clinical skill, leaving some with doubt about their competency close to registration

Impairments after curative intent treatment for non-small cell lung cancer: A comparison with age and gender-matched healthy controls

Background: The aim of this study was to compare measures of exercise capacity, health-related quality of life (HRQoL), muscle force, lung function and feelings of anxiety and depression in people after curative intent treatment for NSCLC with age and gender-matched healthy controls. Methods: This cross-sectional study included 23 participants (68 ± 10yr; 16 females), 6–10 weeks after lobectomy for NSCLC or, for those who received adjuvant chemotherapy, 4–8 weeks after their last cycle. The study also included 20 age and gender-matched healthy controls (69 ± 5yr; 13 females). All participants underwent measurements of exercise capacity (cycle-ergometry test [CPET] and 6-min walk test [6MWT]), HRQoL (Short-Form 36 general health survey [SF-36]), handgrip force, quadriceps torque, lung function and feelings of anxiety and depression. Results When compared with data collected in healthy controls, those in the NSCLC group demonstrated impairments in the peak rate of oxygen consumption (15 ± 3 versus 24 ± 7 ml kg−1·min−1; p < 0.001) and maximum work rate (75 ± 25 versus 127 ± 51Watts; p < 0.001) measured during the CPET, and 6-min walk distance (494 ± 77 versus 649 ± 61 m; p < 0.001). Similarly, impairments were demonstrated in all domains of the SF-36 (p < 0.01 for all), isometric handgrip force (28 ± 7 versus 34 ± 10 kg; p = 0.02), and all measures of lung function (p ≤ 0.001 for all). A higher score for depression was also seen (3.0 ± 2.5 versus 1.5 ± 1.6; p = 0.03). There was no difference between the groups in isometric quadriceps torque or feelings of anxiety.Conclusions: After curative intent treatment for NSCLC, compared to healthy controls, impairments were demonstrated in laboratory and field-based measures of exercise capacity, HRQoL, isometric handgrip force and lung function. Although people after curative intent treatment for NSCLC reported greater feelings of depression, these levels were below those considered clinically relevant. These findings suggest that people after curative intent treatment for NSCLC may benefit from rehabilitative strategies to optimise exercise capacity and HRQoL

Keck Absorption-Line Spectroscopy of Galactic Winds in Ultraluminous Infrared Galaxies

In this paper, we present moderately-high resolution (~65 km/s) spectroscopy, acquired with ESI on Keck II, of 11 ultraluminous infrared galaxies at z < 0.3 from the IRAS 1 Jy sample. The targets were chosen as good candidates to host galaxy-scale outflows, and most have infrared luminosities dominated by star formation. We use a chi-squared minimization to fit one- to three-component profiles to the NaI D interstellar absorption doublet in each object. Assuming that gas blueshifted by more than 70 km/s relative to the systemic velocity of the host is outflowing, we detect outflows in 73% of these objects. We adopt a simple model of a mass-conserving free wind to infer mass outflow rates in the range (dM/dt)_tot(H) = 13-133 M_sun/yr for galaxies hosting a wind. These values of (dM/dt)_tot, normalized to the corresponding global star formation rates inferred from infrared luminosities, are in the range eta = (dM/dt)_tot / SFR = 0.1-0.7. This is on average a factor of only 10 less than eta from recent measurements of nearby dwarfs, edge-on spirals, and lower-luminosity infrared galaxies. Within our sample, we conclude that eta has no dependence on the mass of the host (parameterized by host galaxy kinematics and absolute R- and K'-band magnitudes). We also attempt to estimate the average escape fraction = Sum(dM/dt_esc^i) / Sum(dM/dt_tot^i) and ``ejection efficiency'' = Sum(dM/dt_esc^i) / Sum(SFR^i) for our sample, which we find to be \~0.4-0.5 and ~0.1, respectively. The complex absorption-line properties of Mrk 231, an ultraluminous infrared galaxy which is optically classified as a Seyfert 1, are discussed separately in an appendix.Comment: 34 pages, 12 .ps figures, 10 tables; accepted for publication in ApJ, 10 May 2002, v570 n

The Canada-UK Deep Submillimetre Survey: The Survey of the 14-hour field

We have used SCUBA to survey an area of 50 square arcmin, detecting 19 sources down to a 3sigma sensitivity limit of 3.5 mJy at 850 microns. We have used Monte-Carlo simulations to assess the effect of source confusion and noise on the SCUBA fluxes and positions, finding that the fluxes of sources in the SCUBA surveys are significantly biased upwards and that the fraction of the 850 micron background that has been resolved by SCUBA has been overestimated. The radio/submillmetre flux ratios imply that the dust in these galaxies is being heated by young stars rather than AGN. We have used simple evolution models based on our parallel SCUBA survey of the local universe to address the major questions about the SCUBA sources: (1) what fraction of the star formation at high redshift is hidden by dust? (2) Does the submillimetre luminosity density reach a maximum at some redshift? (3) If the SCUBA sources are proto-ellipticals, when exactly did ellipticals form? However, we show that the observations are not yet good enough for definitive answers to these questions. There are, for example, acceptable models in which 10 times as much high-redshift star formation is hidden by dust as is seen at optical wavelengths, but also acceptable ones in which the amount of hidden star formation is less than that seen optically. There are acceptable models in which very little star formation occurred before a redshift of three (as might be expected in models of hierarchical galaxy formation), but also ones in which 30% of the stars have formed by this redshift. The key to answering these questions are measurements of the dust temperatures and redshifts of the SCUBA sources.Comment: 41 pages (latex), 17 postscript figures, to appear in the November issue of the Astronomical Journa

Cloud angular momentum and effective viscosity in global SPH simulations with feedback

We examine simulations of isolated galaxies to analyse the effects of localized feedback on the formation and evolution of molecular clouds. Feedback contributes to turbulence and the destruction of clouds, leading to a population of clouds that is younger, less massive, and with more retrograde rotation. We investigate the evolution of clouds as they interact with each other and the diffuse interstellar medium, and determine that the role of cloud interactions differs strongly with the presence of feedback: in models without feedback, scattering events dramatically increase the retrograde fraction, but in models with feedback, mergers between clouds may slightly increase the prograde fraction. We also produce an estimate of the viscous time-scale due to cloud–cloud collisions, which increases with increasing strength of feedback (tν ∼ 20 Gyr versus tν ∼ 10 Gyr), but is still much smaller than previous estimates (tν ∼ 1000 Gyr); although collisions become more frequent with feedback, less energy is lost in each collision than in the models without feedback

Directional wetting in anisotropic inverse opals

Porous materials display interesting transport phenomena due to the restricted motion of fluids within the nano- to micro-scale voids. Here, we investigate how liquid wetting in highly ordered inverse opals is affected by anisotropy in pore geometry. We compare samples with different degrees of pore asphericity and find different wetting patterns depending on the pore shape. Highly anisotropic structures are infiltrated more easily than their isotropic counterparts. Further, the wetting of anisotropic inverse opals is directional, with liquids filling from the side more easily. This effect is supported by percolation simulations as well as direct observations of wetting using time-resolved optical microscopy

Left atrial appendage closure with WATCHMAN in Asian patients: 2 year outcomes from the WASP registry

Background: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region. Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality. Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA2DS2-VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p < 0.001) and hence requirement for larger median device size (27 mm for Asians, 24 mm for non-Asians [p < 0.0001]). Conclusion: Real-world experience of left atrial appendage closure with WATCHMAN has demonstrated low peri-procedural risk, and long-term efficacy for stroke and bleeding prevention in a primarily Asian cohort.Karen P. Phillips, Teguh Santoso, Prashanthan Sanders, Jeffrey Alison, Jason Leung Kwai Chan, Hui-Nam Pak, Mann Chandavimol, Kenneth M. Stein, Nicole Gordon, Omar Bin Razal

HI absorption towards nearby compact radio sources

We present the results of HI absorption measurements towards a sample of nearby Compact Steep-Spectrum (CSS) and Giga-Hertz Peaked Spectrum (GPS) radio sources, the CORALZ sample, using the Giant Metrewave Radio Telescope (GMRT). We observed a sample of 18 sources and find 7 new detections. These sources are of lower luminosity than earlier studies of CSS and GPS objects and we investigate any dependence of HI absorption features on radio luminosity. Within the uncertainties, the detection rates and column densities are similar to the more luminous objects, with the GPS objects exhibiting a higher detection rate than for the CSS objects. The relative velocity of the blueshifted absorption features, which may be due to jet-cloud interactions, are within $\sim$$-$250 km s$^{-1}$ and do not appear to extend to values over 1000 km s$^{-1}$ seen for the more luminous objects. This could be due to the weaker jets in these objects, but requires confirmation from observations of a larger sample of sources. There appears to be no evidence of any dependence of HI column density on either luminosity or redshift, but these new detections are consistent with the inverse relation between HI column density and projected linear size.Comment: 10 pages, 6 figures, accepted for publication in MNRA

Adaptive optics imaging and optical spectroscopy of a multiple merger in a luminous infrared galaxy

(abridged) We present near-infrared (NIR) adaptive optics imaging obtained with VLT/NACO and optical spectroscopy from the Southern African Large Telescope (SALT) of a luminous infrared galaxy (LIRG) IRAS 19115-2124. These data are combined with archival HST imaging and Spitzer imaging and spectroscopy, allowing us to study this disturbed interacting/merging galaxy, dubbed the Bird, in extraordinary detail. In particular, the data reveal a triple system where the LIRG phenomenon is dominated by the smallest of the components. One nucleus is a regular barred spiral with significant rotation, while another is highly disturbed with a surface brightness distribution intermediate to that of disk and bulge systems, and hints of remaining arm/bar structure. We derive dynamical masses in the range 3-7x10^10 M_solar for both. The third component appears to be a 1-2x10^10 M_solar mass irregular galaxy. The total system exhibits HII galaxy-like optical line ratios and strengths, and no evidence for AGN activity is found from optical or mid-infrared data. The star formation rate is estimated to be 190 M_solar/yr. We search for SNe, super star clusters, and detect 100-300 km/s outflowing gas from the Bird. Overall, the Bird shows kinematic, dynamical, and emission line properties typical for cool ultra luminous IR galaxies. However, the interesting features setting it apart for future studies are its triple merger nature, and the location of its star formation peak - the strongest star formation does not come from the two major K-band nuclei, but from the third irregular component. Aided by simulations, we discuss scenarios where the irregular component is on its first high-speed encounter with the more massive components.Comment: 24 pages, 16 figures. Accepted MNRAS version, minor corrections only, references added. Higher resolution version (1.3MB) is available from http://www.saao.ac.za/~petri/bird/ulirg_bird_highres_vaisanen_v2.pd

Booms and busts in commodity markets: bubbles or fundamentals?

This paper considers whether there were periodically collapsing rational speculative bubbles in commodity prices over a 40-year period from the late 1960s. We apply a switching regression approach to a broad range of commodities using two different measures of fundamental values—estimated from convenience yields and from a set of macroeconomic factors believed to affect commodity demand. We find reliable evidence for bubbles only among crude oil and feeder cattle, showing the popular belief that the extreme price movements observed in commodity markets were caused by pure speculation to be unsustainabl