Maternal Mortality in Cambodia: Efforts to Meet the Millennium Development Goal for Maternal Health

Recent estimates of global maternal mortality indicate that for the first time since the Safe Motherhood Initiative of 1987, deaths due to pregnancy-related causes are on the decline. Defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, maternal mortality is one of the strongest health statistics showing the disparity between poor and rich countries. Although a global decline is documented, challenges to reducing maternal mortality, and meeting Millennium Development Goals (MDGs) for maternal health remain, particularly in many Sub-Saharan African and Southeast Asian countries. This study presents an assessment of Cambodia’s progress towards reaching the Millennium Development Goal of reducing maternal deaths by ¾ by 2015. The report examines issues related to the improvement of maternal health, outlining the magnitude, determinants, and prevention methods of maternal mortality globally and in Cambodia. Cambodia’s health policies and contextual factors impacting the maternal mortality ratio such as dramatic increases of skilled health personnel for delivery, delivery in health facility, and use of antenatal care are identified as key contributors to MMR reduction. Continued progress in reducing maternal mortality in Cambodia requires improvements to midwifery skill, competencies around normal and emergency birthing care, and salaries of midwives as well as an incentive for new graduates to work in the public sector. An increase in the cooperation between government health centers and hospitals are crucial to ensure obstetric referrals, supervision of health center staff, and an improvement in maternal death data collection. Finally a national priority to increase the use of family planning and safe abortion will significantly contribute to the continued reduction of MMR

Juvenile offending among maltreated youth:Assessing type-specificity and offense specialization in the cycle of violence

This study assesses how different forms of abuse and neglect are associated with juvenile offending, with specific emphasis on whether youth commit offenses analogous to the illicit parental behaviors to which they were exposed. Using statewide child welfare system data linked with juvenile offending records, we assess rates and types of offending among a cohort of youth exposed to child maltreatment, including physical abuse, sexual abuse, and neglect (N = 7,787). Findings suggest that the maltreatment-delinquency link is better characterized as a general rather than a specific cycle of violence, though sex abuse victims tend to specialize in sex offending. Youth exposed to physical abuse, moral neglect, and parent incarceration offend at high rates overall and should be prioritized for prevention and treatment services

Learning from the Past : The Women Writers Project and Thirty Years of Humanities Text Encoding

In recent years, intensified attention in the humanities has been paid to data: to data modeling, data visualization, ?big data?. The Women Writers Project has dedicated significant effort over the past thirty years to creating what Christoph Schöch calls ?smart clean data?: a moderate-sized collection of early modern women?s writing, carefully transcribed and corrected, with detailed digital text encoding that has evolved in response to research and changing standards for text representation. But that data?whether considered as a publication through Women Writers Online, or as a proof of the viability of text encoding approaches like those expressed in the Text Encoding Initiative (TEI) Guidelines?is only the most visible part of a much larger ecology. That ecology includes complex human systems, evolving sets of tools, and a massive apparatus of documentation and organizational memory that have made it possible for the project to work coherently over such a long period of time. In this article we examine the WWP?s information systems in relation to the project?s larger scholarly goals, with the aim of showing where they may generalize to the needs of other projects

Developing strategic partnerships through a sustainability enrichment week

This paper describes the development of a mini-module focused on sustainability and timber engineering as a component of a strategic partnership designed to broaden Transnational Education, increase staff/student mobility, and further develop industry and community links within two universities. Edinburgh Napier University (ENU) draws students from around the world and is internationally recognised for timber construction and wood science. The New Model Institute for Technology and Engineering (NMITE) is a new higher education provider in England pioneering an innovative approach to engineering education integrating business, engineering, the liberal arts, and professional skills. ENU and NMITE leveraged these strengths to develop a strategic partnership that brings together staff, students, industry, and the community for opportunities that create impact beyond traditional learning approaches. This can be seen through the development of a Sustainability Enrichment Week hosted by NMITE’s Centre for Advanced Timber Technology (CATT) and attended by ENU Master’s in Environmental Sustainability students. Students investigated interfaces between buildings, humans, and nature through experiential learning based around the construction of the CATT building, which has been developed as a Living Lab. Each day featured activities aligned to identified learning outcomes and was themed around one of five sustainability competencies: systems thinking, values thinking, strategic thinking, future thinking, and collaboration. The Sustainability Enrichment Week also served as a trial for a short course soon to be offered as part of a Timber Technology, Engineering, and Design programme. This project could be a model for other universities seeking to create similar strategic partnerships and learning experiences

Avian Resistance to Campylobacter jejuni Colonization Is Associated with an Intestinal Immunogene Expression Signature Identified by mRNA Sequencing

peer-reviewedThis research was funded by the The Irish Department of Agriculture and Food’s Food Institutional Research Measure (http://www.agriculture.gov.ie/ research/foodinstitutionalresearchmeasurefirm) – Grant No: 06_RDD_486.Campylobacter jejuni is the most common cause of human bacterial gastroenteritis and is associated with several post-infectious manifestations, including onset of the autoimmune neuropathy Guillain-Barré syndrome, causing significant morbidity and mortality. Poorly-cooked chicken meat is the most frequent source of infection as C. jejuni colonizes the avian intestine in a commensal relationship. However, not all chickens are equally colonized and resistance seems to be genetically determined. We hypothesize that differences in immune response may contribute to variation in colonization levels between susceptible and resistant birds. Using high-throughput sequencing in an avian infection model, we investigate gene expression associated with resistance or susceptibility to colonization of the gastrointestinal tract with C. jejuni and find that gut related immune mechanisms are critical for regulating colonization. Amongst a single population of 300 4-week old chickens, there was clear segregation in levels of C. jejuni colonization 48 hours post-exposure. RNAseq analysis of caecal tissue from 14 C. jejuni-susceptible and 14 C. jejuni-resistant birds generated over 363 million short mRNA sequences which were investigated to identify 219 differentially expressed genes. Significantly higher expression of genes involved in the innate immune response, cytokine signaling, B cell and T cell activation and immunoglobulin production, as well as the renin-angiotensin system was observed in resistant birds, suggesting an early active immune response to C. jejuni. Lower expression of these genes in colonized birds suggests suppression or inhibition of a clearing immune response thus facilitating commensal colonization and generating vectors for zoonotic transmission. This study describes biological processes regulating C. jejuni colonization of the avian intestine and gives insight into the differential immune mechanisms incited in response to commensal bacteria in general within vertebrate populations. The results reported here illustrate how an exaggerated immune response may be elicited in a subset of the population, which alters host-microbe interactions and inhibits the commensal state, therefore having wider relevance with regard to inflammatory and autoimmune disease

Establishing A Timber-Focused Competency Framework To Up- And Re-Skill Built Environment Professionals To Meet Sustainability Goals

Engineers equipped with skills for a sustainable built environment have never been more critical, as government and industry sustainability goals such as the 2050 net zero target have significant implications for the construction sector. Concurrently, the UK’s Construction Industry Training Board (CITB) has estimated that over 250,000 new workers will be needed by 2027 to meet demand. Besides this need for green skills, the sector is also looking towards more sustainable building materials, methods, and technologies, such as homegrown biogenic offsite manufactured (bioOSM) timber: an innovative technology requiring additional engineering and manufacturing expertise. To address this critical skills gap, the Timber Technology, Engineering, and Design (TED) Competency Framework was established by a coalition of academic and industry partners. This framework then informed the development of a hybrid training course that can prepare the next generation of timber engineers with the knowledge, transferable skills, and industry experience that can drive change towards sustainability in the built environment and inform a transformational approach in engineering education. This practice paper describes the development of the Timber TED framework and the launch of the corresponding training programme in September 2022. It also reflects on the initial implementation across two cohorts, delivered at the Centre for Advanced Timber Technology at the New Model Institute for Technology and Engineering in Hereford, England, in partnership with Edinburgh Napier University and Timber Development UK. This educational initiative showcases an innovative and replicable approach to upskilling and reskilling for green skills in engineering education

Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation

Background and Purpose. Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members’ and patients’ perceptions of the utility of the developed intervention. Case Descriptions. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Outcomes. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and care givers and monitoring and progressing exercises were not performed consistently. Conclusions. This case report is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcome

Assessment of wind speeds along the damage path of the Alonsa, Manitoba EF4 tornado on 3 August 2018

Given the impracticality of attempting to directly measure wind speeds in tornadoes, wind speed estimation typically relies on the assessment of damage to structures and vegetation using classifications described in the Enhanced Fujita (EF) Scale. The advent of technology enabling the collection of large amounts of data, including detailed ground, drone, and aerial imagery, has led to a growth in research on non-conventional approaches for estimating tornado wind speeds. Research methods focused on defining the tornadic wind field based on forensic analysis of damage observations have shown promise for improving tornado assessments in a quantitative manner. In this study, novel methods for collecting forensic data following tornadoes are presented. Data from the Alonsa, MB tornado are applied to estimating the wind field along the damage path using treefall pattern analysis and threshold debris flight speed calculations. Comparison of the resulting wind speed estimates show reasonable agreement, with maximum speeds from both methods in the EF5 range. These research methods yield higher wind speeds than the maximum value obtained from the conventional EF-Scale assessment, which is in the low-end of the EF4 range based on a wood-frame house with sub-standard construction that was swept entirely from its foundation. Further work is still needed to make these methods operational for routine tornado intensity estimates