Pregnancy, prison and perinatal outcomes in New South Wales, Australia: a retrospective cohort study using linked health data

BACKGROUND Studies from the United States and the United Kingdom have found that imprisoned women are less likely to experience poorer maternal and perinatal outcomes than other disadvantaged women. This population-based study used both community controls and women with a history of incarceration as a control group, to investigate whether imprisoned pregnant women in New South Wales, Australia, have improved maternal and perinatal outcomes. METHODS Retrospective cohort study using probabilistic record linkage of routinely collected data from health and corrective services in New South Wales, Australia. Comparison of the maternal and perinatal outcomes of imprisoned pregnant women aged 18-44 years who gave birth between 2000-2006 with women who were (i) imprisoned at a time other than pregnancy, and (ii) community controls. OUTCOMES OF INTEREST onset of labour, method of birth, pre-term birth, low birthweight, Apgar score, resuscitation, neonatal hospital admission, perinatal death. RESULTS Babies born to women who were imprisoned during pregnancy were significantly more likely to be born pre-term, have low birthweight, and be admitted to hospital, compared with community controls. Pregnant prisoners did not have significantly better outcomes than other similarly disadvantaged women (those with a history of imprisonment who were not imprisoned during pregnancy). CONCLUSIONS In contrast to the published literature, we found no evidence that contact with prison health services during pregnancy was a "therapunitive" intervention. We found no association between imprisonment during pregnancy and improved perinatal outcomes for imprisoned women or their neonates. A history of imprisonment remained the strongest predictor of poor perinatal outcomes, reflecting the relative health disadvantage experienced by this population of women.This work was undertaken with funding from the National Health and Medical Research Council of Australia. Project Grant ID 457515

A Lattice Test of 1/N_c Baryon Mass Relations

1/N_c baryon mass relations are compared with lattice simulations of baryon masses using different values of the light-quark masses, and hence different values of SU(3) flavor-symmetry breaking. The lattice data clearly display both the 1/N_c and SU(3) flavor-symmetry breaking hierarchies. The validity of 1/N_c baryon mass relations derived without assuming approximate SU(3) flavor-symmetry also can be tested by lattice data at very large values of the strange quark mass. The 1/N_c expansion constrains the form of discretization effects; these are suppressed by powers of 1/N_c by taking suitable combinations of masses. This 1/N_c scaling is explicitly demonstrated in the present work.Comment: 13 pages, 20 figures; v2 version to be published in PR

Reflections on Mental Health Advocacy Across Differing Ecological Levels

Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can affect several levels of the social ecology. Conclusions: Advocacy and interventions that make an effort to encompass the levels of the social-ecological model may contribute to greater progress in improving mental health outcomes

Planning a method for covariate adjustment in individually randomised trials: a practical guide

Background: It has long been advised to account for baseline covariates in the analysis of confirmatory randomised trials, with the main statistical justifications being that this increases power and, when a randomisation scheme balanced covariates, permits a valid estimate of experimental error. There are various methods available to account for covariates but it is not clear how to choose among them. // Methods: Taking the perspective of writing a statistical analysis plan, we consider how to choose between the three most promising broad approaches: direct adjustment, standardisation and inverse-probability-of-treatment weighting. // Results: The three approaches are similar in being asymptotically efficient, in losing efficiency with mis-specified covariate functions and in handling designed balance. If a marginal estimand is targeted (for example, a risk difference or survival difference), then direct adjustment should be avoided because it involves fitting non-standard models that are subject to convergence issues. Convergence is most likely with IPTW. Robust standard errors used by IPTW are anti-conservative at small sample sizes. All approaches can use similar methods to handle missing covariate data. With missing outcome data, each method has its own way to estimate a treatment effect in the all-randomised population. We illustrate some issues in a reanalysis of GetTested, a randomised trial designed to assess the effectiveness of an electonic sexually transmitted infection testing and results service. // Conclusions: No single approach is always best: the choice will depend on the trial context. We encourage trialists to consider all three methods more routinely

Clinician and Patient Experiences of Managing and Living with Oral and Dental Manifestations of Scleroderma: A Scoping Review

Oral and dental manifestations of scleroderma are extremely common, yet they are often overlooked within rheumatology and poorly understood within dentistry. Previous research has indicated the need to understand the oral and dental experiences of people living with scleroderma and those involved in their care. This scoping review aims, for the first time, to comprehensively map what is known regarding the identification and management of oral and dental manifestations of scleroderma, how these are experienced by people living with scleroderma, and to explore key characteristics of barriers and enablers to good oral and dental care in scleroderma. A scoping review was conducted using six databases (Embase, PubMed, PsychINFO, ASSIA, Scopus, and SSCI), according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses – extension for Scoping Review. Grey literature were also included. Studies were eligible for inclusion if the full text and abstract were available in English, published between 2002 and 2022, and focused on the concept of oral and dental care in adults with scleroderma, either relating to identification and management, enablers and barriers to best practice, or patient experiences and wellbeing. Qualitative research which seeks to understand patients’ lived experiences was a notable gap in the literature. Similarly, there was a significant lack of focus on the oral and dental manifestations of scleroderma in rheumatology. Three key features were identified which would facilitate best practice in research and clinical contexts: the necessity of multidisciplinary care; the necessity of centralising patient experience; and the necessity of mitigating barriers to dental care. We conclude that increased awareness of scleroderma within dentistry, and streamlining referral procedures between the disciplines of dentistry and rheumatology, to enable the early identification and management of scleroderma, are crucial

Materials for phantoms for terahertz pulsed imaging

Phantoms are commonly used in medical imaging for quality assurance, calibration, research and teaching. They may include test patterns or simulations of organs, but in either case a tissue substitute medium is an important component of the phantom. The aim of this work was to identify materials suitable for use as tissue substitutes for the relatively new medical imaging modality terahertz pulsed imaging. Samples of different concentrations of the candidate materials TX151 and napthol green dye were prepared, and measurements made of the frequency-dependent absorption coefficient (0.5 to 1.5 THz) and refractive index (0.5 to 1.0 THz). These results were compared qualitatively with measurements made in a similar way on samples of excised human tissue (skin, adipose tissue and striated muscle). Both materials would be suitable for phantoms where the dominant mechanism to be simulated is absorption (similar to ∼100 cm(-1) at 1 THz) and where simulation of the strength of reflections from boundaries is not important; for example, test patterns for spatial resolution measurements. Only TX151 had a frequency-dependent refractive index close to that of tissue, and could therefore be used to simulate the layered structure of skin, the complexity of microvasculature or to investigate frequency-dependent interference effects that have been noted in terahertz images

Simulation-Based Learning to Improve Athletic Trainers’ Knowledge of Exertional Sudden Death Conditions: A Pilot Study

Purpose: Continuing education for the practicing clinician typically involves reading peer-reviewed journals and attending professional conferences. These mechanisms do not allow for practice and real-time evaluation of healthcare skills. Simulation-based learning has been widely used in professional education yet is not common in the continued development of the clinician in their lifespan. Method: We used a cross-sectional, repeated measures pilot study. The participants included 11 athletic trainers (age=40±14 years; certified experience=17±14 years) that engaged in a multi-modal continuing professional development session that included a lecture, large-scale simulated learning experience, and debriefing session at a healthcare conference. The outcome measures included 1) a 6-item effectiveness tool to assess the overall program, 2) pre, post, and 6-month follow-up knowledge assessments, and 3) a 6-month follow-up qualitative viewpoint statement. Results: The participants rated the program as effective and useful. On the knowledge assessment, the participants scored an average of 74% on the pre-test and 87% on the post-test with an average change score of a 20.5% increase following the educational session. We identified a significant improvement (P=0.002) in the participants from pre-test to post-test, however a decay in the knowledge improvements from post-test to follow-up at six months (P=0.188) was noted. Conclusion: A multi-modal educational intervention was effective at improving knowledge immediately following the session. This study offers promise that continuing education through simulation may improve knowledge acquisition while serving as a catalyst for clinical practice behavior change

Candida albicans Hypha Formation and Mannan Masking of β-Glucan Inhibit Macrophage Phagosome Maturation

Received 28 August 2014 Accepted 28 October 2014 Published 2 December 2014 This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 Unported license. ACKNOWLEDGMENTS We thank Janet Willment, Aberdeen Fungal Group, University of Aberdeen, for kindly providing the soluble Dectin-1-Fc reporter. All microscopy was performed with the assistance of the University of Aberdeen Core Microscopy & Histology Facility, and we thank the IFCC for their assistance with flow cytometry. We thank the Wellcome Trust for funding (080088, 086827, 075470, 099215, 097377, and 101873). E.R.B. and A.J.P.B. are funded by the European Research Council (ERC-2009-AdG-249793), and J.L. is funded by a Medical Research Council Clinical Training Fellowship.Peer reviewedPublisher PD

What changed your mind : the roles of dynamic topics and discourse in argumentation process

In our world with full of uncertainty, debates and argumentation contribute to the progress of science and society. Despite of the in- creasing attention to characterize human arguments, most progress made so far focus on the debate outcome, largely ignoring the dynamic patterns in argumentation processes. This paper presents a study that automatically analyzes the key factors in argument persuasiveness, beyond simply predicting who will persuade whom. Specifically, we propose a novel neural model that is able to dynamically track the changes of latent topics and discourse in argumentative conversations, allowing the investigation of their roles in influencing the outcomes of persuasion. Extensive experiments have been conducted on argumentative conversations on both social media and supreme court. The results show that our model outperforms state-of-the-art models in identifying persuasive arguments via explicitly exploring dynamic factors of topic and discourse. We further analyze the effects of topics and discourse on persuasiveness, and find that they are both useful -- topics provide concrete evidence while superior discourse styles may bias participants, especially in social media arguments. In addition, we draw some findings from our empirical results, which will help people better engage in future persuasive conversations