Care and self-reported outcomes of care experienced by women with mental health problems in pregnancy: findings from a national survey

Background mental health problems in pregnancy and the postnatal period are relatively common and, in pregnancy, are associated with an increase in adverse outcome. It is recommended that all women are asked about their emotional and mental health and offered treatment if appropriate. Objectives to describe the care received by women self-identifying with mental health problems in pregnancy, and to describe the effects of support, advice and treatment on outcomes in the postnatal period. Design this study used cross-sectional survey data collected in 2014 which described women's experience of maternity care. Setting England Participants a random sample of women who had a live birth in January 2014. Measurements the questionnaire asked about sociodemographic characteristics, whether women were asked about emotional and mental health in pregnancy, support and treatment offered, about postnatal wellbeing, and questions relating to attachment to their baby. Descriptive statistics and logistic regression were used to examine the associations between mental health and outcomes taking account of sociodemographic characteristics. Findings the survey response rate was 47%. Women with antenatal mental health problems were significantly more worried at the prospect of labour and birth, had lower satisfaction with the experience of birth, worse postnatal mental health, and indications of poorer attachment to their baby. They received substantially more care than other women but they did not always view this positively. Support, advice and treatment for mental health problems had mixed effects. Conclusions this study describes the significant additional care provided to women self-identifying with mental health problems in pregnancy, the mixed effects of support, advice and treatment, and the poor perception of staff interaction among women with mental health problems. Implications for practice health care professionals may need additional training to effectively support women with mental health problems during the perinatal period

Possibility over time: sustaining interdisciplinary practice in the zones of possibility

The lure of practice beyond disciplinary ordinance lies in potential for thinking beyond established paradigms. Belgian philosopher of science, Isabelle Stengers claims that things already impinge across disciplinary boundaries; that an “ecology of practices” is possible in the “event” of interdisciplinary transaction. This paper investigates insights from one art practice that links to other practices for particular durations. It thereby enters zones dependent on temporal aggregation and attentive dialogues, enunciating a chain of potentially generative and sustaining production for those involved

Effects of Online, Collaborative Discourse on Secondary Student Writing: A Case Study of the History and Ecology of an Electronic Exchange

Technological environments where teens spend much of their time after school are environments that educators seldom use in classroom instruction. These Web 2.0 environments are participatory, collaborative environments where teens share music, files, pictures, and ideas and are influenced by the information shared by others within their Web 2.0 environments. This study looks at a particular online environment, the Bread Loaf Teacher Network, and how secondary student writing is affected by the collaborative nature of electronic exchanges conducted on this online network. This study analyzed the history and ecology of one electronic exchange (a technological, participatory discourse community within the classroom) that has been replicated using the described format by hundreds of teachers over the course of the past 15 years on BreadNet, the private, online network of the Bread Loaf School of English. Louise Rosenblatt\u27s transactional theory, M. M. Bakhtin\u27s discourse theory, and Lev Vygotsky\u27s social constructivism formed the conceptual framework for this study. Through the intrinsic case study of Pass the Poetry, an electronic exchange conducted on BreadNet via the Bread Loaf Teacher Network, the researcher traced the writings of four students using the transcript of the year-long exchange looking for evidence of student transactions with literature, watching for changes in writing fluency and syntactical complexity, observing responses to peer and adult audiences, and searching for evidence that students change their writing as a result of interactions with their audiences. Data sources for the research included the transcript of the exchange, open-ended surveys of four students who participated in the exchange, interviews of the two teachers who planned the exchange, and an outside correspondent/poet who participated directly with students in the exchange. An ecological metaphor described the components of the exchange. Themes identified in the research included student literary transactions, the role of audience, analysis of syntactic complexity, and online relationship building

If the Shoe Fits: Proposing a Randomised Control Trial on the effect of a digitised in-custody footwear technology compared to a paper-based footwear method.

In order to address the issue of footwear capture from individuals arrested for recordable crime, technology has been developed, which is known as Tread Finder. This technology and development was made possible through Home Office Police Innovation Funding. Tread Finder is now a finished product and the technology has been deployed into a North London custody suite. Tread Finder incorporates the use of a 300 dpi scanner and newly developed software enabling capture, assisted coding and automated geographical crime scene searching. This paper sets out the proposal of a Randomised Control Trial to replicate and upscale a previous lab based experiment into a field environment to assess the cost, efficiency and crime solving benefits realised as a result of deploying Tread Finder technology compared with the previous paper based alternative

'Health is the number one thing we go for': healthism, citizenship and food choice

This paper explores the centrality of pursuit of health to discourse around food purchasing and eating behaviours. Forty-seven participants from metropolitan and rural South Australia were interviewed about how they decided what to purchase and to eat. The majority (n=39) cite the desire to eat healthily as a consideration in food purchasing. Participants reflect upon a personal and moral responsibility to eat well and to feed their family healthily, a duty that is supported by models of governance which favour personal responsibility for health. While all participants reflect upon this responsibility, it is rejected by a group of males on limited incomes who choose food on the basis of cost, taste, convenience and lack of trust in the health care system. The existence of a moral discourse around food is viewed as an example of healthism in which health is central to all aspects of life and self discipline a means to achieving health

Paramedic perceptions of their role, education, training and working relationships when attending cases of mental illness

Mentally ill patients comprise a growing proportion of the workload of paramedics. This descriptive and exploratory study identifies issues in relation to their perception of workload, education and training, organisational culture and their working relationships with other services. Further research is recommended to understand how these perceptions affect paramedic practice in this area

LGR5 is associated with tumor aggressiveness in papillary thyroid cancer.

PurposeLeucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) is a cancer stem cell marker and a down-stream target in Wnt/β-catenin signaling. In human papillary thyroid cancer (PTC), over activation of Wnt/β-catenin has been associated with tumor aggressiveness.Patients and methodsUsing established human cell lines (TPC-1, KTC-1, Nthy-ori-3-1), we report LGR5 and R-spondin (RSPO1-3) overexpression in PTC and manipulate LGR5 and Wnt/β-catenin signaling via both pharmacologic and genetic interventions. We test the association of LGR5 tumor expression with markers of PTC aggressiveness using a Discovery Cohort (n = 26 patients) and a Validation Cohort (n = 157 patients). Lastly, we explore the association between LGR5 and the BRAFV600E mutation (n = 33 patients).ResultsOur results reveal that LGR5 and its ligand, RSPO, are overexpressed in human PTC, whereby Wnt/β-catenin signaling regulates LGR5 expression and promotes cellular migration. In two separate cohorts of patients, LGR5 and RSPO2 were associated with markers of tumor aggressiveness including: lymph node metastases, vascular invasion, increased tumor size, aggressive histology, advanced AJCC TNM stage, microscopic extra thyroidal extension, capsular invasion, and macroscopic invasion. As a biomarker, LGR5 positivity predicts lymph node metastasis with 95.5% sensitivity (95% CI 88.8%-98.7%) and 61% specificity (95% CI: 48.4%-72.4%) and has a negative predictive value (NPV) of 91.3% (95% CI 79.2%-97.5%) for lymph node metastatic disease. In human PTC, LGR5 is also strongly associated with the BRAFV600E mutation (p = 0.005).ConclusionWe conclude that overexpression of LGR5 is associated with markers of tumor aggressiveness in human PTC. LGR5 may serve as a future potential biomarker for patient risk stratification and loco regional metastases in PTC

Prevalence of mental health conditions and relationship with general health in a whole-country population of people with intellectual disabilities compared with the general population

Background: There are no previous whole-country studies on mental health and relationships with general health in intellectual disability populations; study results vary. Aims: To determine the prevalence of mental health conditions and relationships with general health in a total population with and without intellectual disabilities. Method: Ninety-four per cent completed Scotland’s Census 2011. Data on intellectual disabilities, mental health and general health were extracted, and the association between them was investigated. Results: A total of 26 349/5 295 403 (0.5%) had intellectual disabilities. In total, 12.8% children, 23.4% adults and 27.2% older adults had mental health conditions compared with 0.3, 5.3 and 4.5% of the general population. Intellectual disabilities predicted mental health conditions; odds ratio (OR)=7.1 (95% CI 6.8–7.3). General health was substantially poorer and associated with mental health conditions; fair health OR=1.8 (95% CI 1.7–1.9), bad/very bad health OR=4.2 (95% CI 3.9–4.6). Conclusions: These large-scale, whole-country study findings are important, given the previously stated lack of confidence in comparative prevalence results, and the need to plan services accordingly