Tongue-tie and breastfeeding: Identifying problems in the diagnostic and treatment journey

Background Tongue-tie is a common condition that often adversely affects breastfeeding. There is research that suggests that frenulotomy can improve breastfeeding but there is also evidence of lack of professional knowledge on tongue-tie. Methods This was a qualitative interview study with GPs, midwives, health visitors and nine mothers to explore facilitators and barriers to receiving a diagnosis of and treatment for tongue-tie. Findings Mothers told a common story of having to push for support, experiencing diagnostic and treatment delays and suffering ongoing distress, which threatened their ability to establish breastfeeding. Mothers also described feeling vulnerable in the neonatal period, and witnessing a variation in professional knowledge about tongue-tie. Conclusions Variable professional knowledge, conflicting advice, and a delayed diagnosis can lead to a difficult patient pathway. Assessment for tongue-tie should be considered when approaching infants with feeding difficulties. Frenulotomy should also be considered and services made available where findings suggest the cause is structural and breastfeeding support has not helped. </jats:sec

The use of CML and CML in Computational Chemistry and Physics Programs

Proceedings of the 2004 e-Science All Hands Meeting, 31st August - 3rd September, Nottingham UKThis work addresses problems associated with data exchange and data representation in the computational chemistry and physics communities. Recent computational developments, such as Condor and the Grid, have paved the way for new kinds of simulations that demand more rigorous data handling. To this end, the paper discusses the use of XML and the Chemical Markup Language (CML) in theoretical chemistry and physics. Extensions to the core CML language, known as CMLComp, are also discussed. However, the majority of atomic scale simulation software is written in Fortran. Fortran's lack of XML support represents a potential barrier to the adoption of CML in these fields. This has prompted the authors to develop XML and CML processing tools for Fortran, including native SAX and DOM implementations, as well as libraries for generating well formed XML and CML. These libraries have been used to extend existing simulation packages to work with the CML and CMLComp languages. Finally, we give a practical example that highlights how these XML aware applications can be effectively used as workflow components in complex chemical and physical simulations

Geogenic factors as drivers of microbial community diversity in soils overlying polymetallic deposits

This study shows that the geogenic factors landform, lithology, and underlying mineral deposits (expressed by elevated metal concentrations in overlying soils) are key drivers of microbial community diversity in naturally metal-rich Australian soils with different land uses, i.e., agriculture versus natural bushland. One hundred sixty-eight soil samples were obtained from two metal-rich provinces in Australia, i.e., the Fifield Au-Pt field (New South Wales) and the Hillside Cu-Au-U rare-earth-element (REE) deposit (South Australia). Soils were analyzed using three-domain multiplex terminal-restriction-fragment-length-polymorphism (M-TRFLP) and PhyloChip microarrays. Geogenic factors were determined using field-mapping techniques and analyses of >50 geochemical parameters. At Fifield, microbial communities differed significantly with geogenic factors and equally with land use (P 0.2 m) differed significantly with lithology and mineral deposit (P < 0.05). Across both sites, elevated metal contents in soils overlying mineral deposits were selective for a range of bacterial taxa, most importantly Acidobacteria, Bacilli, Betaproteobacteria, and Epsilonproteobacteria. In conclusion, long-term geogenic factors can be just as important as land use in determining soil microbial community diversity

Getting to the Root of Tree Soil Microbiome Sampling

Microbiomes play critical roles in host functioning and therefore there is increasing interest in the microbiome assembly of plants. However, sampling strategies for long-lived perennial trees need to be standardised to produce robust data that accurately represents the microbiome over time. This issue is currently unresolved because there is little evidence indicating which portion of perennial tree species (e.g., root region or surrounding soil) is the best to sample to produce the most accurate measure of microbiome communities. Our aim was to sample different compartments of a plant’s belowground microbiome to identify the optimal sampling strategy to account for the microbial community present. We found that the structure of the microbial community depends most strongly on the environment (site) and compartment of sample collected (bulk soil, rhizosphere, or rhizoplane), rather than the depth or cardinal direction of the sample. We also found that the microbial community increased in diversity with increased distance from the tree within the rhizoplane and rhizosphere. The data presented here provides systematic evidence for a pragmatic and robust sampling regime that was tested and validated across different environments and soil types while controlling for host genotype. This sampling regime will enable effective partitioning of root compartments when studying the microbiome associated with perennial tree species, allowing targeted questions about the microbiome to be explored with greater accuracy

Factors associated with midwives\u27 job satisfaction and intention to stay in the profession: An integrative review

AIMS AND OBJECTIVES: To conduct an integrative review of the factors associated with why midwives stay in midwifery. BACKGROUND: Midwifery retention and attrition are globally acknowledged as an issue. However, little is known as to why midwives stay in midwifery as the focus has previously focussed on why they leave. DESIGN: A structured six-step integrative review approach was used, and this involved the development of a search strategy, study selection and critical appraisal, data abstraction and synthesis, interpretation of findings and recommendations for future practice. METHODS: The review was conducted using the databases MEDLINE, CINAHL and PsychInfo. Included studies were in the English language with an unlimited publication date. RESULTS: Six studies were included in this review: one qualitative, two quantitative and three using mixed methods. Seven themes emerged from synthesisation of the data reported for the six included studies that together help answer the question of why midwives stay in midwifery. CONCLUSION: This integrative review has highlighted some important factors that assist in answering the question why midwives stay in midwifery. However, it has also highlighted the need for quality data that reflects the range of contexts in which midwifery is practised. RELEVANCE TO CLINICAL PRACTICE: There is an abundance of literature focussing on why midwives leave the profession; however, the gap exists in the reasons why midwives stay. If we can uncover this important detail, then changes within the profession can begin to be implemented, addressing the shortage of midwives issue that has been seen globally for a large number of years

Interactions involving intestinal nematodes of rodents: experimental and field studies

Multiple species infections with parasitic helminths, including nematodes, are common in wild rodent populations. In this paper we first define different types of associations and review experimental evidence for different categories of interactions. We conclude that whilst laboratory experiments have demonstrated unequivocally that both synergistic and antagonistic interactions involving nematodes exist, field work utilizing wild rodents has generally led to the conclusion that interactions between nematode species play no, or at most a minor, role in shaping helminth component communities. Nevertheless, we emphasize that analysis of interactions between parasites in laboratory systems has been fruitful, has made a fundamental contribution to our understanding of the mechanisms underlying host-protective intestinal immune responses,and has provided a rationale for studies on polyparasitism in human beings and domestic animals. Finally, we consider the practical implications for transmission of zoonotic diseases to human communities and to their domestic animals, and we identify the questions that merit research priority

From exercise intolerance to functional improvement: The second wind phenomenon in the identification of McArdle disease

McArdle disease is the most common of the glycogen storage diseases. Onset of symptoms is usually in childhood with muscle pain and restricted exercise capacity. Signs and symptoms are often ignored in children or put down to 'growing pains' and thus diagnosis is often delayed. Misdiagnosis is not uncommon because several other conditions such as muscular dystrophy and muscle channelopathies can manifest with similar symptoms. A simple exercise test performed in the clinic can however help to identify patients by revealing the second wind phenomenon which is pathognomonic of the condition. Here a patient is reported illustrating the value of using a simple 12 minute walk test.RSS is funded by Ciências sem Fronteiras/CAPES Foundation. The authors would like to thank the Association for Glycogen Storage Disease (UK), the EUROMAC Registry funded by the European Union, the Muscular Dystrophy Campaign, the NHS National Specialist Commissioning Group and the Myositis Support Group for funding