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Maternal health inequalities:focusing on Black pregnant women
Get PDFThe gap between maternal mortality for Black and White women in the UK continues to widen. Deprivation significantly increases the risk of maternal morbidity, mortality and adverse birth outcomes, affecting access to nutritious foods and antenatal care as well as increasing the likelihood of negative health behaviours such as smoking and substance use. However, ethnic health disparities exist regardless of social or economic status, meaning social disadvantage fails to explain these differences alone. Studies have identified racial discrimination and bias as important factors fuelling the disparities in pregnancy outcomes among Black women. Black women report dismissal of concerns, assumptions and stereotypes among other negative experiences of their maternity care. This ultimately fosters fear and mistrust in maternity services, causing Black women to report health concerns later and avoid attending for care. Acknowledging that racism exists in maternity systems is a crucial step in addressing inequalities in maternal outcomes
Photocatalytic Conversion of β-O-4 Lignin Model Dimers::The Effect of Benzylic Ketones on Reaction Pathway
Get PDFThe conversion of biomass towards value-added and platform chemicals has become the focus of extensive research this past two decades. One of the methods which has been increasingly studied is the use of semiconductor mediated photocatalysis for biomass conversion. Titanium dioxide has previously been demonstrated to be an effective commercial catalyst for the cleavage of bonds within lignin and also cellulose and hemicellulose. Herein is described the deployment of TiO2 for the cleavage of bonds within two β-O-4 lignin model compounds, one bearing a ketone in the α-position and the other an alcohol. The presence of a ketone in the benzylic position in one of the models had a pronounced effect under photolytic conditions e.g. in the absence of a photocatalyst, but with irradiation present. The subsequent reduction of the benzylic ketone resulted in observed sensitivity towards the irradiation and solely photocatalytic conversion was achieved. In addition, reaction products are proposed which demonstrates a feasible method for β-O-4 cleavage in native lignin extracts
Topical steroid withdrawal: self-diagnosis, unconscious bias and social media:TSW
Get PDFBackgroundConsensus amongst dermatologists regarding the phenomenon of topical steroid withdrawal (TSW) is elusive. This may be contrasted with a growing online patient movement, including social media communities.ObjectivesThis study aimed to investigate dermatologist perspectives regarding TSW and to assess attitudes towards self-diagnosis.MethodsA two-part online questionnaire was disseminated to UK-based Dermatology Consultants, Registrars and Fellows. Section one presented a clinical scenario and randomized respondents into two groups: one mentioning TSW self-diagnosis, and an otherwise identical control without the self-diagnosis. Questions about the clinical scenario were directed to dermatologists and focused on attitudes regarding patient-predicted behaviours. Section two asked about TSW perceptions and experiences, and thematic analysis of open text responses was undertaken.ResultsOne hundred and three responses were received, including 51 Consultants, 38 Trainee Dermatologists, 10 Dermatology Fellows, 3 Specialty And Specialist (SAS) Dermatology doctors and 1 Post-CCT (Certificate of Completion of Training) Fellow. Thirty-four percent (n = 35/103) of respondents considered TSW to be a distinct clinical entity, 17.5% (n = 18/103) did not and 48.5% (n = 50/103) were unsure. Respondents felt that self-diagnosing TSW patients were less likely to comply with treatment, and more likely to take up time and pose management problems compared with controls. Themes of uncertainty regarding diagnostic veracity and social media misinformation were identified.ConclusionsUncertainty regarding the veracity of a TSW diagnosis and its management is common amongst dermatology healthcare professionals (HCPs). Dermatology HCPs in this study considered that patients who self-diagnosed TSW were more difficult to engage with skin disease management. Dermatologists desire further understanding of and research into the nature and management of TSW.<br/
Women’s alcohol use in mid-life: associations between menopause symptoms, drinking behaviour, and mental health
Get PDFObjectives: The study aimed to identify associations between menopause, alcohol use, and mental health. Particularly examining how menopause symptoms may relate to alcohol behaviours in midlife women.Design: An online mixed methods cross-sectional survey study was conducted to gather data on menopause-related symptoms, alcohol use, mental health, and wellbeing among women.Methods: A sample of 936 women aged 40-65 was recruited for the study. Quantitative measures assessed menopause symptoms, alcohol use and associated harm, mental health, and overall wellbeing. Qualitative data were collected through text responses to explore motives for drinking.Results: Perimenopausal participants, compared to pre- or postmenopausal women, reported the highest levels of menopause symptoms, negative reinforcement drinking motives (e.g., drinking to cope), negative mood, and the lowest wellbeing scores. Additionally, negative reinforcement motives partially mediated the relationship between menopausal symptoms and hazardous drinking. Qualitative findings showed that women often drank as a coping mechanism, while some avoided alcohol due to its potential to worsen menopausal symptoms.Conclusions: This study provides new insights into the associations between menopausal symptoms, alcohol use, and mental health in midlife women. The findings highlight the complex factors driving alcohol use and avoidance, suggesting that tailored interventions are needed for women in midlife. This research underscores the importance of addressing alcohol-related risks in this under-researched group, given the potential for significant harm.<br/
P20 The methodological quality of studies assessing healthcare students’ knowledge of antibiotic use and resistance: a systematic review
Get PDFObjectives This systematic review assesses the methodological quality of studies investigating the knowledge of healthcare students on antibiotic use and resistance. Methods The PubMed®, Embase® (via Ovid) and CINAHL (via EBSCO) databases were systematically searched for studies published between 01 January 2014 and 31 December 2024 that reported Healthcare students’ knowledge of antibiotic use and resistance. The quality of the studies was assessed using the Medical Education Research Quality Instrument (MERSQI), which comprises 10 items across six domains: study design, sampling, data type (subjective or objective), validity, data analysis, and outcomes. Each domain is scored up to a maximum of 3, resulting in a total possible MERSQI score of 18. Results Of the 9165 articles identified, 119 studies with data from 46 countries met the inclusion criteria. The total MERSQI scores of the included studies ranged from 7.00 to 14.00, with a mean score of 10.51±1.46. The highest mean domain scores were for type of data (2.76 ± 0.65) and data analysis (2.71 ± 0.45). The lowest scores were for study design (1.01 ± 0.06) and validity (0.73 ± 0.78). Nearly all (98.3%) of the studies were single-group cross-sectional or post-test-only designs. Face validity, either explicitly stated or inferred, was indicated in 72 articles (60.5%), while content validity, ensuring items covered an appropriate range of topics, was reported in 54 articles (45.4%). Reliability statistics were provided in 31 studies (26.1%), with Cronbach’s α reported in 29 of them. The intraclass correlation coefficient (ICC) and Kuder-Richardson 20 (KR20) were each reported in a single study. Conclusions Many of the reviewed studies were judged to have moderate methodological quality. Additionally, there was often a lack of information or clarity about the content validity of the instruments or questions used to evaluate antibiotic knowledge. The reliability of the study instruments, while extremely valuable, was not always determined or reported. Reporting reliability provides confidence that the results are dependable and not influenced by random errors
Autochthony, affect and education: reimagining belonging after Brexit
Get PDFThis provocation examines how Brexit has revived autochthony—claims to native belonging—reshaping emotional attachments to space, identity, and nation. Drawing on geographic and affect theory, it explores how far-right narratives mobilise affect in education, a key site of tension around belonging and exclusion. Using Nancy Fraser’s progressive populism and affective pedagogy, it calls for educational responses that resist exclusionary imaginaries and build solidarity across difference
Absolute and relative intensity physical activity of children with healthy and low levels of cardiorespiratory fitness
No full textIntroduction Accelerometer-derived outcomes describing physical activity (PA) volume and intensity distribution relative to a person’s maximal capacity have provided insight into associations with health in adults. Little is known, however, about how the relative intensity of children’s PA volume and intensity distribution relates to health or fitness. To address this, we examined associations between children’s absolute and relative PA volume and intensity distribution with cardiorespiratory fitness (CRF), and differences in these PA outcomes for children stratified by CRF level.Materials and Methods In 9–10-year-old children (N=235) PA was assessed using wrist accelerometers for up to 7-days and CRF estimated from the 20-m multistage shuttle run test (20mSRT). Children were classified as Healthy or Low CRF. Absolute PA outcomes were PA volume (average acceleration; AvAccabs) and intensity distribution (intensity gradient; IGabs). Equivalent relative PA outcomes were generated (AvAccrel and IGrel) using maximum acceleration values derived from the 20mSRT.Results Absolute, but not relative standardised PA outcomes were positively associated with CRF (AvAccabs Stdβ=0.21, p=0.02; IGabs Stdβ=0.21, p=0.03). Absolute standardised PA outcomes were significantly higher among Healthy CRF children (AvAccabs Stdβ=0.40, p=0.007; IGabs Stdβ=0.46, p=0.008), but there were no significant differences between Healthy and Low CRF groups for relative PA outcomes.Conclusions Children were similarly active relative to their physiological capacity, despite children with Healthy CRF being more active in absolute terms. Future studies should seek to better understand the influence of relative PA on CRF among diverse child populations who differ on a range of physical, physiological and demographic characteristics
Chapter 3 Medical Ethics
No full textAt its heart, the practice of medicine is a human and moral endeavour concerned with forming therapeutic relationships with patients. It is crucial for everyone practicing medicine to understand the moral and legal framework that underpins and regulates their work. In modern routine clinical practice, ethical and legal decisions are made daily by clinical teams working with patients and, where appropriate, involving their families. Increasingly, hospitals have a clinical ethics committee to discuss complex ethical cases. Trust’s may also seek a legal opinion for more challenging cases which involve a point of law. If situations are contested and disagreement seems intractable, the courts will occasionally be asked to give a decision about whether a planned course of action is lawful or unlawful. Many clinicians have qualifications in ethics and law, and further study can lead to academic, policy, legal, ethical and leadership roles. This chapter will explore the key ethical and legal principles that medical students and doctors need to engage with to ensure that their clinical practice meets the standards of the profession
Moving Slow and Fixing Things
Get PDFSilicon Valley, and the U.S. tech sector more broadly, have changed the world in part by embracing a “move fast and break things” mentality popularized by Mark Zuckerberg. While it is true that the tech sector has attempted to break with such a reactive and flippant response to security concerns, including at Microsoft itself through its Security Development Lifecycle, cyberattacks continue at an alarming rate. As a result, there are growing calls from regulators around the world to change the risk equation. An example is the 2023 U.S. National Cybersecurity Strategy, which argues that “[w]e must hold the stewards of our data accountable for the protection of personal data; drive the development of more secure connected devices; and reshape laws that govern liability for data losses and harm caused by cybersecurity errors, software vulnerabilities, and other risks created by software and digital technologies.” What exact form such liability should take is up for debate. The defect model of products liability law is one clear option, and courts across the United States have already been applying it using both strict liability and risk utility framings in a variety of cases. This Article delves into the debates by considering how other cyber powers around the world—including the European Union—are extending products liability law to cover software, and it examines the lessons these efforts hold for U.S. policymakers with case studies focusing on liability for AI-generated content and Internet-connected critical infrastructure
