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Translating evidence into practice: Implementing culturally safe continuity of midwifery care for First Nations women in three maternity services in Victoria, Australia
Get PDFBackground
Strategies to improve outcomes for Australian First Nations mothers and babies are urgently needed. Caseload midwifery, where women have midwife-led continuity throughout pregnancy, labour, birth and the early postnatal period, is associated with substantially better perinatal health outcomes, but few First Nations women receive it. We assessed the capacity of four maternity services in Victoria, Australia, to implement, embed, and sustain a culturally responsive caseload midwifery service.
Methods
A prospective, non-randomised research translational study design was used. Site specific culturally responsive caseload models were developed by site working groups in partnership with their First Nations health units and the Victorian Aboriginal Community Controlled Health Organisation. The primary outcome was to increase the proportion of women having a First Nations baby proactively offered and receiving caseload midwifery as measured before and after programme implementation. The study was conducted in Melbourne, Australia. Data collection commenced at the Royal Women's Hospital on 06/03/2017, Joan Kirner Women's and Children's Hospital 01/10/2017 and Mercy Hospital for Women 16/04/2018, with data collection completed at all sites on 31/12/2020.
Findings
The model was successfully implemented in three major metropolitan maternity services between 2017 and 2020. Prior to this, over a similar timeframe, only 5.8% of First Nations women (n = 34) had ever received caseload midwifery at the three sites combined. Of 844 women offered the model, 90% (n = 758) accepted it, of whom 89% (n = 663) received it. Another 40 women received standard caseload. Factors including ongoing staffing crises, prevented the fourth site, in regional Victoria, implementing the model.
Interpretation
Key enablers included co-design of the study and programme implementation with First Nations people, staff cultural competency training, identification of First Nations women (and babies), and regular engagement between caseload midwives and First Nations hospital and community teams. Further work should include a focus on addressing cultural and workforce barriers to implementation of culturally responsive caseload midwifery in regional areas.
Funding
Partnership Grant (# 1110640), Australian National Health and Medical Research Council and La Trobe University
The relationships between physical activity, lumbar multifidus muscle morphology, and low back pain from childhood to early adulthood: a 12-year longitudinal study
Get PDFWe investigated the longitudinal associations between physical activity (PA), lumbar multifidus morphology, and impactful low back pain (LBP) in young people. Nine-year-old children were recruited from 25 primary schools and followed up at age 13, 16, and 21 years. We measured PA with accelerometers at age 9, 13, and 16; quantified patterns of lumbar multifidus intramuscular adipose tissue (IMAT) change from 13 to 16 years using magnetic resonance imaging; and recorded LBP and its impact with standardised questionnaires and interviews. Associations were examined with crude and adjusted logistic or multinomial models and reported with odds ratios (OR) or relative risk ratios (RRR). We included data from 364 children (mean[SD] age = 9.7[.4] years). PA behaviour was not associated with LBP. Having persistently high IMAT levels at age 13 and 16 was associated with greater odds of LBP (OR[95% CI] = 2.98[1.17 to 7.58]). Increased time in moderate and vigorous intensity PA was associated with a lower risk of higher IMAT patterns (RRR[95% CI] = .67[.46 to .96] to .74[.55 to 1.00]). All associations became non-significant after adjusting for sex and body mass index (BMI). Future studies investigating the relationships between PA behaviour, lumbar multifidus IMAT, and impactful LBP should account for potential confounding by sex and BMI
Aerobic exercise improves episodic memory in late adulthood: A systematic review and meta-analysis
Get PDFBackground
Aerobic exercise remains one of the most promising approaches for enhancing cognitive function in late adulthood, yet its potential positive effects on episodic memory remain poorly understood and a matter of intense debate. Prior meta-analyses have reported minimal improvements in episodic memory following aerobic exercise but have been limited by restrictive inclusion criteria and infrequent examination of exercise parameters.
Methods
We conducted a meta-analysis of randomized controlled trials to determine if aerobic exercise influences episodic memory in late adulthood (M = 70.82 years) and examine possible moderators. Thirty-six studies met inclusion criteria, representing data from 2750 participants.
Results
Here we show that aerobic exercise interventions are effective at improving episodic memory (Hedges’g = 0.28; p = 0.002). Subgroup analyses revealed a moderating effect of age (p = 0.027), with a significant effect for studies with a mean age between 55–68 but not 69–85. Mixed-effects analyses demonstrated a positive effect on episodic memory among studies with a high percentage of females (65–100%), participants with normal cognition, studies reporting intensity, studies with a no-contact or nonaerobic physical activity control group, and studies prescribing >3900 total minutes of activity (range 540–8190 min).
Conclusions
Aerobic exercise positively influences episodic memory among adults ≥55 years without dementia, with larger effects observed among various sample and intervention characteristics—the clearest moderator being age. These results could have far-reaching clinical and public health relevance, highlighting aerobic exercise as an accessible, non-pharmaceutical intervention to improve episodic memory in late adulthood
Transformations of youth resistance: Underground music scene and Islamic politics in post-authoritarian Indonesia
Get PDFThe Indonesian underground music scene was once known as the bastion of progressive and radical Leftist politics for urban youths during the Reformasi era (1997-2002). After the fall of Suharto on 21 May 1998, leftist activism in the scene declined, and was followed by the emergence of the right-wing Islamic underground movement and the hijrah movement. Their opposition to democracy and enmity towards minority groups has undermined the scene’s reputation as one of the key elements in Indonesia’s emerging democratic culture. The existing studies on the ‘conservative turn’ have failed to explain the ideological shift of underground subcultural participants towards Islamic conservatism and right-wing Islamism. This study was inspired by this background and aimed to answer the following research question: ‘Why did some underground music scene participants shift to conservative Islam and right-wing Islamism in post-authoritarian Indonesia?’ Drawing from extensive (ethnographic) fieldwork in Indonesia between 2015 and 2018, and informed by subcultural theory, I argue that the transformations of the Indonesian underground music scene including the most recent shift towards conservative Islam and right-wing Islamism reflect the transformations of youth resistance in response to different socio-political and economic conditions that have disempowered and marginalised them. These conditions are both external and internal to the scene. The external factors include post-Suharto’s political stagnancy, suppression and co-optation of Left activists by the state and right-wing groups, the domestication of the underground’s subcultural capital and practices, material inequality, and the lack of economic opportunities. The internal factors include polarisation and fragmentation, informal hierarchies, nihilism, the absence of central figures, and stagnancy within the scene. Due to the absence of coherent leftist activism within the scene, the participants sought for alternative channels to express their dissent, including new ideological and organisational platforms to resist hegemonic cultures and authorities and find solutions to the demoralising effects generated by the above conditions
Gene Variants in Pro-Coagulant and Anti-Coagulant Genes Could Be Prognostic Genetic Markers of COVID-19 Susceptibility
Get PDFPresent study aimed to identify DNA polymorphisms (variants) which can modulate the risk of COVID-19 infection progression to severe condition. TaqMan based SNP genotyping assay was performed for 11 single nucleotide polymorhisms (SNPs) in pro-coagulant and anti-coagulant genes.
A total of 33 COVID-19 patients, including dead, severe and moderately infected individuals were compared to 35 healthy controls. Both alleles in the SNP were labeled with two different fluorescent dyes (FAM and VIC) during assay formulation. DNA of study subjects were mixed with SNP assay and TaqMan master mix on 96 well PCR plate according to manufacturer’s protocol and RT-PCR was performed. Allelic discrimination assay gave clear results for presence of specific allele in each sample. Three SNPs were located in the pro-coagulant genes, another three involved in blood clot dissolution while rest five were in the genes encoding natural anti-coagulants. COVID-19 infected patients were further sub-divided into three groups, deceased (n=16), severe (n=10) and moderately infected (n=7).
Results of SNP genotyping showed significant difference between COVID-19 patients and controls in two SNPs, rs6133 in Selectin-P (SELP) and rs5361 in Selectin-E (SELE) gene. Also, rs2020921 and rs8176592, in clot dissolution genes, tissue Plasminogen activator (tPA) and tissue factor pathway inhibitor (TFPI) respectively showed significant genotypic and allelic difference in patients of COVID-19 compared to healthy controls. Further three SNPs rs2227589, rs757583846 and rs121918476 in natural anti-coagulant genes anti-thrombin III (ATIII), protein C (PROC) and protein S (PROS) respectively showed statistically significant difference between the study groups.
Our findings indicate that gene variants, those involved in coagulation and anti-coagulation may play a major role in determining individual susceptibility to COVID-19.
Funding Information: This work was supported by Defence Institute of Physiology and Allied Sciences (DIPAS), Defence Research and Development Organization (DRDO), Delhi-110054.
Conflict of Interests: The authors declare that there is no conflict of interest or financial disclosure related to this publication.
Ethical Approval: The study parameters and design was approved by the Ethical Committee of Indian Council of Medical Research (ICMR), India. Written informed consent was obtained from all study participants before collection of their blood sample. All experimental protocols were conducted in accordance to the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) guidelines
Activation‐Induced surface modulation of Biowaste‐Derived hierarchical porous carbon for supercapacitors
Get PDFHierarchically porous carbon materials derived from bio-waste with desired surface functional groups are attractive for electrochemical applications. Both acid and base activating reagents are harnessed to modulate the electrode-electrolyte interface relevant to electrochemical supercapacitors in satisfying structural, electronic, and electrochemical properties together. This study helps to understand molecular-level tailoring of various activating reagents to tune the electronic properties for energy storage..
Seagrass ‘fairy circles’ on the Isles of Scilly
No full textPerfectly circular patches bare of vegetation in otherwise continuous swards of seagrass, and perfect circles of seagrass with lush fringes of shoots on the outer margins but with virtually bare centres, have both attracted popular attention as ‘fairy circles’ or ‘fairy rings’ in view of the folklore surrounding the supernatural origins of their terrestrial fungal counterparts. Aerial photographic and satellite surveys show that, on the Isles of Scilly, circles of Zostera marina of the second type occur sporadically, with exceptionally prolific clusters in specific localities associated with the colonization of bare substratum after disturbance, gradually disappearing over the period of this study at one site and appearing at another. Their abundance is the highest recorded anywhere in the world. Early suggestions that they represent seaweed growth on the stones of ancient hut-circles, submerged for centuries as a result of sea-level rise, are refuted. It is argued that they result from the unrestricted clonal growth of genets arising from individual Zostera seedlings, expanding equally in two dimensions and colonizing vacant habitat, with the older central shoots senescing and dying. Diameters of the circles constitute a stepwise increase in size, and the growth increments may represent a similar rate of seasonal growth in consecutive years, implying a linear rhizome growth rate of ~2.5 m year−1, which would be exceptional for Zostera marina, but which is supported by an observation on circles exposed on a low spring tide and would be an evolutionary adaptation for rapid recolonization in such a physically disturbed environment
Bringing together approaches to reporting on within species genetic diversity
Get PDFGenetic diversity is one of the three main levels of biodiversity recognised in the Convention on Biological Diversity (CBD). Fundamental for species adaptation to environmental change, genetic diversity is nonetheless under-reported within global and national indicators. When it is reported, the focus is often narrow and confined to domesticated or other commercial species.
Several approaches have recently been developed to address this shortfall in reporting on genetic diversity of wild species. While multiplicity of approaches is helpful in any development process, it can also lead to confusion among policy makers and heighten a perception that conservation genetics is too abstract to be of use to organisations and governments.
As the developers of five of the different approaches, we have come together to explain how various approaches relate to each other and propose a scorecard, as a unifying reporting mechanism for genetic diversity.
Policy implications. We believe the proposed combined approach captures the strengths of its components and is practical for all nations and subnational governments. It is scalable and can be used to evaluate species conservation projects as well as genetic conservation projects
Nitrogen but not phosphorus addition affects symbiotic N2 fixation by legumes in natural and semi-natural grasslands located on four continents
Get PDFBackground and aims
The amount of nitrogen (N) derived from symbiotic N2 fixation by legumes in grasslands might be affected by anthropogenic N and phosphorus (P) inputs, but the underlying mechanisms are not known.
Methods
We evaluated symbiotic N2 fixation in 17 natural and semi-natural grasslands on four continents that are subjected to the same full-factorial N and P addition experiment, using the 15N natural abundance method.
Results
N as well as combined N and P (NP) addition reduced aboveground legume biomass by 65% and 45%, respectively, compared to the control, whereas P addition had no significant impact. Addition of N and/or P had no significant effect on the symbiotic N2 fixation per unit legume biomass. In consequence, the amount of N fixed annually per grassland area was less than half in the N addition treatments compared to control and P addition, irrespective of whether the dominant legumes were annuals or perennials.
Conclusion
Our results reveal that N addition mainly impacts symbiotic N2 fixation via reduced biomass of legumes rather than changes in N2 fixation per unit legume biomass. The results show that soil N enrichment by anthropogenic activities significantly reduces N2 fixation in grasslands, and these effects cannot be reversed by additional P amendment
Probing the chemical reactivity of the B2O3 -I (1 0 1) Surface: Interaction with H2O and H2S
No full textDiboron trioxide is of interest because of its unique unreactive functionality properties. In this work we have studied – via computational first-principle techniques - the adsorption and dissociation mechanisms of two hydrogen chalcogenides, namely water (H2O) and hydrogen sulfide (H2S) molecules, over the B2O3 -I (1 0 1) surface. We show that the water molecules undergo dissociative adsorption over diboron via an activation energy of 39 kJ/mol. Furthermore, desorption of both molecularly adsorbed and dissociated structures of water molecules from the B2O3 -I (1 0 1) surface requires activation energies of 124–127 kJ/mol. Our investigation on the other hydrogen-chalcogenide compound, i.e. H2S, reveals that diboron trioxide attracts H2S molecules and forms molecular adsorption via sp3 hybridisation between the lone pair electron of the H2S and the empty p orbital of the Bsurf atom without encountering an activation barrier. However, the energy barrier required to dissociate H2S over the B2O3 -I (1 0 1) surface appears exceedingly high at 310 kJ/mol. The present insight resolves the two different behaviours of B2O3 concerning hydrogen chalcogenides reported in the literature. While acting as a water scavenger to generate dissociated radicals, it exhibits an inhibitor characteristic towards the dissociation of H2S molecules, representing an ideal reactor wall coating for desired pure gas phase reactions