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Determinants of eclampsia in women with severe preeclampsia at Mpilo Central Hospital, Bulawayo, Zimbabwe.
No full textObjective Globally, preeclampsia is a significant contributor to adverse maternal outcomes. Once women develop eclampsia, they face considerable risks especially in countries with limited resources to deal with such a life-threatening complication. This study was carried out to investigate determinants of eclampsia in pregnant mothers with severe preeclampsia. Study design This institutional based study was completed at Mpilo Central Hospital, a quaternary referral unit from 1st January 2016 – 31st December 2018. In this study, pregnant women with severe preeclampsia/eclampsia were the study participants. The independent variables included socio-demographic and clinical characteristics, and maternal outcomes. Multivariable logistic regression analyses were used to determine independent association with p < 0.05 taken as statistically significant with 95% Confidence Interval (CI). Main outcome measure Eclampsia Results Development of eclampsia was more frequent in women aged 14-19 years compared to women aged ≥35 years (adjusted odds ratio (AOR) 6.64, 95% CI 1.20-22.06, p=0.02) and in primiparous women compared to women with parity ≥3 (AOR 2.76, 95% CI 1.48-5.15, p=0.001). Eclampsia was more frequent in women with diastolic blood pressure of 131-150mmHg (AOR 5.48, 95% CI 1.05-28.75, p=0.04), and ≥150mmHg (AOR 5.78, 95% CI 1.05-31.78, p=0.04) compared with those with diastolic blood pressure of ≤110mmHg. Symptoms of visual disturbances were also associated with eclampsia (AOR 2.13, 95% CI 1.08-4.18, p=0.03). Conclusions This study has identified independent determinants of eclampsia which can be used to identify which women should receive magnesium sulphate prophlyaxis or more intensive monitoring to prevent deterioration in maternal condition
Service learning in pharmacy: An effective pedagogical approach to undergraduate education
No full textMaster of Pharmacy (MPharm) students at the University of Manchester experience service learning during the third year of the course. The students put their academic learning into practice and develop many professional skills whilst teaching and enthusing local high school pupils about various public health topics. This article explores how this example of service learning helps prepare the next generation of pharmacists for their future roles and summarises the practical aspects of the project and its success
High resolution Hα imaging of the Northern Galactic Plane, and the IGAPS images database
No full textThe INT Galactic Plane Survey (IGAPS) is the merger of the optical photometric surveys, IPHAS and UVEX, based on data from the Isaac Newton Telescope (INT) obtained between 2003 and 2018. These capture the entire northern Galactic plane within the Galactic coordinate range, -5<b<+5 deg. and 30<l<215 deg. From the beginning, the incorporation of narrowband H-alpha imaging has been a unique and distinctive feature of this effort. Alongside a focused discussion of the nature and application of the H-alpha data, we present the IGAPS world-accessible database of images for all 5 survey filters, i, r, g, U-RGO and narrowband H-alpha, observed on a pixel scale of 0.33 arcsec and at an effective (median) angular resolution of 1.1 to 1.3 arcsec. The background, noise, and sensitivity characteristics of the narrowband H-alpha filter images are outlined. Typical noise levels in this band correspond to a surface brightness at full one-arcsec resolution of around 2e-16 erg/cm2/s/arcsec2. Illustrative applications of the H-alpha data to planetary nebulae and Herbig-Haro objects are outlined and, as part of a discussion of mosaicking technique, we present a very large background-subtracted narrowband mosaic of the supernova remnant, Simeis 147. Finally we lay out a method that exploits the database via an automated selection of bright ionized diffuse interstellar emission targets for the coming generation of wide-field massive-multiplex spectrographs. Two examples of the diffuse H-alpha maps output from this selection process are presented and compared with previously published data
Cyclic Ether Triggers for Polymeric Frustrated Lewis Pair Gels
No full textSterically hindered Lewis acid and base centers are unable to form Lewis adducts, instead forming frustrated Lewis pairs (FLPs), where latent reactivity can be utilized for the activation of small molecules. Applying FLP chemistry into polymeric frameworks transforms this chemistry into responsive and functional materials. Here, we report a versatile synthetic strategy for the preparation of macromolecular FLPs and explore its potential with the ring-opening reactions of cyclic ethers. Addition of the cyclic substrates triggered polymer network formation, where the extent of cross-linking, strength of network, and reactivity are tuned by the steric and electronic properties of the ethers. The resultant networks behave like covalently cross-linked polymers, demonstrating the versatility of FLPs to simultaneously tune both small molecule capture and mechanical properties of materials
Unravelling the Impact of Graphene Addition to Thermoelectric SrTiO3 and Ladoped SrTiO3 Materials: A Density Functional Theory Study
No full textWe present a detailed theoretical investigation of the interaction of graphene with the SrO terminated (001) surface of pristine and La-doped SrTiO3. The adsorption of graphene is thermodynamically favourable with interfacial adsorption energies of -0.08 Jm-2 and -0.32 Jm-2 to pristine SrTiO3 and La- doped SrTiO3 surfaces respectively. We find that graphene introduces C 2p states at the Fermi level, rendering the composite semi-metallic, and thus the electrical properties are predicted to be highly sensitive to the amount and quality of the graphene in the composites. An investigation of the lattice dynamics predicts that graphene adsorption may lead to a 60-90 % reduction in the thermal conductivity due to a reduction in the phonon group velocities, accounting for the reduced thermal conductivity of the composite materials observed experimentally. This effect is enhanced by La doping. We also find evidence that both La dopant ions and adsorbed graphene introduce low-frequency modes that may scatter the heat-carrying acoustic phonons, and that, if present, these effects likely arise from stronger phonon-phonon interactions
Eye Gaze and Perceptual Adaptation to Audiovisual Degraded Speech
No full textPurpose: Visual cues from a speaker’s face may benefit perceptual adaptation to degraded speech, but current evidence is limited. We aimed to replicate results from previous studies to establish the extent to which visual speech cues can lead to greater adaptation over time, extending existing results to a real-time adaptation paradigm (i.e., without a separate training period). A second aim was to investigate whether eye gaze patterns towards the speaker’s mouth were related to better perception, hypothesising that listeners who looked more at the speaker’s mouth would show greater adaptation. Method: A group of listeners (N=30) were presented with 90 noise-vocoded sentences in audiovisual format while a control group (N=29) were presented with the audio signal only. Recognition accuracy was measured throughout and eye tracking was used to measure fixations towards the speaker’s eyes and mouth in the audiovisual group.Results: Previous studies were partially replicated: the audiovisual group had better recognition throughout and adapted slightly more rapidly, but both groups showed an equal amount of improvement overall. Longer fixations on the speaker’s mouth in the audiovisual group were related to better overall accuracy. An exploratory analysis further demonstrated that the duration of fixations to the speaker’s mouth decreased over time. Conclusions: The results suggest that visual cues may not benefit adaptation to degraded speech as much as previously thought. Longer fixations on a speaker’s mouth may play a role in successfully decoding visual speech cues, however this will need to be confirmed in future research to fully understand how patterns of eye gaze are related to audiovisual speech recognition. All materials, data, and code are available at https://osf.io/2wqkf/.<br/
Which Promises Actually Matter?:Election Pledge Centrality and Promissory Representation
No full textParties make hundreds of campaign promises but not all are seen by voters as central to a party's offering. Studies of government promise fulfilment accept that not all promises are equivalent but in practice treat all promises equally because they lack an appropriate means of measuring promise centrality. To demonstrate the importance of accounting for pledge fulfilment, we develop a conjoint experiment method to measure public opinion about promise centrality which can be used to construct centrality weights. We demonstrate this approach’s utility by examining the 2017 UK Conservative manifesto. Centrality weighting reduces our assessment of Conservative promise-keeping by 21 percentage points (1.3 standard deviations of typical promise completion rates found in comparative studies). Weighting increases the centrality of EU promises sevenfold, immigration promises sixfold, and reduces the centrality of miscellaneous administrative promises by more than half. These results illustrate that pledge centrality cannot be ignored when assessing pledge fulfillment
Listening to Children and Young People: An Educational Psychology Service Co-production Journey
No full text‘Co-production’ is advocated within UK legislation outlining children and young people’s right to be heard and to take part in the development of the services they use. This paper aims to explore understanding and knowledge around engaging with children and young people about how services can be co-produced within education. By using cycles of action and reflection, this research presents what children and young people think is important when working with, and receiving services from, educational psychologists, and explores the experiences of both children and young people, and educational psychologists, as they have worked and continue to work together to co-construct an educational psychology service
New error bounds for Laplace approximation via Stein's method
No full textWe use Stein's method to obtain explicit bounds on the rate of convergence for the Laplace approximation of two different sums of independent random variables; one being a random sum of mean zero random variables and the other being a deterministic sum of mean zero random variables in which the normalisation sequence is random. We make technical advances to the framework of Pike and Ren [38] for Stein's method for Laplace approximation, which allows us to give bounds in the Kolmogorov and Wasserstein metrics. Under the additional assumption of vanishing third moments, we obtain faster convergence rates in smooth test function metrics. As part of the derivation of our bounds for the Laplace approximation for the deterministic sum, we obtain new bounds for the solution, and its first two derivatives, of the Rayleigh Stein equation
Stillbirth rates, service outcomes and costs of implementing NHS England’s Saving Babies’ Lives care bundle in maternity units in England: a cohort study
No full textObjective – To assess implementation of the Saving Babies Lives (SBL) Care Bundle, a collection of practice recommendations in four key areas, to reduce stillbirth in England. Design – A retrospective cohort study of 463,630 births in 19 NHS Trusts in England using routinely collected electronic data supplemented with case note audit (n=1,658), and surveys of service users (n=2,085) and health care professionals (n=1,064). The primary outcome was stillbirth rate. Outcome rates two years before and after the nominal SBL implementation date were derived as a measure of change over the implementation period. Data were collected on secondary outcomes and process outcomes which reflected implementation of the SBL care bundle. Results - The total stillbirth rate, declined from 4.2 to 3.4 per 1,000 births between the two time points (adjusted Relative Risk (aRR) 0.80, 95% Confidence Interval (95% CI) 0.70 to 0.91, P<0.001). There was a contemporaneous increase in induction of labour (aRR 1.20 (95%CI 1.18- 1.21), p<0.001) and emergency Caesarean section (aRR 1.10 (95%CI 1.07-1.12), p<0.001). The number of ultrasound scans performed (aRR 1.25 (95%CI 1.21-1.28), p<0.001) and the proportion of small for gestational age infants detected (aRR 1.59 (95%CI 1.32-1.92), p<0.001) also increased. Organisations reporting higher levels of implementation had improvements in process measures in all elements of the care bundle. An economic analysis estimated the cost of implementing the care bundle at ~£140 per birth. However, neither the costs nor changes in outcomes could be definitively attributed to implementation of the SBL care bundle. Conclusions – Implementation of the SBL care bundle increased over time in the majority of sites. Implementation was associated with improvements in process outcomes. The reduction in stillbirth rates in participating sites exceeded that reported nationally in the same timeframe. The intervention should be refined to identify women who are most likely to benefit and minimise unwarranted interventio