13 research outputs found
Late reproductive effects of cancer treatment
No full textGynaecologists are seeing an ever-growing population of cancer survivors who are at risk from developing a broad range of adverse outcomes relating to cancer treatment. This review discusses the most commonly observed reproductive concerns in young people who are awaiting, or have undergone treatment for cancer. We also discuss the options for maintaining fertility in both men and women, and possible subsequent pregnancy outcomes. The fertility preservation options available to any particular cancer survivor will depend on age at the time of diagnosis and treatment, the cancer type and primary site, the stage and the type of treatment.<br/
Biological rhythms in female reproduction: a link with clinical data, uterine receptivity and implantation
No full textMany aspects of physiological function are strongly circadian. Disturbance of these intrinsic modulators is implicated in disease states, but the role of biological rhythmic control in the context of reproduction is still largely unknown. The circadian network is apparent in all aspects of reproductive functioning; from menstruation to implantation and pregnancy. Endometrial dysfunction may occur if regulatory processes do not happen, with a disruptive effect on the synchronisation of implantation. Whether this dysregulation happens at the level of the endometrium, at the embryo-endometrial interface or at the level of clock genes is not known.This work has investigated the role these biological rhythms, in particular those pertaining to that of uterine receptivity and implantation. By a systematic review and a meta-analysis of shift workers, a population being at risk of adverse early reproductive outcomes was identified. The link between experiencing poor early reproductive outcomes and sleep and activity was further investigated and it was shown that sleeping and activity patterns are different in reproductive pathology as compared with fertile healthy women.The molecular basis of observed relationships between sleep and reproductive difficulty was investigated by examination of the uterine environment. Human samples were compared in-vivo, and with in-vitro culture models in unstimulated, normal menstrual cycles. This was to examine whether the difference in the circadian rhythm, which leads to deleterious effects in other pro-inflammatory disease, could be linked to the uterine environment of women with reproductive pathology. The immunomodulatory uterine secretome profile in women suffering from recurrent implantation failure (RIF) was shown to be different from fertile women.The expression of core clock genes within the uterus was shown to be cyclical in a circadian manner. The effect of decidualisation appeared to effect the phase, but not the period of this expression. The distinct pattern of endometrial secretions in each group of women (RIF and fertile controls) was compared with the reciprocal core clock gene expression, and was shown to be correlated with a four-hour time lag. The geneimmunomodulator association was effected by decidualisation, more so in the women suffering from RIF than the controls. The addition of melatonin to the cell culture model made the RIF endometrium respond more like the control endometrium. After treatment with melatonin, cells from women with RIF had a more similar geneimmunomodulator profile to the control women. This effect was more noticeable after decidualisation. Whether or not this can be considered a beneficial alteration has not been ascertained
Are skin scar characteristics associated with the degree of pelvic adhesions at laparoscopy?
No full textObjectiveTo investigate whether individual or a combination of abdominal surgical scar characteristics can predict the severity and extent of intra-abdominal adhesions.DesignA prospective cohort study.SettingA tertiary referral center in the United Kingdom.Patient(s)One hundred women who had previously undergone abdominopelvic surgery and were undergoing an elective laparoscopic gynecologic operations.Intervention(s)Abdominal scars were evaluated preoperatively using the modified Manchester Scar Questionnaire Adhesions were assessed intraoperatively and compared with the cutaneous findings.Main Outcome Measure(s)Presence and severity of intra-abdominal adhesions.Result(s)Of 100 women recruited into this study, 71 (71%) women were found to have intra-abdominal Aadhesions, and 29 (29%) had no adhesions. Women who had more than one abdominal scar, a palpable scar, and/or a longer scar were most likely to have pelvic adhesions during the current surgery. Women with the highest mean scar scores also had a greater total adhesion score.Conclusion(s)Adhesions are a common postoperative consequence of open or laparoscopic surgery. Skin scar characteristics are associated with the presence and degree of pelvic adhesions. Future studies should examine whether these characteristics can be used as a preoperative predictive tool to facilitate surgical decision-making and elective operating room organization
Provision of obstetrics and gynaecology services during the COVID19 pandemic : a survey of junior doctors in the UK National Health Service
No full textObjective: The COVID-19 pandemic is disrupting health services worldwide. We aimed to evaluate the provision of obstetrics and gynaecology services in the UK during the acute-phase of the COVID-19 pandemic.
Design: Interview-based national survey.
Setting: Women’s healthcare units in the National Health Service.
Population: Junior doctors in obstetrics and gynaecology.
Methods: Participants were interviewed by members of the UKARCOG trainees’ collaborative between 28th March and 7th of April 2020. We used a quantitative analysis for closed-ended questions and a thematic framework analysis for open comments.
Results: We received responses from 148/155 units (95%), majority of the participants were in years 3-7 of training (121/148, 82%). Most completed specific training drills for managing obstetric and gynaecological emergencies in women with COVID-19 (89/148, 60.1%) and two-persons donning and doffing of Personal Protective Equipment (PPE) (96/148, 64.9%). The majority of surveyed units implemented COVID-19 specific protocols (130/148, 87.8%), offered adequate PPE (135/148, 91.2%) and operated dedicated COVID-19 emergency theatres (105/148, 70.8%).
Most units reduced face-to-face antenatal clinics (117/148, 79.1%), and suspended elective gynaecology services (131/148, 88.5%). The two-week referral pathway for oncology gynaecology was not affected in half of the units (76/148, 51.4%), while half reported a planned reduction in oncology operating (82/148, 55.4%).
Conclusion: The provision of obstetrics and gynaecology services in the UK during the acute phase of the COVID-19 pandemic seems to be in line with current guidelines, but strategic planning is needed to restore routine gynaecology services and ensure safe access to maternity care on the longterm
Is sleep deficit associated with infertility and recurrent pregnancy losses? Results from a prospective cohort study
No full textThe Other Side of Silence: Using fiction to explore the resources and limitations in writing about women's lives
No full textThis dissertation consists of two distinct components: a creative manuscript, titled “The Other Side of Silence,” and an accompanying exegesis. Both pieces endeavour to answer key questions: What are the different ways fiction might be used to write about the life of a woman from the past? How might we write about such women, taking into account the constraints by which their stories have been forgotten, omitted or displaced? And what are the implications of foregrounding such silences in the writing and reading of narratives?
“The Other Side of Silence” tells the story of Alba, an Italian woman who, with her young family, is leaving her hometown of Salerno for Australia in 1952. The narrative focuses on Alba’s relationship with her mother, Serafina, who fears that Alba’s journey to Australia is motivated by a desire to distance herself from her past. Within this narrative I explore how each of these characters views and consequently deals with the past.
The exegesis discusses several texts that have influenced and inspired “The Other Side of Silence.” In reading contemporary texts about the lives of women in the past, I noted two distinct approaches in the ways women’s stories were written. Some writers use recuperative strategies that allow them to tell stories previously omitted from or distorted by historical discourse and dominant cultural ideologies. By contrast, other writers use poststructuralist narrative strategies to foreground the ways in which traditional realist narratives gloss over the gaps, contradictions and omissions in women’s stories. These alternative narratives indicate how revelation and closure in traditional realism can preclude the probing of some subtle and significant questions about narrating and making sense of women’s experiences. The exegesis examines the different ways writers have challenged and subsequently enlarged conventional notions of realist fiction to imagine and speculate on the possibilities for and limitations on narrative
The JCMT Gould Belt Survey : first results from the SCUBA-2 observations of the Ophiuchus molecular cloud and a virial analysis of its prestellar core population
No full textIn this paper, we present the first observations of the Ophiuchus molecular cloud performed as part of the James Clerk Maxwell Telescope (JCMT) Gould Belt Survey (GBS) with the SCUBA-2 instrument.We demonstratemethods for combining these datawith previous HARP CO, Herschel, and IRAM N2H+ observations in order to accurately quantify the properties of the SCUBA-2 sources in Ophiuchus. We produce a catalogue of all of the sources found by SCUBA-2. We separate these into protostars and starless cores. We list all of the starless cores and perform a full virial analysis, including external pressure. This is the first time that external pressure has been included in this level of detail. We find that the majority of our cores are either bound or virialized. Gravitational energy and external pressure are on average of a similar order of magnitude, but with some variation from region to region. We find that cores in the Oph A region are gravitationally bound prestellar cores, while cores in the Oph C and E regions are pressure-confined. We determine that N2H+ is a good tracer of the bound material of prestellar cores, although we find some evidence for N2H+ freeze-out at the very highest core densities.We find that non-thermal linewidths decrease substantially between the gas traced by C18O and that traced by N2H+, indicating the dissipation of turbulence at higher densities. We find that the critical Bonnor-Ebert stability criterion is not a good indicator of the boundedness of our cores. We detect the pre-brown dwarf candidate Oph B-11 and find a flux density and mass consistent with previous work. We discuss regional variations in the nature of the cores and find further support for our previous hypothesis of a global evolutionary gradient across the cloud from south-west to north-east, indicating sequential star formation across the region.Peer reviewe
‘Dyvers kyndes of religion in sondry partes of the Ilande’: the geography of pastoral care in thirteenth-century England
No full textThe Church was not the only progenitor and disseminator of ideas in medieval England, but it was the most pervasive. Relations between the ecclesiastical and lay realms are well documented at high social levels but become progressively obscure as one descends to the influence of the Church at large on society at large (and vice versa). The twelfth century was a time of great energy and renewal in the leadership and scholarship of the Church; comparable religious energy and renewal can be seen in late-medieval lay culture. The momentum was passed on in the thirteenth century, and pastoral care was the means of its transfer.
The historical sources in this field tend to be either prescriptive, such as treatises on how to hear confessions, or descriptive, such as bishops’ registers. Prescription and description have generally been addressed separately. Likewise, the parish clergy and the friars are seldom studied together. These families of primary sources and secondary literature are brought together here to produce a more fully-rounded picture of pastoral care and church life.
The Church was an inherently local institution, shaped by geography, personalities, social structures, and countless ad hoc solutions to local problems. Few studies of medieval English ecclesiastical history have fully accepted the considerable implications of this for pastoral care; close attention to local variation is a governing methodology of this thesis, which concludes with a series of local case studies of pastoral care in several dioceses, demonstrating not only the divergences between them but also the variations within them
Molecular characterisation of neurotransmitter receptors in the CNS of the stargazer mutant mouse
No full textThe mutant mouse stargazer shows both ataxia and absence epilepsy from P14 onwards. A PGR amplification strategy was utilised to identify adult (i.e. > 3 months) +/stg from +/+ mice, which share the same phenotype, for use for breeding purposes. The same technique was employed to identify +/+, +/stg and stg/stg neonates (i.e. < 7 days old) for cell culture purposes, since the stargazer phenotype is not apparent at this age. GABA(_A) receptor α(_6) subunit expression levels were significantly decreased in adult stargazer (stg/stg) cerebella when compared to control (+/+ and +/stg) cerebella. Interestingly, autoradiography using [(^3)H] Ro15-4513 revealed an apparent upregulation in α(_4)γ-containing receptors in the adult stargazer dentate gyrus. No significant differences in the expression of NMDAR subunits were detected between adult control and stargazer brain membranes. A significant decrease was observed in AMPAR subunit expression within the adult stargazer cerebellum, particularly with the GIuR2 subunit, which was reduced by 73 %. This decrease was replicated in cerebellar granule cells cultured from stargazer neonates, which also expressed at the cell surface only 18 % of the total GluR2 found in control granule cells. Inmunohistochemistry analyses using mouse anti-stargazin antibodies revealed stargazin to be found throughout the adult control brain, with highest levels of expression being within the hippocampus and cerebellum. Stargazin protein, however, was not expressed in adult stargazer forebrain nor in adult stargazer cerebellar membranes. Finally, immunoaffinity columns using the anti-stargazin antibodies were prepared and demonstrated that stargazin could be purified from adult control mouse brain extracts. Moreover, AMPAR subunits co-immunoprecipitated, indicating an association in vivo
From bad weapons to bad states: the evolution of U.S. counterproliferation policy
No full textOne of the key features of the 2002 United States National Security Strategy was an abrupt shift from the traditional U.S. approach to proliferation threats that prioritized deterrence and promotion of nondiscriminatory nonproliferation norms, to an approach called counterproliferation that emphasized military preemption and direct challenges to adversarial state identity. This thesis asks the question, what caused counterproliferation to largely replace deterrence and nonproliferation as the central national security policies of the U.S. concerning unconventional weapons? The thesis argues that to understand this policy change requires not merely an appreciation of changes in the post-Cold War international security environment, but also an examination of how culturally shaped threat conceptions among American policymakers interacted with capabilities development and policy institutionalization within the U.S. military. As no current theory adequately addresses those dynamics, complimentary strategic culture and organizational theory models are presented as the framework for analysis. This thesis will contend that policy shift from NP to CP resulted from the merging of strategic cultural efforts aimed at legitimizing conceptions of proliferation threats as originating from state identity, with a military organizational drive to avoid uncertainty through the development of counterproliferation capabilities. Together these strategic cultural and organizational responses to shifting proliferation threats altered the menu of choice for policymakers by institutionalizing and legitimizing a policy response that directly challenged existing nonproliferation norms and practices. This thesis relies on a detailed case study of the evolution of counterproliferation policy from 1993 to 2002, with particular focus on the analysis of public discourse, declassified policy planning and Department of Defense documents, and participant interviews
