36 research outputs found
International Interlaboratory Digital PCR Study Demonstrating High Reproducibility for the Measurement of a Rare Sequence Variant
No full textQualitative study of the clinician–parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK
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Qualitative study of the clinician–parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK
M E Harvey1,2,3, M E Redshaw2 On behalf of the ePrime Research Group
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Abstract
Objective To explore communication and interaction between parents and clinicians following neonatal ultrasound (US) and MRI of the brain of babies born preterm.
Setting This qualitative study was undertaken as part of a larger UK study of neonatal brain imaging. 511 infants were cared for in 14 London neonatal units with MR and cerebral US imaging in a specialist centre.
Participants Parents with infants born at <33 weeks gestation were randomised to receive prognostic information based on either MRI or US findings on their infants at term-corrected age.
Methods Discussions between parents and clinicians about the MRI or US result were audio recorded. Parents were told about the findings and their baby's predicted outcome. A topic guide ensured essential aspects were covered. Recordings were fully transcribed. Discussion of the scan results, the content and style of the interaction and parental response were analysed qualitatively in 36 recordings using NVivo V.10.
Outcomes Key themes and subthemes were identified in the clinician–parent discussions.
Results The overarching theme of ‘the communication interface’ was identified with three key themes: ‘giving information’, ‘managing the conversation’ and ‘getting it right’ and further subthemes. A range of approaches were used to facilitate parental understanding and engagement. There were differences in the exchanges when information about an abnormal scan was given. The overall structure of the discussions was largely similar, though the language used varied. In all of the discussions, the clinicians talked more than the parents.
Conclusions The discussions represent a difficult situation in which the challenge is to give and receive complex prognostic information in the context of considerable uncertainty. The study highlights the importance of being able to re-visit specific issues and any potential areas of misunderstanding, of making time to talk to parents appreciating their perspective and level of knowledge
The Birth Satisfaction Scale-Revised Indicator (BSS-RI)
No full text© 2017 The Author(s). Background: The current study sought to develop a short birth satisfaction indicator utilising items from the Birth Satisfaction Scale-Revised (BSS-R) for use as a brief measure of birth satisfaction and as a possible key performance indicator for perinatal service delivery evaluation. Building on the recently developed BSS-R, the study aimed to develop a simplified version of the instrument to assess birth satisfaction easily that could work as a short evaluative measure of clinical service delivery for labour and birth that is consistent with policy documents, placing women at the centre of the birth experience. Methods: The six item Birth Satisfaction Scale-Revised Indicator (BSS-RI) was embedded within the 2014 National Maternity Survey for England. A random selection of mothers who had given birth in a two week period in England were surveyed three months after the birth. Using a two-stage design and split-half dataset, exploratory factor analysis, confirmatory factor analysis, internal consistency, convergent, divergent and known-groups discriminant validity evaluation were conducted in a secondary analysis of the survey data. Results: Using this large population based survey of recent mothers the short revised measure was found to comprise two distinct domains of birth satisfaction, 'stress and emotional response to labour and birth' and 'quality of care'. The psychometric qualities of the tool were robust as were the indices of validity and reliability evaluated. Conclusion: The BSS-RI represents a short easily administered and scored measure of women's satisfaction with care and the experience of labou r and birth. The instrument is potentially useful for researchers, service evaluation and policy makers
Evaluating the Mental Models Approach to Developing a Risk Communication: A Scoping Review of the Evidence
No full textThis is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordRisk communication is fundamental in ensuring people are equipped with the knowledge needed to navigate varied risks. One generally well-regarded framework for the development of such communications is the mental models approach to risk communication (MMARC). Developed during the 1990s, the MMARC has been applied to a range of health, technological, and environmental risks. However, as yet, we know of no attempt to collate and review articles that evaluated communications developed using the MMARC. This article took a first step at addressing this gap by conducting a scoping review that aimed to begin to explore the fidelity with which the approach has been applied, explore whether there appeared to be sufficient studies to warrant a future systematic review, and identify future research questions. Although the initial search found over 100 articles explicitly applying the MMARC, only 12 of these developed a risk-related communication that was tested against a control (and thus included in the current review). All studies reported a positive effect of the MMARC versus control communication for at least some of the outcome measures (knowledge being the most prevalent). However, there was wide variation between studies including type of control, outcomes assessed, and only five studies reported adopting a randomized design. The review highlights both the need for greater fidelity in the way future studies operationalize the MMARC approach, and suggests that a full-scale systematic review of the MMARC literature appears justified, especially given the possibility of a large gray literature in this area.This was part of a PhD project funded by the European Social Fund Convergence Programme for Cornwall and the Isles of Scilly. The European Centre for Environment and Human Health (part of the University of Exeter Medical School) is part financed by the European Regional Development Fund Programme 2007 to 2013 and European Social Fund Convergence Programme for Cornwall and the Isles of Scilly
Toxic alkaloids in Lyngbya majuscula and related tropical marine cyanobacteria
No full textThe cyanobacterium Lyngbya majuscula is found in the littoral zone and to a depth of 30. m in tropical, subtropical and temperate regions across the globe, as well as being an important contributor to coral reef ecosystems. This cyanobacterium produces a range of chemicals that may contribute to a variety of negative health outcomes including skin, eye and respiratory irritation. The toxic compounds, lyngbyatoxin A and debromoaplysiatoxin, have been implicated in acute dermatologic reactions in human swimmers, and experiments involving these two toxins show the formation of acute dermal lesions. We explore the reported distribution and health implications of L. majuscula, with reference to factors affecting bloom frequency. The likely implications of climate change upon the distribution of the organism, and frequency of blooms are also described
Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period.
No full textthe Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum
Direct determination of the La β-decay Q value using Penning trap mass spectrometry
No full textInternational audienceBackground: The understanding and description of forbidden decays provides interesting challenges for nuclear theory. These calculations could help to test underlying nuclear models and interpret experimental data. Purpose: Compare a direct measurement of the La138β-decay Q value with the β-decay spectrum end-point energy measured by Quarati et al. using LaBr3 detectors [Appl. Radiat. Isot. 108, 30 (2016)ARISEF0969-804310.1016/j.apradiso.2015.11.080]. Use new precise measurements of the La138β-decay and electron capture (EC) Q values to improve theoretical calculations of the β-decay spectrum and EC probabilities. Method: High-precision Penning trap mass spectrometry was used to measure cyclotron frequency ratios of La138, Ce138, and Ba138 ions from which β-decay and EC Q values for La138 were obtained. Results: The La138β-decay and EC Q values were measured to be Qβ=1052.42(41) keV and QEC=1748.41(34) keV, improving the precision compared to the values obtained in the most recent atomic mass evaluation [Wang , Chin. Phys. C 41, 030003 (2017)1674-113710.1088/1674-1137/41/3/030003] by an order of magnitude. These results are used for improved calculations of the La138β-decay shape factor and EC probabilities. New determinations for the Ce138 2EC Q value and the atomic masses of La138, Ce138, and Ba138 are also reported. Conclusion: The La138β-decay Q value measured by Quarati et al. is in excellent agreement with our new result, which is an order of magnitude more precise. Uncertainties in the shape factor calculations for La138β decay using our new Q value are reduced by an order of magnitude. Uncertainties in the EC probability ratios are also reduced and show improved agreement with experimental data
Behind the medical mask : medical technology and medical power
No full textThis thesis explores the role of technology as a resource in the
structure of medical domination of birth and death, stressing
technology's pivotal position at the intersection of control and
uncertainty.
Based in Intensive Care and Obstetrics (between which the health status
of patients diverges sharply), it notes the convergence of technology
used and examines the contest for control within the labour process.
This includes using technology to facilitate a 'standardized' birth or
death; a more retrospectively defensible event. In general, the
'burden of proof' is concluded to lie with those wishing not to
intervene rather than the reverse.
Given the (cognitively male) biomedical model, mind-body dualism is an
assumption embedded in medical technology: this is especially
significant in childbirth, where it fractures the woman's ontological
experience of giving birth. Its positivistic and pathological
emphasis is associated with a reification of processes and a
commodification of their 'solution': which becomes located in
technology. It is argued that commodification in health provision will
increase with the further application of market principles to the NHS.
It is concluded that 'uncertainty', endemic to medicine and a possible
challenge to control, is proactively manipulated and pressed into the
service of medical domination. Technology is used to mask uncertainty
and aid the medical profession's control of patients/relatives, and
subordinate work groups.
A technological fix may be viewed as the opposite to re-discovering
societal dreams and myths, however, more paradoxically, it is concluded
that dreams and myths have become attached to technology. Thus, the
symbolic role of technology is: to provide hope of continued survival
(or cure), the veiling of existential uncertainty and the offer of
'absolution' - should all efforts fail (a freedom from guilt in the
assurance that "everything possible was tried"). Its 'heroic' project
is viewed as an existentially 'masculine' health provision and
'feminized' health care is posited as an alternative
P2‐263: CELL‐FREE DNA IN CEREBROSPINAL FLUID: EVALUATING A NEW BIOMARKER FOR ALZHEIMER'S DISEASE
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