Objective
The objective of this analysis was to explore the healthcare‐seeking behaviours and experiences of maternity care among women from different socio‐economic groups in order to improve ...understanding of why socially disadvantaged women have poorer maternal health outcomes in the UK.
Design
Secondary analysis of a national survey of women conducted 3 months after they had given birth.
Setting
England.
Sample
A total of 5332 women.
Methods
Logistic regression analysis to investigate differences in outcomes among different socio‐economic groups, classified by the Index of Multiple Deprivation (IMD).
Main outcome measures
Healthcare‐seeking behaviours, outcomes and experiences of maternity care.
Results
With each increase in IMD quintile (decrease in socio‐economic position), women were shown to be 25% (adjusted odds ratio aOR 0.75; 95% confidence interval 95% CI 0.63–0.90) less likely to have had any antenatal care and 15% (aOR 0.85; 95% CI 0.80–0.90) less likely to have had a routine postnatal check‐up. They were 4% (aOR 1.04; 95% CI 0.99–1.10) more likely to have had an antenatal hospital admission, 7% (aOR 1.07; 95% CI 0.99–1.16) more likely to have been transferred during labour and 4% (aOR 1.04; 95% CI 0.99–1.09) more likely to have had a caesarean birth, although these results were not statistically significant. With decreasing socio‐economic position women were more likely to report that they were not treated respectfully or spoken to in a way they could understand by doctors and midwives.
Conclusions
This analysis suggests the need for a focusing of professionals and services towards pregnant women from lower socio‐economic groups and more targeted maternal public health education towards socially disadvantaged women.
Over a quarter of UK births are to women who were born outside of the UK. Black and Minority Ethnic (BME) women are disproportionately affected by poor mental health and inequitable access to mental ...health care in the perinatal period, yet the influence of the migrant status (mothers' UK vs. non-UK birth) is poorly understood. This study aimed to explore the relationship between ethnicity, migration and mental health indicators among mothers participating in a large nationally representative cohort study.
This is a secondary analysis of data from the Millennium Cohort Study.
Logistic regression quantified the crude and adjusted effects of self-reported ethnicity and migrant status on prevalence of psychological distress and treatment for anxiety/depression at 9-month and 5-year postpartum.
We found substantial variation in the prevalence of distress according to ethnicity and migrant status, with Indian and Pakistani women at greatest risk. Despite equal or greater risk, BME and migrant women were less likely to report treatment for anxiety/depression. Mutually adjusted analyses showed ethnicity to be a stronger predictor of both outcomes than migrant status; however, at 5 years, being a migrant independently predicted lower odds of treatment, for a statistically similar level of distress.
Migrant women are likely to be at high risk of poor mental health in the perinatal period and beyond, yet may face significant barriers to accessing mental health care. A better understanding of ethnicity and migration as interrelated risk factors for perinatal mental ill-health is needed to help National Health Service organisations develop policy and practice that is flexible and responsive to diversity.
•Migrant and ethnic minority mothers are at increased risk of psychological distress.•But are less likely than non-migrant/white British women to be treated for anxiety/depression.•Ethnicity was a stronger predictor than migrant status of these differences.
Maternal ante- and postnatal anxiety have been associated with children's socio-emotional development. Moreover, maternal anxiety has been studied as both a contributing factor and consequence of ...preterm birth, and children born preterm are more likely to develop behavioural problems compared to term-born controls. This study investigated the association between maternal anxiety measured soon after birth and mental health in 215 ex-preterm children, born at <33 weeks, who participated in the Evaluation of Preterm Imaging Study. Children were followed-up at a median age of 4.6 years (range 4.2–6.6), and received behavioural and cognitive evaluation. Maternal trait anxiety was assessed with the Spielberger State-Trait Anxiety Index at term corrected age. Primary outcome measures were children's Strengths and Difficulties Questionnaire (SDQ) and Social Responsiveness Scale 2 (SRS-2) scores, indicative of generalised psychopathology and autism symptomatology, respectively. IQ was assessed with the Wechsler Preschool and Primary Scales of Intelligence. The final sample, after excluding participants with missing data and multiple pregnancy (n = 75), consisted of 140 children (51.4% male). Results showed that increased maternal trait anxiety at term corrected age was associated with children's higher SDQ scores (β = 0.25, 95% CI 0.09–0.41, p = 0.003, f2 = 0.08) and SRS-2 scores (β = 0.15, 95% CI 0.02–0.28, p = 0.03, f2 = 0.04). Our findings indicate that children born preterm whose mothers are more anxious in the early postnatal period may show poorer mental health outcomes at pre-school age. Further research is needed to investigate preventative measures that can be offered to high-risk premature babies and their families.
•Postnatal maternal anxiety may predict behavioural problems in ex-preterm children.•Postnatal maternal anxiety is not associated with IQ in ex-preterm children.•Further research needed in the prevention of mental illness in ex-preterm children.
The study is part of a larger research programme on neonatal brain imaging in the trial element of which parents were randomised to receive prognostic information based upon either magnetic resonance ...imaging (MRI) or ultrasound findings (ePrime study). The aim of this study was to investigate the strategies used by clinicians in communicating with parents following imaging at term age of the brain of preterm infants born before 33 weeks gestation, focusing on explanations and information-giving about prognosis
Audio recordings of discussions between parents and clinicians were made following MRI and ultrasound assessment. Parents were given the scan result and the baby's predicted prognosis. A framework was developed based on preliminary analysis of the recordings and findings of other studies of information-giving in healthcare. Communication of scan results by the clinicians was further explored in qualitative analysis with 36 recordings using NVivo 10 and the specifically developed framework. Emerging themes and associated sub-themes were identified.
The ways in which clinicians gave information and helped parents to understand were identified. Within the over-arching theme of clinician strategies a wide range of approaches were used to facilitate parental understanding. These included orienting, checking on previously acquired information, using analogies, explaining terminology, pacing the information, confirming understanding, inviting clarification, answering parents' questions and recapping at intervals. Ultimately four key themes were identified: 'Framing the information-giving', 'What we are looking at', 'Presenting the numbers and explaining the risk' and 'Appreciating the position of parents'.
The interviews represent a multifaceted situation in which there is a tension between the need to explain and inform and the inherent complexity of neurological development, potential problems following preterm birth and the technology used to investigate and monitor these.
Abstract
At Central Michigan University (CMU), we are developing the CMU High Precision Penning Trap (CHIP-TRAP) with the aim of performing high-precision mass measurements on stable and long-lived ...radioactive isotopes. A major goal of CHIP-TRAP is to measure the
163
Ho EC Q value to ∼1 eV precision to aid direct neutrino mass determination experiments with
163
Ho. CHIP-TRAP utilizes a laser ablation source (LAS) and a Penning ion trap source to produce ions from solid and gaseous samples, respectively. Ions from these sources are identified by measuring their times-of-flight from the source to their detection on a micro channel plate detector (MCP). With the goal of producing
163
Ho+ ions from a solution of
163
Ho dissolved in nitric acid and dried out on a backing target to be inserted into the LAS, we investigated the production of naturally occurring, stable
165
Ho+ following this method. We aimed to determine the minimum number of Ho atoms required on the target to produce a detectable number of Ho
+
ions, and to investigate different backing materials to determine if a particular material minimized contaminant ions from the backing material and maximized the number of Ho
+
ions compared to, for example, HoO
+
ions.
Abstract
At Central Michigan University (CMU) we have been developing the CMU High Precision Penning Trap (CHIP-TRAP) mass spectrometer for precise mass measurements on stable and long-lived ...radioactive isotopes. As part of this apparatus, we have designed a Penning Ion Trap (PIT) source to produce singly-charged, low intensity (∼100s to 1000s of ions in ∼1
μ
s duration) ion pulses from gaseous samples. The PIT source is similar to a PIG type source, composed of an electric field superimposed on a magnetic field. The electric field is produced by a cylindrical Penning trap structure consisting of two end caps and a center ring with a trap volume of about 0.8 cm
3
. The trap structure is housed inside a permanent neodymium ring magnet bore. Gas is inserted into the trapping region and ionized by an ∼1
μ
A electron beam from a thermal emitter. Ions are extracted from the PIT source by lowering the voltage on one of the end caps. They are then accelerated into the beam line. In this paper, we report on the design of the PIT source and simulations to investigate and characterize the expected beam properties.
We report high-precision mass measurements of ^{50-55}Sc isotopes performed at the LEBIT facility at NSCL and at the TITAN facility at TRIUMF. Our results provide a substantial reduction of their ...uncertainties and indicate significant deviations, up to 0.7 MeV, from the previously recommended mass values for ^{53-55}Sc. The results of this work provide an important update to the description of emerging closed-shell phenomena at neutron numbers N=32 and N=34 above proton-magic Z=20. In particular, they finally enable a complete and precise characterization of the trends in ground state binding energies along the N=32 isotone, confirming that the empirical neutron shell gap energies peak at the doubly magic ^{52}Ca. Moreover, our data, combined with other recent measurements, do not support the existence of a closed neutron shell in ^{55}Sc at N=34. The results were compared to predictions from both ab initio and phenomenological nuclear theories, which all had success describing N=32 neutron shell gap energies but were highly disparate in the description of the N=34 isotone.
Among the wide energy range of
β
decays, there can exist decays with
Q
values as low as a few hundred eV. These decays can occur when the parent decays to a excited state in the daughter nucleus. ...Such decays have been called “ultra-low”
Q
value
β
decays. Their application is mainly twofold: (1) they are of interest as potential candidates for neutrino mass determination experiments, and (2) they provide a testing ground for theoretical studies of atomic interference effects in the nuclear decay process. In this work we have identified a number of such potential candidates by analyzing the most recent atomic mass and nuclear energy level data. To determine if an ultra-low
Q
value
β
decay branch is energetically allowed for these candidates, more precise and accurate data for the
Q
value of the ultra-low decay branch is needed. In most cases, this requires more precise atomic mass measurements for the parent and/or daughter atoms. These requirements can be met using Penning trap mass spectrometry.
STUDY QUESTION
Is asthma more common in children born after subfertility and assisted reproduction technologies (ART)?
SUMMARY ANSWER
Yes. Asthma, wheezing in the last year and anti-asthmatic ...medication were all more common in children born after a prolonged time to conception (TTC). This was driven specifically by an increase in children born after ART.
WHAT IS KNOWN ALREADY
Few studies have investigated any association between ART and asthma in subsequent children, and findings to date have been mixed. A large registry-based study found an increase in asthma medication in ART children but suggests underlying infertility is the putative risk factor. Little is known about asthma in children after unplanned or mistimed conceptions.
STUDY DESIGN, SIZE, DURATION
The Millennium Cohort Study is a UK-wide, prospective study of 18 818 children recruited at 9 months of age. Follow-up is ongoing. This study analyses data from follow-up surveys at 5 and 7 years of age (response rates of 79 and 70%, respectively).
PARTICIPANTS/MATERIALS, SETTING, METHODS
Singleton children whose natural mothers provided follow-up data were included. Mothers reported whether their pregnancy was planned; planners provided TTC and details of any ART. The population was divided into ‘unplanned’ (unplanned and unhappy), ‘mistimed’ (unplanned but happy), ‘planned’ (planned, TTC < 12 months), ‘untreated subfertile’ (planned, TTC >12 months), ‘ovulation induced’ (received clomiphene citrate) and ‘ART’ (IVF or ICSI). The primary analysis used the planned children as the comparison group; secondary analysis compared the treatment groups to the children born to untreated subfertile parents. Outcomes were parent report of asthma and wheezing at 5 and 7 years, derived from validated questions in the International Study of Asthma and Allergies in Childhood, plus use of anti-asthmatic medications. A total of 13 041 (72%) children with full data on asthma and confounders were included at 5 years of age, and 11 585 (64%) at 7 years.
MAIN RESULTS AND THE ROLE OF CHANCE
Compared with planned children, those born to subfertile parents were significantly more likely to experience asthma, wheezing and to be taking anti-asthmatics at 5 years of age adjusted odds ratio (OR): 1.39 (95% confidence interval (CI): 1.07, 1.80), OR: 1.27 (1.00, 1.63) and OR: 1.90 (1.32,2.74), respectively. This association was mainly related to an increase among children born after ART (adjusted OR: 2.65 (1.48, 4.76), OR: 1.97, (1.10, 3.53) and OR: 4.67 (2.20, 9.94) for asthma, wheezing and taking anti-asthmatics, respectively). The association was also present, though reduced, at the age of 7 years.
LIMITATIONS, REASONS FOR CAUTION
The number of singletons born after ART was relatively small (n = 104), and as such the findings should be interpreted with caution. However, data on a wide range of possible confounding and mediating factors were available and analysed. The data were weighted for non-response to minimize selection bias.
WIDER IMPLICATIONS OF THE FINDINGS
The findings add to the growing body of evidence suggesting an association between subfertility, ART and asthma in children. Further work is needed to establish causality and elucidate the underlying mechanism. These findings are generalizable to singletons only, and further work on multiples is needed.
STUDY FUNDING/COMPETING INTEREST(S)
This study was funded by a Medical Research Council project grant. No competing interests.
A laser ablation source for offline ion production at LEBIT Izzo, C.; Bollen, G.; Bustabad, S. ...
Nuclear instruments & methods in physics research. Section B, Beam interactions with materials and atoms,
06/2016, Letnik:
376
Journal Article
Recenzirano
A laser ablation ion source has been developed and implemented at the Low-Energy Beam and Ion Trap (LEBIT) facility at the National Superconducting Cyclotron Laboratory. This offline ion source ...enhances the capabilities of LEBIT by providing increased access to ions used for calibration measurements and checks of systematic effects as well as stable and long-lived ions of scientific interest. The design of the laser ablation ion source and a demonstration of its successful operation are presented.
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