Objective
To review quality of care in births planned in midwifery‐led settings, resulting in an intrapartum‐related perinatal death.
Design
Confidential enquiry.
Setting
England, Scotland and Wales.
...Sample
Intrapartum stillbirths and intrapartum‐related neonatal deaths in births planned in alongside midwifery units, freestanding midwifery units or at home, sampled from national perinatal surveillance data for 2015/16 (alongside midwifery units) and 2013–16 (freestanding midwifery units and home births).
Methods
Multidisciplinary panels reviewed medical notes for each death, assessing and grading quality of care by consensus, with reference to national standards and guidance. Data were analysed using thematic analysis and descriptive statistics.
Results
Sixty‐four deaths were reviewed, 30 stillbirths and 34 neonatal deaths. At the start of labour care, 23 women were planning birth in an alongside midwifery unit, 26 in a freestanding midwifery unit and 15 at home. In 75% of deaths, improvements in care were identified that may have made a difference to the outcome for the baby. Improvements in care were identified that may have made a difference to the mother's physical and psychological health and wellbeing in 75% of deaths. Issues with care were identified around risk assessment and decisions about planning place of birth, intermittent auscultation, transfer during labour, resuscitation and neonatal transfer, follow up and local review.
Conclusions
These confidential enquiry findings do not address the overall safety of midwifery‐led settings for healthy women with straightforward pregnancies, but suggest areas where the safety of care can be improved. Maternity services should review their care with respect to our recommendations.
Tweetable
Confidential enquiry of intrapartum‐related baby deaths highlights areas where care in midwifery‐led settings can be made even safer.
Tweetable
Confidential enquiry of intrapartum‐related baby deaths highlights areas where care in midwifery‐led settings can be made even safer.
A block coil geometry is appealing in the body of particle accelerator dipole or quadrupole magnets, but less so in the ends of conventional designs, because conductors near the midplane of the beam ...tube must be bent in the hard direction to cross over to the other side of the tube. To avoid damage to brittle conductors such as Nb 3 Sn or HTS, the bend must be very gradual, resulting in undesirably long magnet ends. An alternative design - "overpass/underpass" or "cloverleaf" - can ramp the conductor within a short length with bending only in the easy direction. Described here is a proof-of-principle design and analysis of an "overpass/underpass" coil geometry for a block coil dipole of 11 T or more.
We report on the progress in our R&D program, targeted to develop the technology for the application of (Bi-2212) in accelerator magnets. The program uses subscale coils, wound from insulated cables, ...to study suitable materials, heat treatment homogeneity, stability, and effects of magnetic field and thermal and electro-magnetic loads. We have addressed material and reaction related issues and report on the fabrication, heat treatment, and analysis of subscale Bi-2212 coils. Such coils can carry a current on the order of 5000 A and generate, in various support structures, magnetic fields from 2.6 to 9.9 T. Successful coils are therefore targeted towards a hybrid -HTS magnet which will demonstrate the feasibility of Bi-2212 for accelerator magnets, and open a new magnetic field realm, beyond what is achievable with .
Since the 1960s, Nb-Ti (superconducting transition temperature T/sub c/=9 K) and Nb/sub 3/Sn (T/sub c/=18 K) have been the materials of choice for virtually all superconducting magnets. However, the ...prospects for the future changed dramatically in 1987 with the discovery of layered cuprate superconductors with T/sub c/ values that now extend up to about 135 K. Fabrication of useful conductors out of the cuprates has been difficult, but a first generation of silver-sheathed composite conductors based on (Bi,Pb)/sub 2/Sr/sub 2/Ca/sub 2/Cu/sub 3/O/sub 10/ (T/sub c//spl sim/110 K) has already been commercialized. Recent progress on a second generation of biaxially aligned coated conductors using the less anisotropic YBa/sub 2/Cu/sub 3/O/sub 7/ structure has been rapid, suggesting that it too might enter service in the near future. The discovery of superconductivity in MgB/sub 2/ below 39 K in 2001 has brought yet another candidate material to the large-scale applications mix. Two distinct markets for superconductor wires exist-the more classical low-temperature magnet applications such as particle accelerators, nuclear magnetic resonance and magnetic resonance imaging magnets, and plasma-containment magnets for fusion power, and the newer and potentially much larger market for electric power equipment, such as motors, generators, synchronous condensers, power transmission cables, transformers, and fault-current limiters for the electric utility grid. We review key properties and recent progress in these materials and assess their prospects for further development and application.
This study explored the potential relationship between the social cognitive variables of career decision‐making self‐efficacy and perceptions of barriers and the outcome variables of vocational ...identity and career exploration behaviors in a sample of 128 urban Latino/a high school students. The results indicated that higher levels of career decision‐making self‐efficacy were related to both a more differentiated vocational identity and a greater engagement with career exploration tasks. Perception of fewer barriers was also found to be related to a more integrated vocational identity. Implications for career counseling and future research are discussed.
The content, synthesis and transport of d‐aspartate (d‐Asp) in the CNS of Aplysia californica is investigated using capillary electrophoresis (CE) with both laser‐induced fluorescence and ...radionuclide detection. Millimolar concentrations of d‐Asp are found in various regions of the CNS. In the cerebral ganglion, three adjacent neuronal clusters have reproducibly different d‐Asp levels; for example, in the F‐ and C‐clusters, up to 85% of the free Asp is present in the d‐form. Heterogeneous distribution of d‐Asp is also found in the individual identified neurons tested, including the optical ganglion top‐layer neurons, metacerebral cells, R2 neurons, and F‐, C‐ and G‐cluster neurons. The F‐cluster neurons have the highest percentage of d‐Asp (∼58% of the total Asp), whereas the lowest value of ∼8% is found in R2 neurons. In pulse‐chase experiments with radiolabeled d‐Asp, followed by CE with radionuclide detection, the synthesis of d‐Asp from l‐aspartate (l‐Asp) is confirmed. Is d‐Asp in the soma, or is it transported to distantly located release sites? d‐Asp is clearly detected in the major nerves of A. californica, including the pleuroabdominal and cerebrobuccal connectives and the anterior tentacular nerves, suggesting it is transported long distances. In addition, both d‐Asp and l‐Asp are transported in the pleuroabdominal connectives in a colchicine‐dependent manner, whereas several other amino acids are not. Finally, d‐Asp produces electrophysiological effects similar to those induced by l‐Asp. These data are consistent with an active role for d‐Asp in cell‐to‐cell communication.
Magnet programs at BNL, LBNL and FNAL have observed instabilities in high J/sub c/ Nb/sub 3/Sn strands and magnets made from these strands. This paper correlates the strand stability determined from ...a short sample-strand test to the observed magnet performance. It has been observed that strands that carry high currents at high fields (greater than 10 T) cannot sustain these same currents at low fields (1-3 T) when the sample current is fixed and the magnetic field is ramped. This suggests that the present generation of strand is susceptible to flux jumps (FJ). To prevent flux jumps from limiting stand performance, one must accommodate the energy released during a flux jump. To better understand FJ this work has focused on wire with a given sub-element diameter and shows that one can significantly improve stability by increasing the copper conductivity (higher residual resistivity ratio, RRR, of the Cu). This increased stability significantly improves the conductor performance and permits it to carry more current.
HTS conductors for magnets Hasegawa, T.; Koizumi, T.; Hikichi, Y. ...
IEEE transactions on applied superconductivity,
03/2002, Letnik:
12, Številka:
1
Journal Article, Conference Proceeding
Recenzirano
We have successfully improved the J/sub c/ value of Bi-2212 round wire to 500 kA/cm/sup 2/ at 4.2 K in self-field. The J/sub c/ value strongly depended on the filament size, aspect ratio, and ...geometry. Adjusting the filament size made it possible to obtain wires with J/sub c/ values higher than 450 kA/cm/sup 2/ in a range of wire diameters from 0.8 to 1.3 mm. The J/sub c/ value remained constant up to an applied tensile strength of 150 MPa. A 1 + 6 stranded cable fabricated using 1.02 mm diameter wires carried an I/sub c/ value of 4.5 kA at 4.2 K in self-field. A 16-strand Rutherford cable could also be fabricated using this wire.
The paper examines two-dimensional force functions useful in the wind-response analysis of bluff bodies, such as bridges, that are elongated in the across-wind direction. Airfoil-type theoretical 2-D ...indicial, admittance, and oscillatory force functions and their interrelationships are first recalled for their analogical value. Following this, a spectral force expression is developed for the lift on a bluff section due to a cross-wind with a vertical turbulence component. The expression proposed involves an aerodynamic admittance that is based upon measured flutter derivatives for the bluff section plus information on the coherence of vertical turbulence in the atmospheric boundary layer.
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