Objective The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter ...study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile. Study Design Over 1100 consecutive ultrasound-dated singleton pregnancies with EFW <10th centile were recruited from January 2010 through June 2012. A range of IUGR definitions were used, including EFW or abdominal circumference <10th, <5th, or <3rd centiles, with or without oligohydramnios and with or without abnormal umbilical arterial Doppler (pulsatility index >95th centile, absent or reversed end-diastolic flow). Adverse perinatal outcome, defined as a composite outcome of intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, and death was documented for all cases. Results Of 1116 fetuses, 312 (28%) were admitted to neonatal intensive care unit and 58 (5.2%) were affected by adverse perinatal outcome including 8 mortalities (0.7%). The presence of abnormal umbilical Doppler was significantly associated with adverse outcome, irrespective of EFW or abdominal circumference measurement. The only sonographic weight-related definition consistently associated with adverse outcome was EFW <3rd centile ( P = .0131); all mortalities had EFW <3rd centile. Presence of oligohydramnios was clinically important when combined with EFW <3rd centile ( P = .0066). Conclusion Abnormal umbilical artery Doppler and EFW <3rd centile were strongly and most consistently associated with adverse perinatal outcome. Our data call into question the current definitions of IUGR used. Future studies may address whether using stricter IUGR cutoffs comparing various definitions and management strategies has implications on resource allocation and pregnancy outcome.
Magdalen history has long been marginalised. Even as women's activism and contributions are included in new histories of the revolutionary era, the lives of women regarded as marginal are still ...excluded. This collection examines how Magdalen history can contribute to a more nuanced, inclusive understanding of post-independence Irish history.
When Paris Sizzled vividly portrays the City of Light during the fabulous 1920s, when art and architecture, music, literature, fashion, entertainment, transportation, and behavior all took ...dramatically new forms. Through rich illustrations and evocative narrative, Mary McAuliffe brings this vibrant era to life.
Mary McAuliffe’s Dawn of the Belle Epoque took the reader from the multiple disasters of 1870–1871 through the extraordinary re-emergence of Paris as the cultural center of the Western world. Now, in ...Twilight of the Belle Epoque, McAuliffe portrays Paris in full flower at the turn of the twentieth century, where creative dynamos such as Picasso, Matisse, Stravinsky, Debussy, Ravel, Proust, Marie Curie, Gertrude Stein, Jean Cocteau, and Isadora Duncan set their respective circles on fire with a barrage of revolutionary visions and discoveries. Such dramatic breakthroughs were not limited to the arts or sciences, as innovators and entrepreneurs such as Louis Renault, André Citroën, Paul Poiret, François Coty, and so many others—including those magnificent men and women in their flying machines—emphatically demonstrated. But all was not well in this world, remembered in hindsight as a golden age, and wrenching struggles between Church and state as well as between haves and have-nots shadowed these years, underscored by the ever-more-ominous drumbeat of the approaching Great War—a cataclysm that would test the mettle of the City of Light, even as it brutally brought the Belle Epoque to its close. Through rich illustrations and evocative narrative, McAuliffe brings this remarkable era from 1900 through World War I to vibrant life.
Conflict between England and France was a fact of life for centuries, but few realize that this conflict originated with the Vikings and their settlement of what would become Normandy. In this ...compelling and entertaining history, Mary McAuliffe takes the reader back to those dark and turbulent times when Viking descendant William the Conqueror became king of England, yet as duke of Normandy remained an unwilling subject to the French crown. This led to ongoing hostility between his descendants and generations of French monarchs, culminating in the clash between young Philip Augustus of France and his royal English rivals, most notably Richard Lionheart. Mary McAuliffe colorfully provides the background and context for this "clash of crowns," whose outcome would shape the course of English and French history throughout the centuries that followed.
Paris in 1871 was a shambles following military defeat, siege, and a bloody uprising, and the question loomed, could this extraordinary city even survive? By 1900, the Belle Epoque was in full ...flower, but the decades between were marked by tension and conflict, as the new challenged the old in everything from politics to art, literature, music, science, and engineering. With the addition of an evocative new preface, Mary McAuliffe takes the reader back to these perilous years following the abrupt collapse of the Second Empire and France's uncertain venture into the Third Republic--examining this era through the eyes of Monet, Zola, Debussy, Eiffel, Marie Curie, and others as they struggled with the forces of tradition. Through rich illustrations and vivid narrative, McAuliffe brings this vibrant and seminal era to life.
This article takes a close look at the history and development of the Irish right to choose and anti-amendment abortion campaigns from 1979-1983. In 1980 the Women’s Right to Choose Group (WRCG) was ...formed and was the first Irish feminist group to openly campaign for women’s right to choose. This article will consider why campaigns for choice happened so late, and why the response by the anti-choice lobby to any right to choose activism was so fierce and dogmatic. By situating the abortion campaigns in their historical context, we can further understand the barriers that the pro-choice feminist activists faced. The activism and ideas of the WRCG, as well as those of the Women’s Right to Choose Campaign (WRCC), trade union activists, political parties etc., along with tactics of the Anti-Amendment Campaign (AAC) will be considered. The arguments used by all groups will be analysed, as will the discussion points put forward by the board-based umbrella group, the AAC. The tensions and splits in the anti-amendment side will be analysed to further understand the enduring legacies of the 1983 anti-amendment campaign for the Irish women’s movement once the 8th amendment was inserted into the Irish Constitution.
It is vital health services have systems in place for staff mandatory training to meet safe quality health outcomes. The aim of this review is to identify enablers supporting staff attendance at ...mandatory training (including BLS) and barriers that pose challenges for staff participation in mandatory training that will be used to inform the development of a structured mandatory staff training program in an IPE environment.
An integrative literature review was sought to answer the question: What are the enablers and barriers that influence health professional attendance and successful completion of mandatory training (including BLS) in an IPE environment?
An international literature search was undertaken using advance search of the databases: Medline, CINAHL, Google Scholar and Web of Science (WoS). English language, peer reviewed articles published from 2010 to 2022 were retrieved and screened for relevance.
An integrative review of papers included systematic reviews, a case study, quantitative and qualitative studies, RCT, mixed method studies and expert opinion papers.
Only 34 articles were eligible for inclusion in the review based on their relevance to staff attendance at mandatory training (including BLS). Analysis of literature identified four key themes: ‘mandatory training’ and ‘certification’; ‘knowledge and skills’; ‘enablers’ and ‘barriers’ for ‘mandatory training (including BLS) attendance’ and ‘IPE’. The literature highlighted that IPE is an appropriate means of delivering a redesign education/training process that may increase attendance at mandatory training with recommendations for increased inclusivity and interactivity as well as providing useful logistic information.
The outcome of the review can inform development of an IPE Implementation Strategy in a health service aiming to improve staff attending and engaging in mandatory training. The findings are valuable to other health services seeking to improve and achieve mandatory and accreditation targets.
Objective An objective of the Prospective Observational Trial to Optimize Pediatric Health in IUGR (PORTO) study was to evaluate multivessel Doppler changes in a large cohort of intrauterine growth ...restriction (IUGR) fetuses to establish whether a predictable progressive sequence of Doppler deterioration exists and to correlate these Doppler findings with respective perinatal outcomes. Study Design More than 1100 unselected consecutive ultrasound-dated singleton pregnancies with estimated fetal weight (EFW) less than the 10th centile were recruited between January 2010 and June 2012. Eligible pregnancies were assessed by serial Doppler interrogation of umbilical (UA) and middle cerebral (MCA) arteries, ductus venosus (DV), aortic isthmus, and myocardial performance index (MPI). Intervals between Doppler changes and patterns of deterioration were recorded and correlated with respective perinatal outcomes. Results Our study of 1116 nonanomalous fetuses comprised 7769 individual Doppler data points. Five hundred eleven patients (46%) had an abnormal UA, 300 (27%) had an abnormal MCA, and 129 (11%) had an abnormal DV Doppler. The classic pattern from abnormal UA to MCA to DV existed but no more frequently than any of the other potential pattern. Doppler interrogation of the UA and MCA remains the most useful and practical tool in identifying fetuses at risk of adverse perinatal outcome, capturing 88% of all adverse outcomes. Conclusion In contrast to previous reports, we have demonstrated multiple potential patterns of Doppler deterioration in this large prospective cohort of IUGR pregnancies, which calls into question the usefulness of multivessel Doppler assessment to inform frequency of surveillance and timing of delivery of IUGR fetuses. These data will be critically important for planning any future intervention trials.
The powerful story of gender history in Ireland and how the State treated its citizens on the basis of gender Insightful questions that challenge the concept of masculinity, femininity and ...'otherness' within Irish society. Includes a fascinating study of activists from various campaigns that surround the progression of Pro-Choice and Pro-Life since 1983. This innovative and compelling collection offers a new understanding of sexual and gender politics throughout the 19th and 20th centuries in Ireland. This book provides a fresh approach to the perspectives of the past that are unheard of throughout Irish history. The notable contributors to this unique collection provide a captivating and controversial debate on sexuality. Further debates include the exploration of lesbian histories, the treatment of intersex persons in Ireland, the patriarchal system, bigamy, prostitution, sex education, and the ongoing issue of abortion. Ireland's relationship between the Church and State is investigated and questioned, along with the 'double standards' attitude towards women and their position within the law. Arguments made by the experts in gender and women's history throughout this book offer a re-examination of our understanding of the State and how it treated, and continues to treat, its people on the basis of gender.
PDF
