Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no…
Abstract
Purpose
Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no clustering of TTTS; instead the threat remains pathologically distinctive due to its pervasiveness. However, while incidence rates are random, survival rates are not. Despite compliant acceptance of “routine prenatal care,” sadly, there are many women who for currently unknown reasons are not receiving the advanced prenatal care needed to appropriately screen for, diagnosis and treat TTTS. And these women are paying the ultimate price for such obstetrical oversight.
Methodology
This study hypothesizes that differential care being given by primary obstetricians of TTTS patients is resulting in experienced inequalities. Utilizing social reproduction theory, and through ethnographic and quantitative analyses of primary data, this study seeks to divulge the complex social processes taking place (or failing to take place) within the world of American obstetrics, and begin to understand how they are affecting TTTS mortality and morbidity rates.
Findings
Findings illuminate a profound imbalance of power and influence amongst the following entities: American Congress of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine; obstetrical training and practice; and levels of patient awareness and advocacy.
Value
This study argues that the current social relations being reproduced by these entities are perpetuating a climate that allows for disregard of proper TTTS management. Specifically, this study theoretically explores what social relations and subsequent (in)actions are being reproduced prior to TTTS diagnoses, and applies the effects of those observations.
Details
Keywords
Elizabeth Lowe, Shabana Akhtar, Oliver Emmerson, Thomas Parkman and Edward Day
Less than 15 per cent of people starting opiate substitution treatment (OST) in England are employed, but few gain employment during treatment. Increasingly punitive approaches…
Abstract
Purpose
Less than 15 per cent of people starting opiate substitution treatment (OST) in England are employed, but few gain employment during treatment. Increasingly punitive approaches have been tried to encourage individuals with substance dependence into employment in the hope of facilitating recovery. It is not clear which factors are associated with the successful maintenance of employment whilst receiving OST, and whether this group can be said to be “in recovery”. The paper aims to discuss these issues.
Design/methodology/approach
A cross-sectional study of the OST population in one English region was conducted between January and April 2017. Measures of physical health, employment patterns, drug use, mental health, recovery capital, and dependence severity were administered to 55 employed and 55 unemployed clients.
Findings
Those in employment had higher levels of “recovery capital”, better physical and mental health, fewer drug problems, and less severe dependence, despite reporting heroin use at a similar level. Three variables were significantly associated with employment: longest period of employment (OR=1.01, p=0.003); number of chronic medical conditions (OR=0.44, p=0.011); and number of days of psychological problems in the last month (OR=0.95, p=0.031).
Practical implications
These results suggest that abstinence may not be required in order to maintain stable employment when OST is in place. Different treatment strategies are required for clients receiving OST already in employment compared with those who are unemployed.
Originality/value
This is the first UK study to the author’s knowledge to focus on people receiving OST who are also in employment.
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Edward Day, Sabrina Kirberg and Nicola Metrebian
Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use…
Abstract
Purpose
Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues.
Design/methodology/approach
A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS).
Findings
A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001).
Practical implications
A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate.
Originality/value
The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.
Details
Keywords
EVERY librarian in his inmost heart dislikes newspapers. He regards them as bad literature; attractors of undesirable readers; a drain upon the limited resources of the library;…
Abstract
EVERY librarian in his inmost heart dislikes newspapers. He regards them as bad literature; attractors of undesirable readers; a drain upon the limited resources of the library; and a target against which the detractors of public libraries are constantly battering. From the standpoint of the librarian, newspapers are the most expensive and least productive articles stocked by a library, and their lavish provision is, perhaps, the most costly method of purchasing waste‐paper ever devised. Pressure of circumstances and local conditions combine, however, to muzzle the average librarian, and the consequence is that a perfectly honest and outspoken discussion of the newspaper question is very rarely seen. In these circumstances, an attempt to marshal the arguments for and against the newspaper, together with some account of a successful practical experiment at limitation, may prove interesting to readers of this magazine.
THE younger generation of library worthies unacquainted with the earlier conditions of the service no doubt with justice feel rebellious at present pay and conditions. Although…
Abstract
THE younger generation of library worthies unacquainted with the earlier conditions of the service no doubt with justice feel rebellious at present pay and conditions. Although something has been done during the past fifty years to improve these conditions, there is still room for improvement.
ALTHOUGH my articles are chiefly concerned with conditions appertaining to the early days of the public library, I cannot resist the temptation to step aside and reflect upon the…
Abstract
ALTHOUGH my articles are chiefly concerned with conditions appertaining to the early days of the public library, I cannot resist the temptation to step aside and reflect upon the administration of an old established proprietary library and the idiosyncrasies of its governing body.
The total number of samples analysed in 1911 was 103,221, an increase of 2,472 samples over the number for the previous year. The principal increases were the following: Milk…
Abstract
The total number of samples analysed in 1911 was 103,221, an increase of 2,472 samples over the number for the previous year. The principal increases were the following: Milk, 2,954; flour, 405; bread, 291; and spirits, 255. The principal decreases occurred in lard, 973; cheese, 285; and margarine, 208.
THE first library in connection with an English University was founded at Oxford by Richard d'Aungerville, better known as Richard de Bury, Bishop of Durham. At the time of its…
Abstract
THE first library in connection with an English University was founded at Oxford by Richard d'Aungerville, better known as Richard de Bury, Bishop of Durham. At the time of its foundation it was considered one of the best collections of books in England. It was housed in Durham College—now Trinity—and the donor drew up copious rules for its management and preservation. It appears that this library was destroyed in the days of Edward VI.
David F. Cheshire, Mike Cornford, Sandra Vogel, Sue Lacey Bryant, Edward Dudley, Shirley Day, Edwin Fleming and Allan Bunch
1989 was designated Museums Year to commemorate the centenary of the Museums Association, and unlike many of these PR exercises this one resulted in museums (especially national…
Abstract
1989 was designated Museums Year to commemorate the centenary of the Museums Association, and unlike many of these PR exercises this one resulted in museums (especially national museums based in London) receiving an unusual amount of coverage in the qualities. Whether stories of protests and problems would have the desired positive effect on actual attendances has not yet been calculated. The unusually sunny weather cannot have helped much either. But the Museums Association itself produced a series of 11 regional guides which if read on the beach or in the pool would have enabled the readers almost to think that they had actually visited the collections described in considerable detail. Too many to note here but a list of all the titles is available from the MA or the Museums and Galleries Commission. Simon Olding's Exploring Museums: London (ISBN 0 11 2904653) and Arnold Wilson's Exploring Museums: The South West (ISBN 0 11 2904696) tackle their areas entertainingly, but their step‐by‐step guides to some of their subjects may soon be outdated as many existing museums are currently undergoing major rearrangements or refurbishments.