Assessment of the effects of maternal exposure to heatwave on birth outcomes in Brisbane, Australia

Even though heatwave events have become more frequent and intense in most regions around the world, little is known about the impact of heatwave on birth outcomes. This thesis uses a population-based study design to investigate the relationship between maternal heatwave exposure and adverse birth outcomes in Brisbane, Australia. This study found that heatwave exposure at any stage of pregnancy can be harmful to fetal growth, and further increase the risk of adverse birth outcomes. Both short- and long-term effects of heatwave on adverse birth outcomes were found. The findings in this thesis may have significant public health implications.

Back to normal: A retrospective, cross-sectional study of the multi-factorial determinants of normal birth in Queensland, Australia

Background Currently, care providers and policy-makers internationally are working to promote normal birth. In Australia, such initiatives are being implemented without any evidence of the prevalence or determinants of normal birth as a multidimensional construct. This study aimed to better understand the determinants of normal birth (defined as without induction of labour, epidural/spinal/general anaesthesia, forceps/vacuum, caesarean birth, or episiotomy) using secondary analyses of data from a population survey of women in Queensland, Australia. Methods Women who birthed in Queensland during a two-week period in 2009 were mailed a survey approximately three months after birth. Women (n=772) provided retrospective data on their pregnancy, labour and birth preferences and experiences, socio-demographic characteristics, and reproductive history. A series of logistic regressions were conducted to determine factors associated with having labour, having a vaginal birth, and having a normal birth. Findings Overall, 81.9% of women had labour, 66.4% had a vaginal birth, and 29.6% had a normal birth. After adjusting for other significant factors, women had significantly higher odds of having labour if they birthed in a public hospital and had a pre-existing preference for a vaginal birth. Of women who had labour, 80.8% had a vaginal birth. Women who had labour had significantly higher odds of having a vaginal birth if they attended antenatal classes, did not have continuous fetal monitoring, felt able to ‘take their time’ in labour, and had a pre-existing preference for a vaginal birth. Of women who had a vaginal birth, 44.7% had a normal birth. Women who had a vaginal birth had significantly higher odds of having a normal birth if they birthed in a public hospital, birthed outside regular business hours, had mobility in labour, did not have continuous fetal monitoring, and were non-supine during birth. Conclusions These findings provide a strong foundation on which to base resources aimed at increasing informed decision-making for maternity care consumers, providers, and policy-makers alike. Research to evaluate the impact of modifying key clinical practices (e.g., supporting women׳s mobility during labour, facilitating non-supine positioning during birth) on the likelihood of a normal birth is an important next step.

Osteopenia and rickets in the extremely low birth weight infant: A survey of the incidence and a radiological classification

A review was carried out of the radiographs of twenty-five infants with birth weights under 1000 G, who survived for more than twenty-eight days; eighteen of these had enough suitable films for a survey of the progressive bone changes which occur in these infants, including estimation of humeral cortical cross-sectional area. The incidence of the changes has been assessed and a typical progression of radiographic appearances has been shown, with a suggested system of staging. All infants showed some loss of bone mineral, with frank changes of rickets occurring in forty-four percent. Aetiological factors are mainly concerned with the difficulty of supplying and ensuring absorption of sufficient bone mineral (calcium and phosphate) and vitamin D. Liver immaturity may be another factor. Disease states additional to prematurity accentuate the problem. Rib fractures occurring around 80–90 days post-nataEy commonly draw attention to the bone disorder and are probably the major clinical factor of importance; there is a high incidence of associated lung disease of uncertain pathology. Attention is drawn to possible confusion with other bone disorders in the post-natal period.

A Soul for Europe? : Contributions of European Churches to the Forum of the Convention on the Future of Europe

The aim of this research was to study how European churches contributed to the shaping of the Constitutional Treaty during the work of the Convention on the future of Europe through the public discussion forum, established by the Convention for this specific purpose in the years 2002 2003. In particular, this study sought to uncover the areas of interest brought up by the churches in their contributions, the objectives they pursued, and the approaches and arguments they employed to reach those objectives. The data for this study comprised all official submissions by European churches and church alliances to the Forum, totalling 21 contributions. A central criterion for inclusion of the data was that the organization can reasonably be assumed to represent the official position of one or more Christian churches within the European Union before the 2004 expansion. The contributing churches and organizations represent the vast majority of Christians in Europe. The data was analyzed using primarily qualitative content analysis. The research approach was a combination of abductive and inductive inference. Based on the analysis a two-fold theoretical framework was adopted, focusing on theories of public religion, secularization and deprivatization of religion, and of legitimation and collective identity. The main areas of interest found in the contributions of the churches were the value foundation of the European Union, which is demanded to coherently permeate all policies and actions of the EU, and the social dimension of Europe, which must be given equal status to the political and economic dimensions. In both areas the churches claim significant experience and expertise, which they want to see recognized in the Constituional Treaty through a formally guaranteed status for churches and religious communities in the EU. In their contributions the churches show a strong determination to secure a significant role for both religion and religious communities in the public life of Europe. As for the role of religion, they point out to its potential as a motivating and cohesive force in society and as a building block for a collective European identity, which is still missing. Churches also pursue a substantial public role for themselves beyond the spiritual dimension, permeating the secular areas of the social, political and economic dimensions. The arguments in suppport of such role are embedded in their interest and expertise in spiritual and other fundamental values and their broad involvement in providing social services. In this context churches use expressions inclusive of all religions and convictions, albeit clearly advocating the primacy of Europe's Christian heritage. Based on their historical role, their social involvement and their spiritual mission they use the public debate on the Constitutional Treaty to gain formal legitimacy for the public status of religion and religious communities, both nationally and on a European level, through appropriate provisions in the constitutional text. In return they offer the European Union ways of improving its own legitimacy by reducing the democratic and ideological deficit of the EU and advancing the development a collective European identity.

Preterm Birth and Surgical Treatment of the Uterine Cervix

Cervical cancer is the second most common cancer among women globally. Most, probably all cases, arise through a precursor, cervical intraepithelial neoplasia (CIN). Effective cytological screening programmes and surgical treatments of precancerous lesions have dramatically reduced its prevalence and related mortality. Although these treatments are effective, they may have adverse effects on future fertility and pregnancy outcomes. The aim of this study was to evaluate the effects of surgical treatment of the uterine cervix on pregnancy and fertility outcomes, with the focus particularly on preterm birth. The general preterm birth rates and risk factors during 1987–2005 were studied. Long-term mortality rates of the treated women were studied. In this study, information from The Medical Birth Register (MBR), The Hospital Discharge Register (HDR), The Cause-of-Death Register (CDR), and hospital records were used. Treatments were performed during 1987–2003 and subsequent deliveries, IVF treatments and deaths were analyzed. The general preterm birth rate in Finland was relatively stable, varying from 5.1% to 5.4% during the study period (1987 to 2005), although the proportion of extremely preterm births had decreased substantially by 12%.The main risk factor as regards preterm birth was multiplicity, followed by elective delivery (induction of delivery or elective cesarean section), primiparity, in vitro fertilization treatment, maternal smoking and advanced maternal age. The risk of preterm birth and low birth weight was increased after any cervical surgical treatment; after conization the risk of preterm birth was almost two-fold (RR 1.99, 95% CI 1.81– 2.20). In the conization group the risk was the highest for very preterm birth (28–31 gestational weeks) and it was also high for extremely preterm birth (less than 28 weeks). In this group the perinatal mortality was also increased. In subgroup analysis, laser ablation was not associated with preterm birth. When comparing deliveries before and after Loop conization, we found that the risk of preterm birth was increased 1.94-fold (95% CI 1.10–3.40). Adjusting for age, parity, or both did not affect our results. Large or repeat cones increased the risk of preterm birth when compared with smaller cones, suggesting that the size of the removed cone plays a role. This was corroborated by the finding that repeat treatment increased the risk as much as five-fold when compared with the background preterm birth rate. We found that the proportion of IVF deliveries (1.6% vs. 1.5%) was not increased after treatment for CIN when adjusted for year of delivery, maternal age, or parity. Those women who received both treatment for CIN and IVF treatment were older and more often primiparous, which explained the increased risk of preterm birth. We also found that mortality rates were 17% higher among women previously treated for CIN. This excess mortality was particularly seen as regards increased general disease mortality and alcohol poisoning (by 13%), suicide (by 67%) and injury death (by 31%). The risk of cervical cancer was high, as expected (SMR 7.69, 95% CI 4.23–11.15). Women treated for CIN and having a subsequent delivery had decreased general mortality rate (by -22%), and decreased disease mortality (by -37%). However, those with preterm birth had increased general mortality (SMR 2.51, 95% CI 1.24–3.78), as a result of cardiovascular diseases, alcohol-related causes, and injuries. In conclusion, the general preterm birth rate has not increased in Finland, as in many other developed countries. The rate of extremely preterm births has even decreased. While other risk factors of preterm birth, such as multiplicity and smoking during pregnancy have decreased, surgical treatments of the uterine cervix have become more important risk factors as regards preterm birth. Cervical conization is a predisposing factor as regards preterm birth, low birth weight and even perinatal mortality. The most frequently used treatment modality, Loop conization, is also associated with the increased risk of preterm birth. Treatments should be tailored individually; low-grade lesions should not be treated at all among young women. The first treatment should be curative, because repeat treatments are especially harmful. The proportion of IVF deliveries was not increased after treatment for CIN, suggesting that current treatment modalities do not strongly impair fertility. The long-term risk of cervical cancer remains high even after many years post-treatment; therefore careful surveillance is necessary. In addition, accidental deaths and deaths from injury were common among treated women, suggesting risk-taking behavior of these women. Preterm birth seems be associated with extremely high mortality rates, due to cardiovascular, alcohol-related and injury deaths. These women could benefit from health counseling, for example encouragement in quitting smoking.

Construct and content validity of the Greek version of the birth satisfaction scale (G-BSS).

Background: ‘Birth Satisfaction’ is a term that encompasses a woman’s evaluation of her birth experience. The term includes factors such as her appraisal of the quality of care she received, a personal assessment of how she coped, and her reconstructions of what happened on that particular day. Her accounts may be accurate or skewed, yet correspond with her reality of how events unfolded. Objective: To evaluate properties of an instrument designed to measure birth satisfaction in a Greek population of postnatal women. Study design: We assessed factor structure, internal consistency, divergent validity and known-groups discriminant validity of the 30-item Greek Birth Satisfaction Scale – Long Form (30-item G-BSS-LF) and its revised version the 10-item Greek-BSS-Revised (10-item-G-BSS-R), using survey data collected in Athens. Participants: A convenience sample of healthy Greek postnatal women (n = 162) aged 22–46 years who had delivered between 34 and 42 weeks’ gestation. Results: The 30-item-G-BSS-LF performed poorly in terms of factor structure. The short-form 10-item-G-BSS-R performed well in terms of measurement replication of the English equivalent version as a multidimensional instrument. The short-form 10-item-G-BSS-R comprises three subscales which measure distinct but correlated domains of: (1) quality of care provision (4 items), (2) women’s personal attributes (2 items), and (3) stress experienced during labour (4 items). Key conclusions: The 10-item-G-BSS-R is a valid and reliable multidimensional psychometric instrument for measuring birth satisfaction in Greek postnatal women.

Knowledge and judgments about events that occurred prior to birth: The measurement of the persistence of information

Data from five laboratories using five different techniques were reanalyzed to measure subjects' knowledge of events that occurred over the past 70 years. Subjects were about 20 years of age, so the measures included events that extended up to 50 years before birth. The functions relating knowledge about the events to age do not decrease precipitously at birth but gradually drop to above-chance levels. Techniques usually used to study retention within the individual can be used to study the persistence of ideas and fashions within an age cohort in a culture.

EFFECT OF MUSIC ON THE SOUL: INTENT OR INDIFFERENCE IN THE COMPOSITION OF EWAZEN, FETTER, HIDAS, HOVHANESS, PEDERSON AND WILDER

This performance dissertation completed in 2009 by bass trombonist and Doctor of Musical Arts candidate Karl Wiederwohl consists of three live recitals and a written document which serves as a complement to the performances. The document discusses the six composers whose music is performed on the recitals. The document's six chapters respectively discuss each composer's disposition with regard to their purpose in composing music. As a complement to the performances the document gives special attention to each composer's thoughts on affecting listeners through their music. Wiederwohl creates a window into the mentality behind the artistry of Eric Ewazen, David Fetter, Frigyes Hidas, Alan Hovhaness, Tommy Pederson and Alec Wilder. The document serves to inform and enrich the experience of both performers and listeners of these six composers. This is achieved through the document's treatment of the following four questions for each composer: How did each come to be a composer? How did each come to compose in his particular style? Does the composer intend his music to serve a purpose? Does the composer intend his music to serve a purpose, and, if so, does this purpose involve reaching and/or affecting the listener at the deepest level?

The effect of month of birth on the attainments of primary and secondary school pupils

Background: Previous research has produced conflicting results regarding the effects of season of birth and age-position on cognitive attainments. In Northern Ireland the school year divides the summer season into two providing an opportunity to evaluate the relative contribution of season of birth and age-position effects. Aims: To investigate the relationship between attainment in literacy skills and month of birth for primary and secondary school pupils and to determine the relationship between motor skills and month of birth in primary school pupils. Sample: One thousand one hundred and twenty four primary school pupils participated, and results for key stage 3 (KS3) English and GCSE English Language, for 3,493 Year 10 and 3,697 Year 12 secondary school pupils, respectively, were obtained. Method: Primary school pupils were individually assessed using standardised reading and spelling tests, as well as tests of motor skill. They were also assessed using a standardised group reading test in their class groups. For the secondary school pupils, the results for two year cohorts, in KS3 English and GCSE English language, respectively, were analysed. Results: For the primary school pupils there was evidence of both a season of birth and an age-position effect on all of the cognitive measures, particularly in the early years of schooling. There was, also, evidence of a significant age-position effect at both KS3 and GCSE in favour of the older pupils. For the younger primary school pupils there was evidence of significant age-position effects on both motor measures. Conclusions: The findings from the present study suggest that month of birth may be related to both season of birth and age-position effects. These effects may be compounded, particularly in the early years of primary school, when summer born children are youngest in their year, as in England. In Northern Ireland, age-position effects are also evident in secondary school public examination results, which may have implications for long-term life choices. © 2009 The British Psychological Society.

The birth place of the type Ic supernova 2007gr

We report our attempts to locate the progenitor of the peculiar Type Ic SN 2007gr in Hubble Space Telescope (HST) preexplosion images of the host galaxy, NGC 1058. Aligning adaptive optics Altair/NIRI imaging of SN 2007gr from the Gemini ( North) Telescope with the preexplosion HST WFPC2 images, we identify the supernova (SN) position on the HST frames with an accuracy of 20 mas. Although nothing is detected at the SN position, we show that it lies on the edge of a bright source 134 +/- 23 mas (6.9 pc) from its nominal center. On the basis of its luminosity, we suggest that this object is possibly an unresolved, compact, and coeval cluster and that the SN progenitor was a cluster member, although we note that model profile fitting favors a single bright star. We find two solutions for the age of this assumed cluster: 7 -/+ 0.5 Myr and 20 - 30 Myr, with turnoff masses of 28 +/- M-circle dot and 12 - 9 M-circle dot, respectively. Preexplosion ground-based K- band images marginally favor the younger cluster 4 age/higher turnoff mass. Assuming the SN progenitor was a cluster member, the turnoff mass provides the best estimate for its initial mass. More detailed observations, after the SN has faded, should determine whether the progenitor was indeed part of a cluster and, if so, allow an age estimate to within similar to 2 Myr, thereby favoring either a high-mass single star or lower-mass interacting binary progenitor.

Experimental Moments: R.U.R. and the Birth of British Television Science Fiction

Drawing on material from the BBC Written Archive Centre, this article examines the earliest sf dramas broadcast by the BBC Television Service: two adaptations of Karel Capek's "R.U.R." ("Rossum's Universal Robots") from 1938 and 1948. These productions are used as sites of formal experimentation with the possibilities of the new medium, representing one aspect of contemporary debates about the purpose of television and the style it would assume.