Glycemic targets in the second and third trimester of pregnancy for women with type 1 diabetes

OBJECTIVE: To assess the relationship between second and third trimester glycemic control and adverse outcomes in pregnant women with type 1 diabetes, as uncertainty exists about optimum glycemic targets.

RESEARCH DESIGN AND METHODS: Pregnancy outcomes were assessed prospectively in 725 women with type 1 diabetes from the Diabetes and Pre-eclampsia Intervention Trial. HbA1c (A1C) values at 26 and 34 weeks' gestation were categorized into five groups, the lowest, <6.0% (42 mmol/mol), being the reference. Average pre- and postprandial results from an eight-point capillary glucose profile the previous day were categorized into five groups, the lowest (preprandial <5.0 mmol/L and postprandial <6.0 mmol/L) being the reference.

RESULTS: An A1C of 6.0-6.4% (42-47 mmol/mol) at 26 weeks' gestation was associated with a significantly increased risk of large for gestational age (LGA) (odds ratio 1.7 [95% CI 1.0-3.0]) and an A1C of 6.5-6.9% (48-52 mmol/mol) with a significantly increased risk of preterm delivery (odds ratio 2.5 [95% CI 1.3-4.8]), pre-eclampsia (4.3 [1.7-10.8]), need for a neonatal glucose infusion (2.9 [1.5-5.6]), and a composite adverse outcome (3.2 [1.3-8.0]). These risks increased progressively with increasing A1C. Results were similar at 34 weeks' gestation. Glucose data showed less consistent trends, although the risk of a composite adverse outcome increased with preprandial glucose levels between 6.0 and 6.9 mmol/L at 34 weeks (3.3 [1.3-8.0]).

CONCLUSIONS: LGA increased significantly with an A1C ≥6.0 (42 mmol/mol) at 26 and 34 weeks' gestation and with other adverse outcomes with an A1C ≥6.5% (48 mmol/mol). The data suggest that there is clinical utility in regular measurement of A1C during pregnancy.

Contemporary Politics in the Middle East (Cambridge: Polity, 2011 – third edition)

The third edition of this dynamic book has been fully revised and updated to provide a comprehensive introduction to contemporary politics in the Middle East. Purposefully employing a clear thematic structure and including a wide range of case studies, data, visuals and further reading guidance the book explores and analyses the major issues which define the politics of this region of the globe.
Milton-Edwards begins by introducing and explaining key concepts and debates and goes on to outline the impact of colonialism and its legacy, the rise of Arab nationalism and anti-colonial politics. She then examines major political issues affecting the region, such as American foreign policy, political Islam, war and conflict, political economy, democratization, ethnicity and the role of women. The book concludes by highlighting the politics of the region in the twenty-first century and the future challenges it faces. This is a perfect introduction for undergraduates, covering key political, economic and social debates and providing updates and guidance for further reading.

"The genius of this book is that it integrates together the different themes which run through Middle Eastern politics. The coherence of the approach which the author has adopted is indicated by the manner in which she has updated the work in this second edition. Despite the substantial changes which the East has undergone since 9/11 and the 2003 Gulf War, the original line of analysis retains all its force. It remains a key reference for all those who are seeking to understand the region's politics, whether undergraduates, postgraduates or lay readers."
Tim Niblock, Exeter University
"I welcome the new edition of this comprehensive guide to the politics of such an important region of the world. It combines sensible generalizations with useful case studies of particularly important subjects. It is a must for all those who want to understand the complex politics of the modern Middle East."
Roger Owen, Harvard University
"Beverley Milton-Edwards has produced an excellent book, which is both wide-ranging in its coverage and punchy in its arguments. As such, its functions are dual. It works well as a text book, introducing the general reader to key themes in the contemporary region, from oil politics to ethnicity, to women and nationalism. But it also works as a running commentary on key debates, such as the rile of colonialism and the relationship between Islam and democracy. In short, this is a book with attitude."
Philip Robins, St Antony's College, Oxford

Quantum control of photodissociation using intense, femtosecond pulses shaped with third order dispersion

We demonstrate the ability to control the molecular dissociation rate using femtosecond pulses shaped with third-order dispersion (TOD). Explicitly, a significant 50% enhancement in the dissociation yield for the low lying vibrational levels (v ∼ 6) of an H+2 ion-beam target was measured as a function of TOD. The underlying mechanism responsible for this enhanced dissociation was theoretically identified as non-adiabatic alignment induced by the pre-pulses situated on the leading edge of pulses shaped with negative TOD. This control scheme is expected to work in other molecules as it does not rely on specific characteristics of our test-case H+2 molecule.

Government as Institutional Entrepreneur: Extending Working Life in the UK and Japan

Through the lens of Institutional Entrepreneurship, this paper discusses how governments use the levers of power afforded through business and welfare systems to affect change in the organisational management of older workers. It does so using national stakeholder interviews in two contrasting economies: the United Kingdom and Japan. Both governments have taken a ‘light-touch’ approach to work and retirement. However, the highly institutionalised Japanese system affords the government greater leverage than that of the liberal UK system in changing employer practices at the workplace level.

Studying administrative reforms through textual analysis: the case of Italian central government accounting

This paper contributes to the literature on public-sector reforms by proposing textual analysis as a useful research strategy to explore how reform archetypes and related ideas are deployed in the parliamentary debate and regulations advancing reforms. Public Administration (PA) (Wilson 1887; Weber 1922), New Public Management (NPM) (Hood 1991, 1995; Dunleavy and Hood 1994; Ferlie et al. 1996) and Public Governance (GOV) (Osborne 2010; Rhodes 1997) can be depicted as three different archetypes providing characteristic administrative ideas and concepts (i.e. interpretive schemes) and related tools and practices (i.e. structures and systems) which lead reforms. We use textual analysis to look into more than twenty years of Italian central government accounting reforms and investigate how the three administrative archetypes have evolved, intertwined and replaced each other. Textual analysis proves a useful tool to investigate reform processes and allows highlighting that in neo-Weberian countries, such as Italy, NPM and GOV, far from being revolutionary paradigms, may represent fashionable trends that did not leave significant traces in the practice and rhetoric of reforms. These results also suggest interesting implications for practitioners and policy makers.

The impact of organisational factors and government policy on psychiatric nurses family focused practice with parents who have mental illness, their dependent children and families in Ireland

Government policy and organizational factors influence family focused practice in adult mental health services. However, how these aspects shape psychiatric nurses’ practice with parents who have mental illness, their dependent children and families is less well understood. Drawing on the findings of a qualitative study, this article explores the way in which Irish policy and organizational factors might influence psychiatric nurses’ family focused practice, and whether (and how) family focused practice might be further promoted. A purposive sample of 14 psychiatric nurses from eight mental health services completed semi-structured interviews in 2013. The analysis was inductive and presented as thematic networks. Both groups described how policies and organizational culture enabled and/or hindered family focused practice, with differences between community and acute participants seen. The need to develop national and international policies along with practices to embed information and support regarding parenting into ongoing care is implicated in this study.