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  • 1
    Electronic Resource
    Electronic Resource
    The creation of twin centile curves for size (2002)
    Oxford, UK : Blackwell Science Ltd
    BJOG 109 (2002), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To create twin centile charts for size.Design Retrospective study.Setting Aberdeen Maternity Hospital.Methods Ultrasound measurements of abdominal circumference (AC), biparietal diameter (BPD) and femur length (FL) for 1011 twin pregnancies were extracted from a databank. The methodology is based on that described by Altman and Chitty [Br. J. Obstet. Gynaecol. 101 (1994) 29.]; only one measurement from each twin was used, polynomial regression models were fitted separately to the mean and standard deviation (SD) of the ultrasound parameter as functions of gestational age. The centiles were obtained assuming that at each gestation, the measurements had a normal distribution.Results The growth pattern of AC for twins appear to follow closely that of singletons until 32 weeks. Thereafter, there is a gradual but definite fall off in growth away from singleton standards. The pattern of growth of FL is largely similar to that of singletons. From mid to early third trimester, the BPD of twin babies was larger than that of singletons.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2002.01361.x
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  • 2
    Electronic Resource
    Electronic Resource
    Maternity Satisfaction Studies and Their Limitations: “What Is, Must Still Be Best” (2003)
    Malden, USA : Blackwell Science Inc
    Birth 30 (2003), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : Background: Health policymakers throughout the developed world are paying close attention to factors in maternity care that may influence women's satisfaction. This paper examines some of these factors in the light of observations from previous studies of satisfaction with health services.Methods: The Scottish Birth Study, a cross-sectional questionnaire survey, sought the views of all women in Scotland delivering during a 10-day period in 1998. A total of 1,137 women completed and returned questionnaires (response rate = 69%).Results: Women were overwhelmingly satisfied with their prenatal, intrapartum, and postnatal care. As is common in this type of study, reports of dissatisfaction were relatively low. However, differences occurred in satisfaction levels between subgroups; for example, the fewer the number of caregivers the woman had during childbirth, the more likely she was to be satisfied with the care received. A range of factors appeared to influence reported satisfaction levels, such as characteristics of the care provided and the woman's psychosocial circumstances.Conclusions: In addition to the inherent limitations of satisfaction studies found in the literature, problems may arise if such surveys are used uncritically to shape the future provision of maternity services, because service users tend to value the status quo over innovations of which they have no experience. Therefore, although satisfaction surveys have a role to play, we argue that they should only be used with caution, and preferably as part of an array of tools. (BIRTH 30:2 June 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536X.2003.00224.x
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  • 3
    Electronic Resource
    Electronic Resource
    Estimation of fetal weight in twins: a new mathematical model (1999)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 106 (1999), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives Evaluation of new mathematical formula (Femur 4) derived from a twin population to estimate fetal weight in twins using ultrasound. Comparison of Femur 4 is with conventional mathematical models.Design Retrospective analysis of ultrasonic measurements of 297 twin babies from 24 to 40 weeks of gestation who were born within 10 days of ultrasound examination.Setting Aberdeen Maternity Hospital.Methods With ultrasonic measurements obtained from twin babies, estimated fetal weight was calculated using the mathematical models of Campbell, Shepard and Hadlock. The calculations were repeated for the model of Femur 4. All models were compared against Femur 4.Results The coefficient of determination of the linear regression between the actual and predicted weight was highest for Femur 4 (0,852). Femur 4 had the highest proportion of babies with estimated weights within 10% of actual birth weight (71.4%). In babies who weighed between 2000 and 3000 g, Femur 4 had the least systematic and random error of −1.69 and 8.96, respectively. For babies below the 10th centile for weight, Femur 4 had comparable positive and negative predictive values of 76.0% and 92.3%, respectively. Femur 4 was equally poor at predicting growth discordancy with positive and negative predictive values of 70.0% and 86.5% only.Conclusion Femur 4 requires measurements of femur length and abdominal circumference only, hence avoiding the need to obtain difficult head measurements which is a common problem in twins. It is a good model for estimation of fetal weight in twins. However, prediction of growth discordancy remains problematic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1999.tb08431.x
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  • 4
    Electronic Resource
    Electronic Resource
    A randomised controlled trial of microwave endometrial ablation without endometrial preparation in the outpatient setting: patient acceptability, treatment outcome and costs (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  To compare outpatient microwave endometrial ablation (MEA) in the postmenstrual phase to standard MEA treatment after drug preparation in a day case theatre environment.Design  A randomised controlled trial.Setting  A large United Kingdom teaching hospital.Population  Two hundred and ten women complaining of excessive menstrual loss.Methods  Two hundred and ten women with excessive menstrual loss were randomised. Ninety-seven women were treated as outpatients in the immediate post-menstrual phase and 100 were treated in an operating theatre after hormonal preparation. All procedures were commenced under local anaesthesia with or without conscious sedation. Analysis was by modified intention to treat.Main outcome measures  Primary outcome measures were satisfaction with treatment (measured at one year) and acceptability of treatment (measured at two weeks). Secondary outcome measures were menstrual outcome and financial cost.Results  Significantly more women found treatment post-menses acceptable; 86 (89.5%) versus 76 (76.0%) [difference in proportions 13.6%, 95% CI (3.0%, 23.9%)]. Similar numbers in each arm were totally or generally satisfied with the treatment, 86 (92.5%) versus 84 (88.4%) [difference in proportions 4.1%, 95% CI (−4.7%, 12.9%)] while amenorrhoea rates at one year were comparable, 52 (55.9%) versus 60 (61.9%). [difference in proportions −5.9%, 95% CI (−19.8%, 7.6%)]. The mean health service costs were £124 (95% CI £86–194) lower for the patients in the post-menses group.Conclusion  MEA performed under local anaesthesia (with or without conscious sedation) in the post-menstrual phase achieves high levels of satisfaction is very acceptable to patients and results in significantly reduced health service costs. Importantly menstrual outcomes are not affected by omission of drug preparation. There is now good evidence to support the use of MEA, without drug endometrial preparation, in the outpatient setting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00630.x
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  • 5
    Electronic Resource
    Electronic Resource
    Raising research awareness among midwives and nurses: does it work? (2000)
    Oxford UK : Blackwell Science Ltd
    Journal of advanced nursing 31 (2000), S. 0 
    Details
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Raising research awareness among midwives and nurses: does it work? Objective The primary aim of the study was to evaluate the effectiveness of two approaches to increase research awareness among midwives and nurses. Design Quasi-experimental with the attitudes of staff in the two groups being measured at two points (January and October 1997). Sample All midwives and nurses working in four clinical areas in an acute NHS Trust. The intervention arm of the study involved all midwives and nurses in the Clinical Directorate of Obstetrics and Gynaecology, while the control arm involved all nurses working in a specialist oncology and haematology unit and in the children’s directorate. Ethics The Joint Ethics Committee considered approval unnecessary because the study involved staff and not patients. Data collection Data were collected by self-complete questionnaires. Interventions A programme of education with policy and practice interventions targeted at ward sisters. Outcome measures Staff attitudes to, knowledge of, and level of involvement in, research. Results The study demonstrated a significant increase in both knowledge and use of research resources. Following the programme of education, staff in the intervention group were significantly more likely to use resources associated with research utilization and to report that they had read a research paper within the last month. Study limitations The time scale of the intervention was restricted by the funding available; a significant Hawthorne effect was evident with both groups showing an increase in knowledge; the pragmatic nature of the study meant that it was not possible to randomize the study groups; the scale of the study did not permit an economic evaluation. Conclusions The introduction of clinical governance challenges healthcare providers to improve the care they deliver. There are huge opportunities for Trusts to invest in developing staff knowledge and use of research. However, staff will only seize these opportunities if there is an appropriate, enabling environment — an environment that delivers intensive interventions and is sensitive to the wider structural factors in the NHS affecting staff morale and commitment. In the absence of this environment, what may be seen as opportunities to managers may be regarded as just another burden by staff.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2648.2000.01257.x
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  • 6
    Electronic Resource
    Electronic Resource
    Biochemistry and molecular genetics of cell-wall lipid biosynthesis in mycobacteria (1997)
    Oxford BSL : Blackwell Science Ltd
    Molecular microbiology 24 (1997), S. 0 
    Details
    ISSN: 1365-2958
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Medicine
    Notes: Tuberculosis and other mycobacterial infections are the most serious infectious diseases in terms of human fatalities. The high content of unique cell-wall lipids helps these organisms to resist antimicrobial drugs and host defences. The biosynthesis of these lipids is discussed briefly. The recent advances in recombinant DNA technology have begun to help to elucidate the nature of some of the enzymes involved in this process and the genes that encode them. Gene disruption and other molecular genetic technologies are beginning to provide new approaches to test for the biological functions of these gene products and may lead to identification of new antimycobacterial drug targets.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2958.1997.3361705.x
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  • 7
    Electronic Resource
    Electronic Resource
    A Rhizobium meliloti mutant, lacking a functional γ-aminobutyrate (GABA) bypass, is defective in glutamate catabolism and symbiotic nitrogen fixation (1993)
    Oxford, UK : Blackwell Publishing Ltd
    FEMS microbiology letters 109 (1993), S. 0 
    Details
    ISSN: 1574-6968
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology
    Notes: Abstract A Rhizobium meliloti mutant, CMF1 2:38, was isolated which was specifically defective in the degradation of glutamate as sole carbon and nitrogen source. Biochemical analysis of CMF1 2:38 revealed a reduction in succinic semialdehyde dehydrogenase (SSDH) activity, the third enzyme of the γ-aminobutyrate (GABA) bypass. Evidence is presented which suggests that the Tn 5-induced mutation in CMF1 2:38 exists in a regulatory gene governing the expression of both NAD and NADP-linked SSDH activity. CMF1 2:38 nodulated alfalfa plants, but was reduced in its nitrogen fixation activity and biomass accumulating ability relative to the wild-type strain. The results presented in this study indicate that the GABA bypass is a major mechanism of glutamate degradation in R. meliloti CMF1 and that glutamate catabolism via this pathway may play an important role in the symbiotic nitrogen fixation process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1574-6968.1993.tb06167.x
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  • 8
    Electronic Resource
    Electronic Resource
    Glutamate catabolism in Rhizobium meliloti (1991)
    Springer
    Archives of microbiology 155 (1991), S. 422-427 
    Details
    ISSN: 1432-072X
    Keywords: Carbon metabolism ; Glutamate ; Glutamate dehydrogenase ; Gamma-aminobutyrate bypass ; Bacteroids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract The pathway by which glutamate is degraded as a carbon source has not previously been elucidated, but enzymatic analysis of Rhizobium meliloti CMF1 indicated that both glutamate dehydrogenase (GDH) and gamma-aminobutyrate (GABA) bypass activities were present in free living cells. However, when similar studies were performed on R. meliloti CMF1 bacteroids, isolated from alfalfa nodules, only GABA bypass activities were detectable. Both GDH and GABA bypass activities were influenced by the carbon source provided, with maximum activities being detected when glutamate was present as sole carbon and nitrogen source. Addition of a second carbon source, such as succinate, to the growth medium did not influence GDH activity but substantially decreased levels of the first enzyme of the GABA bypass, glutamate decarboxylase (GDC). Cyclic adenosine 3′5′-monophosphate (cAMP) failed to increase GDC activities in R. meliloti CMF1 cells grown in the presence of an additional carbon source. It is proposed that the GABA bypass is a major mechanism of glutamate carbon degradation in R. meliloti CMF1, a system whose enzymatic activities are influenced by the nature of the carbon source present in the growth environment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00244956
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