Search

Abstract Background: There is a lack of knowledge about how persons with cerebral palsy (CP) perceive their ‘process of doing’ while performing everyday occupations. As described in the Model of the Process of Doing (MPoD), performing an occupation is a complex process consisting of six phases (generate idea, plan, initiate, enact, adjust, end) and time management. Aim: To collect the experiences of young adults with CP, classified at Manual Ability Classification System (MACS) level I or II, regarding how they perceive challenges in their occupational performance in relation to the different phases of the ‘process of doing’. Method: Semi-structured interviews were performed with ten participants with CP aged 19–30 years, MACS level I or II. The interview material was related to the MPoD phases using directed content analysis. Results: The participants’ descriptions of how they perceived their personal ‘process of doing’ showed problems in all MPoD phases. All participants experienced difficulties in one or more phases, but none had difficulties in all phases. Difficulties were more frequent in some phases than in others. Conclusion/Significance: To understand the complexity of doing everyday occupations in young adults with CP, there is a need to address all phases of the ‘process of doing’. [ABSTRACT FROM AUTHOR]

During the Late Pleistocene, several possibly endemic cingulate species, known mostly from isolated osteoderms, cara-pace fragments, and caudal tubes, coexisted in the Brazilian Intertropical Region. Here, we describe the osteoderm micro- structure of Pachyarmatherium brasiliense, as well as the glyptodonts Panochthus greslebini, Panochthus jaguaribensis and Glyptotherium sp., in order to provide additional species-diagnostic characters and shed light on their evolutionary relationships. Pachyarmatherium brasiliense lacks several derived features shared by glyptodonts and pampatheres, such as extensive bone remodeling, fibers arranged in large bundles, and relatively poorly developed layers of compact bone, thus supporting its exclusion from glyptodonts as suggested by a recent cladistic study. The osteoderm histology of P. greslebini resembles that of other species of Panochthus (e.g., Panochthus frenzelianus). By contrast, the presence of relatively thick layers of compact bone, the configuration and size of resorption areas, the absence of randomly oriented lateral fiber bundles, and the absence of an intermediary region between the compact and trabecular bone potentially support the exclusion of Panochthus jaguaribensis from the genus. Finally, osteoderms of the Brazilian specimens of Glyptodontinae share histological features with Glyptotherium floridanus, rather than Glyptodon, thus reinforcing their assignment to Glyptotherium. These results highlight the relevance of histological osteoderm characters in cingulate systematics, ands call for further and more comprehensive studies. [ABSTRACT FROM AUTHOR]

Landau phenomenological theory in combination with first-principles calculations was used to reveal the origin of the metamagnetic nature and the unusually strong dependence of the ordering temperature with doping of the Fe2P compound. We show that the magnetism of the two sublattices occupied by Fe atoms has an entwined codependency, which is strongly influenced by alloying. We furthermore demonstrate that a constrained disordered local moment approach combined with Monte Carlo simulations can only reproduce the experimental ordering temperatures in these technologically important prototype alloys for magnetocaloric refrigeration. [ABSTRACT FROM AUTHOR]

Based on first-principles calculations and kinetic Monte Carlo simulations, we design a realistic and practical codoping technique for increasing the concentration of Mn atoms in GaAs and realizing high Curie temperatures in (Ga,Mn)As. We found that using codoping of Li interstitial atoms during the crystal growth has two great advantages. First, due to lower formation energy of Li interstitials compared to Mn interstitials, Li prevents formation of unwanted Mn interstitials. Second, Li interstitials can be removed by using post-growth annealing at low temperatures. This codoping method offers a general strategy to go far beyond the solubility limit and it should be applicable also to other diluted magnetic semiconductor systems. [ABSTRACT FROM AUTHOR]

Abstract: The structural and magnetic properties of a new ternary Ir–Mn–Ge phase, Mn3IrGe, as well as the solid solution Mn3Ir(Si1-xGex), , have been investigated by means of X-ray and neutron powder diffraction, magnetization measurements and first principles calculations. The crystal structure is cubic, of the AlAu4-type (an ordered form of the β-Mn structure), , space group P213, and the unit-cell dimension varies linearly with the silicon content. For all compositions, antiferromagnetic ordering is found below a critical temperature of about 225K. The magnetic structure is noncollinear, as a result of frustrated magnetic interactions on a triangular network of Mn atoms, on which the moments rotate 120° around the triangle axes. The magnitude of the magnetic moment at 10K is 3.39(4)μB for Mn3IrGe. The theoretical calculations reproduce with very good accuracy the magnitudes as well as the directions of the experimentally observed magnetic moments. [Copyright &y& Elsevier]

Purpose: To develop a method for isolated perfusion of the liver using radiological methods.Methods: Twenty-one pigs, weighing about 20 kg, were divided into three groups. By transjugular and transfemoral approaches two occlusion balloons were placed in the inferior vena cava cranial and caudal, respectively, to the origin of the hepatic veins. One occlusion balloon was placed transfemorally in the common hepatic artery. Another occlusion balloon was inserted in the main branch of the portal vein via the transjugular-transhepatic approach in 11 pigs (groups 1 and 2), and in 10 pigs (group 3) by a percutaneous transhepatic route. After inflation of the balloons, patency of the isolated liver circulation was evaluated by recirculation of 99Tcm-labelled human albumin during 30 min. Blood tests were obtained after 1, 3, 5, 10, 15, and 30 min to evaluate leakage from the liver to the systemic circulation.Results: Increasing leakage to the systemic circulation from the isolated liver circulation was observed in groups 1 and 2. In the third group the leakage was less than 10%.Conclusion: In an experimental animal model, isolated perfusion of the liver with minor leakage to the systemic circulation may be achieved using radiological methods. [ABSTRACT FROM AUTHOR]

Abstract Background Negative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers' attitudes toward future pregnancies and choice of delivery method. Postpartum questionnaires assessing mothers' childbirth experiences are needed to aid in identifying mothers in need of support and counselling and in isolating areas of labour and birth management and care potentially in need of improvement. The aim of this study was to develop and evaluate a questionnaire for assessing different aspects of first-time mothers' childbirth experiences. Methods Childbirth domains were derived from literature searches, discussions with experienced midwives and interviews with first-time mothers. A draft version of the Childbirth Experience Questionnaire (CEQ) was pilot tested for face validity among 25 primiparous women. The revised questionnaire was mailed one month postpartum to 1177 primiparous women with a normal pregnancy and spontaneous onset of active labor and 920 returned evaluable questionnaires. Exploratory factor analysis using principal components analysis and promax rotation was performed to identify dimensions of the childbirth experience. Multitrait scaling analysis was performed to test scaling assumptions and reliability of scales. Discriminant validity was assessed by comparing scores from subgroups known to differ in childbirth experiences. Results Factor analysis of the 22 item questionnaire yielded four factors accounting for 54% of the variance. The dimensions were labelled Own capacity, Professional support, Perceived safety, and Participation. Multitrait scaling analysis confirmed the fit of the four-dimensional model and scaling success was achieved in all four sub-scales. The questionnaire showed good sensitivity with dimensions discriminating well between groups hypothesized to differ in experience of childbirth. Conclusion The CEQ measures important dimensions of the first childbirth experience and may be used to measure different aspects of maternal satisfaction with labour and birth.

The strong coupling between the crystal structure and magnetic state (ferromagnetic or helical antiferromagnetic) of FeMnP0.75Si0.25 is investigated using density functional theory in combination with atomistic spin dynamics. We find many competing energy minima for drastically different ferromagnetic and noncollinear magnetic configurations. We also find that the appearance of a helical spin-spiral magnetic structure at finite temperature is strongly related to one of the crystal structures reported for this material. Shorter Fe-Fe distances are found to lead to a destabilized ferromagnetic coupling, while out-of-plane Mn-Mn exchange interactions become negative with the shortening of the interatomic distances along the c axis, implying an antiferromagnetic coupling for the nearest-neighbor Mn-Mn interactions. The impact of the local dynamical correlations is also discussed. [ABSTRACT FROM AUTHOR]

The electronic, thermodynamical, and transport properties of ordered Fe3X (X=Al,Si) alloys are studied from first principles. We present here a unified approach to the phase stability, the estimate of the Curie temperature, the temperature dependence of sublattice magnetizations, magnon spectra, the spin-stiffnesses, and residual resistivities. An important feature of the present study is that all calculated physical properties are determined in the framework of the same first-principles electronic structure model combined with the effective Ising and Heisenberg Hamiltonians used for study of the thermodynamical properties of alloys. Curie temperatures, spin-stiffnesses, and magnon spectra are determined using the same calculated exchange integrals. Finally, the transport properties are calculated using the linear-response theory. Our theoretical estimates compare well with available experimental data. In particular, calculations predict (in agreement with experiment) the ordered D03 phase as the ground-state alloy structure, demonstrate that a correct relation of Curie temperatures of Fe3Al/Fe3Si alloys can be obtained only by going beyond a simple mean-field approximation, provide reasonable estimates of spin-stiffnesses, and give resistivities compatible with structural disorder observed in the experiment. Although the calculated temperature dependences of the Fe magnetization on different sublattices are similar, they nevertheless deviate more than in the experiment, and we discuss a possible origin. [ABSTRACT FROM AUTHOR]

Di-iron phosphide (Fe2P) is a parent system for a set of magnetocaloric materials. Although the magnetic ordering temperature (Tc = 215 K) of the stoichiometric composition is too low for room-temperature magnetic refrigeration, the partial replacement of P with B, Si, or As elements results in a steep increase in the magnetic ordering temperature. Doping leads to different equilibrium volumes and hexagonal axial ratios (c/a) within the same crystallographic phase over a wide concentration range. Here, using first principles theory, we decompose the change in the total magnetic exchange interaction upon doping into chemical and structural contributions, the latter including the c/a-ratio and volume effects. We demonstrate that for the investigated alloys the structural effect can be ascribed mainly to the decrease in the c/a ratio that strengthens the magnetic exchange interactions between the two Fe sublattices. [ABSTRACT FROM AUTHOR]

The half-metallic half-Heusler alloy NiMnSb is a promising candidate for applications in spintronic devices due to its low magnetic damping and its rich anisotropies. Here we use ferromagnetic resonance (FMR) measurements and calculations from first principles to investigate how the composition of the epitaxially grown NiMnSb influences the magnetodynamic properties of saturation magnetization Ms, Gilbert damping a, and exchange stiffness A. Ms and A are shown to have a maximum for stoichiometric composition, while the Gilbert damping is minimum. We find excellent quantitative agreement between theory and experiment for Ms and α. The calculated A shows the same trend as the experimental data but has a larger magnitude. In addition to the unique in-plane anisotropy of the material, these tunabilities of the magnetodynamic properties can be taken advantage of when employing NiMnSb films in magnonic devices. [ABSTRACT FROM AUTHOR]

The high Curie temperature multiferroic compound CuO has a quasidegenerate magnetic ground state that makes it prone to manipulation by the so-called "order-by-disorder" mechanism. First principle computations supplemented with Monte Carlo simulations and experiments show that isovalent doping allows us to stabilize the multiferroic phase in nonferroelectric regions of the pristine material phase diagram with experiments reaching a 250% widening of the ferroelectric temperature window with 5% of Zn doping. Our results allow us to validate the importance of a quasidegenerate ground state on promoting multiferroicity on CuO at high temperatures and open a path to the material engineering of multiferroic materials. In addition we present a complete explanation of the CuO phase diagram and a computation on the incommensurability in excellent agreement with experiment without free parameters. [ABSTRACT FROM AUTHOR]

In this work we examine critically the electronic structure of the rare-earth elements by use of the so-called Hubbard I approximation. From the theoretical side all measured features of both occupied and unoccupied states are reproduced, without significant deviations between observations and theory. We also examine cohesive properties like the equilibrium volume and bulk modulus, where we find, in general, a good agreement between theory and measurements. In addition, we have reproduced the spin and orbital moments of these elements as they are reflected from measurements of the saturation moment. We have also employed the Hubbard I approximation to extract the interatomic exchange parameters of an effective spin Hamiltonian for the heavy rare earths. We show that the Hubbard I approximation gives results which are consistent with calculations where 4f electrons are treated as core states for Gd. The latter approach was also used to address the series of the heavy/late rare earths. Via Monte Carlo simulations we obtained ordering temperatures which reproduce measurements within about 20%. We have further illustrated the accuracy of these exchange parameters by comparing measured and calculated magnetic configurations for the heavy rare earths and the magnon dispersion for Gd. The Hubbard I approximation is compared to other theories of the electronic structure, and we argue that it is superior. We discuss the relevance of our results in general and how this makes it possible to treat the electronic structure of materials containing rare-earth elements, such as permanent magnets, magnetostrictive compounds, photovoltaics, optical fibers, topological insulators, and molecular magnets. [ABSTRACT FROM AUTHOR]

The number of medical students and doctors in training is growing, particularly in private practices due to the promotion of the internal medicine and primary care curriculum. Therefore, doctors increasingly find themselves in a teaching role with the responsibility to give feedback to the people in training. This article aims to give the definition of feedback and to review the reasons for its central role in pre- and postgraduate medical education. We describe the opportunities and barriers to giving feedback, how to make it effective and present a selection of frequently used feedback models., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Purpose: This study aims to investigate whether the treatment effects, in terms of goal attainment, transfer effects and impact on executive functions, of an intervention in children with cerebral palsy or spina bifida using the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach are maintained over time, from immediately after the intervention to three months afterwards., Method: A three-month follow-up study, from an intervention using CO-OP. Thirty-four children (7-16 years) each identified four goals (one untrained to examine transfer) and participated in an eleven-session intervention. Assessments were performed at baseline, immediately after the intervention and at a three-month follow-up using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Executive function and self-rated competence were assessed at the same timepoints., Results: Statistically significant and clinically relevant improvements in goal achievement were demonstrated for both trained and untrained goals after the intervention and were maintained at follow-up. The clinically relevant improvement in untrained goals continued to increase until follow-up. Self-rated competence increased after the intervention and was maintained at follow-up., Conclusion: The CO-OP intervention was effective in achieving and maintaining the children's own goals over time. The transfer effect was confirmed by higher goal attainment for the untrained goals.

Pseudomonas aeruginosa is a Gram-negative bacterium and an opportunistic pathogen ubiquitously present throughout nature. LecB, a fucose-, and mannose-binding lectin, is a prominent virulence factor of P. aeruginosa, which can be expressed on the bacterial surface but also be secreted. However, the LecB interaction with human immune cells remains to be characterized. Neutrophils comprise the first line of defense against infections and their production of reactive oxygen species (ROS) and release of extracellular traps (NETs) are critical antimicrobial mechanisms. When profiling the neutrophil glycome we found several glycoconjugates on granule and plasma membranes that could potentially act as LecB receptors. In line with this, we here show that soluble LecB can activate primed neutrophils to produce high levels of intracellular ROS (icROS), an effect that was inhibited by methyl fucoside. On the other hand, soluble LecB inhibits P. aeruginosa-induced icROS production. In support of that, during phagocytosis of wild-type and LecB-deficient P. aeruginosa, bacteria with LecB induced less icROS production as compared with bacteria lacking the lectin. Hence, LecB can either induce or inhibit icROS production in neutrophils depending on the circumstances, demonstrating a novel and potential role for LecB as an immunomodulator of neutrophil functional responses., (© 2023 The Authors. European Journal of Immunology published by Wiley-VCH GmbH.)

Background: There is a lack of knowledge about how persons with cerebral palsy (CP) perceive their 'process of doing' while performing everyday occupations. As described in the Model of the Process of Doing (MPoD), performing an occupation is a complex process consisting of six phases (generate idea, plan, initiate, enact, adjust, end) and time management. Aim: To collect the experiences of young adults with CP, classified at Manual Ability Classification System (MACS) level I or II, regarding how they perceive challenges in their occupational performance in relation to the different phases of the 'process of doing'. Method: Semi-structured interviews were performed with ten participants with CP aged 19-30 years, MACS level I or II. The interview material was related to the MPoD phases using directed content analysis. Results: The participants' descriptions of how they perceived their personal 'process of doing' showed problems in all MPoD phases. All participants experienced difficulties in one or more phases, but none had difficulties in all phases. Difficulties were more frequent in some phases than in others. Conclusion/Significance: To understand the complexity of doing everyday occupations in young adults with CP, there is a need to address all phases of the 'process of doing'.

Neutrophils express several G protein-coupled receptors (GPCRs) connected to intracellular Gα i or Gα q containing G proteins for down-stream signaling. To dampen GPCR mediated inflammatory processes, several inhibitors targeting the receptors and/or their down-stream signals, have been developed. Potent and selective inhibitors for Gα q containing G proteins are available, but potent and specific inhibitors of Gα i containing G proteins are lacking. Recently, Larixol, a compound extracted from the root of Euphorbia formosana, was shown to abolish human neutrophil functions induced by N-formyl-methionyl-leucyl-phenylalanine (fMLF), an agonist recognized by formyl peptide receptor 1 (FPR1) which couple to Gα i containing G proteins. The inhibitory effect was suggested to be due to interference with/inhibition of signals transmitted by βγ complexes of the Gα i containing G proteins coupled to FPR1. In this study, we applied Larixol, obtained from two different commercial sources, to determine the receptor- and G protein- selectivity of this compound in human neutrophils. However, our data show that Larixol not only lacks inhibitory effect on neutrophil responses mediated through FPR1, but also on responses mediated through FPR2, a Gα i coupled GPCR closely related to FPR1. Furthermore, Larixol did not display any features as a selective inhibitor of neutrophil responses mediated through the Gα q coupled GPCRs for platelet activating factor and ATP. Hence, our results imply that the inhibitory effects described for the root extract of Euphorbia formosana are not mediated by Larixol and that the search for a selective inhibitor of G protein dependent signals generated by Gα i coupled neutrophil GPCRs must continue., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal, Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

Objective: To assess whether electrical impedance spectroscopy (EIS) as an adjunctive technology enhances the performance of colposcopy., Design: Prospective cohort study., Setting: University Hospital colposcopy clinic., Participants: Colposcopy with EIS for 647 women and conventional colposcopy for 962 women., Interventions: Comparison of the performance of colposcopy by referral cervical cytology in two cohorts, with and without EIS as an adjunctive technology., Outcome Measures: Prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), diagnostic testing accuracy to detect CIN2+ with and without EIS and their relative differences between cohorts., Results: The prevalence of CIN2+ varied between the cohorts according to referral cytology: 17.0% after abnormal squamous cells of unknown significance referral cytology in EIS cohort and 9.1% in the reference cohort, 16.5% and 18.9% after low-grade squamous intraepithelial lesion (LSIL), 44.3% and 58.2% after atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (HSIL) (atypical squamous cells that cannot exclude HSIL), and 81.9% and 77.0% after HSIL cytology, respectively. Sensitivity to detect CIN2+ was higher in the EIS cohort, varying from 1.79 (95% CI 1.30 to 2.45) after LSIL referral cytology to 1.16 (95% CI 1.09 to 1.23) after HSIL referral cytology, with correspondingly lower specificity after any referral cytology., Conclusions: Colposcopy with EIS had overall higher sensitivity but lower specificity to detect CIN2+ than conventional colposcopy. CIN2+ prevalence rates were, however, not consistently higher in the EIS cohort, suggesting innate differences between the cohorts or truly lower detection rates of CIN2+ for EIS, highlighting the need for randomised controlled trials on the effectiveness of EIS., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Among the responders to microbial invasion, neutrophils represent the earliest and perhaps the most important immune cells that contribute to host defense with the primary role to kill invading microbes using a plethora of stored anti-microbial molecules. One such process is the production of reactive oxygen species (ROS) by the neutrophil enzyme complex NADPH-oxidase, which can be assembled and active either extracellularly or intracellularly in phagosomes (during phagocytosis) and/or granules (in the absence of phagocytosis). One soluble factor modulating the interplay between immune cells and microbes is galectin-3 (gal-3), a carbohydrate-binding protein that regulates a wide variety of neutrophil functions. Gal-3 has been shown to potentiate neutrophil interaction with bacteria, including Staphylococcus aureus, and is also a potent activator of the neutrophil respiratory burst, inducing large amounts of granule-localized ROS in primed cells. Herein, the role of gal-3 in regulating S. aureus phagocytosis and S. aureus-induced intracellular ROS was analyzed by imaging flow cytometry and luminol-based chemiluminescence, respectively. Although gal-3 did not interfere with S. aureus phagocytosis per se, it potently inhibited phagocytosis-induced intracellular ROS production. Using the gal-3 inhibitor GB0139 (TD139) and carbohydrate recognition domain of gal-3 (gal-3C), we found that the gal-3-induced inhibitory effect on ROS production was dependent on the carbohydrate recognition domain of the lectin. In summary, this is the first report of an inhibitory role of gal-3 in regulating phagocytosis-induced ROS production., (© The Author(s) 2023. Published by Oxford University Press.)

Purpose: Children with cerebral palsy (CP) or spina bifida (SB) often have executive dysfunction affecting activity performance. With the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach, children find their own way to perform activities, using problem-solving strategies and meta-cognitive thinking. The present study aimed to investigate the effectiveness of the CO-OP Approach in children with CP or SB, compared with conventional rehabilitation, in achieving self-identified activity goals, and to explore any generalization and transfer effects., Method: Randomized controlled trial, CO-OP versus treatment as usual, 38 children (7-16 years) participated. Each child identified four goals (to study generalization and transfer, one remained untrained). Primary outcomes: Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Secondary outcomes assessed executive functions and self-rated everyday-life competence., Results: Self-rated goal attainment (COPM) was significantly greater for both trained and untrained goals in the CO-OP group compared with the control group. The rating of observed performance (PQRS) was significantly higher for trained goals in the CO-OP group. The CO-OP group experienced fewer problems in everyday life after treatment. Executive functions did not differ significantly between groups., Conclusion: CO-OP is more effective than ordinary treatment in achieving both trained and untrained goals.IMPLICATIONS FOR REHABILITATIONCO-OP enables children with CP (MACS levels I-III) or SB without intellectual disabilities to reach self-identified goals.CO-OP shows transfer effects to new activities and situations, which may enhance children's self-efficacy.CO-OP is an important complement to conventional rehabilitation services for children with CP and SB.

Background: During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for prolonged labour to prevent secondary FOC., Materials and Methods: To explore the factors behind secondary FOC among multiparous women, a follow-up of referral reasons for 600 women with severe FOC was made between 2015 and 2017 at a Swedish University Hospital. In the group with the most common factor, namely prolonged labour, 41 women were interviewed. From their answers, further research and existing professional knowledge, a care process to prevent secondary FOC was designed, 'Time-out in prolonged labour' (the Time-out). To improve the quality of the care process, the functional resonance analysis method was used. The findings from the interviews were categorised into three themes: lack of involvement; lack of communication and information; and lack of care plan. The women explained that if these areas had been fulfilled, it may have reduced their FOC., Result: To prevent the above-mentioned themes, 'Time-out in prolonged labour' was developed with supporting factors such as gathering the interprofessional team, collecting information, dialogue within the team and the involvement of the women when deciding the care plan. Result after implementation shows a reduction of referral reason due to prolonged labour for women with severe FOC from 28% in 2016 to 8.5% in 2020., Conclusions: The Time-out is a good model to prevent secondary FOC. Central aspects of the model are to ensure women's involvement, good communication and a documented care plan for women in prolonged labour. The supporting factor of interprofessional teamwork is of importance when using the Time-out in practice., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice., Methods: A mixed method study based on an implementation of MiMo was carried out in a labor ward at a university hospital in Sweden, with another labor ward as a reference. The qualitative core component was a secondary analysis of focus groups with midwives after the implementation. The supplemental quantitative components were oxytocin use for augmentation of labor and women's childbirth experiences before and after the implementation., Results: The midwives viewed MiMo as a useful tool for comprehending the birthing woman holistically, and for identifying what might disturb the birth process. Hindering factors were a lack of organizational stability and time, and midwives' unwillingness to understand the model. Oxytocin use decreased significantly only in the implementation ward (p=0.002) and a significant difference was found between wards in the post-implementation period (p=0.004). However, logistic regression analyses showed that the interaction between ward and time period, controlling for age, epidural use, and birth outcome, was not significant (p=0.304), indicating that the decrease was not significantly related to the implementation. Childbirth experience did not differ before and after the implementation., Conclusions: By using MiMo in practice, midwives have a tool for comprehending the woman holistically and identifying disturbing factors during the birth. However, more research is needed for further implementation that should focus on the potential as well as hindering factors., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2022 Lundgren I. et al.)

Cerebral palsy (CP) comprises a heterogeneous group of conditions recognized by disturbances of movement and posture and is caused by a non-progressive injury to the developing brain. Birth prevalence of CP is about 2-2.5 per 1,000 live births. Although the motor impairment is the hallmark of the diagnosis, individuals with CP often have other impairments, including cognitive ones. Cognitive impairments may affect communication, education, vocational opportunities, participation, and mental health. For many years, CP has been considered a "childhood disability," but the challenges continue through the life course, and health issues may worsen and new challenges may arise with age. This is particularly true for cognitive impairments, which may become more pronounced as the demands of life increase. For individuals with CP, there is no one-to-one correlation between cognition and functioning in other areas, and therefore, cognition must be individually assessed to determine what targeted interventions might be beneficial. To facilitate this for children with CP, a systematic follow-up protocol of cognition, the CP Cog , has been implemented in Norway and Sweden. However, no such protocol currently exists for adults with CP. Such discontinuity in healthcare services that results from lack of follow-up of cognitive functioning and subsequent needs for adjustments and interventions makes transition from pediatric to adult healthcare services challenging. As a result, a protocol for the surveillance of cognition in adults with CP, the CP Cog -Adult, has been developed. It includes assessment of verbal skills, non-verbal reasoning, visual-spatial perception, and executive functioning. It is recommended to perform these assessments at least once in young adulthood and once in the mid-fifties. This report describes the process of developing the CP Cog- Adult, which has a three-fold purpose: (1) to provide equal access to healthcare services to enable the detection of cognitive impairments; (2) to provide interventions that increase educational and vocational participation, enhance quality of life, and prevent secondary impairments; and (3) to collect systematic data for research purposes. The consent-based registration of data in the well-established Swedish and Norwegian national CP registries will secure longitudinal data from childhood into adulthood., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Stadskleiv, van Walsem, Andersen, Bergqvist, Bøttcher, Christensen, Heyerdahl, Hollung, Høye, Jahnsen, Klevberg, Lindquist, Passmark, Rike, Rodby-Bousquet and Alriksson-Schmidt.)