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Abstract Background No midwifery-led units existed in Ireland before 2004. The aim of this study was to compare midwife-led (MLU) versus consultant-led (CLU) care for healthy, pregnant women without risk factors for labour and delivery. Methods An unblinded, pragmatic randomised trial was designed, funded by the Health Service Executive (Dublin North-East). Following ethical approval, all women booking prior to 24 weeks of pregnancy at two maternity hospitals with 1,300-3,200 births annually in Ireland were assessed for trial eligibility.1,653 consenting women were centrally randomised on a 2:1 ratio to MLU or CLU care, (1101:552). 'Intention-to-treat' analysis was used to compare 9 key neonatal and maternal outcomes. Results No statistically significant difference was found between MLU and CLU in the seven key outcomes: caesarean birth (163 [14.8%] vs 84 [15.2%]; relative risk (RR) 0.97 [95% CI 0.76 to 1.24]), induction (248 [22.5%] vs 138 [25.0%]; RR 0.90 [0.75 to 1.08]), episiotomy (126 [11.4%] vs 68 [12.3%]; RR 0.93 [0.70 to 1.23]), instrumental birth (139 [12.6%] vs 79 [14.3%]; RR 0.88 [0.68 to 1.14]), Apgar scores < 8 (10 [0.9%] vs 9 [1.6%]; RR 0.56 [0.23 to 1.36]), postpartum haemorrhage (144 [13.1%] vs 75 [13.6%]; RR 0.96 [0.74 to 1.25]); breastfeeding initiation (616 [55.9%] vs 317 [57.4%]; RR 0.97 [0.89 to 1.06]). MLU women were significantly less likely to have continuous electronic fetal monitoring (397 [36.1%] vs 313 [56.7%]; RR 0.64 [0.57 to 0.71]), or augmentation of labour (436 [39.6%] vs 314 [56.9%]; RR 0.50 [0.40 to 0.61]). Conclusions Midwife-led care, as practised in this study, is as safe as consultant-led care and is associated with less intervention during labour and delivery. Trial registration number ISRCTN: ISRCTN14973283

Abstract Background High serum uric acid concentration (hyperuricemia) has been studied for its relationship with multiple adverse health outcomes, such as metabolic syndrome. Intervention studies have produced inconsistent outcomes for the relationship between fructose intake and serum uric acid concentration. Methods The association of dietary fructose intake with hyperuricemia risk in adults was examined using logistic regression and U.S. NHANES 1999-2004 databases. A total of 9,384 subjects, between the ages 20 and 80 years, without diabetes, cancer, or heart disease, were included. Results The highest added or total fructose intake (quartiles by grams or % energy) was not associated with an increase of hyperuricemia risk compared to the lowest intake with or without adjustment (odds ratios = 0.515-0.992). The associations of alcohol and fiber intakes with the risk were also determined. Compared to the lowest intake, the highest alcohol intake was associated with increased mean serum uric acid concentration (up to 16%, P < 0.001) and hyperuricemia risk (odds ratios = 1.658-1.829, P = 0.057- < 0.001); the highest fiber intake was correlated with decreases of uric acid concentration (up to 7.5%, P < 0.002) and lower risk (odds ratios = 0.448-0.478, P = 0.001- < 0.001). Adults who were over 50 y old, male, or obese had significantly greater risk. Conclusions The data show that increased dietary fructose intake was not associated with increased hyperuricemia risk; while increased dietary alcohol intake was significantly associated with increased hyperuricemia risk; and increased fiber intake was significantly associated with decreased hyperuricemia risk. These data further suggest a potential effect of fructose consumption in an ordinary diet on serum uric acid differs from results found in some short-term studies using atypical exposure and/or levels of fructose administration.

Purpose: To reduce the use of mechanical restraints, Safewards was introduced to a ward in a psychiatric hospital in Poland. Design and Methods: Three aspects of Safewards were applied for 8 months. The comparison time period was the same time frame of the previous year. Findings: Restraint use dropped by 24%, and the number of patients restrained dropped 34%. The duration of restraint remained at 2.8 days per episode. Practice Implications: Simple techniques aimed at promoting positive interactions between staff and patients can reduce the frequency of restraints. [ABSTRACT FROM AUTHOR]

Abstracts are presented on topics involving adapted physical activity, including manual wheelchair propulsion, childcare providers' attitudes toward and perceived competence of inclusion, and the body equilibrium of people with intellectual disabilities.

This paper examines whether financial disclosures on acquired entities allow investors to effectively predict goodwill impairment, a task that has become more important following the recent abolishment of goodwill amortization. In predicting goodwill impairment, we use variables relating to the postacquisition performance of the operating segment(s) to which the acquired company's assets are allocated as well as to the characteristics of the acquisition. We find that available disclosures do not provide financial statement users with information to adequately predict future write-offs of goodwill. In fact, the characteristics of the original acquisitions are more powerful predictors of eventual goodwill write-offs than those based on segment disclosures of the acquired entities' performance. We also find that goodwill write-offs lag behind the economic impairment of goodwill by an average of three to four years. For one-third of the companies examined, the delay can extend up to ten years. Although most of our analyses are conducted on goodwill generated before the introduction of Statement of Financial Accounting Standards No. 142 (SFAS 142), certain features of the sample and the analysis suggest that the results are generalizable to the current reporting regime. Sensitivity tests on a smaller sample of goodwill write-offs made upon the adoption of SFAS 142 confirm this expectation. [ABSTRACT FROM AUTHOR]

We present a model of managerial discretionary disclosure under litigation risk. In our model, the manager bears a personal cost of litigation in addition to the costs prescribed by the legal system. Investors share litigation damages with their attorneys and therefore are less than fully insured against market losses. We find that the interaction between the manager's level of aversion to litigation and investors' degree of insurance determines the quality of the manager's disclosure. This is a "cheap-talk" model similar to that of Crawford and Sobel [1982]. Like C&S, we find that, in general, the manager's and investors' preferences do not coincide and that there is a partition equilibrium that is consistent with managers providing a range forecast of earnings. In our setting, we are able to extend C&S and determine what condition is necessary for congruence of preferences resulting in full disclosure and informationally efficient security prices, consistent with managers providing point estimates of earnings. We also address a suggestion of C&S to test the robustness of the partition equilibrium by relaxing the assumption that investors have complete knowledge of the manager's preferences, and we find that, in general, the partition equilibrium is robust. We also show that under restrictive conditions, when the preferences of the manager are not known, a biasing equilibrium exists, consistent with managers providing biased forecasts of earnings. [ABSTRACT FROM AUTHOR]

The purpose of this article is to help better prepare pre-service/student teachers for the little things they should do during their student teaching experience, while at the same time give those who work with pre-service and student teachers (PETE faculty) a reminder of little things they can emphasize to help prepare students for the student teaching experience. The little things can be considered those topics which are not necessarily addressed in all physical education pedagogy classes or programs. For this article, eight cooperating teachers who have mentored student teachers for many years were interviewed either in person, by phone, or by e-mail. The teachers came from two Midwest states, with teaching experience ranging from five to 22 years at elementary, middle, and high school levels. Nine topics emerged during the interviews. The first six relate to personal behaviors of the student teacher, and the last three related to teaching behaviors.

This paper considers a setting in which managers have private information about the values of their firms and can communicate it to uninformed investors through the use of two signals: capital structure and inventory accounting method. We show conditions under which a separating equilibrium with debt alone does not exist. The two-signal equilibrium involves a partitioned separation in which the highest quality firms choose FIFO and the lower quality firms choose LIFO, and all firms then distinguish themselves within these two partitions through capital structure choices. The analysis helps to explain the many observed empirical regularities about firms' capital structure choices and LIFO/FIFO choices and, in addition, produces numerous testable predictions about the relation between capital structure and inventory accounting method. [ABSTRACT FROM AUTHOR]

In this paper we present a new approach to measuring government efficiency, based on the theory that communities that allocate resources efficiently in the local public sector maximize property values. We use Data Envelopment Analysis (DEA) to identify the counties in Minnesota that are characterized by property-value maximization and hence an efficient public sector. The results indicate that the dominant source of public sector inefficiency is an inappropriate scale of operations. It appears that some county jurisdictions are too large to service the population efficiently. The size and concentration of government power are also responsible in part for observed inefficiencies., In this paper we present a new approach to measuring government efficiency, based on the theory that communities that allocate resources efficiently in the local public sector maximize property values. We use Data Envelopment Analysis (DEA) to identify the counties in Minnesota that are characterized by property-value maximization and hence an efficient public sector. The results indicate that the dominant source of public sector inefficiency is an inappropriate scale of operations. It appears that some county jurisdictions are too large to service the population efficiently. The size and concentration of government power are also responsible in part for observed inefficiencies.

William Butler Yeats had an extra-marital lover, Lily O'Neill or Honor Bright, from 1918 to 1925. Garda Superintendent Leopold Dillon murdered her on orders from Kevin O'Higgins, Minister of Justice of the Irish Free State. George, Yeats's wife, reported falsely that Lily was a Republican spy. O'Higgins wanted to restore credence in the Free State, which would otherwise have been reclaimed by the British due to maladministration. Afterwards a bogus trial was concocted outside the court circuit by Chief Superintendent David Neligan, at which Lily was reinvented as a prostitute to conceal Yeats's affair and son and hide the involvement of Free State officials. On the strength of false evidence the jury unanimously acquitted the assassin after three minutes' deliberation. [ABSTRACT FROM AUTHOR]

There are currently four graduate entry schemes into UK medical school based at Oxford, Cambridge, Leicester and Warwick, and St George's Hospital, London. Career focus asked pioneers of the scheme [...]