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A healthy multiparous woman presented at 35 weeks and 4 days’ gestation with threatened preterm labour on multiple occasions. An incidental finding of severe hypokalaemia (2.4 mmol/L) was detected on routine blood tests. The cause of this hypokalaemia was not initially obvious. It was eventually linked to overuse of over-the-counter antacids for pregnancy-associated heartburn. The patient was managed with parenteral and then oral electrolyte replacement which corrected a pH of 7.55, bicarbonate of 36.7 mEq/L and a base excess 13.1. In this case report we consider whether hypokalaemia could be linked to uterine irritability and threatened preterm labour, whether antacids were being abused in the context of an eating disorder and the importance of taking a full drug history.

To study the rate of hearing preservation and outcomes of hearing preservation candidates in a national cochlear implant centre. The HEARRING criteria was used.All cochlear implant candidates with preserved low frequency pure tone average (PTA) were included. All patients underwent cochlear implantation using a standard 'soft-surgery' technique. PTA was assessed at switch-on, 3, 6, 9 and 12 months postoperatively. The primary outcome was hearing preservation at 12 months.Sixty six patients were included in the study between 2015 and 2020. Seventy one ears were implanted including 33 adults and 33 children with 5 bilateral implantations. Mean preoperative PTA was 74.8 dB (range 52.3-92 dB), mean postoperative PTA was 95.3 dB corresponding to a mean shift of 20.5 dB. In the adult population, HP rates were as follows: complete HP in 13%, partial HP in 39.1%, minimal HP in 30.4%, loss of hearing in 17.4%. In the paediatric population: complete HP in 20.7%, partial HP in 51.7%, minimal HP in 13.8% and loss of hearing in 13.8%. After the initial postoperative shift, there was no significant worsening of residual hearing during follow-up between 3 and 12 months. There were no significant prognostic factors for hearing preservation.Hearing preservation rates using the HEARRING criteria are described. This study will help counselling and decision making in patients eligible for cochlear implantation with hearing preservation. Further studies are required to assess the performances and outcomes of electronatural and electroacoustic stimulation.

Objective: To evaluate the value of fetal scalp blood sampling (FBS) as an adjunct test to cardiotocography, to predict adverse neonatal outcomes.\ud Study design: A multicentre service evaluation observational study in forty-four maternity units in the UK. We collected data retrospectively on pregnant women with singleton pregnancy who received FBS in labour using a standardised data collection tool. The primary outcome was prediction of neonatal acidaemia diagnosed as umbilical cord arterial pH

Previous measures of sexual orientation ignore the possibility that attraction to men and attraction to women vary independently. In two studies, we test the structure and validity of the n...

Using an experiential qualitative design, this study explored 11 female prisoners’ perspectives of problems living in prison. The findings reflected the immediate impact of the physical, so...

Sociologists have frequently noted the relationship between fiscal institutions and the development of national financial markets, but the centrality of national budgets for structuring that relationship has received scant attention. This article uses a historical case study from the United States to address that gap. A 1960s political battle between the federal government and the Johnson administration over asset sales and the budget culminated in a reorganization of U.S. housing finance policy: Fannie Mae was “spun off” and authorized to issue mortgage-backed securities. This case study situates the early days of the modern U.S. securitization market within a broader political effort to use financial engineering and liberalization to avoid the redistribution of wealth, revealing how the effort to mobilize capital and influence outside of budgetary constraints can organize government engagements with finance. Implications are drawn for fiscal sociology, the sociology of finance, and the interaction betwe...

How often, at the end of the reception year, instead of celebrating the positive difference you make to children's lives, are you left wondering what you could have done better? Perhaps, it is time to take stock.

A growing literature posits the importance of boundaries in structuring social systems. Yet sociologists have not adequately theorized one of the most fraught and consequential sites of boundary-making in contemporary life: the delineation of the official edges of the government—and, consequently, of state from society. This article addresses that gap by theorizing the mechanisms of state boundary formation. In so doing, we extend culturalist theories of the state by providing a more specific model of how the state-society boundary is produced. Further, we contribute to institutionalist accounts of politics by highlighting boundary-work during policy creation as a crucial site of political struggle, one with causal implications insofar as it illuminates a process that determines fine-grained distinctions in policy forms.

The ‘floor book’ method can be used for a variety of different reasons, including teaching children to communicate and collaborate effectively; and it can be used as an effective tool for staff development.

Although many conceptualisations of critical thinking (CT) exist, the vast majority acknowledge the importance of both skill-based and disposition-based components. There is, however, a notable lack of agreement regarding what constitutes CT dispositions and how best to approach the measurement of CT dispositions. The current study reports on the development and validation of a new Student-Educator Negotiated CT Dispositions scale (SENCTDS). Using collective intelligence methods for scale item generation and both exploratory and confirmatory factor analysis across two independent samples for factor structure identification, a six-factor CT disposition scale was developed. Convergent and predictive validity tests indicated relationships between CT dispositions and other constructs and outcomes, including Need for Cognition (NCS), Motivated Strategies for Learning (MSLQ), Real World Outcomes of Critical Thinking (RWO), and both conspiracy and paranormal beliefs. Given the limited availability of measures of CT dispositions, the development of the SENCTDS is a valuable contribution to the field, which may prove useful in future research that seeks to examine predictors and outcomes of both skill-based and disposition-based aspects of CT.

Sarah Quinn discusses the benefits of using ‘I can’ statements to evaluate the progress of two to five-year-olds, instead of relying on the guidance contained in the Development Matters document.

Students with Asperger's Syndrome (AS) face challenges, within third-level education, related to the person, environment, and occupation. This study describes an occupational therapy (OT) service that aims to enhance the interplay between the person (i.e., the student) and his/her occupation within a given context (i.e., college environment). A chart review and Student Satisfaction Survey was used to identify the demographics, concerns, and goals of the students using it. It was found that goals and concerns shift according to students' stage in college and recommends that services employ a student-centered, flexible approach responsive to the particular concerns of these students.

Introduction: There is increasing evidence for the use of psychotherapies, including cognitive behavioural therapy, acceptance and commitment therapy, and mindfulness based stress reduction therapy, as an approach to management of chronic pain. Similarly, online psychotherapeutic interventions have been shown to be efficacious, and to arguably overcome practical barriers associated with traditional face-to-face treatment for chronic pain. This is a protocol for a systematic review and network meta-analysis aiming to evaluate and rank psychotherapies (delivered in person and online) for chronic pain patients.Methods/ design:Four databases, namely the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO will be searched from inception. Randomised controlled trials that have evaluated psychological interventions for pain management delivered online or in person will be included in the review. Data will be independently extracted in duplicate and the Cochrane Collaboration Risk of Bias Tool will be used to assess study quality. Measures of pain interference will be extracted as the primary outcome and measures of psychological distress will be extracted as the secondary outcome. A network meta-analysis will generate indirect comparisons of psychotherapies across treatment trials. Rankings of psychotherapies for chronic pain will be made available. Discussion:A variety of psychotherapies, delivered both online and in person, have been used in an attempt to help manage chronic pain. Although occasional head to head trials have been conducted, little evidence exists to help identify which psychotherapy is most effective in reducing pain interference. The current review will address this gap in the literature and compare the psychotherapies used for internet delivered and in person interventions for chronic pain in relation to the reduction of pain interference and psychological distress. Results will provide a guide for clinicians when determining treatment course and will inform future research into psychotherapies for chronic pain.PROSPERO registration:CRD4201604851801/11/16

Given the prevailing spirit of teacher frustration regarding current educational policy, the authors perused frequently visited teacher blogs and discussion boards in the summer of 2009 to determine whether teachers are effectively using them to express professionally informed political dissent regarding educational policy. While many teachers are frustrated with educational policies, they are not particularly adept at voicing their dissent against such policies. Many downplay their professional knowledge, avoid overtly political postings, and feel isolated from others who share their views.

Mobile phone technology has become an integral part of peoples' lives. It has changed how we interact with each other and how we access information. This article describes how mobile phone use, in particular text messaging, has been used to communicate with and support students with mental health problems attending a university within Ireland to manage their academic and social lives. This study was descriptive, non-experimental, and predominantly qualitative in nature. It employed a mixed-method approach, by way of: (1) Collecting text messaging data, relating to 40 students, from four therapists across three years, and (2) auditing the service files to gather demographic data and some intervention-related information that was cross-analyzed with the qualitative text messaging data. Thematic analysis of the data using QSR N6 produced five over-arching themes: practicalities around appointments; condition/illness management; thanks, but I'm fine; progress—both academic and personal; and non-therapeutic in...

This article adopts an institutional approach to describe the changing secondary market for life insurance in the United States. Since the 1990s, this market, in which investors buy strangers' life insurance policies, has grown in the face of considerable moral ambivalence. The author uses news reports and interviews to identify and describe three conceptions of this market: sacred revulsion, consumerist consolation, and rationalized reconciliation. Differences among the conceptions are considered in view of the institutional legacy of life insurance and its success in organizing practices, perceptions, and understandings about markets and death. From this case, the author draws implications for analyses of morals in markets, an important and emergent topic within economic sociology.

Primary school approaches to student voice and leadership rarely change, despite concerns about manipulation and tokenism. This single case study investigated an approach to student voice and student leadership in an Australian primary school that was very different to a traditional student council. Thematic analysis of school documents and staff and student interviews found that informal pathways, such as daily teacher/student interactions, consultation with students and students collaborating with teachers in learning contributed to elevating the power of student voice in the school community. However, building leadership in a formal program was problematic for staff and students. The disruption of traditional school structures placed primary school students at the forefront of school leadership and teachers and students working together to build a democratic and inclusive learning environment was a greater challenge than anticipated. Refereed/Peer-reviewed

Confidence levels of 136 Irish occupational therapists were measured before and after an evidence based practice training course. Ranked scores on the evidence based practice confidence scale showed statistically significant improvement in all areas between pre and post course. Goals set by therapists to integrate EBP into their practice following the course were analysed and grouped into categories which included: 1) getting ready to use evidence based practice, 2) examining current and best practices, and 3) promoting a culture of evidence based practice in the workplace. Course feedback using Likert scales identified satisfaction with course content and delivery method.

This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: "orthostatic dizziness" (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark's spiral of panic.

To ensure excellent practice in the early years and to deliver outstanding learning and development opportunities for children, practitioners must focus, not on the goals of the EYFS, but on its principles.

The new online self-evaluation form, if used properly, should enable early years providers to guide the inspector, leading to a process that is characterised more by cooperation and less by confrontation.

This article explores the power of student voice, in recognition of the child's right to be treated as a capable, competent social actor involved in the education process. In this study, student voice is considered in the light of improving students' engagement and personal and social development at the primary school level. It emphasizes the importance of soliciting and respecting students' voice through their involvement as individuals in collective decision-making and governance as part of a "Students' Parliament." The aim is to understand how children view their roles and opportunities to be involved in making decisions about their own learning and about the wider school community. The study has significant implications for educators about ways of effectively and respectfully engaging students in matters that are important to them, which in turn has a positive impact on students' engagement, motivation, and individual development. Refereed/Peer-reviewed

There has been an upsurge of social activism amongst older adults in Ireland, which was particularly evident during the ‘medical card’ protests in Dublin in October 2008. This study used phenomenological interviews to explore the occupational meaning of social activism to seven older adults in Ireland. Social activism was found to be an occupation that firstly, is meaningful, valued and embedded in a wider pattern of leisure and social interests; secondly, develops over a lifetime and is chosen for a multitude of personal, social and political reasons; thirdly, is defined differently by participants, but is unanimously reported to be a vital component of how one sees oneself in the world and finally; is a complex occupation that has many benefits including improved well-being, a more powerful and respected status in society, fulfilment of spiritual goals, development of skills and providing a life of busyness and purpose in retirement. The study contributes to the understanding of the occupational participation of older adults and expands the study of occupation by exploring the meanings, benefits and challenges of social activism for these participants. peer-reviewed

Publication of an unprovenanced New Kingdom stela dedicated by Sn-htp, a scribe of the Southern City, and presented to Girton College, Cambridge in 1896. It shows Amenophis I, who wears the ḫprš, offering to Amon-Re. A list of contemporary and posthumous representations of this king wearing the ḫprš is included.

Objective To compare the ThinPrep Imaging System (Cytyc Corp., Boxborough Massachusetts, U.S.A) to manual screening in the detection of cervical squamous epithelial lesion (SIL). Study design A total of 27,525 manually screened ThinPrep Pap tests were compared with 27,725 imaged ThinPrep Pap tests for: (1) diagnostic rates of atypical squamous cells of undetermined significance; atypical squamous cells of undetermined significance, cannot rule out high grade SIL (ASC-H); low grade SIL and high grade SIL (HSIL); (2) ASC/SIL ratio; (3) high-risk HPV positivity for ASC; and (4) biopsy follow-up for ASC-H and HSIL. Results There were significant increases in the percentage of cytologic diagnoses in all categories with the imager. The ASC/SIL ratios of both groups were comparable. There was a significant decrease in HPV positivity in the imager group of ASC. Biopsy results confirmed a significant increase in the detection of HSIL in both the ASC-H and HSIL groups of the imaged cohort. Conclusion The ThinPrep Imaging System is significantly better than manual screening in the detection of cervical SIL.