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International Journal of Obstetric Anesthesia ; Conference: Obstetric Anaesthesia Annual Scientific Meeting 2023. Edinburgh United Kingdom. 54(Supplement 1) (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-20244281


Introduction: One in five pregnant women in the UKis obese. Obesity is associated with increased risk of both maternal and foetal adverse outcomes. RCOG guidelines [1] recommend that all women with a booking BMI over 40 kg/m2 should be reviewed antenatally by a senior obstetric anaesthetist to guide risk assessment, medical optimisation and shared decision-making. The 2021 MBRRACE report [2] recommends that all women should be reweighed in the third trimester for accurate VTE risk scoring and prophylactic LMWH dosing. In our institution, reconfiguration of hospital areas as part of the COVID-19 response led to loss of designated clinic space for our obstetric anaesthetic clinic. As a result, our practice since has been to initially offer a telephone consultation followed by a face-to-face review if needed. Finding space for the latter has often been a significant logistical challenge. Our project sought to assess whether our practice continued to meet national standards in the wake of these changes. Method(s): Following audit approval, we retrospectively reviewed all women with a BMI >40 kg/m2 undergoing caesarean section (CS) over a six-month period (1/4/22 to 31/9/22). Result(s): 20 women met inclusion criteria (Category 1-3 CS - 12 women;Category 4 CS - 8 women). 100% of patients had booking height, weight and BMI recorded. 20% (4/20) of patients were reweighed in the 3rd trimester. Only 55% (11/20) of patients had been referred to and reviewed in the antenatal obstetric anaesthetic clinic (Figure). Of the 11 patients referred, 6 were referred later than 30 weeks. Of the 9 patients not referred, 8 had a BMI between 40 and 45 kg/m2. By contrast, 87% (6/7) of patients with BMI over 45 kg/m2 were referred and seen. Discussion(s): Our audit showed that we are not meeting national standards. Possible reasons identified were lack of awareness of the RCOG standards and referral criteria (especially for women with a BMI of 40 to 45 kg/m2) and logistical issues in undertaking face-to-face reviews without designated clinic space. Presentation of our results at the joint anaesthetic, obstetric and midwifery governance meeting has helped identify space in the antenatal clinic for face-to-face reviews, to start from March 2023 and to raise awareness of the national standards to ensure referral of all women with a BMI over 40 kg/m2. A reaudit is planned in 6 months. [Figure presented]Copyright © 2023 Elsevier Ltd

Asia Pacific Viewpoint ; : 17, 2022.
Article in English | Web of Science | ID: covidwho-1723051


Alternative economic indicators are becoming policy in Vanuatu, particularly focusing on what national policy calls traditional economy. Although this acknowledges livelihoods and customary land in rural areas, urban places receive less attention. This article advances an argument that cities are also home to traditional economies. We draw on concepts of diverse economies and translocality to examine how economic practices typically associated with community activities on customary land are also found in cities where households lack direct access to customary resources. Empirical data come from the authors' fieldwork and participation in community-based organisations in Port Vila, Vanuatu, from 2017 to 2020. The case study presents surveys of agrobiodiversity in 27 urban backyards and livelihood practices of 24 households;and accounts of co-authors' participation in community-based disaster to distribute disaster relief supplies from urban to rural, create urban markets for rural crops and build urban resilience following Ambae Island's Manaro volcano eruptions and COVID-19-related unemployment. This study demonstrates how traditional economies are part of everyday urban life.

adolescence |childhood |Pandemic ; 2022(Revista Latinoamericana de Ciencias Sociales, Ninez y Juventud)
Article in Spanish | WHO COVID | ID: covidwho-1863316


The advent of the COVID-19 pandemic and the preventive and compulsory social confinement established as a response by the national government of Argentina had an impact on the daily lives and subjectivities of children and adolescents. The authors carried out a qualitative exploratory-descriptive study that focused on the construction of meanings and emotions in relation to the pandemic, lock-downs, school experiences and care practices. A total of 68 children and adolescents from four different jurisdictions in Argentina participated in the study between March and June 2020. The authors collected oral narratives, photos, drawings and videos produced by the children and adolescents. The participants reinvented ways of bonding, playing and inhabiting spaces, establishing themselves as ethical-political subjects who are capable of caring and transforming the roles assigned to them by society despite worsening situations of inequality, fear of contagion and loss of loved ones. © 2022 Women's Health Care. All rights reserved.