Healthcare professionals' attitudes towards the termination of pregnancy: a qualitative analysis of survey data in Northern Ireland.

Abortion was decriminalised in Northern Ireland in October 2019. Following decriminalisation, the new regulations set out legal provision for abortion up until 12 weeks, with conditions thereafter. This cross-sectional descriptive survey, conducted in late 2019 in Northern Ireland, gathered the views of health professionals on decriminalisation, and their willingness to provide abortion services. This article provides a thematic analysis of answers to narrative questions from the online survey, and identifies priority areas of engagement with healthcare professionals. We assess how healthcare professional roles and responsibilities, abortion procedures, the foetus, and women and pregnant people were discursively constructed by respondents who are willing or unwilling to provide abortion services in Northern Ireland. We identify a narrow understanding of 'harm', and gendered norms of women as irresponsible or duplicitous, as inhibitory factors to the normalisation of abortion services in Northern Ireland.

Abortion provision in Northern Ireland: the views of health professionals working in obstetrics and gynaecology units.

INTRODUCTION: Abortion became decriminalised in Northern Ireland in October 2019. Until that point there existed no evidence concerning the views of health professionals on decriminalisation or on their willingness to be involved in abortion care. The purpose of this study was to address this lack of evidence, including all categories of health professionals working in obstetrics and gynaecology units in Northern Ireland. METHODS: The online survey was targeted at medical, nursing and midwifery staff working in the obstetrics and gynaecology units in each Health and Social Care (HSC) Trust in Northern Ireland. The survey was issued via clinical directors in each Trust using the REDCap platform. RESULTS: The findings showed widespread support for decriminalisation of abortion up until 24 weeks' gestation (n=169, 54%). The majority of clinicians stated they were willing to provide abortions in certain circumstances (which were undefined) (n=188, 60% medical abortions; n=157, 50% surgical abortions). Despite regional variation, the results show that there are sufficient numbers of clinicians to provide a service within each HSC Trust. The results indicate that many clinicians who report a religious affiliation are also supportive of decriminalisation (n=46, 51% Catholic; n=53, 45% Protestant) and are willing to provide care, countering the assumption that those of faith would all raise conscientious objections to service provision. CONCLUSIONS: The findings of this study are very encouraging for the development, implementation and delivery of local abortion care within HSC Trusts in Northern Ireland and should be of value in informing commissioners and providers about the design of a service model and its underpinning training programmes.

Attention orienting near the hand following performed and imagined actions.

Recent studies have documented that the hand's ability to perform actions affects the visual processing and attention for objects near the hand, suggesting that actions may have specific effects on visual orienting. However, most research on the relation between spatial attention and action focuses on actions as responses to visual attention manipulations. The current study examines visual attention immediately following an executed or imagined action. A modified spatial cuing paradigm tested whether a brief, lateralized hand-pinch performed by a visually hidden hand near the target location, facilitated or inhibited subsequent visual target detection. Conditions in which hand-pinches were fully executed (action) were compared to ones with no hand-pinch (inaction) in Experiment 1 and imagined pinches (imagine) in Experiment 2. Results from Experiment 1 indicated that performed hand pinches facilitated rather than inhibited subsequent detection responses to targets appearing near the pinch, but target detection was not affected by inaction. In Experiment 2, both action and imagined action conditions cued attention and facilitated responses, but along differing time courses. These results highlight the ongoing nature of visual attention and demonstrate how it is deployed to locations even following actions.

Top-down influences mediate hand bias in spatial attention.

Spatial attention can be biased to locations near the hand. Some studies have found facilitated processing of targets appearing within hand-grasping space. In this study, we investigated how changing top-down task priorities alters hand bias during visual processing. In Experiment 1, we used a covert orienting paradigm with nonpredictive cues and emphasized the location of the hand relative to the target. Hands or visual anchors (boards) were placed next to potential target locations, and responses were made with the contralateral hand. Results indicated a hand-specific processing bias: Hand location, but not board location, speeded responses to targets near the hand. This pattern of results replicated previous studies using covert orienting paradigms with highly predictive cues. In Experiment 2, we used the same basic paradigm but emphasized the location of the response hand. Results now showed speeded responses to targets near response locations. Together these experiments demonstrated that top-down instructional sets (i.e., what is considered to be most relevant to task performance) can change the processing priority of hand location by influencing the strength of top-down, as compared with bottom-up, inputs competing for attention resources.

Implied body action directs spatial attention.

Research confirms that the body influences perception, but little is known about the embodiment of attention. We investigated whether the implied actions of others direct spatial attention, using a lateralized covert-orienting task with nonpredictive central cues depicting static, right/left-facing bodies poised in midaction. Validity effects (decreased response times for validly compared with invalidly cued trials) indicated orienting in the direction of the implied action. In Experiment 1, we compared action (running, throwing) with nonaction (standing) cues. Only the action cues produced validity effects, suggesting that implied action directs attention. The action cues produced faster responses overall, suggesting that action cues prime motor responses. In Experiment 2, we determined whether action cues shifted attention in a specific direction rather than to a general side of space: Two cues had similar action speed and motor effort but differed in implied direction (jumping, vertical; throwing, horizontal). Validity effects were found only for the throw cues for which the implied motion direction was consistent with lateralized target locations. In Experiment 3, we compared block-like stimuli to the throwing action stimuli to examine whether lower level perceptual information could account for the attention effects alone. Validity effects were found only for the human-action stimuli. Overall, the results suggest that predictive simulations of action shift attention in action-consistent directions.

Grab it! Biased attention in functional hand and tool space.

This study explored whether functional properties of the hand and tools influence the allocation of spatial attention. In four experiments that used a visual-orienting paradigm with predictable lateral cues, hands or tools were placed near potential target locations. Results showed that targets appearing in the hand's grasping space (i.e., near the palm) and the rake's raking space (i.e., near the prongs) produced faster responses than did targets appearing to the back of the hand, to the back of the rake, or near the forearm. Validity effects were found regardless of condition in all experiments, but they did not interact with the target-in-grasping/raking-space bias. Thus, the topology of the facilitated space around the hand is, in part, defined by the hand's grasping function and can be flexibly extended by functional experience using a tool. These findings are consistent with the operation of bimodal neurons, and this embodied component is incorporated into a neurally based model of spatial attention.

Walking reveals trunk orientation bias for visual attention.

Our trunks influence where we perform actions in space. Thus, trunk direction may define a region of spacethat is accorded special treatment by the attention system. We investigated conditions under which a trunk orientation bias for attention might be relevant for healthy adults. Three experiments compared visual detection performance for participants standing and walking on a treadmill. Together, the experiments disambiguate the relative contributions of motor activity, motor load, and cognitive load on trunk orientation biases. In Experiment 1, trunk orientation biases (i.e., faster target detection for targets in front of the body midline) were observed in both forward and sideways walking conditions, but not in standing conditions. In Experiment 2, we ruled out the notion that the trunk orientation bias arose from increased motor activity; in fact, the bias was greatest when participants walked at an unusually slow pace. In Experiment 3, we directly compared motor load with cognitive load in a dual-task paradigm; cognitive load influenced overall performance speed, but only motor load produced trunk orientationbias. These results suggest that a trunk orientation bias emerges during walking and motor load conditions.

Correction factors for low perturbation in vivo diodes used in the determination of entrance doses in high energy photon beams.

PURPOSE: Low perturbation diodes, with thin buildup caps, can be used to reduce perturbations to the delivered dose. The literature states that additional correction factors are required for low perturbation diodes, however, there are few reported studies into their use. This report measured the dose perturbations and correction factors for diodes with varying buildup cap thicknesses. METHODS AND MATERIALS: Scanditronix EDP15, EDD5, and EDD2 diodes were investigated. Dose perturbations and correction factors for field size, source-surface distance (SSD), obliquity, and wedge were measured in megavoltage photon beams. RESULTS: EDP15 produces a 6% dose perturbation. EDD5 produces a perturbation between 1% and 2%. EDD2 perturbation is negligible. The variation of correction factors for the full buildup EDP15 diode is small and consistent with the literature. The low perturbation diode EDD2 has large correction factors. The field size correction factor varies from 1.38 to 0.87 for 10 MV. The SSD correction factor varies from 0.92 to 1.09 for 10 MV. At the maximum angle measured, the obliquity correction factor is 0.73 for 10 MV. Intermediate results were observed for the EDD5 diode. CONCLUSIONS: It is expected that it will be very difficult to achieve accurate in vivo dosimetry using the EDD2 diode. The EDD5 diode may represent a reasonable compromise between EDD2 and the full buildup EDP15. The EDD5 dose perturbation is small and the correction factors are not as large as for EDD2, so accurate in vivo dosimetry may be possible as long as the obliquity is below 45 degrees.

A 24-year retrospective study of bone growth after implant placement.

This study quantifies the changes in bone height noted in the body of the edentulous mandibles when the load of the complete denture is born by an RA Ramus Frame Implant (Pacific Implant, Rio Dell, Calif). Eighty-three patients with implants were followed for 3 to 24 years. Pre- and postoperative panoramic films were taken and again at each succeeding 5-year follow-up. The results of the bone changes were gathered retrospectively and calculated. The data revealed a significant increase in bone height from 4.413 to 13 mm and statistically significant P values of <.0003 were determined. The growth of bone appears to be influenced by the design of the posterior feet, dominant chewing side, and a range of extreme atrophy from 5.9 mm to 15 mm. Also, the previously lost anatomical structures appear to repair, such as the luman of the mental foramen and the superior wall over the inferior alveolar canal. All mandibles were loaded postoperatively with an appliance having cutting bars and porcelain teeth or just porcelain teeth in both appliances.

Improving resource efficiency through management science.

Optimal management of resources is a very complex and difficult task for healthcare systems. Nevertheless, healthcare providers can employ data-driven methodologies and management science tools, coupled with managerial insights, to significantly improve both their resource effectiveness and efficiency. Understanding the full technical complexities of management science models is a daunting task for healthcare managers, but they can be aided by the increased availability of management science software. Readily available software does not require extensive technical competencies and is easily adaptable to resource changes. This article reports how a large healthcare system improved the cost effectiveness and service efficiency of its laboratory courier service through the use of management science techniques and readily available software. The laboratory courier system existed to serve a large multihospital healthcare system located in a major Texas metropolis. The routing and scheduling solution reported in this article yielded a very substantial 16.4 percent reduction in annual laboratory courier costs and a significant improvement in service levels. This study indicates that management science techniques and software are readily adaptable to the healthcare environment and are amenable to use by healthcare administrators.

Placement of plate-form implants using osteotomes.

This article describes the use of osteotomes for the placement of plate-form implants. Comparison is made between the use of cylinders and the plate form as it relates to bone mass and resistant forces. It concludes by showing several cases in function.

Synthesis and anticonvulsant activity of enaminones. 4. Investigations on isoxazole derivatives.

Due to the exceptional anticonvulsant activity displayed by substituted aniline enaminones, related pyridine derivatives and phenothiazines synthesised in our laboratories, the further investigation of various aromatic heterocycles was undertaken. Condensation of cyclic 1,3-diketo esters with 3-, and 5-aminoisoxazole derivatives led to a series of potent anti-maximal electroshock (MES) analogues, three of which occurred in the 3-amino series: ethyl ester (10), orally (po) active in rats [ED(50) 68.9 mg kg(-1), TD(50) > 500 mg kg(-1), protective index (PI = TD(50)/ED(50)) > 49.6]; methyl ester (9), ED(50) 68.9 mg kg(-1) intraperitoneally (ip) in mice, TD(50) > 500 mg kg(-1), PI > 7.3, and tert-butyl ester (8), ED(50) 28.1 mg kg(-1) po in rats, TD(50) > 500 mg kg(-1), PI > 17.8. Sodium channel binding studies, as well as evaluations against pentylenetetrazol, bicuculline, and picrotoxin on isoxazole 10 were all negative, leading to an unknown mechanism of action. X-ray diffraction patterns of a representative of the 3-amino series (isoxazoles 6-11) unequivocally display the existence of intramolecular hydrogen bonding of the nitrogen to the vinylic proton in the cyclohexene ring, providing a pseudo three ring structure which was also shown previously with the vinylic benzamides. Physicochemical-permeability across the BBB suggested an efflux mechanism for the previously synthesised aniline enaminones, but not with isoxazole 10.

A neuropsychological examination of the underlying deficit in attention deficit hyperactivity disorder: frontal lobe versus right parietal lobe theories.

A neuropsychological approach was used to examine the frontal lobe and right parietal lobe theories of attention deficit hyperactivity disorder (ADHD). Considerable attempts were made to select as pure a group of ADHD boys as possible. The performance of 10-14-year-old ADHD boys (n = 22), both on and off stimulant medication, was compared with the performance of non-ADHD control boys (n = 22) on tasks purported to assess frontal lobe functioning (Stopping Task, Antisaccade Task, Tower of Hanoi) and right parietal lobe functioning (Visual-Spatial Cuing Task, Turning Task, Spatial Relations). Three important findings emerged: (a) unmedicated ADHD boys exhibited performance deficits on tasks in both frontal and parietal domains compared with control boys, (b) unmedicated ADHD boys appeared to be more severely impaired on the frontal tasks than on the parietal tasks, and (c) medicated ADHD boys performed better in both task domains compared with unmedicated ADHD boys. Several alternative interpretations of the results are discussed.

Reactions of (Triphenylsilyl)ethylene Oxide with Grignard Reagents (and with MgBr(2)). A Reinvestigation.

Reactions of (triphenylsilyl)ethylene oxide (1) with simple Grignard reagents such as EtMgBr and PhMgBr have been reported to yield crystalline hydroxysilanes assigned as the alpha-hydroxy silanes expected from beta opening of the epoxide. Reinvestigation of these reactions showed that the hydroxysilanes were the beta-hydroxy silanes 4 and 7 expected from a rearrangement-trapping sequence; a bromohydrin, assigned as the alpha-bromo-beta-hydroxy silane 9 from alpha opening, and (triphenylsilyl)acetaldehyde (8) were also formed.

The synthesis of heterocyclic compounds of pharmaceutical interest from conjugated acetylenic and allenic nitriles

The reaction of hydroxyacetylenic nitriles with 2-aminoethanethiol gives 3-(2-aminoethylthio)-4-hydroxy-alkyl-2-enenitriles. These do not cyclise directly to a furan but isomerise directly to the corresponding N-adducts which then cyclise to give 5-amino-3-(2-thioethylamino)-2,2-dialkyl-2,3-dihydrofurans in > 90 percent yield. After protecting the hydroxyl function of a 3-(2-aminoethylthio)-4-hydroxyalkyl-2-enenitrile as a tetrahydropyranyl derivative, this S-adduct isomerised to the corresponding N-adduct on keeping. Three new 5,6-dihydro-3H-furo [3,4-b]-1,4-thiazines were prepared from the 5-(1-alkyl-1-tetrahydropyranyl-oxyalkyl)-6-cyano-2,3-dihydro-4H-1,4-thiazines by hydrolysis to the corresponding 5-(1-hydroxyalkyl)-6-cyano-2,3-dihydro-1,4-thiazines followed by base catalysed cyclisation. The addition of half molar amounts of a-phenylethylamine to two allenic nitriles resulted in the isolation of recovered allenic nitrile with low optical purity. In both cases the absolute configuration of the recovered allene was related to that of the resolving agent(Summary)