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To evaluate the uptake of universal vitamin D supplementation during pregnancy, its effectiveness in preventing vitamin D deficiency and the factors associated with these.
Design:
The regional public health organisation in Ayrshire, Scotland has a policy of universal provision of vitamin D supplements (10 µg/d) to all pregnant women for the duration of their pregnancy. Pregnant women in this area were recruited at their 12-week antenatal appointment. Blood samples were collected at the 12-week and 34-week appointments. To account for the seasonal variation, women were recruited in two cohorts: summer and winter. Telephone interviews were conducted at 34 weeks to assess the uptake of vitamin D supplements during pregnancy. Other variables were obtained from medical records.
Setting:
The study was conducted in the NHS Ayrshire and Arran Health Board in Scotland.
Participants:
612 pregnant women (aged 15–44 years) living in Ayrshire (latitude 55°), Scotland.
Results:
Sixty-six percentage took supplementation as recommended. Consumption of supplementation was significantly associated with a higher median serum 25-hydroxyvitamin D concentrations at 34 weeks. Despite this at 34 weeks, 33 % of the summer cohort had insufficient or deficient vitamin D status, while 15 % of the winter cohort had insufficient or deficient status. In multivariable analysis, only adherence and season were independent predictors of vitamin D status.
Conclusions:
While supplementation improved and maintained vitamin D status during pregnancy, it was not adequate to ensure all those insufficient at 12 weeks achieved sufficient status at the end of pregnancy.
Traumatic spinal cord injuries (tSCI) are common, often leaving patients irreparably debilitated. Therefore, novel strategies such as nerve transfers (NT) are needed for mitigating secondary SCI damage and improving function. Although different tSCI NT options exist, little is known about the epidemiological and injury-related aspects of this patient population. Here, we report such characteristics to better identify and understand the number and types of tSCI individuals who may benefit from NTs.
Materials and Methods:
Two peripheral nerve experts independently evaluated all adult tSCI individuals < 80 years old admitted with cervical tSCI (C1–T1) between 2005 and 2019 with documented tSCI severity using the ASIA Impairment Scale for suitability for NT (nerve donor with MRC strength ≥ 4/5 and recipient ≤ 2/5). Demographic, traumatic injury, and neurological injury variables were collected and analyzed.
Results:
A total of 709 tSCI individuals were identified with 224 (32%) who met the selection criteria for participation based on their tSCI level (C1–T1). Of these, 108 (15% of all tSCIs and 48% of all cervical tSCIs) were deemed to be appropriate NT candidates. Due to recovery, 6 NT candidates initially deem appropriate no longer qualified by their last follow-up. Conversely, 19 individuals not initially considered appropriate then become eligible by their last follow-up.
Conclusion:
We found that a large proportion of individuals with cervical tSCI could potentially benefit from NTs. To our knowledge, this is the first study to detail the number of tSCI individuals that may qualify for NT from a large prospective database.
Friedrich Schiller is not only one of the leading poets and dramatists of German Classicism but also an inspiring philosopher. His essay 'über Anmut und Würde' (On Grace and Dignity) marks a radical break with Enlightenment thinking and its morally prescriptive agenda. Here Schiller does not pursue the prevalent interest in the individual artist as genius or in the creative act; instead, he establishes a harmony of mind and body in the aesthetic realm, putting down his thoughts on aesthetics in a systematic way for the first time, building on his own earlier forays into the field and on an intensive study of Kant. The popular essay form allowed Schiller to combine condensed thought with clear and rhetorically effective presentation, but his innovation here is his insistence on a freedom for art that affirms the moral freedom of reason, reuniting the human faculties radically separated by Enlightenment thought. Schiller sees aesthetic autonomy as the way forward for civilization. This is the first English scholarly edition of this pivotal essay, accompanied by the first comprehensive commentary on it. The essays focus on various facets of Schiller's essay and its socio-historical and philosophical context. Schiller's analysis is examined in the light of the thematic context of his plays as well as its surviving influence into the twentieth century. Contributors: Jane Curran, Christophe Fricker, David Pugh, Fritz Heuer, Alan Menhennet. Jane V. Curran is Professor of German at Dalhousie University, Halifax, Nova Scotia. Christophe Fricker is a D. Phil. candidate at St. John's College, Oxford.
Pygmalion creates statues marked by a certain majesty but lacking grace. Only when the goddess of beauty appears to the artist in a dream is he capable of making statues so perfect that he wishes them to come alive. This eventually happens, and the figure moves gracefully. This version of the myth of Pygmalion with its notable opposition of two characteristics comes from the French Enlightenment author André-François Boureau-Deslandes. It speaks to us even today: we still talk about dignity of bearing and about grace if we are attracted to a person because of a special air about him or her. At first glance, the concepts seem to be complementary.
For millennia, philosophers and poets have tried to define grace. The discussion usually starts by referring to grace as a gift granted by a divine being for a limited time. This gift becomes visible in the posture and movements of a person. It has thus to be interpreted primarily from an aesthetic viewpoint. The connection with a transcendental sphere changes its meaning in the eighteenth century; it loses its religious dimension but remains important as a reference point. The transcendental becomes the vanishing point for concepts unable to come to terms with undeniable and attractive appearances. This inadequacy of definitions, this je ne sais quoi, is ever present. Grace, in an Enlightenment context, becomes a “kulturphilosophische Heilskategorie” (a cultural and philosophical road to salvation). It thus fulfills the function of an educational standard in a time when bourgeois society is trying to define itself.
All higher trainees in psychiatry are required to spend one day a week in research or further study. A cross-sectional postal survey was used to investigate how senior registrars use their allocated research time, and to identify specific difficulties that prevent successful research being carried out. The instigation of the specialist registrar grade offers the chance to improve trainees' involvement in research. This has implications for the design and implementation of postgraduate teaching on research in psychiatry.
The aim of this article is to promote a clearer understanding of the Mental Health Commission's development, structure and function. Over recent years, mental health professionals and patients have become more aware of the organisation and its work, although some may remain uncertain about its function and how it fits into the overall care of detained patients. The Commission's fundamental job is to safeguard the well-being and interests of patients detained under the Act. Its remit does not extend to informal patients. Unless otherwise indicated, all statutory references are to the 1983 Mental Health Act.
Urinary incontinence commonly occurs in the setting of organic brain damage. However a literature search found no previous reports of an association between urinary incontinence and functional psychosis. Three cases are described in which patients with organic predisposing factors for the development of urinary incontinence showed an association between the degree of incontinence and the severity of their mental illness. It is suggested that the underlying psychosis may have contributed to the worsening of urinary incontinence, perhaps through non-specific factors such as poor attention, memory and psychotic symptoms. An association between functional psychosis and urinary incontinence has not been previously reported, and thus merits further investigation.
In an earlier issue of this Journal, M. E. Sushka criticized the methodology of such “revisionists” as Peter Temin in their evaluation of the impact of the Bank War on the Jacksonian economy. Sushka characterizes the work of the revisionists as the “use of descriptive statistical tools in an attempt to analyze developments empirically.” Sushka, on the other hand, applies “modern econometric techniques” to “an economic framework drawn from contemporary monetary and macroeconomic theory.”