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"Edwards, Alison"
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Lingo : a language spotter's guide to Europe
\"Welcome to Europe as you've never known it before, seen through the peculiarities of its languages and dialects. Combining linguistics and cultural history, Gaston Dorren takes us on an intriguing tour of the continent, from Proto-Indo-European (the common ancestor of most European languages) to the rise and rise of English, via the complexities of Welsh plurals and Czech pronunciation. Along the way we learn why Esperanto will never catch on, how the language of William the Conqueror lives on in the Channel Islands and why Finnish is the easiest European language. Surprising, witty and full of extraordinary facts, this book will change the way you think about the languages around you. Polyglot Gaston Dorren might even persuade you that English is like Chinese.\"--Wheelers.co.nz.
Book
Plasmonic twinned silver nanoparticles with molecular precision
Determining the structures of nanoparticles at atomic resolution is vital to understand their structure–property correlations. Large metal nanoparticles with core diameter beyond 2 nm have, to date, eluded characterization by single-crystal X-ray analysis. Here we report the chemical syntheses and structures of two giant thiolated Ag nanoparticles containing 136 and 374 Ag atoms (that is, up to 3 nm core diameter). As the largest thiolated metal nanoparticles crystallographically determined so far, these Ag nanoparticles enter the truly metallic regime with the emergence of surface plasmon resonance. As miniatures of fivefold twinned nanostructures, these structures demonstrate a subtle distortion within fivefold twinned nanostructures of face-centred cubic metals. The Ag nanoparticles reported in this work serve as excellent models to understand the detailed structure distortion within twinned metal nanostructures and also how silver nanoparticles can span from the molecular to the metallic regime.
The structure of nanoparticles strongly influences their properties. Here, the authors use single crystal X-ray diffraction to resolve the crystal structures of Ag
136
and Ag
374
nanoparticles, enabling the observation of local structure distortion and the lower size limit of surface plasmon resonance.
Journal Article
Postnatal and Neonatal Midwifery Skills
This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to supporting women and babies during the postnatal/neonatal period. Written in an accessible way, this book provides step-by-step processes for students to follow, and is ideal for professionals to share with the women and families in their care.
Anatomy. Bereavement – dealing with the loss of a baby. Bottle feeding. Breastfeeding. Calculating feed requirements. Changing stools. Contraception. Cord care. Developmental care. Discharge. Drugs for neonates. Emergencies. Fluid balance. Hand expression. Hypoglycaemia in the newborn. Lochia. Neonatal examination. Neonatal jaundice. Neonatal screening. Phototherapy. Post birth care. Postnatal examination. Postnatal complications. Skin to skin. Stillbirth and neonatal death. Sudden Infant Death Syndrome (SIDS). Thermoregulation of the newborn. Transient tachypnoea of the newborn. General abbreviations. Support groups
Alison Edwards is a Senior Midwifery Lecturer and Programme Director for the Shortened Midwifery programme at the University of Birmingham, UK. Alison has been a nurse and midwife for over 32 years, progressing through a BSc and Masters’ degree during that time. Current projects involve the development of virtual teaching tools including the use of avatars simulating labour scenarios, and escape room technology.
eBook
Antenatal Midwifery Skills
This pocket-sized book, presented in an easy-to-follow format, is designed as a tool for students and professionals to carry in any setting, providing a quick reference guide to antenatal care and related anatomy and physiology. Used as a platform for wider reading, this text is an ideal reference point for any student or professional involved with the care of childbearing women.
ABDOMINAL EXAMINATION.Amniotic fluid index,Inspection,Palpation,Auscultation,Measurement,Expected findings. ANAEMIA. ANATOMY.Fetal circulation,Female external genitalia,Uterus. ANTENATAL APPOINTMENTS. ANTENATAL SCREENING,Blood tests at booking,Follow-up blood tests,Urine,Ultrasound scans,Additional screening,Routine surveillance. BENEFITS. BISHOP’S SCORE FOR INDUCTION OF LABOUR. BLOOD PRESSURE TAKING. BLOOD VALUES. BMI. BOOKING ADVICE. BRITISH SIGN LANGUAGE. CALCULATING ESTIMATED DELIVERY DATES. CHOLESTASIS. CTG INTERPRETATION. CUSTOMISED GROWTH CHARTS. DIABETES.Type 1 diabetic women,Gestational diabetic women. DRUG ADMINISTRATION.Drugs and midwives/student midwives,Midwives exemptions and PGDS,Safe administration,Drug abbreviations,Formulas. EMERGENCIES,Adult life support for a pregnant woman,Antepartum haemorrhage,Eclampsia. FEMALE GENITAL MUTILATION. FUNCTIONS OF THE PLACENTA. METHODS OF INDUCTION. MINOR DISORDERS. PRE- ECLAMPSIA. RECORD KEEPING. SUBSTANCE MISUSE. SUPPORT GROUPS. USEFUL WEBSITES. VENEPUNCTURE.Procedure for taking blood,Vacutainer blood bottles and tests. VULNERABLE GROUPS OF WOMEN
Alison Edwards is a Senior Midwifery Lecturer and Programme Director for the Shortened Midwifery programme at the University of Birmingham, UK. Alison has been a nurse and midwife for over 32 years, progressing through a BSc and Masters’ degree during that time. Current projects involve the development of virtual teaching tools including the use of avatars simulating labour scenarios, and escape room technology.
eBook
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system
Background
Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two possible alert fatigue mechanisms: (A)
cognitive overload
associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B)
desensitization
from repeated exposure to the same alert over time.
Methods
Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians. The cognitive overload hypotheses were that alert acceptance would be lower with higher workload (number of encounters, number of patients), higher work complexity (patient comorbidity, alerts per encounter), and more alerts low in informational value (repeated alerts for the same patient in the same year). The desensitization hypothesis was that, for newly deployed alerts, acceptance rates would decline after an initial peak.
Results
On average, one-quarter of drug alerts received by a primary care clinician, and one-third of clinical reminders, were repeats for the same patient within the same year. Alert acceptance was associated with work complexity and repeated alerts, but not with the amount of work. Likelihood of reminder acceptance dropped by 30% for each additional reminder received per encounter, and by 10% for each five percentage point increase in proportion of repeated reminders. The newly deployed reminders did not show a pattern of declining response rates over time, which would have been consistent with desensitization. Interestingly, nurse practitioners were 4 times as likely to accept drug alerts as physicians.
Conclusions
Clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert. Reducing within-patient repeats may be a promising target for reducing alert overrides and alert fatigue.
Journal Article
Three year clinical outcomes in a nationwide, observational, siteless clinical trial of atrial fibrillation screening—mHealth Screening to Prevent Strokes (mSToPS)
Atrial fibrillation (AF) is common, often without symptoms, and is an independent risk factor for mortality, stroke and heart failure. It is unknown if screening asymptomatic individuals for AF can improve clinical outcomes.
mSToPS was a pragmatic, direct-to-participant trial that randomized individuals from a single US-wide health plan to either immediate or delayed screening using a continuous-recording ECG patch to be worn for two weeks and 2 occasions, ~3 months apart, to potentially detect undiagnosed AF. The 3-year outcomes component of the trial was designed to compare clinical outcomes in the combined cohort of 1718 individuals who underwent monitoring and 3371 matched observational controls. The prespecified primary outcome was the time to first event of the combined endpoint of death, stroke, systemic embolism, or myocardial infarction among individuals with a new AF diagnosis, which was hypothesized to be the same in the two cohorts but was not realized.
Over the 3 years following the initiation of screening (mean follow-up 29 months), AF was newly diagnosed in 11.4% (n = 196) of screened participants versus 7.7% (n = 261) of observational controls (p<0.01). Among the screened cohort with incident AF, one-third were diagnosed through screening. For all individuals whose AF was first diagnosed clinically, a clinical event was common in the 4 weeks surrounding that diagnosis: 6.6% experienced a stroke,10.2% were newly diagnosed with heart failure, 9.2% had a myocardial infarction, and 1.5% systemic emboli. Cumulatively, 42.9% were hospitalized. For those diagnosed via screening, none experienced a stroke, myocardial infarction or systemic emboli in the period surrounding their AF diagnosis, and only 1 person (2.3%) had a new diagnosis of heart failure. Incidence rate of the prespecified combined primary endpoint was 3.6 per 100 person-years among the actively monitored cohort and 4.5 per 100 person-years in the observational controls.
At 3 years, screening for AF was associated with a lower rate of clinical events and improved outcomes relative to a matched cohort, although the influence of earlier diagnosis of AF via screening on this finding is unclear. These observational data, including the high event rate surrounding a new clinical diagnosis of AF, support the need for randomized trials to determine whether screening for AF will yield a meaningful protection from strokes and other clinical events.
The mHealth Screening To Prevent Strokes (mSToPS) Trial is registered on ClinicalTrials.gov with the identifier NCT02506244.
Journal Article
A hexagonal planar transition-metal complex
Transition-metal complexes are widely used in the physical and biological sciences. They have essential roles in catalysis, synthesis, materials science, photophysics and bioinorganic chemistry. Our understanding of transition-metal complexes originates from Alfred Werner’s realization that their three-dimensional shape influences their properties and reactivity
1
, and the intrinsic link between shape and electronic structure is now firmly underpinned by molecular-orbital theory
2
–
5
. Despite more than a century of advances in this field, the geometries of transition-metal complexes remain limited to a few well-understood examples. The archetypal geometries of six-coordinate transition metals are octahedral and trigonal prismatic, and although deviations from ideal bond angles and bond lengths are frequent
6
, alternative parent geometries are extremely rare
7
. The hexagonal planar coordination environment is known, but it is restricted to condensed metallic phases
8
, the hexagonal pores of coordination polymers
9
, or clusters that contain more than one transition metal in close proximity
10
,
11
. Such a geometry had been considered
12
,
13
for [Ni(P
t
Bu)
6
]; however, an analysis of the molecular orbitals suggested that this complex is best described as a 16-electron species with a trigonal planar geometry
14
. Here we report the isolation and structural characterization of a simple coordination complex in which six ligands form bonds with a central transition metal in a hexagonal planar arrangement. The structure contains a central palladium atom surrounded by three hydride and three magnesium-based ligands. This finding has the potential to introduce additional design principles for transition-metal complexes, with implications for several scientific fields.
A six-coordinate transition-metal complex with a hexagonal planar geometry is isolated and characterized.
Journal Article
Anion stabilised hypercloso-hexaalane Al6H6
Boron hydride clusters are an extremely diverse compound class, which are of enormous importance to many areas of chemistry. Despite this, stable aluminium hydride analogues of these species have remained staunchly elusive to synthetic chemists. Here, we report that reductions of an amidinato-aluminium(III) hydride complex with magnesium(I) dimers lead to unprecedented examples of stable aluminium(I) hydride complexes, [(
Ar
Nacnac)Mg]
2
[Al
6
H
6
(Fiso)
2
] (
Ar
Nacnac = [HC(MeCNAr)
2
]
−
, Ar = C
6
H
2
Me
3
-2,4,6 Mes; C
6
H
3
Et
2
-2,6 Dep or C
6
H
3
Me
2
-2,6 Xyl; Fiso = [HC(NDip)
2
]
−
, Dip = C
6
H
3
Pr
i
2
-2,6), which crystallographic and computational studies show to possess near neutral, octahedral
hypercloso
-hexaalane, Al
6
H
6
, cluster cores. The electronically delocalised skeletal bonding in these species is compared to that in the classical borane, [B
6
H
6
]
2−
. Thus, the chemistry of classical polyhedral boranes is extended to stable aluminium hydride clusters for the first time.
While polyhedral boron hydride complexes have found application in a number of diverse fields, the isolation of stable aluminium analogues remains highly challenging. Here, Jones and colleagues demonstrate that reduction of an amidinato-aluminum(III) hydride complex with magnesium(I) dimers affords stable aluminium(I) hydride compounds.
Journal Article
Synthesis Of Research On Patient-Centered Medical Homes Brings Systematic Differences Into Relief
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and quality, we conducted a metaanalysis of methodologically standardized findings from evaluations of eleven major PCMH initiatives. There was significant heterogeneity across individual evaluations in many outcomes. Across evaluations, PCMH initiatives were not associated with changes in the majority of outcomes studied, including primary care, emergency department, and inpatient visits and four quality measures. The initiatives were associated with a 1.5 percent reduction in the use of specialty visits and a 1.2 percent increase in cervical cancer screening among all patients, and a 4.2 percent reduction in total spending (excluding pharmacy spending) and a 1.4 percent increase in breast cancer screening among highermorbidity patients. These associations were significant. Identification of the components of PCMHs likely to improve outcomes is critical to decisions about investing resources in primary care.
Journal Article
Structural snapshots of concerted double E–H bond activation at a transition metal centre
Bond activation at a transition metal centre is a key fundamental step in numerous chemical transformations. The oxidative addition of element–hydrogen bonds, for example, represents a critical step in a range of widely applied catalytic processes. Despite this, experimental studies defining steps along the bond activation pathway are very rare. In this work, we report on fundamental studies defining a double oxidative activation pathway: combined experimental and computational approaches yield structural snapshots of the simultaneous activation of both bonds of a β-diketiminate-stabilized GaH
2
unit at a single metal centre. Systematic variation of the supporting phosphine ligands and single crystal X-ray/neutron diffraction are exploited in tandem to allow structural visualization of the activation process, from a η
2
-H,H
σ
-complex showing little Ga–H bond activation, through species of intermediate geometry featuring stretched Ga–H and compressed M–H/M–Ga bonds, to a fully activated metal dihydride featuring a neutral (carbene-type) N-heterocyclic Ga
I
ligand.
X-ray and neutron diffraction studies, in conjunction with quantum chemical techniques, have been used to define a new oxidative bond activation pathway that involves simultaneous activation of both bonds of a β-diketiminate-stabilized GaH
2
unit at a single metal centre.
Journal Article