International journal of environmental research and public health
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Int J Environ Res Public Health · Jan 2019
Observational StudyDiagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre.
HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome is a severe and rapidly progressing condition that requires distinct diagnostic considerations. The aim of this study was to evaluate the impact of the Mississippi triple-class system on the HELLP syndrome diagnosis, treatment, and outcomes in a perinatology centre during a 10-year period, and consider its effectiveness and necessity in everyday practice. A retrospective observational cohort study was carried out using the medical records of a tertiary perinatology centre with the diagnosis of HELLP syndrome from the period of time between 2005 and 2014. ⋯ The clinical presentation varied within all of the classes, and the only objective means of diagnosis and evaluation of progression of the condition were laboratory tests. Even though HELLP syndrome is considered a hypertensive multi-organ disorder of pregnancy, the level of hypertension does not correlate to the severity of the condition; hence, the diagnosis should be based on biochemical laboratory evidence. Vigilance in suspicion and the recognition of HELLP syndrome and appropriate treatment are essential in order to ensure better maternal and neonatal outcomes.
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Int J Environ Res Public Health · Jan 2019
Attitudes to E-Cigarettes and Cessation Support for Pregnant Women from English Stop Smoking Services: A Mixed Methods Study.
Smoking in pregnancy remains a public health problem. In the UK e-cigarettes are the most popular aid to quitting smoking outside of pregnancy, but we don't know the extent of e-cigarette use in pregnancy or how English Stop Smoking Services (SSS) respond to pregnant women who vape. In 2015 we surveyed SSS managers about cessation support for pregnant women and responses to clients who vaped. ⋯ Most SSS reported supporting pregnant women who already vaped, but would not recommend e-cigarette use; for women that were still smoking and not using e-cigarettes, 8.3% of SSS were likely/very likely to advise using e-cigarettes, with 56.9% of SSS unlikely/very unlikely to advise using them. Fifteen respondents were interviewed; interviewees were generally positive about the potential of e-cigarettes for cessation in pregnancy although concerns about perceived lack of evidence for safety were expressed and most wanted research on this. Clear guidance on e-cigarette use informed by pregnancy specific research will assist SSS to provide consistent evidence-based support.
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Int J Environ Res Public Health · Jan 2019
Urban Growth-Oriented Green Accumulation: Ecological Conservation Planning in the Shenzhen DaPeng Peninsula in Southern China.
Neoliberal conservation has recently become a topic of academic research and a method of practice within the context of globalization. Less attention has been given to how neoliberal conservation has been practiced at the urban scale. This paper draws on the concept of 'urban-growth-oriented green grabbing' to capture the multidimensionality of the reasoning and process of ecological conservation in an urban growth context. ⋯ Through empirical investigation, this article traces the political economy of these plans and draws out the insights they offer regarding theories of urban environmentalism. The empirical results show that the ecological conservation plans are best understood as 'green grabbing' that has been achieved by land transfer and spatial interest redistribution. Conceptually, the paper provides further evidence of the process of neoliberal conservation within the urban context.