Publications by authors named "Shawn Walker"
Problem: Despite the recent introduction of midwifery services in India to improve maternal and newborn healthcare, there is limited research on women's perspectives on midwife-led care.
Background: The Government of India initiated midwifery services guidelines in 2018 to improve the quality of care for pregnant women and newborns across the country. It is important to develop evidence-based strategies which can optimise the implementation of these new midwifery services.
The field of misinformation studies has experienced a boom of scholarship in recent years. Buoyed by the emergence of information operations surrounding the 2016 election and the rise of so-called "fake news," researchers hailing from fields ranging from philosophy to computer science have taken up the challenge of detecting, analyzing, and theorizing false and misleading information online. In an attempt to understand the spread of misinformation online, researchers have adapted concepts from different disciplines.
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- Wildlife biodiversity helps keep ecosystems healthy and strong.
- Scientists study this diversity to learn more about life and how it started.
- Due to the rapid loss of various species, immediate action is needed from conservationists, and new techniques like stem cell technologies could help protect animal diversity.
Article Synopsis
- Microcrystal electron diffraction (microED) is a new technique for quickly analyzing small molecule crystals, particularly useful in pharmaceuticals.
- In a study involving 30 samples from Amgen Inc., researchers successfully determined the structures of 15 crystals using just 40 hours of microscope time.
- All chiral compounds analyzed had their absolute stereochemistry correctly assigned through dynamic refinement, showcasing the effectiveness of dynamic refinement in determining stereochemistry for pharmaceutical compounds.
Article Synopsis
- The problem highlighted is the limited training and clinical experience in breech birth, leading to reduced confidence among maternity professionals.
- The OptiBreech collaborative care pathway aims to enhance safety and professional training for breech presentations by providing person-centered care and dedicated support facilities.
- Through interviews with staff at OptiBreech trial sites, key factors such as skill development, resource availability, and social support were identified as facilitators and barriers, offering insights for improving future implementation of this care model.*
Variations of cervical head entrapment in vaginal breech births: New insights on how to prevent, manage and resolve.
Eur J Obstet Gynecol Reprod Biol
August 2024
Article Synopsis
- - This paper explores the causes of cervical head entrapment during vaginal breech births, outlining three distinct types: unpredictable, manageable, and preventable.
- - Each type is illustrated with examples, focusing on their impacts on different fetal conditions, like preterm or growth-restricted fetuses, along with complications like uterine prolapse.
- - The authors suggest both traditional and new strategies for managing and preventing cervical head entrapment, highlighting the need for further research in this area.
Article Synopsis
- OptiBreech is a new care pathway designed for women with a breech-presenting fetus, offering continuity from a specialist midwife and the option for vaginal breech birth (VBB).
- A pilot trial was conducted from January to June 2022 with 68 women, but the randomisation process faced challenges, as many participants preferred OptiBreech care over standard options.
- Results showed that women in the OptiBreech group had higher rates of vaginal births and lower rates of complications compared to those receiving standard care, leading to a recommendation for a different study design for future evaluations.
Article Synopsis
- Guidelines for breech management emphasize the importance of choice and informed decision-making, yet many women find it challenging to access vaginal breech birth (VBB) options.
- A systematic review of 19 studies revealed that women desiring a VBB seek a sense of "connected autonomy," highlighting themes such as feelings of isolation, external judgment, and the need for supportive healthcare.
- To enhance the experience for these women, healthcare services should focus on fostering confident, empathetic connections between patients and providers, ensuring their emotional and informational needs are met.
Not too fast, not too slow: A review of historical trends in vaginal breech time management.
Eur J Obstet Gynecol Reprod Biol
August 2023
Article Synopsis
- There is a lack of consistent professional advice on when to intervene during the emergence phase of a vaginal breech birth, which can lead to complications like hypoxia and asphyxia due to umbilical cord compression.
- A literature review of obstetric textbooks from 1960 to 2000 showed varying recommendations for the 'safe' intervals between the birth of the umbilicus and the head, ranging from 5 to 20 minutes, with no supporting evidence for these guidelines.
- The findings highlight the need for clear, evidence-based guidance in breech birth training to prevent unnecessary injuries related to oxygen deprivation, and this guidance must be thoroughly evaluated.
Article Synopsis
- OptiBreech Care is a care pathway designed for breech births at term, focusing on safe and proficient vaginal deliveries with trained professionals.
- The study assessed the feasibility of implementing this care pathway across 13 NHS sites in England and Wales, evaluating factors like training, cost, safety, and recruitment.
- Results indicated successful training implementation, with a high percentage of vaginal births attended by qualified staff and relatively low neonatal admission rates, supporting the potential for a future pilot trial.
Article Synopsis
- A systematic review analyzed the barriers and facilitators to implementing midwife-led care in low- and middle-income countries (LMICs), highlighting its importance for maternal and neonatal health and alignment with United Nations' goals.
- The review included 31 studies from 21 LMICs, emphasizing the need for women's knowledge and confidence, improved midwifery education, and better collaboration among stakeholders for successful implementation.
- Key challenges identified included insufficient funding and political instability, which hinder the establishment and sustainability of midwife-led care programs.
A Dynamic Analysis of Conspiratorial Narratives on Twitter During the Pandemic.
Cyberpsychol Behav Soc Netw
May 2023
Article Synopsis
- The study examines the spread of conspiracy theories related to Bill Gates and COVID-19 on Twitter, analyzing over 313,000 tweets from 2020.
- It identifies ten main topics related to these conspiracy theories and explores how they influence one another using statistical methods.
- The findings reveal that emotionally charged conspiracies tend to generate more conspiratorial narratives over time, indicating a complex and interconnected landscape of misinformation.
Optimal time intervals for vaginal breech births: a case-control study.
NIHR Open Res
September 2022
Article Synopsis
- Breech births can lead to serious complications like hypoxic injury, and the Physiological Breech Birth Algorithm offers time guidelines for intervention during delivery.
- A study conducted in London analyzed 15 breech birth cases and 30 controls from 2012 to 2020 to determine how exceeding these time limits affects neonatal outcomes.
- Results indicated that delays beyond specified time frames were significantly linked to worse outcomes, with longer intervention times observed in adverse cases, suggesting room for improvement in clinical practices.
Article Synopsis
- Skilled professionals at breech births can improve outcomes, and the study aimed to assess the feasibility, acceptability, fidelity, and safety of OptiBreech training in NHS services across 13 locations in England and Wales.
- A mix of methods was used, including patient interviews and outcome analysis, showing that dedicated clinics led by specialized midwives achieved significant fidelity to training goals and maintained low neonatal admission rates of 5.5%.
- The findings support the use of specialist midwife-led clinics for vaginal breech birth care as a promising approach, but emphasize the need for ongoing development of the team to ensure sustained quality of care.
Article Synopsis
- - The study investigates the formation of toroidal-shaped nuclei in columnar lyotropic chromonic liquid crystals, contrasting usually spherical shapes found in crystals and liquid crystal droplets.
- - The shape and thickness of these toroids are influenced by the concentrations of disodium cromoglycate (DSCG) and polyethylene glycol (PEG), with varying levels leading to different structural characteristics.
- - The diverse toroidal shapes can be explained by the interplay between bending elasticity and anisotropic interfacial tension within the materials.
Article Synopsis
- Women with breech pregnancies at term face higher risks, and while caesarean delivery is common, some prefer vaginal birth, leading to the need for a standard measure of outcomes.
- This study aims to create a Breech Core Outcome Set (Breech-COS) by reviewing existing research, gathering input from patients and families, and conducting an international survey to prioritize what outcomes matter most.
- The Breech-COS is intended to be a standard for future research, enabling better comparisons and ultimately improving the safety and outcomes for mothers and newborns.
Article Synopsis
- Bacteriophages store their long double-stranded DNA in a protein shell called a capsid, which has a hexagonal liquid crystalline structure affected by the capsid's electrochemistry.
- The study presents a model that connects the arrangement of DNA within these capsids to the types and concentrations of ions in the surrounding environment.
- By developing a computational method, researchers can simulate larger systems to analyze DNA bending, repulsion between DNA segments, and the electrochemical properties both inside and outside the capsid, with results aligning well with experimental and molecular dynamics data from smaller capsids.
Article Synopsis
- Women with breech pregnancies at term face higher risks and often need a caesarean delivery, but alternatives exist and require better outcome evaluations.
- Current research shows varied quality and inadequate reporting on crucial outcomes for women in labor with breech fetuses.
- The study aimed to compile a core outcome set (Breech-COS) to standardize and improve reporting in future research by reviewing literature and engaging with a Patient and Public Involvement group.
Article Synopsis
- The study aims to gather insights from student midwives, educators, and clinicians at a London university to improve understanding of sexual and gender diversity within a midwifery curriculum.
- It employs a mixed-methods approach, utilizing an online survey and focus groups, which included 47 survey respondents and 16 participants in focus groups.
- Data analysis revealed two main themes—Practising Open Mindedness and Cultivating Openness—along with sub-themes that stress the importance of self-awareness, challenging assumptions, and creating safe learning spaces.
Article Synopsis
- - The "physiological breech birth" training program aims to improve clinicians' skills in managing breech births, enhancing their confidence and knowledge based on prior evaluations, but its real-world impact on clinical practice remains unclear.
- - A mixed-methods study conducted across eight NHS hospitals assessed the training's effectiveness through surveys and audit data on breech births before and after training; results showed increased confidence and knowledge among 263 participants, and a rise in upright birthing positions.
- - While the training led to more clinicians using upright positions during breech births, the overall rates of vaginal births remained unchanged; further research is needed to fully understand how these practice changes could affect clinical outcomes.
Article Synopsis
- Understanding how DNA is packed in viral capsids is crucial for studying virus spread and developing targeted drug delivery systems.
- This article introduces a mathematical model to design bacteriophage viruses and explores the similarities between viral DNA configurations and chromonic phases, using liquid crystal theory.
- The model provides a numerical algorithm for analyzing viral capsid structures, highlighting areas of order and disorder, and helps reconstruct the DNA arrangement inside the capsid.
Article Synopsis
- A physiological breech birth allows women to stay active during labor and choose their birthing positions, with innovative techniques like the face-to-pubes rotational maneuver for resolving complications like nuchal arm entrapment.
- This study focused on a single case to understand how the face-to-pubes maneuver effectively alleviated bilateral nuchal arm entrapment during a breech birth.
- The technique can be taught to midwives for use in upright births, highlighting the importance of having trained professionals available for expecting parents’ decision-making.
Article Synopsis
- - The study analyzed 42 videos of successful upright vaginal breech births to identify features that promote positive outcomes and enhance teaching methods for breech deliveries.
- - Results showed that only 33% of births were completely spontaneous, with a median time of 1:52 minutes between the birth of the fetal pelvis and head; specific maneuvers were utilized to address complications like fetal arm entrapment.
- - The findings suggest that most upright breech births happen within 3 minutes of the fetal pelvis being born, leading to the introduction of a new physiological breech algorithm for teaching and practice.