A review of antenatal corticosteroid use in premature neonates in a middle-income country

Background. Antenatal corticosteroid (ANS) use in premature neonates has become a standard of practice. However, there is low ANS coverage in low- to middle-income countries (LMICs). Recent studies have questioned the efficacy of ANSs in such countries.Objective. To review the use of ANSs in preterm neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa.Methods. This was a retrospective observational study of all neonates with a birth weight of 500 - 1 800 g born at CMJAH between 1 January 2013 and 30 June 2016. Neonatal and maternal characteristics of neonates exposed to ANSs were compared with those of neonates who were not exposed.Results. The ANS coverage of the final sample was 930/2 109 (44.1%). The mean (standard deviation (SD)) birth weight was 1 292.4 (323.2) g and the mean gestational age 30.2 (2.9) weeks. Attending antenatal care and maternal hypertension were associated with increased use of ANSs, whereas vaginal delivery was associated with decreased use. In neonates weighing <1 500 g, the use of ANSs was associated with decreased mortality, decreased intraventricular haemorrhage and decreased patent ductus arteriosus. There was no association between ANSs and respiratory distress syndrome, necrotising enterocolitis, sepsis or need for respiratory support in all premature neonates, and no association with improved outcomes in those weighing ≥1 500 g.Conclusion. The benefits of ANSs in terms of neonatal morbidity in this study were not as marked as those published in high-income countries. A randomised controlled trial may be indicated in LMICs

Process simulation and analysis of carbon capture with an aqueous mixture of ionic liquid and monoethanolamine solvent

This study investigated the prospect of using aqueous mixture of 1-butylpyridinium tetrafluoroborate ([Bpy][BF4]) ionic liquid (IL) and monoethanolamine (MEA) as solvent in post-combustion CO2 capture (PCC) process. This is done by analysis of the process through modelling and simulation. In literature, reported PCC models with a mixture of IL and MEA solvent were developed using equilibrium-based mass transfer approach. In contrast, the model in this study is developed using rate-based mass transfer approach in Aspen Plus®. From the results, the mixed aqueous solvent with 5–30 wt% IL and 30 wt% MEA showed 7%–9% and 12%–27% less specific regeneration energy and solvent circulation rate respectively compared to commonly used 30 wt% MEA solvent. It is concluded that the IL concentration (wt%) in the solvent blend have significant impact on specific regeneration energy and solvent circulation rate. This study is a starting point for further research on technical and economic analysis of PCC process with aqueous blend of IL and MEA as solvent

Racism, anti-racist practice and social work: articulating the teaching and learning experiences of Black social workers

In the mid 1990s a Black practice teacher programme was established in Manchester and Merseyside with the primary aim to increase the number of Black practice teachers in social work organisations, and in turn provide a supportive and encouraging learning environment for Black student social workers whilst on placement. In the north‐west of England research has been undertaken, to establish the quality of the practice teaching and student learning taking place with Black practice teachers and students. This paper is an exploration of the ideas generated within the placement process that particularly focused on the discourse of racism and ant‐racist practice. Black students and practice teachers explain their understanding of racism and anti‐racist practice within social work. From the research, the paper will critique some of the ideas concerning anti‐racism. In particular, it will question whether anti‐racist social work practice needs to be re‐evaluated in the light of a context with new migrants, asylum seekers and refugees. It will concluded, by arguing that whilst the terms anti‐racism, Black and Minority Ethnic have resonance as a form of political strategic essentialism, it is important to develop more positive representations in the future

An assessment of the validity and reliability of EU data on orders to leave and the return of third country nationals

Each year the Member States of the European Union issue around 500,000 return decisions to persons who do not, or no longer, have legal stay. A return decision requires the person to leave the territory of the state issuing the return decision and to go to a country where he/she does have legal stay, usually his/her country of citizenship. If persons do not leave themselves, they risk being returned by force. The implementation of assisted and forced return often requires cooperation by the countries of citizenship of the person receiving the return decision, and thus partially depends on the intergovernmental relations between EU+ (EU Member States plus Norway, Switzerland, and the United Kingdom) and non-EU+ countries. The WODC has conducted three interrelated studies on the influence of these relations on return. In Part 1 of the study, the results of which are reported here, we explore the validity and reliability of Eurostat return data. The aim is to investigate whether and how Eurostat return data can be used to answer research questions on factors influencing return rates across EU Member States and across third countries. We pose two research questions: What can be said about the validity and reliability of the EU data on returns and return decisions? If there are issues pertaining to the validity and reliability of EU data on returns and return decisions, what methodologies are suitable to research the effects of return frameworks on return outcomes and/or to identify differences between comparable corridors in the level and/or type (e.g., forced vs. voluntary) of return? CONTENT Introduction Return frameworks and plausible effects on enforced return Methods Results Conclusion See External links for Part 2 and 3 of this reserch

A review of antenatal corticosteroid use in premature neonates in a middle-income country

Background. Antenatal corticosteroid (ANS) use in premature neonates has become a standard of practice. However, there is low ANS coverage in low- to middle-income countries (LMICs). Recent studies have questioned the efficacy of ANSs in such countries.Objective. To review the use of ANSs in preterm neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), South Africa.Methods. This was a retrospective observational study of all neonates with a birth weight of 500 - 1 800 g born at CMJAH between 1 January 2013 and 30 June 2016. Neonatal and maternal characteristics of neonates exposed to ANSs were compared with those of neonates who were not exposed.Results. The ANS coverage of the final sample was 930/2 109 (44.1%). The mean (standard deviation (SD)) birth weight was 1 292.4 (323.2) g and the mean gestational age 30.2 (2.9) weeks. Attending antenatal care and maternal hypertension were associated with increased use of ANSs, whereas vaginal delivery was associated with decreased use. In neonates weighing <1 500 g, the use of ANSs was associated with decreased mortality, decreased intraventricular haemorrhage and decreased patent ductus arteriosus. There was no association between ANSs and respiratory distress syndrome, necrotising enterocolitis, sepsis or need for respiratory support in all premature neonates, and no association with improved outcomes in those weighing ≥1 500 g.Conclusion. The benefits of ANSs in terms of neonatal morbidity in this study were not as marked as those published in high-income countries. A randomised controlled trial may be indicated in LMICs.