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  1. Article ; Online: (Mis)measuring men's involvement in global health: the case of expectant fathers in Dakar, Senegal.

    Powis, Richard

    BMC pregnancy and childbirth

    2022  Volume 22, Issue 1, Page(s) 754

    Abstract: Background: In 2018, USAID published a report based on Demographic and Health Surveys data on the relationship between men's involvement and women and children's health outcomes. Using a flawed operationalization of "men's involvement," USAID's analysis ...

    Abstract Background: In 2018, USAID published a report based on Demographic and Health Surveys data on the relationship between men's involvement and women and children's health outcomes. Using a flawed operationalization of "men's involvement," USAID's analysis implies that Senegalese men are not involved in women and children's health.
    Methods: The findings of this study come from 12 months of ethnographic research in Dakar, Senegal that examined the roles and responsibilities of expectant fathers. Research participants included 32 pregnant women and 27 expectant partners recruited from three maternity wards. Research methods included long-term, immersive participant observation and semi-structured interviews.
    Results: Pregnant women in Senegal are surrounded by a kin-based network of care providers called the entourage who share responsibilities for support. Expectant fathers, as members of the entourage, are expected to provide financial and emotional support, while other members of the entourage are expected to undertake the responsibilities which USAID have designated as "men's involvement." Men typically do not undertake additional forms of care and support because they are considered "women's business," meaning that women actively discourage men from doing those things, in order to preserve women's autonomy.
    Conclusion: This research demonstrates that expectant fathers are involved in antenatal care in ways that USAID does not track through DHS. Further, I argue that USAID's heterosexist, monogamous, and nuclear operationalization of "men's involvement" aligns with a long history of Eurocentrism in development discourse which may be potentially harmful and obstructive to improving maternal and child health when the problem that is targeted is not a problem at all. This study is yet another case that demonstrates an urgent need of public and global health engagement with local stakeholders and ethnographic researchers.
    MeSH term(s) Child ; Fathers/psychology ; Female ; Global Health ; Humans ; Male ; Men/psychology ; Pregnancy ; Prenatal Care ; Senegal
    Language English
    Publishing date 2022-10-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059869-5
    ISSN 1471-2393 ; 1471-2393
    ISSN (online) 1471-2393
    ISSN 1471-2393
    DOI 10.1186/s12884-022-05093-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Handbooks and health interpreters: How men are assets for their pregnant partners in Senegal.

    Powis, Richard / Bunkley, Emma N

    Social science & medicine (1982)

    2023  Volume 331, Page(s) 116074

    Abstract: Introduction: Global health researchers often approach fatherhood initiatives from a deficit-based perspective, assuming men need sensitization, education, or correction. Senegalese men, which some global health and development organizations have ... ...

    Abstract Introduction: Global health researchers often approach fatherhood initiatives from a deficit-based perspective, assuming men need sensitization, education, or correction. Senegalese men, which some global health and development organizations have determined to be uninvolved, are part of a team of prenatal and postpartum support called the "entourage" and have a very specific role to play as ad hoc health interpreters.
    Methods: The findings of this article come from 12 months of ethnographic research in Dakar, Senegal in 2018. In addition to participant-observation in three maternity wards across the city, semi-structured interviews were conducted with 32 pregnant women, 27 expectant fathers, and numerous family members, midwives, physicians, and governmental and nongovernmental organization employees. Data were coded and evaluated using thematic analysis.
    Results: In Senegal, the Handbook of Mother and Child Health is distributed in state-funded maternity wards. The Handbook outlines what pregnant women should know about pregnancy and how to appropriately engage with clinical services. Male partners of pregnant women commonly read the book for and to their pregnant partners. Men are placed in the unique position of intermediary between pregnant women and the State and as such, they learn a lot about pregnancy and childbirth, as well as prenatal and postpartum care.
    Conclusions: Our ethnographic insights challenge global health rhetoric that frames men as uninvolved in women and children's health and this study demonstrates that future interventions should take an asset-based approach to men's involvement. Senegalese men are uniquely positioned by gendered expectations to act as health interpreters for their pregnant partners. We conclude with specific, actionable recommendations for the Senegalese case.
    MeSH term(s) Child ; Humans ; Female ; Male ; Pregnancy ; Prenatal Care ; Senegal ; Men ; Parturition ; Pregnant Women
    Language English
    Publishing date 2023-07-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 4766-1
    ISSN 1873-5347 ; 0037-7856 ; 0277-9536
    ISSN (online) 1873-5347
    ISSN 0037-7856 ; 0277-9536
    DOI 10.1016/j.socscimed.2023.116074
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Florida Doulas' Perspectives on Their Role in Reducing Maternal Morbidity and Health Disparities.

    Louis-Jacques, Adetola F / Applequist, Janelle / Perkins, Megan / Williams, Charlette / Joglekar, Ria / Powis, Richard / Daniel, Angela / Wilson, Roneé

    Women's health issues : official publication of the Jacobs Institute of Women's Health

    2024  

    Abstract: Background: Maternal mortality rates continue to rise in the United States. Considerable racial disparities exist, as Black women face two to three times the risks of dying from pregnancy-related complications compared with white women. Doulas have been ...

    Abstract Background: Maternal mortality rates continue to rise in the United States. Considerable racial disparities exist, as Black women face two to three times the risks of dying from pregnancy-related complications compared with white women. Doulas have been associated with improved maternal outcomes. This study aimed to 1) investigate Florida doulas' perspectives and influence on severe maternal morbidity/mortality and related inequities, as well as 2) identify opportunities for actionable change. The social ecological model, which acknowledges how individual, interpersonal, institutional, community, and public policy factors intersect, informed our analysis.
    Methods: This qualitative study included seven online in-depth interviews and seven focus groups with doulas (N = 31) in Florida. Interview guides investigated how doulas perceive their role in the context of a) maternal morbidity and b) health disparities.
    Results: Doulas associated maternal morbidity and health disparities with Black pregnant people, identifying racism as a major contributor. Doulas identified their role as one that most often intersects with the individual and interpersonal levels of the social ecological model. Doulas report providing positive social surveillance and emotional support, contributing education and resources, and championing for advocacy in health care settings. Actionable steps recommended by doulas to further mitigate health disparities include the integration of implicit bias training into doula certification programs, increasing public health funding to bolster a doula workforce that can serve racial and ethnic communities, establishing doula-hospital partnerships to improve relational communication, providing tailored resources for clients featuring representative messaging, and doulas' continued engagement in positive social surveillance of their clients.
    Conclusions: Doulas perceived their role as integral to mitigating maternal morbidity and health disparities, particularly in the context of supporting and advocating for birthing persons on all levels of the social ecological model. Equitable access to doulas for low-income and/or minoritized populations may be one key strategy to improve maternal health equity.
    Language English
    Publishing date 2024-03-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1085396-0
    ISSN 1878-4321 ; 1049-3867
    ISSN (online) 1878-4321
    ISSN 1049-3867
    DOI 10.1016/j.whi.2024.01.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Multi-institutional evaluation of a Pareto navigation guided automated radiotherapy planning solution for prostate cancer.

    Wheeler, Philip A / West, Nicholas S / Powis, Richard / Maggs, Rhydian / Chu, Michael / Pearson, Rachel A / Willis, Nick / Kurec, Bartlomiej / Reed, Katie L / Lewis, David G / Staffurth, John / Spezi, Emiliano / Millin, Anthony E

    Radiation oncology (London, England)

    2024  Volume 19, Issue 1, Page(s) 45

    Abstract: Background: Current automated planning solutions are calibrated using trial and error or machine learning on historical datasets. Neither method allows for the intuitive exploration of differing trade-off options during calibration, which may aid in ... ...

    Abstract Background: Current automated planning solutions are calibrated using trial and error or machine learning on historical datasets. Neither method allows for the intuitive exploration of differing trade-off options during calibration, which may aid in ensuring automated solutions align with clinical preference. Pareto navigation provides this functionality and offers a potential calibration alternative. The purpose of this study was to validate an automated radiotherapy planning solution with a novel multi-dimensional Pareto navigation calibration interface across two external institutions for prostate cancer.
    Methods: The implemented 'Pareto Guided Automated Planning' (PGAP) methodology was developed in RayStation using scripting and consisted of a Pareto navigation calibration interface built upon a 'Protocol Based Automatic Iterative Optimisation' planning framework. 30 previous patients were randomly selected by each institution (I
    Results: PGAP led to marked improvements across the majority of rectal dose metrics, with D
    Conclusions: PGAP enabled intuitive adaptation of automated protocols to an institution's planning aims and yielded plans more congruent with the institution's clinical preference than the locally produced manual clinical plans.
    MeSH term(s) Male ; Humans ; Radiotherapy, Intensity-Modulated/methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Urinary Bladder ; Prostatic Neoplasms/radiotherapy ; Organs at Risk
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-024-02404-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Clinical implementation of a knowledge based planning tool for prostate VMAT.

    Powis, Richard / Bird, Andrew / Brennan, Matthew / Hinks, Susan / Newman, Hannah / Reed, Katie / Sage, John / Webster, Gareth

    Radiation oncology (London, England)

    2017  Volume 12, Issue 1, Page(s) 81

    Abstract: Background: A knowledge based planning tool has been developed and implemented for prostate VMAT radiotherapy plans providing a target average rectum dose value based on previously achievable values for similar rectum/PTV overlap. The purpose of this ... ...

    Abstract Background: A knowledge based planning tool has been developed and implemented for prostate VMAT radiotherapy plans providing a target average rectum dose value based on previously achievable values for similar rectum/PTV overlap. The purpose of this planning tool is to highlight sub-optimal clinical plans and to improve plan quality and consistency.
    Methods: A historical cohort of 97 VMAT prostate plans was interrogated using a RayStation script and used to develop a local model for predicting optimum average rectum dose based on individual anatomy. A preliminary validation study was performed whereby historical plans identified as "optimal" and "sub-optimal" by the local model were replanned in a blinded study by four experienced planners and compared to the original clinical plan to assess whether any improvement in rectum dose was observed. The predictive model was then incorporated into a RayStation script and used as part of the clinical planning process. Planners were asked to use the script during planning to provide a patient specific prediction for optimum average rectum dose and to optimise the plan accordingly.
    Results: Plans identified as "sub-optimal" in the validation study observed a statistically significant improvement in average rectum dose compared to the clinical plan when replanned whereas plans that were identified as "optimal" observed no improvement when replanned. This provided confidence that the local model can identify plans that were suboptimal in terms of rectal sparing. Clinical implementation of the knowledge based planning tool reduced the population-averaged mean rectum dose by 5.6Gy. There was a small but statistically significant increase in total MU and femoral head dose and a reduction in conformity index. These did not affect the clinical acceptability of the plans and no significant changes to other plan quality metrics were observed.
    Conclusions: The knowledge-based planning tool has enabled substantial reductions in population-averaged mean rectum dose for prostate VMAT patients. This suggests plans are improved when planners receive quantitative feedback on plan quality against historical data.
    MeSH term(s) Algorithms ; Humans ; Knowledge Bases ; Male ; Organs at Risk/radiation effects ; Prostatic Neoplasms/radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy Planning, Computer-Assisted/standards ; Radiotherapy, Intensity-Modulated/methods ; Rectum/radiation effects
    Language English
    Publishing date 2017-05-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-017-0814-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Book: Der neueste englische Hufschmied oder Prüfungen und Erfahrungen über die Zweckmässigkeit der neuesten in England erfundenen und daselbst üblichen Hufeisen nach Maßgabe der verschiedenen Beschaffenheit der Pferdehufe, sowohl für kranke als gesunde Pferde

    Powis, Richard

    nebst Beschreibung der vorzüglichsten Krankheiten und Fehler der Pferdehufe ; auch Angabe der Mittel sowohl diesen Krankheiten und Fehlern vorzubeugen, als auch solche zu heilen. Nebst zwey Zugaben über dieselben Gegenstände nach Richard Lawrence

    1817  

    Title translation An examination of the different systems of shoeing horses <dt.>
    Author's details von Richard Powis
    Language German
    Size XII, 146 S., Ill., 8"
    Publisher Hartleben
    Publishing place Pesth
    Document type Book
    Database Special collection on veterinary medicine and general parasitology

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  7. Book ; Online: Der neueste englische Hufschmied oder Prüfungen und Erfahrungen über die Zweckmässigkeit der neuesten in England erfundenen und daselbst üblichen Hufeisen nach Maßgabe der verschiedenen Beschaffenheit der Pferdehufe, sowohl für kranke als gesunde Pferde

    Powis, Richard

    nebst Beschreibung der vorzüglichsten Krankheiten und Fehler der Pferdehufe ; auch Angabe der Mittel sowohl diesen Krankheiten und Fehlern vorzubeugen, als auch solche zu heilen. Nebst zwey Zugaben über dieselben Gegenstände nach Richard Lawrence

    1817  

    Title translation An examination of the different systems of shoeing horses <dt.>
    Author's details von Richard Powis
    Language German
    Size Online-Ressource, Ill., 8"
    Publisher Tierärztl. Hochsch ; Hartleben
    Publishing place Hannover ; Pesth
    Document type Book ; Online
    Database Special collection on veterinary medicine and general parasitology

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  8. Book ; Online: An examination of the different systems of shoeing the feet of horses

    Powis, Richard

    particularly the thin-heeled system of the college and the system now practised in the Prince Regent's stables

    1814  

    Author's details by R. Powis
    Keywords Horseshoeing
    Language English
    Size Online-Ressource, 21 cm
    Publisher Cradock and Joy
    Publishing place London
    Document type Book ; Online
    Note Goldsmiths'-Kress no. 20912.29 ; OCLC, 16085250 ; Reproduction of original from Kress Library of Business and Economics, Harvard University
    Database Former special subject collection: coastal and deep sea fishing

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