An exploration of midwives’ and obstetricians’ perceptions of risk in relation to care practices for low risk women and normal childbirth

This thesis explores how midwives’ and obstetricians’ perceptions of risk affect care practices for low-risk women and normal childbirth. Four academic papers are incorporated into the thesis. The research aims to provide an understanding of how perceptions of risk may contribute to intervention during birth. Areas investigated include factors that contribute to midwives and obstetricians feeling safe or unsafe when facilitating birth, their trust in physiological birth and their attitudes towards the importance of achieving normal birth A systematic integrative review was undertaken (Paper 1), synthesising data from 13 studies, identified on the basis of a pre-determined search strategy. This review highlighted an assumption of abnormality in the birthing process. Following this, a discussion paper (Paper 2) was published that presented an over-view of the current structures and processes of maternity care, incorporating preliminary results from the primary qualitative study into the discussion. The primary qualitative study (Papers 3 and 4) involved analysing data gathered from semi-structured interviews with 16 midwives and nine obstetricians recruited from hospitals, midwifery-led units and the community. The findings highlight that in the current climate of risk management and intense surveillance of birth, midwives’ professional identity as promoters and protectors of normal birth is in jeopardy. Fear of litigation and implication in adverse outcomes and an increased focus on risk management duties are contributing factors. Apparent is that outcomes, particularly infant and maternal mortality rates, take precedent over compassionate, holistic care where the former are the quality markers currently used to assess maternity care. This thesis concludes that midwifery must become more pro-active in supporting physiological birth. There must be a refocus on how maternity care is organised and reflection on the hierarchy of outcomes if services are to become more woman-centred. Implications of the findings of this thesis on maternity practice and policy are discussed in the final chapter

An exploration of midwives’ and obstetricians’ perceptions of risk in relation to care practices for low risk women and normal childbirth

This thesis explores how midwives’ and obstetricians’ perceptions of risk affect care practices for low-risk women and normal childbirth. Four academic papers are incorporated into the thesis. The research aims to provide an understanding of how perceptions of risk may contribute to intervention during birth. Areas investigated include factors that contribute to midwives and obstetricians feeling safe or unsafe when facilitating birth, their trust in physiological birth and their attitudes towards the importance of achieving normal birth A systematic integrative review was undertaken (Paper 1), synthesising data from 13 studies, identified on the basis of a pre-determined search strategy. This review highlighted an assumption of abnormality in the birthing process. Following this, a discussion paper (Paper 2) was published that presented an over-view of the current structures and processes of maternity care, incorporating preliminary results from the primary qualitative study into the discussion. The primary qualitative study (Papers 3 and 4) involved analysing data gathered from semi-structured interviews with 16 midwives and nine obstetricians recruited from hospitals, midwifery-led units and the community. The findings highlight that in the current climate of risk management and intense surveillance of birth, midwives’ professional identity as promoters and protectors of normal birth is in jeopardy. Fear of litigation and implication in adverse outcomes and an increased focus on risk management duties are contributing factors. Apparent is that outcomes, particularly infant and maternal mortality rates, take precedent over compassionate, holistic care where the former are the quality markers currently used to assess maternity care. This thesis concludes that midwifery must become more pro-active in supporting physiological birth. There must be a refocus on how maternity care is organised and reflection on the hierarchy of outcomes if services are to become more woman-centred. Implications of the findings of this thesis on maternity practice and policy are discussed in the final chapter

Blowing of polycrystalline silicon fuses

Polycrystalline silicon fuses are one time programmable memory elements which allow the calibration of integrated circuits at wafer and package level. We present a zero-dimensional lumped parameter model of the programming of fuses made from a combination of tungsten silicide and polycrystalline silicon. The components of the model are an electrical model, a thermal model, and a flow model. The model generates quantitatively accurate results and reproduces trends with applied voltage and fuse size. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3457469

Detecting heart rate while jogging: blind source separation of gait and heartbeat

A blind source signal separation problem that was brought to a Study Group in Limerick in 2013 required a way to prevent the gait of a jogger from masking the heartbeat, when detected by a simple photodiode that measures light transmission through a jogger’s wrist tissues. The group was successful in discovering a singular value decomposition (SVD) approach, which not only allows accurate detection of heart rate but also allows recovery of a good facsimile of the entire blood pressure time series from the mixed photodiode signal

Cross platform microarray analysis for robust identification of differentially expressed genes-2

<p><b>Copyright information:</b></p><p>Taken from "Cross platform microarray analysis for robust identification of differentially expressed genes"</p><p>http://www.biomedcentral.com/1471-2105/8/S1/S5</p><p>BMC Bioinformatics 2007;8(Suppl 1):S5-S5.</p><p>Published online 8 Mar 2007</p><p>PMCID:PMC1885857.</p><p></p>xpressed genes

Cross platform microarray analysis for robust identification of differentially expressed genes-0

<p><b>Copyright information:</b></p><p>Taken from "Cross platform microarray analysis for robust identification of differentially expressed genes"</p><p>http://www.biomedcentral.com/1471-2105/8/S1/S5</p><p>BMC Bioinformatics 2007;8(Suppl 1):S5-S5.</p><p>Published online 8 Mar 2007</p><p>PMCID:PMC1885857.</p><p></p>BrdU was added 30 min before harvesting and samples were processed for cell cycle analysis and BrdU incorporation analysis

Cross platform microarray analysis for robust identification of differentially expressed genes-1

<p><b>Copyright information:</b></p><p>Taken from "Cross platform microarray analysis for robust identification of differentially expressed genes"</p><p>http://www.biomedcentral.com/1471-2105/8/S1/S5</p><p>BMC Bioinformatics 2007;8(Suppl 1):S5-S5.</p><p>Published online 8 Mar 2007</p><p>PMCID:PMC1885857.</p><p></p>ray precision within each microarray platform for the three replicates. CAT Plots describe the proportion of genes in common between replicates as function of list size. To generate CAT Plots on treated samples we used the lists of genes ranked b

Cross platform microarray analysis for robust identification of differentially expressed genes-4

<p><b>Copyright information:</b></p><p>Taken from "Cross platform microarray analysis for robust identification of differentially expressed genes"</p><p>http://www.biomedcentral.com/1471-2105/8/S1/S5</p><p>BMC Bioinformatics 2007;8(Suppl 1):S5-S5.</p><p>Published online 8 Mar 2007</p><p>PMCID:PMC1885857.</p><p></p>s passing SAM statistical validation only in ABI, C) Set of 204 genes passing SAM statistical validation only in AFFX. AFFX data are reported in red, ABI in black. The lack of statistical significance in one of the platforms (B, C) is also associated with a limited log(Fold Change) variation. On the other hand, log(Fold Change) variation for genes passing the statistical validation in both platforms (A) is quite similar, although ABI seems to have wider log(Fold Change) dynamic range

Cross platform microarray analysis for robust identification of differentially expressed genes-3

<p><b>Copyright information:</b></p><p>Taken from "Cross platform microarray analysis for robust identification of differentially expressed genes"</p><p>http://www.biomedcentral.com/1471-2105/8/S1/S5</p><p>BMC Bioinformatics 2007;8(Suppl 1):S5-S5.</p><p>Published online 8 Mar 2007</p><p>PMCID:PMC1885857.</p><p></p>greement. The Correspondence at the top was evaluated for AFFX and ABI using the full set of genes after the IQR filtering step (black line) or after the IC filtering step (red line). For each of the two platforms averag

Ryuvidine elicits a DNA damage response.

<p>A) Protein extracts prepared from HeLa cells treated with either PHA-767491, Ryuvidine, Mitoxantrone or hydroxyurea (HU) for the indicated time were analyzed by western blot with indicated antibodies. B) Formation of γ-H2AXnuclear foci in cells treated with ATM inhibitor KU55933, Mitoxantrone, Ryuvidine alone or in combination was assessed by fluorescence microscopy. Nuclei were stained with DAPI. Representative fields are shown.</p