Becoming a mother: a study exploring occupational change in first-time motherhood

Having a first baby is considered a major life event, due to significant role change impacting on the ordinary and familiar activities the new mother performs every day. The aim of this study was to explore changes in the occupational lives of first time mothers. A concurrent nested strategy of enquiry was used. Quantitative data via the Modified Interest Checklist and the Role Checklist was nested within the predominantly qualitative data collection in the form of semi-structured interviews. Six first time mothers, who were two and a half years post motherhood and aged between 28 and 42 years, participated in this study. The findings indicate that 'new mothers' engaging in a balanced lifestyle pre-motherhood in the areas of self-care, leisure, productivity and rest experience a period of occupational disruption and occupational imbalance before adapting into motherhood through activities, tasks and finally occupations. These mothers' occupational lives are productivity dominant with most of their time being spent in paid employment and/or performing homecare/family care activities. Their occupational lives are also obligatory dominant, for example, they are performing activities they need to do to enable them to fulfil their role as mother, as opposed to activities they choose to do. Also evident is a daily process of change as individuals adapt into motherhood

Report of review of St Stephen’s Children’s Centre, Newham: services for children aged up to 3 years

Formation of surface depressions is a significant geological hazard. Prediction of future sinkholes in buried karstic areas needs knowledge about the subsurface. In order to determine the varying topography of the karstifiable bedrock we carried out multielectrode measurements. Due to the hard field conditions, the bedrock depth could not be detected. The resistivity anomalies in some places had a seasonal variation (low-resistivity in springtime, high-resistivity in the end of summer); therefore we interpreted the springtime resistivity lows as indicators of locations with high water content, that is as high porosity, saturated with water. At the same time, when pushing the current- and potential electrodes into the ground, we discovered a regularity in the areal distribution of the soil's rock debris content. Therefore we carried out a systematic electrode-pricking experiment, and categorized the soil's "toughness" corresponding to soft penetration, scratching or blockage within the upper 30 cm. We have found a close relationship between the locations of resistivity- and the soil's toughness extremes. From some epikarstic features we think that high "pricking probe" values indicate smaller depths of the bedrock. The corresponding (springtime) resistivity minima may indirectly indicate more or less collapsed horsts of the carbonate rock

Patient experiences of an ankle fracture and the most important factors in their recovery : a qualitative interview study

Objective The objective of this qualitative research study is to explore patient experiences of ankle fracture and the factors most important to them in recovery. Design Semistructured interviews exploring patient experiences of ankle fracture recovery at 16–23 weeks following injury. Interviews followed a topic guide and were recorded with an encrypted audio recorder and then transcribed verbatim. Thematic content analysis was used to identify themes in the data. Setting Individuals were recruited from a sample of participants of a UK-based clinical trial of immobilisation methods for ankle fracture (ISRCTN15537280 at the pre-results stage at time of writing). Interviews were conducted at the participants’ own homes or on a university campus setting. Participants A purposive sample was used to account for key variables of age, gender and fracture management. Participants recruited from the clinical trial sample were adults aged 18 years or over with a closed ankle fracture. Results Ten participants were interviewed, five of whom were female and six of whom needed an operation to fix their ankle fracture. The age range of participants was 21–75 years with a mean of 51.6 years. Eight themes emerged from the data during analysis; mobility, loss of independence, healthcare, psychological effects, social and family life, ankle symptoms, sleep disturbance and fatigue, and activities of daily living. Factors of importance to participants included regaining their independence, sleep quality and quantity, ability to drive, ability to walk without walking aids or weight-bearing restrictions, and radiological union. Conclusions The results of this research demonstrates the extensive impact of ankle fracture on individuals’ lives, including social and family life, sleep, their sense of independence and psychological well-being. The results of this study will enable an increased understanding of the factors of relevance to individuals with ankle fracture, allowing collection of appropriate outcomes in clinical studies for this condition. Ultimately these results will help formulate appropriate patient-centred rehabilitation plans for these patients

Translating Research to Practice for Children With Autism Spectrum Disorder: Part 2: Behavior Management in Home and Health Care Settings

Introduction Managing home and health care for children with autism spectrum disorder can be challenging because of the range of symptoms and behaviors exhibited. Method This article presents an overview of the emerging science related to the methods to foster family self-management of common concerns regarding activities of daily living and behaviors, as well as for the health care provider in primary and acute health care settings. Results Recommendations are provided to enhance the overall delivery of services, including understanding and managing a child\u27s challenging behaviors, and supporting family management of common activities of daily living and behaviors. Discussion Health care providers\u27 knowledge of evidence-based recommendations for providing care, supporting family self-management of common concerns, and referral heighten the likelihood of better outcomes for children with autism spectrum disorder

Making Rasch decisions: The use of Rasch analysis in the construction of preference based health related quality of life instruments

Objective: To set out the methodological process for using Rasch analysis alongside traditional psychometric methods in the development of a health state classification that is amenable to valuation. Methods: The overactive bladder questionnaire is used to illustrate a four step process for deriving a reduced health state classification from an existing nonpreference based health related quality of life instrument. Step I excludes items that do not meet the initial validation process and step II uses criteria based on Rasch analysis and psychometric testing to select the final items for the health state classification. In step III, item levels are examined and Rasch analysis is used to explore the possibility of reducing the number of item levels. Step IV repeats steps I to III on alternative data sets in order to validate the selection of items for the health state classification. Conclusions: The techniques described enable the construction of a health state classification amenable for valuation exercises that will allow the derivation of preference weights. Thus, the health related quality of life of patients with conditions, like overactive bladder, can be valued and quality adjustment weights such as quality adjusted life years derived