The Midwife's coracle: a phenomenological study of midwives' experiences of emotionally supporting motherhood.

Background An initial review of the literature pertaining to the emotional health of women in their transition to motherhood was undertaken. It became clear that this is an emotional time for women where they are particularly at risk of becoming distressed (Drift 2004) and if women are emotionally distressed at this time it may have long term implications for mother (Drift 2004), baby (Miller et al 1993, Lemaitre-Sillere 1998, McMahon et a1200l) and family (Burke 2003, Tammentie et al 2004a, Tammentie et al 2004b). This understanding led to an exploration of who might provide for the emotional health needs ofwomen at this time. Midwives were identified as key professionals because of their regular contact with women through pregnancy, labour, birth and early childcare. The literature review indicated that midwives were providing for the emotional needs of women but there was no indication of how, despite the recent studies conducted into the emotion work of midwives by Hunter and her colleagues (Hunter 2001,2005,2006, Hunter and Deery 2009). Design This study has been conducted using the Husserlian philo.sophical approach with Giorgi's psychological method (Giorgi 1985). Eight community midwives were recruited following a presentation at their community midwifery team meeting at a local NHS Trust and subsequent 'snowballing'. Unstructured interviews were conducted with them in 2004 in order to explore their experiences ofproviding emotional support to women who were becoming mothers. Findings A general structure was developed along with four constituents: these were 'tipping the balance to showing emotionally supportive care', 'showing emotionally supportive care', 'struggles in showing emotionally supportive care' and 'emotional experiences'. The descriptions of experiences shared by the midwives led to an understanding that emotional support is a special type of care. This occurs in an intimate relationship supported by a 'circle of care'. The midwives use their communication skills with the aim of facilitating comfort and ameliorating emotional distress. To give this care, midwives needed to go through a process of 'tipping the balance' but even after this was enacted, they still struggled in providing this care. They appeared to particularly struggle with maintaining their 'with woman' ideology within their current professional culture. Recommendations There is a need for midwifery to consider how midwives might manage their 'with woman' care within health and social care services. For the midwives in this study, having the autonomy to manage their own diaries and caseloads along with good working relationships with their colleagues was facilitative. This was a small study in one geographical area but it clearly indicates the need for further research in this area

Muddying the water or swimming dowstream? A critical analysis of literature reviewing in a phenomenological study through an exploration of lifeworld, reflexivity and role of the researcher.

This paper proceeds from examining the debate regarding the question of whether a systematic literature review should be undertaken within a qualitative research study to focusing specifically on the role of a literature review in a phenomenological study. Along with pointing to the pertinence of orientating to, articulating and delineating the phenomenon within a review of the literature, the paper presents an appropriate approach for this purpose. How a review of the existing literature should locate the focal phenomenon within a given context is illustrated by excerps from the first author's literature review within a descriptive phenomenological study. Also discussed is the important issue of when the researcher should fully enter the attitude of the phenomenological reduction and how this may influence the study

The midwife's coracle : a phenomenological study of midwives' experiences of emotionally supporting motherhood

Background An initial review of the literature pertaining to the emotional health of women in their transition to motherhood was undertaken. It became clear that this is an emotional time for women where they are particularly at risk of becoming distressed (Drift 2004) and if women are emotionally distressed at this time it may have long term implications for mother (Drift 2004), baby (Miller et al 1993, Lemaitre-Sillere 1998, McMahon et a1200l) and family (Burke 2003, Tammentie et al 2004a, Tammentie et al 2004b). This understanding led to an exploration of who might provide for the emotional health needs ofwomen at this time. Midwives were identified as key professionals because of their regular contact with women through pregnancy, labour, birth and early childcare. The literature review indicated that midwives were providing for the emotional needs of women but there was no indication of how, despite the recent studies conducted into the emotion work of midwives by Hunter and her colleagues (Hunter 2001,2005,2006, Hunter and Deery 2009). Design This study has been conducted using the Husserlian philo.sophical approach with Giorgi's psychological method (Giorgi 1985). Eight community midwives were recruited following a presentation at their community midwifery team meeting at a local NHS Trust and subsequent 'snowballing'. Unstructured interviews were conducted with them in 2004 in order to explore their experiences ofproviding emotional support to women who were becoming mothers. Findings A general structure was developed along with four constituents: these were 'tipping the balance to showing emotionally supportive care', 'showing emotionally supportive care', 'struggles in showing emotionally supportive care' and 'emotional experiences'. The descriptions of experiences shared by the midwives led to an understanding that emotional support is a special type of care. This occurs in an intimate relationship supported by a 'circle of care'. The midwives use their communication skills with the aim of facilitating comfort and ameliorating emotional distress. To give this care, midwives needed to go through a process of 'tipping the balance' but even after this was enacted, they still struggled in providing this care. They appeared to particularly struggle with maintaining their 'with woman' ideology within their current professional culture. Recommendations There is a need for midwifery to consider how midwives might manage their 'with woman' care within health and social care services. For the midwives in this study, having the autonomy to manage their own diaries and caseloads along with good working relationships with their colleagues was facilitative. This was a small study in one geographical area but it clearly indicates the need for further research in this area.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Unique Normality

This was a descriptive phenomenological study of midwives emotional support of women becoming mothers. It used Giorgi’s (1997) Psychological Phenomenology to explore the lifeworld experiences of community midwives. Downe developed the concept of 'unique normality' related to the birth experience, she wrote it should be seen as “an ordinary drama – not a crisis and not as a routine event, but as a one off exciting event, full of possibility” (Downe 2006: 354). The midwives in this study appeared to be trying to achieve this unique normality for the women for whom they were giving emotional care. They approached the journey as a unique experience for each woman but they also tried to provide the women with a sense that their experiences were normal to reduce expressed or anticipated emotional distress. It was found that midwives came alongside the women and shared their intuition, experiences and themselves as one woman with another woman to normalise the women’s extraordinary unique experiences to facilitate a sense of comfort

Using structural motifs to identify proteins with DNA binding function

This work describes a method for predicting DNA binding function from structure using 3-dimensional templates. Proteins that bind DNA using small contiguous helix¿turn¿helix (HTH) motifs comprise a significant number of all DNA-binding proteins. A structural template library of seven HTH motifs has been created from non-homologous DNA-binding proteins in the Protein Data Bank. The templates were used to scan complete protein structures using an algorithm that calculated the root mean squared deviation (rmsd) for the optimal superposition of each template on each structure, based on Ca backbone coordinates. Distributions of rmsd values for known HTH-containing proteins (true hits) and non-HTH proteins (false hits) were calculated. A threshold value of 1.6 Å rmsd was selected that gave a true hit rate of 88.4% and a false positive rate of 0.7%. The false positive rate was further reduced to 0.5% by introducing an accessible surface area threshold value of 990 Å2 per HTH motif. The template library and the validated thresholds were used to make predictions for target proteins from a structural genomics project

The experiences of older people who live with a long-term condition

AIM: The aim of this study was to gain insight into the experiences of people aged 65 and older who have learned to live with a pre-existing long-term condition. METHOD: A qualitative approach and the principles of narrative research were used to learn as much as possible about the individuals' stories. A focus group of five men was interviewed and two women were interviewed as a pair. FINDINGS: Existing skills in condition management and interactions with professionals are transferable to new health needs that older people develop, but additional, age-related problems can affect management of long-term conditions. Progressive long-term conditions may become more difficult to manage with age, and it is difficult to distinguish between ageing processes and deterioration of pre-existing long-term conditions. Age-related social and financial changes and society's perception of older people may also present challenges to condition management. CONCLUSION: Nurses who care for older people should take into account the effects of the person's long-term condition and the ageing process when assessing their needs; understand that people may be reluctant to ask for practical assistance; explore existing support mechanisms that people have in place and their sustainability; and advocate with people to secure appropriate choices related to their health needs

Haemoparasites of free-roaming dogs associated with several remote Aboriginal communities in Australia

BACKGROUND: Tick-borne haemoparasites Babesia vogeli and Anaplasma platys are common among the free-roaming canine populations associated with Aboriginal communities in Australia, whilst the prevalence of haemoplasmas, which are also suspected to be tick-borne, remained unexplored. The aim of this study was to determine the prevalence of haemoplasma infection in these populations, and to identify any correlation with other haemoparasites. Blood was collected from 39 dogs associated with four Aboriginal communities and screened for infection using PCR and serology. DNA was purified and PCR analyses for piroplasms, Anaplasmataceae family bacteria and haemoplasmas performed. Serum was analysed using a commercial haemoparasite ELISA. Prevalence of infection was compared between communities. RESULTS: Seventeen dogs (44%) were infected (PCR positive) with Mycoplasma haemocanis, eight (21%) with ‘Candidatus Mycoplasma haematoparvum’, 20 (51%) with A. platys, and 17 (44%) with B. vogeli. Two dogs were infected with a novel haemoplasma as determined by DNA amplification and sequencing. Two dogs (5%) were serologically positive for Dirofilaria immitis antigens, one (3%) was positive for Ehrlichia canis antibodies and nine (24nbsp;%) were positive for A. platys antibodies. Co-infections were frequent. Haemoplasma prevalence was highest (73%, 16/22) in Central Australia and lowest (22%, 2/9) in Western Australia (p = 0.017). In contrast, B. vogeli prevalence was low in Central Australia (18%, 4/22) but higher (78%, 7/9) in Western Australia (p = 0.003). CONCLUSIONS: This is the first time haemoplasma infections, including a novel species, have been molecularly documented in Australian dogs. The wide regional variation in prevalence of some of the haemoparasite infections detected in this study warrants further investigation