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

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

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

Changing expendable bathythermograph fall rates and their impact on estimates of thermosteric sea level rise

A time-varying warm bias in the global XBT data archive is demonstrated to be largely due to changes in the fall rate of XBT probes likely associated with small manufacturing changes at the factory. Deep-reaching XBTs have a different fall rate history than shallow XBTs. Fall rates were fastest in the early 1970s, reached a minimum between 1975 and 1985, reached another maximum in the late 1980s and early 1990s, and have been declining since. Field XBT/CTD intercomparisons and a pseudoprofile technique based on satellite altimetry largely confirm this time history. A global correction is presented and applied to estimates of the thermosteric component of sea level rise. The XBT fall rate minimum from 1975 to 1985 appears as a 10-yr “warm period” in the global ocean in thermosteric sea level and heat content estimates using uncorrected data. Upon correction, the thermosteric sea level curve has reduced decadal variability and a larger, steadier long-term trend

Plant-expressed Hepatitis B core antigen virus-like particles: Characterization and investigation of their stability in simulated and pig gastro-intestinal fluids

Virus-like particles (VLPs) are potential oral vaccine candidates, as their highly compact structure may allow them to withstand the harsh conditions of the gastro-intestinal (GI) environment. Hepatitis B core antigen (HBcAg) is an immunogenic protein that assembles into 30 or 34 nm diameter VLPs. Here, the stabilities of both the HBcAg polypeptide itself and the three-dimensional structure of the VLPs upon exposure to in vitro and ex vivo simulated gastric and intestinal fluids were investigated. Plant-expressed HBcAg VLPs were efficiently purified by sucrose density gradient and characterized. The purified VLPs did not show major chemical or physical instability upon exposure to the low pH conditions typically found in the stomach; however, they completely agglomerated upon acidification and subsequent pH neutralization. The HBcAg polypeptide was highly digested upon exposure to pepsin in simulated gastric fluids. HBcAg appeared more stable in both simulated and ex vivo intestinal fluids, where despite a partial digestion of the HBcAg polypeptide, the VLPs maintained their most immunogenic epitopes and their particulate conformation. These results suggest that HBcAg VLPs are likely to be unstable in gastric fluids, yet if the gastric instability could be bypassed, they could maintain their particulate structure and immunogenicity in intestinal fluids

Investigating Embryonic Expression Patterns and Evolution of AHI1 and CEP290 Genes, Implicated in Joubert Syndrome

Joubert syndrome and related diseases (JSRD) are developmental cerebello-oculo-renal syndromes with phenotypes including cerebellar hypoplasia, retinal dystrophy and nephronophthisis (a cystic kidney disease). We have utilised the MRCWellcome Trust Human Developmental Biology Resource (HDBR), to perform in-situ hybridisation studies on embryonic tissues, revealing an early onset neuronal, retinal and renal expression pattern for AHI1. An almost identical pattern of expression is seen with CEP290 in human embryonic and fetal tissue. A novel finding is that both AHI1 and CEP290 demonstrate strong expression within the developing choroid plexus, a ciliated structure important for central nervous system development. To test if AHI1 and CEP290 may have co-evolved, we carried out a genomic survey of a large group of organisms across eukaryotic evolution. We found that, in animals, ahi1 and cep290 are almost always found together; however in other organisms either one may be found independent of the other. Finally, we tested in murine epithelial cells if Ahi1 was required for recruitment of Cep290 to the centrosome. We found no obvious differences in Cep290 localisation in the presence or absence of Ahi1, suggesting that, while Ahi1 and Cep290 may function together in the whole organism, they are not interdependent for localisation within a single cell. Taken together these data support a role for AHI1 and CEP290 in multiple organs throughout development and we suggest that this accounts for the wide phenotypic spectrum of AHI1 and CEP290 mutations in man