Evaluation of changes in postnatal care using the "Parents' Postnatal Sense of Security" instrument and an assessment of the instrument's reliability and validity

<p>Abstract</p> <p>Background</p> <p>A sense of security is important for experiences of parenthood in the early postpartum period. The objectives of this study were to evaluate two models of postnatal care using a questionnaire incorporating the Parents' Postpartum Sense of Security (<it>PPSS</it>) instrument and to test the validity of the <it>PPSS </it>instrument.</p> <p>Methods</p> <p>Postal surveys were sent to 234 mothers who had experienced two different forms of postnatal care (study group and control group) and returned by 86.8%. These two groups of mothers were compared for total scores on the <it>PPSS </it>instrument. Demographic variables and mothers' opinions about care interventions were also compared and these variables were tested for correlations with the total <it>PPSS </it>score. A regression analysis was carried out to assess areas of midwifery care which might affect a sense of security. The internal consistency and concurrent validity of the instrument were tested for the total population.</p> <p>Results</p> <p>there were no significant differences between the groups for scores on the <it>PPSS </it>instrument. A total of three variables predicted 26% of the variability on the <it>PPSS </it>scores for the study group and five variables predicted 37% of the variability in the control group. One variable was common to both: "<it>The midwives on the postnatal ward paid attention to the mother as an individual"</it>. There were significant correlations between the total <it>PPSS </it>scores and scores for postpartum talks and visits to the breastfeeding clinic. There was also a significant correlation between the single question: "<it>I felt secure during the first postpartum week</it>" and the total <it>PPSS </it>score. Tests for internal consistency and concurrent validity were satisfactory.</p> <p>Conclusion</p> <p>The proposed new model of care neither improved nor impaired mothers' feelings of security the week following birth. Being seen as an individual by the midwife who provides postnatal care may be an important variable for mothers' sense of postnatal security. It is possible that postpartum talks may encourage the processing of childbirth experiences in a positive direction. Availability of breastfeeding support may also add to a sense of security postpartum. The <it>PPSS </it>instrument has shown acceptable reliability and validity.</p

Radiographic evaluation of calcaneal fractures: To measure or not to measure

Objective: The aim of this study was to correlate the functional outcome after treatment for displaced intra-articular calcaneal fracture with plain radiography. Design: The design was a prognostic study of a retrospective cohort with concurrent follow-up. Patients: A total of 33 patients with a unilateral calcaneal fracture and a minimum follow-up of 13 months participated. Patients filled in three disease-specific questionnaires, graded their satisfaction and the indication for an arthrodesis was noted. Standardised radiographs were made of the previously injured side and the normal (control) side. Different angles and distances were measured on these radiographs and compared with values described in the literature. The differences in values in angles and distances between the injured and uninjured (control) foot were correlated with the outcome of the questionnaires, and the indication for an arthrodesis. Results: None of the angles correlated with the disease-specific outcome scores. Of the angles only the tibiotalar angle correlated with the VAS (r=0.35, p=0.045) and only the absolute foot height correlated with the indication for an arthrodesis (odds=0.70, CI=0.50-0.99). Conclusion: In this study the radiographic evaluation correlated poorly with the final outcome. Measurements on plain radiographs seem not to be useful in determining outcome after intra-articular calcaneal fractures

Parents' assessment of parent-child interaction interventions – a longitudinal study in 101 families

<p>Abstract</p> <p>Background</p> <p>The aim of the study was to describe families with small children who participated in parent-child interaction interventions at four centres in Sweden, and to examine long term and short term changes regarding the parents' experience of parental stress, parental attachment patterns, the parents' mental health and life satisfaction, the parents' social support and the children's problems.</p> <p>Methods</p> <p>In this longitudinal study a consecutive sample of 101 families (94 mothers and 54 fathers) with 118 children (median age 3 years) was assessed, using self-reports, at the outset of the treatment (T1), six months later (T2) and 18 months after the beginning of treatment (T3). Analysis of the observed differences was carried out using Wilcoxon's Signed-Rank test and Cohen's d.</p> <p>Results</p> <p>The results from commencement of treatment showed that the parents had considerable problems in all areas examined. At the outset of treatment (T1) the mothers showed a higher level of problem load than the fathers on almost all scales. In the families where the children's problems have also been measured (children from the age of four) it appeared that they had problems of a nature and degree otherwise found in psychiatric populations. We found a clear general trend towards a positive development from T1 to T2 and this development was also reinforced from T2 to T3. Aggression in the child was one of the most common causes for contact. There were few undesired or unplanned interruptions of the treatment, and the attrition from the study was low.</p> <p>Conclusion</p> <p>This study has shown that it is possible to reach mothers as well as fathers with parenting problems and to create an intervention program with very low dropout levels – which is of special importance for families with small children displaying aggressive behaviour. The parents taking part in this study showed clear improvement trends after six months and this development was reinforced a year later. This study suggests the necessity of clinical development and future research concerning the role of fathers in parent-child interaction interventions.</p

X-RAY AND UV PHOTOELECTRON SPECTRA FROM OUTER ELECTRONS OF SOME RARE EARTHS

Les techniques de photoémission X (ESCA ou XPS) et de photoémission UV (UPS) ont été appliquées à l'étude des électrons 4 f dans des échantillons maintenus propres des terres rares suivantes : Nd, Sm, Eu, Gd, Dy, Er, Yb. Afin d'effectuer une comparaison, on a inclu Ba à cette étude. La méthode UPS donne une résolution supérieure tandis que la méthode XPS a l'avantage de permettre une exploration plus profonde en dessous du niveau de Fermi et l'étude des niveaux internes. La force d'oscillateur d'excitation des électrons 4 f est très petite pour les photons de basse énergie. Mais elle augmente rapidement avec l'énergie des photons ce qui rend la technique XPS très propice à l'étude de ces niveaux. Le spectre enregistré présente une forme simple pour les éléments dont la sous-couche 4 f est à demi-remplie (Eu, Gd) ou remplie (Yb) tandis que le spectre des autres éléments possède une structure plus compliquée et étendue. Ceci s'interprète par la séparation en multiplet du niveau final intervenant dans le processus de photoémission.The X-ray photoemission (ESCA or XPS) and the UV photoemission (UPS) techniques have been applied to the study of the 4 f electrons in clean samples of the following rare earths, Nd, Sm, Eu, Gd, Dy, Er, and Yb. For comparison the element Ba has also been included. The UPS method gives a higher resolution while the XPS method has the advantage of probing deeper below the Fermi level allowing also core levels to be studied. The oscillator strength for exciting 4 f electrons is very small for low photon energies. However, it increases rapidly with photon energy which makes the XPS technique very favourable to study these levels. The recorded spectra show a simple shape for elements with a half-filled (Eu, Gd) or filled (Yb) 4 f subshell while the spectra for the other elements exhibit a more complicated and extended structure. An interpretation of this is given in terms of multiplet splitting of the final state involved in the photoemission process

Management of Waste from the International Tokamak Experimental Reactor and from future fusion power plants

An important inherent advantage of fusion would be the total absence of high-level radioactive spent fuel as produced in fission reactors. Fusion will, however, produce activated material containing both activation products and tritium. Part of the material may also contain chemically toxic substances. This paper describes methods that could be used to manage these materials and also methods to reduce or entirely eliminate the waste quantities. The results are based on studies for the International Thermonuclear Experimental Reactor (ITER) and also for future fusion power station designs currently under investigation within the European programme on the Safety and Environmental Assessment of fusion power, Long-term (SEAL)