Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms

Background: Many women experience childbirth as traumatic and 2% develop post-traumatic stress disorder (PTSD). This study examined the role of health practitioner support and personal control during birth as predictors of PTS symptoms, adjusting for vulnerability factors of prior trauma, depression, control beliefs and birth intervention. It also investigated interactions between support, prior trauma and birth intervention and their association with PTS symptoms. Methods: A prospective longitudinal survey of 138 women recruited from UK NHS maternity clinics. Measures were taken in pregnancy, three-weeks and three-months after the birth. Results: Support and control during birth were not predictive of postnatal PTS symptoms. However, support was predictive of PTS symptoms in a subset of women with prior trauma (beta = -.41, R2 = 16%) at both three-weeks and three-months postpartum. The interaction of birth intervention and support was associated with PTS symptoms three-months after birth, the relationship between support and PTS symptoms was stronger in women experiencing more intervention. Conclusions: Low support from health practitioners is predictive of postnatal PTS symptoms in women who have a history of trauma. Longer-term effects of low support on postnatal PTS symptoms are also found in women who had more intervention during birth

A single-board preprocessor and pulse generator

The Aeronomy Lab. of NOAA has designed and built a single board, programmable radar controller for use with VHF ST (stratosphere troposphere) radars. The controller consists of a coherent integrator preprocessor and a radar pulse generator, both of which are described, as well as interfaces to an antenna beam switch and a receiver bandwidth switch. The controller occupies a single slot in a Data General Nova of Eclipse computer. The integrator and pulse generator take advantage of high density, dual port FIFO chips such as the 512 x 9 Mostek MK 4501. These FIFOs have separate input and output ports and independent read and write cycles with cycle times of less than 200 ns, making them very fast and easy to interface. A simple block diagram of the coherent integrator is shown. The integrator is designed to handle inputs from one receiver (2 channels) with 1 sec sample spacing. The pulse generator is based on controllers designed by R. F. Woodman for the Arecibo and SOUSY radars us a recirculating memory scheme

Haze in the Klang Valley of Malaysia

Continuous measurements of dry aerosol light scattering (Bsp) were made at two sites in the Klang Valley of Malaysia between December 1998 and December 2000. In addition 24-h PM2.5 samples were collected on a one-day-in-six cycle and the chemical composition of the aerosol was determined. Periods of excessive haze were defined as 24-h average Bsp values greater than 150 Mm-1 and these occurred on a number of occasions, between May and September 1999, during May 2000, and between July and September 2000. The evidence for smoke being a significant contributor to aerosol during periods of excessive haze is discussed and includes features of the aerosol chemistry, the diurnal cycle of Bsp, and the coincidence of forest fires on Sumatra during the southwest (SW) monsoon period, as well as transport modelling for one week of the southwest Monsoon of 2000. The study highlights that whilst transboundary smoke is a major contributor to poor visibility in the Klang Valley, smoke from fires on Peninsular Malaysia is also a contributor, and at all times, the domestic source of secondary particle production is present

The City MISS: development of a scale to measure stigma of perinatal mental illness

Objective: This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. Background: Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. Method: A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. Results: The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. Conclusion: The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness

A Consistent Reduced Network for HCN Chemistry in Early Earth and Titan Atmospheres: Quantum Calculations of Reaction Rate Coefficients

HCN is a key ingredient for synthesizing biomolecules such as nucleobases and amino acids. We calculate 42 reaction rate coefficients directly involved with or in competition with the production of HCN in the early Earth or Titan atmospheres. These reactions are driven by methane and nitrogen radicals produced via UV photodissociation or lightning. For every reaction in this network, we calculate rate coefficients at 298 K using canonical variational transition state theory (CVT) paired with computational quantum chemistry simulations at the BHandHLYP/augcc-pVDZ level of theory. We also calculate the temperature dependence of the rate coefficients for the reactions that have barriers from 50 to 400 K. We present 15 new reaction rate coefficients with no previously known value; 93% of our calculated coefficients are within an order of magnitude of the nearest experimental or recommended values. Above 320 K, the rate coefficient for the new reaction H2CN -> HCN + H dominates. Contrary to experiments, we find the HCN reaction pathway, N + CH3 -> HCN + H2, to be inefficient and suggest that the experimental rate coefficient actually corresponds to an indirect pathway, through the H2CN intermediate. We present CVT using energies computed with density functional theory as a feasible and accurate method for calculating a large network of rate coefficients of small-molecule reactions.Comment: 34 pages, 8 figures, 14 tables, accepted for publication in J Phys Chem

How women with high risk pregnancies use lay information when considering place of birth: A qualitative study

INTRODUCTION: Where to give birth is a key decision in pregnancy. Women use information from family, friends and other sources besides healthcare professionals when contemplating this decision. This study explored women's use of lay information during high risk pregnancies in order to examine differences and similarities in the use of information in relation to planned place of birth. Half the participants were planning hospital births and half were planning to give birth at home. METHODS: A qualitative study using semi-structured interviews set in a hospital maternity department in South East England. Twenty-six participants with high risk pregnancies, at least 32 weeks pregnant. Results were analysed using thematic analysis. RESULTS: Three themes emerged: approaches to research - how much information women chose to seek out and from which sources; selection of sources - how women decided which sources they considered reliable; and unhelpful research - information they considered unhelpful. Women planning homebirths undertook more research than women planning to give birth in hospital and were more likely to seek out alternative sources of information. Women from both groups referred to deliberately seeking out sources of information which reflected their own values and so did not challenge their decisions. CONCLUSIONS: There are similarities and differences in the use of lay information between women who plan to give birth in hospital and those who plan homebirths. Professionals working with women with high risk pregnancies should consider these factors when interacting with these women

Pregnancy related risk perception in pregnant women, midwives & doctors: a cross-sectional survey

Background: Risk perception in relation to pregnancy and birth is a complex process influenced by multiple personal, psychological and societal factors. Traditionally, the risk perception of healthcare professionals has been presented as more objective and authoritative than that of pregnant women. Doctors have been presented as more concerned with biomedical risk than midwives. Such dichotomies oversimplify and obscure the complexity of the process. This study examines pregnancy-related risk perception in women and healthcare professionals, and what women and professionals believe about each other’s risk perception. Methods: A cross sectional survey of set in UK maternity services. Participants were doctors working in obstetrics (N = 53), midwives (N = 59), pregnant women (N = 68). Participants were recruited in person from two hospitals. Doctors were also recruited online. Participants completed a questionnaire measuring the degree of perceived risk in various childbirth-related scenarios; and the extent to which they believed others agreed with them about the degree of risk generally involved in childbirth. Main outcome measures were the degree of risk perceived to the mother in baby in pregnancy scenarios, and beliefs about own perception of risk in comparison to their own group and other groups. Results: There were significant differences in total risk scores between pregnant women, doctors and midwives in perception of risk to the mother in 68/80 scenarios. Doctors most frequently rated risks lowest. Total scores for perceived risk to the baby were not significantly different. There was substantial variation within each group. There was more agreement on the ranking of scenarios according to risk. Each group believed doctors perceived most risk whereas actually doctors most frequently rated risks lowest. Each group incorrectly believed their peers rated risk similarly to themselves. Conclusions: Individuals cannot assume others share their perception of risk or that they make correct assessments regarding others’ risk perception. Further research should consider what factors are taken into account when making risk assessments

Can self-affirmation exacerbate adverse reactions to stress under certain conditions?

OBJECTIVE: Self-affirmation has repeatedly been shown to reduce adverse psychological and physiological responses to stress. However, it is plausible that self-affirmation could exacerbate negative reactions to stress under certain conditions. The current research explored whether self-affirmation would increase negative psychological responses to a stressor occurring in a central life domain characterised by low levels of control. DESIGN: Female participants (Study 1 N = 132; Study 2 N = 141) completed baseline measures of anxiety and mood. They were then randomly allocated to complete a self-affirmation or control task, before reading a narrative documenting a stressful birth and imagining themselves in the place of the woman giving birth. After completing this task, participants again reported their levels of anxiety and positive mood. MAIN OUTCOME MEASURES: Anxiety and positive mood assessed at follow-up. RESULTS: Study 1 demonstrated that self-affirmed women experienced increased anxiety and less positive mood at follow-up, compared both to baseline and to women in the control condition. Study 2 revealed that the effect of self-affirmation on outcomes was moderated by fear of childbirth. CONCLUSION: These results provide preliminary evidence that self-affirmation may worsen negative responses to stressors under certain conditions and for certain individuals

Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study

Objective: To examine the perception of risk among a group of women with high risk pregnancies who were either planning to give birth in hospital, or at home despite medical advice to the contrary. The intention was to consider differences and similarities between the groups to examine how perception of risk relates to choice of place of birth. Design: Qualitative study using semi-structured interviews. Setting Maternity department in a hospital in South East England. Participants Twenty-six women with high risk pregnancies, at least 32 weeks pregnant. Half were planning hospital births and half homebirths. Measurements and findings: Semi-structured interviews to investigate women's understanding and assessment of risk. Results were analysed using thematic analysis. Five themes emerged: understanding of situation; judgement of risk; reassuring factors; impact of risk; and coping with risk. Women from both groups had some understanding of the implications of their medical/obstetric conditions. They displayed concerns about their babies' wellbeing. Women planning homebirths assessed their risks as lower and expressed less concerns than women planning hospital births. Women planning hospital births more frequently described following professional advice. Key conclusions: Risk perception is individual and subjective. Women with high risk pregnancies who plan to give birth at home perceive risk differently to women who plan hospital births. Implications for practice: Healthcare professionals working with women with high risk pregnancies should be aware of the potential for differences in definitions and perceptions of risk within this group

A Thematic Analysis of Stigma and Disclosure for Perinatal Depression on an Online Forum.

BACKGROUND: Perinatal mental illness is a global health concern; however, many women do not get the treatment they need to recover. Some women choose not to seek professional help and get no treatment because they feel stigmatized. Online forums for various health conditions, including perinatal mental health, can be beneficial for members. Little is known about the role that online forums for perinatal mental illness play in reducing stigma and subsequent disclosure of symptoms to health care providers and treatment uptake. OBJECTIVE: This study aimed to examine stigma and disclosure in forums and describe any potential disadvantages of forum use. METHODS: An online forum for mothers was examined and 1546 messages extracted from 102 threads from the antenatal and postnatal depression section. These messages were subjected to deductive systematic thematic analysis to identify common themes regarding stigma and disclosure of symptoms and potential disadvantages of forum use. RESULTS: Two major themes were identified: stigma and negative experiences of disclosure. Stigma had 3 subthemes: internal stigma, external stigma, and treatment stigma. Many women were concerned about feeling like a "bad" or "failed" mother and worried that if they disclosed their symptoms to a health care provider they would be stigmatized. Posts in response to this frequently encouraged women to disclose their symptoms to health care providers and accept professional treatment. Forum discourse reconstructed the ideology of motherhood as compatible with perinatal mental illness, especially if the woman sought help and adhered to treatment. Many women overcame stigma and replied that they had taken advice and disclosed to a health care provider and/or taken treatment. CONCLUSIONS: Forum use may increase women's disclosure to health care providers by challenging their internal and external stigma and this may strengthen professional treatment uptake and adherence. However, a few posts described negative experiences when disclosing to health care providers