Care and self-reported outcomes of care experienced by women with mental health problems in pregnancy: findings from a national survey

Background mental health problems in pregnancy and the postnatal period are relatively common and, in pregnancy, are associated with an increase in adverse outcome. It is recommended that all women are asked about their emotional and mental health and offered treatment if appropriate. Objectives to describe the care received by women self-identifying with mental health problems in pregnancy, and to describe the effects of support, advice and treatment on outcomes in the postnatal period. Design this study used cross-sectional survey data collected in 2014 which described women's experience of maternity care. Setting England Participants a random sample of women who had a live birth in January 2014. Measurements the questionnaire asked about sociodemographic characteristics, whether women were asked about emotional and mental health in pregnancy, support and treatment offered, about postnatal wellbeing, and questions relating to attachment to their baby. Descriptive statistics and logistic regression were used to examine the associations between mental health and outcomes taking account of sociodemographic characteristics. Findings the survey response rate was 47%. Women with antenatal mental health problems were significantly more worried at the prospect of labour and birth, had lower satisfaction with the experience of birth, worse postnatal mental health, and indications of poorer attachment to their baby. They received substantially more care than other women but they did not always view this positively. Support, advice and treatment for mental health problems had mixed effects. Conclusions this study describes the significant additional care provided to women self-identifying with mental health problems in pregnancy, the mixed effects of support, advice and treatment, and the poor perception of staff interaction among women with mental health problems. Implications for practice health care professionals may need additional training to effectively support women with mental health problems during the perinatal period

Managing uncertainty for preventive conservation

This paper examines how conservators engage with uncertainty when creating preventive conservation strategies. It argues that by recognising contexts in which uncertainty will be encountered conservators can develop effective management strategies. A typology of uncertainty explores a range of categories of uncertainty, their experience in preventive conservation and identifies distinct approaches to manage them. Managing uncertainty may include acts of defining its parameters, exposing and resolving through communication or protecting from with contingency. Whatever approach is adopted it must be accepted that uncertainty cannot be avoided. It is important therefore to aim to live well with uncertainty and the paper advocates for preventive conservation applications of strategies recommended in health care for patients with life-threatening illnesses. These strategies include working on things that can be controlled, goal setting, acceptance and factoring in emotions. The ability to identify contexts in which uncertainty is inbuilt should trigger those concerned with preventive conservation to activate strategies developed for managing and living well with uncertaint

New skills new influence.

Conservators and those charged with responsibility for collections care are often required to try to change the way that most people in their institutions work and think. Yet conservators are often seen as poor communicators. This paper argues that this can change and identifies one feature of communication science, persuasion, that can be studied and learnt by conservators to increase their positive influence within the organisations in which they work

Reflections on the psychological basis for suboptimal environmental practices in conservation

Jonathan Ashley-Smith's ‘Let's be Honest’ presentation and paper from the 1994 International Institute for Conservation (IIC) conference on preventive conservation is the starting point for this article which considers the evolution of environmental standards to ask whether it is technological or psychological factors that have initiated their greatest change. It examines the implications of categorising types of damage for decision-making and asks whether understanding damage as a process rather than an outcome contributes to a cautionary approach to environmental standards in conservation. The article considers the possible psychological justifications used by those advocating standards for collections and asks whether these may lead to behaviour which is ineffective or ethically compromised. Challenging questions are then asked of the profession about what it cannot do, does not understand, and where it fails. The article concludes that although conservation has made progress in understanding materials and their properties to inform the implementation of environmental standards, it has made significantly less progress in understanding how and why decision-makers introduce and apply standards

Influence: the impact of language, credibility and gender

Psychology and communication studies can help conservators to examine the impact of gender, the expectations of others and the components of credibility. A small selections of theories from psychology are used to analyse the way that people expect others to communicate and the impact on situations where expectations are breached. The research suggests that conservators can improve their persuasiveness by increasing their understanding of the views of those that they try to influence. In addition the conservator can critically assess their own behaviour and consider if it is likely to have a positive or negative outcome. Being aware of some of the issues that affect persuasiveness allows the conservator to analyse puzzling responses and gives them the opportunity, if they choose it, to adapt their image or style

University teaching in the development of conservation professionals

The teaching of students entering conservation is a foundation of the development of a profession of people who are sufficiently dedicated, knowledgeable and skilled to take the necessary actions to protect cultural heritage. This paper considers the way that society expresses value of cultural heritage and how that need is expressed and communicated to University students via the profession and their teachers. It will look at some approaches to teaching and assessment within UK Universities considering the learning outcomes for students and how educators strive to ensure that their graduates are fit for the profession which they will enter. The paper will consider the need for developing expertise and the connection between professionals at the start of their career with those that have achieved excellence via years of informed practice. The critical and challenging role of identifying and acting on valid feedback to conservation outcomes will be discussed with a view to creating a discipline of reflective practitioners