Midwives' role in screening for antenatal depression and postnatal depression

This is an educational paper which aims to inform midwives of tools available to help them make appropriate provisional diagnosis of perinatal depression. A second aim of the paper is to increase midwives' awareness of the relatively newer diagnosis of antenatal depression (AND). Of additional clinical importance, midwives need to recognise that postnatal depression (PND) may be a continuation of AND. To date, screening for AND has received relatively little attention compared with PND, with the evidence-base supporting that the impact can be as severe. It is important for midwives to know that screening for AND can be undertaken using valid and reliable psychometric self-report depression screening questionnaires which have known validity characteristics and threshold cut-off scores. There are several of these tools available to help midwives make the decision about whether or not to refer the women to the mental health team. Current practice in the UK involves the midwife asking an initial short two-item ‘Whooley Question’ screen which, if indicates depression, can be followed up by the women completing a self-report depression screening questionnaire. To highlight their availability, a selection of valid and reliable psychometric self-report depression screening questionnaires are discussed herein, with it being important for midwives to develop a toolkit that can be given to women at clinics, in pamphlets, online or embedded into mobile applications

Reflective evaluations of perinatal bereavement care provision in the US and UK: an exploratory qualitative comparative study

There is increased recognition of the need to improve standards of perinatal bereavement care, due to its frequency and potential sequelae. As part of a Fulbright Scholar award, United States (US) and United Kingdom (UK) researchers collaborated to explore similarities and differences in perinatal bereavement care between two nations. Using an explorative qualitative comparative method, key categories within perinatal bereavement provision were identified and analysed. Themed findings include: (1) Differences in definitions of miscarriage and stillbirth impact care pathways; (2) For the experiencer grief is the same regardless of legal lines drawn; (3) The meaning of loss is personal and ‘fetal personhood’ needs to be acknowledged during care; (4) Appropriate psychological care is required whether miscarriage or stillbirth is experienced. We conclude that perinatal bereavement care should include screening for Postnatal Depression (PND) and Post-Traumatic-Stress-Disorder (PTSD), and support should be equally available to all women who experience perinatal bereavement, irrespective of type of loss. Acknowledging that cultures react to loss in different ways, we recommend that strategies are developed to build human resilience. For example, Compassionate-Mind-Training (CMT), which helps people cope with trauma through cultivating compassion and teaching self-care strategies to build resilience, reduce self-criticism, and decrease threat-based emotions

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead