Professional issues in maternal mental health scale (PIMMHS): The development and initial validation of a brief and valid measure

Introduction:The life-threatening consequences of perinatal mental health problems (PMHP) are well documented. Midwives are ideally placed to effectively identify women at risk and facilitate early intervention. However, a multitude of factors contribute to failure in recognition and treatment. It would be of value for service providers to be able to identify key professional issues in their own context. The present study sought to develop and evaluate a ‘professional issues in maternal mental health’ scale (PIMMHS), explore its psychometric properties and potential application.Methods:A cross-sectional design and instrument evaluation approach was taken to investigate the psychometric properties of the PIMMHS. A total of 266 student midwives from 10 UK institutions completed the PIMMHS via Survey Monkey.Results:PIMMHS comprises two sub-scales of emotion/communication (PIMMHSEmotion sub-scale) and training (PIMMHS-Training sub-scale). Both PIMMHS subscales demonstrate adequate divergent and convergent validity. Sub-optimal internal consistency was observed for the training sub-scale, however, the PIMMHS-Training had a more impressive effect size in terms of known-groups discriminant validity compared to PIMMHS-Emotion.Conclusions:The PIMMHS appears to be a sound psychometric instrument for assessing professional issues that influence the practice of student midwives in PMH. The PIMMHS could support education providers to identify areas for curriculum development, as well as maternity services in proactive assessment of service provision, to identify training and service development opportunities

The development and initial validation of the Perinatal Mental Health Awareness scale in student midwives

Background & aim: Perinatal mental health problems have been demonstrated to impact upon maternal, and fetal/child outcomes. Despite the global evidence and a policy-driven responsibility for identification of these problems, research demonstrates that student midwives/midwives lack knowledge and confidence to assess, identify, and manage them. A similar context is evident for learning disabilities, despite the holistic care philosophy of midwifery. A brief assessment tool to identify knowledge and confidence defecits and strengths within a holistic care framework could support curriculum development. This study sought to develop a Perinatal Mental Health Awareness scale and evaluate its psychometric properties in student midwives.Methods: We employed a cross-sectional and exploratory instrument development and evaluation design to determine the measurement veracity of the new scale.Results: The scale demonstrated good psychometric properties, revealing three subscales mapping onto (i) mental health symptoms, (ii) physical/medical issues and (iii) learning disability. Results indicated a clear differentiation in scores across the subscales, indicating comparative deficits in mental health domains.Conclusion: Our findings facilitate confidence in the psychometric robustness of the measure. The scale enables student midwives to assess and compare different domains of midwifery practice, in line with a holistic model of midwifery care. A focus on physical health in midwifery education appears to disadvantage knowledge and confidence for managing mental health problems in a midwifery context. This valuable finding highlights the potential need for curriculum rebalancing. The measure offers the opportunity to assess and develop curriculum/training provision and monitor the effectiveness of subsequent curricular developments

Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context

© 2016 Jefford et al. Background: The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. Method: A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Findings: Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general midwifery practice'. Conclusion: EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous

Local Food Marketing as a Development Opportunity for Small UK Agri-Food Businesses

Local Food Marketing as a Development Opportunity for Small UK Agri-Food Businesseslocal food, marketing, small-business development, UK, Agribusiness, Agricultural and Food Policy, Farm Management, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Production Economics, Risk and Uncertainty,

Admission to psychiatric hospital for mental illnesses 2 years prechildbirth and postchildbirth in Scotland: a health informatics approach to assessing mother and child outcomes

Objective: To identify factors associated with: admission to a specialist mother and baby unit (MBU) and the impact of perinatal mental illness on early childhood development using a data linkage approach in the 2 years prechildbirth and postchildbirth. Methods: Scottish maternity records (SMR02) were linked to psychiatric hospital admissions (SMR04). 3290 pregnancy-related psychiatric admissions for 1730 women were assessed. To investigate factors associated with MBU admission, the group of mothers admitted to an MBU were compared with those admitted to general psychiatric wards. To assess the impact of perinatal mental illness on early child development, a pragmatic indicator for ‘at potential risk of adversity’, defined as a child who was recorded as requiring intensive treatment at any time under the health plan indicators (HPI) and/or who had no record of completing three doses of the 5-in-1 vaccine by 12 months was generated. Logistic regression models were used to describe the association between each variable and the risk of admission between those with a history of prior psychiatric admission and those without. Results Women admitted to an MBU were significantly more likely to be admitted with non-affective psychosis (OR=1.97, 95% CI 1.22 to 3.18), affective psychosis (OR=2.44, 95% CI 1.37 to 4.33) and non-psychotic depressive episodes (OR=1.93, 95% CI 1.42 to 2.63). They were less likely to come from deprived areas (OR=0.68 95% CI 0.49 to 0.93). Women with a previous history of psychiatric admission were significantly more likely to be located in the two most deprived quintiles. Almost one-third (29%) of children born to mothers with a pregnancy-related psychiatric admission were assessed as ‘at potential risk of adversity.’ Conclusions: A health informatics approach has potential for improving understanding of social and clinical factors, which contribute to the outcomes of perinatal mental illness, as well as potential adverse developmental outcomes for offspring

Investigating the effects of methanol on ammonia-oxidising archaea in marine sediment microcosms

Ammonia-oxidising archaea (AOA) are dominant in nutrient-scarce marine sediments and are important primary producers sustaining the activity of other microorganisms. They are also assumed to be globally important producers of vitamin B12, which is essential to all living organisms. Previous research has shown that AOA are inhibited by various organic compounds, including methanol. Therefore, we aimed to assess how AOA are affected by the presence of methanol in concentrations corresponding to treated wastewater. The aim was addressed by enriching AOA in marine sediments using a microcosm approach. Sediments enriched with AOA were thereafter exposed to methanol in concentrations simulating treated wastewater. The microbial activity was monitored by measuring the pH, ORP, and concentration of nitrogen species in the microcosms. Metabarcoding and qPCR were employed to assess the microbial diversity and metabolic potential in the microcosm sediments. To ensure proper targeting of archaeal DNA, a preliminary primer evaluation was carried out. We did observe signs of ammonia-oxidising activity, although we could not attribute it to AOA. While the relative abundance of AOA decreased in the presence of methanol, there were little signs of an absolute decrease in their abundance. Altogether, we did not observe a direct inhibition of AOA by methanol, possibly due to the initially low concentration of methanol. Unexpectedly, the main archaeal response to methanol was the enrichment of Methanosarciniales, which might have contributed to keeping the concentration of methanol at a minimum by converting it to methane. We conclude that the interplay between AOA and methane-producing archaea might be an interesting aspect for further investigation

Isthmus Zapotec vowel formants

This paper addresses several questions regarding the acoustic properties of Isthmus Zapotec vowels. Based on earlier recordings of a female, mother-tongue speaker of the language, average formant frequencies for each of the five phonemic vowels are determined for this speaker. I then look at differences in formant frequencies between stressed and unstressed modal vowels. Finally, I compare modal, laryngealized and checked productions of the vowels, to see if there are systematic differences between these three phonation types