Midwifery students in health visitor placements: the importance of student-mentor relationships

OBJECTIVE: The aim of this study was to explore midwifery students and health visitor practice mentors experiences of a health visiting placement for midwifery students, focusing on the student-mentor relationship. DESIGN: Interview study SETTING: East London, United Kingdom PARTICIPANTS: Eighteen students and eighteen mentors were invited to take part in an interview. Ten midwifery students (55.5%) and fifteen health visitor practice mentors (83.3%) took part in interviews or provided information via email. Thematic analysis was used to analyse findings. FINDINGS: The main study finding was that students reported valuing practice mentors who took the time to get to know them, were welcoming and enthusiastic and planned their time in advance. The mentors in turn spoke highly of the students who were keen and enthusiastic about the placement, but noted that not all students had appeared interested. KEY CONCLUSIONS: The findings from this small interview study show that taking time to make the students feel welcome was important to facilitate a student-mentor relationship. Another important factor in whether a student enjoyed their placement was the mentors' advance planning

Midwifery students' experiences in a health visiting placement: An interview study

In the UK, there is a clear remit for midwives and health visitors to work collaboratively to care for pregnant women and new mothers. This study evaluated a clinical placement for midwifery students with health visitor mentors. The evaluation explored the experience of mentors and students during the placement, the effect on their understanding of the different roles and the potential effect on collaborative working in the future. Results indicated that students developed their knowledge of the health visitor role and learned transferable skills to take back to midwifery. They saw little collaborative practice, but identified ways to incorporate interprofessional working into their practice once qualified. Mentors were positive about sharing health visiting practice and the potential impact on relationships in the future

Women’s views on contact with a health visitor during pregnancy: an interview study

Aim: To explore recent mothers’ views of the health visiting antenatal contact in England. Background: English health visitors are mandated to be in contact with all women in the third trimester of pregnancy. The aim of this antenatal contact is to assess the needs of the family before the birth and support preparation for parenthood. Recent data show that this contact is provided fragmentarily and not always face-to-face. More information on how women view this contact could inform service provision. Methods: Twenty-nine mothers with a baby less than 1 year old were recruited via social media and word of mouth. Having had antenatal contact with a health visitor was not a requirement to participate in the study. Women took part in face-to-face or phone interviews and all recordings were transcribed verbatim. Data were analysed using systematic thematic analysis. Findings: Eleven women had contact with a health visitor during pregnancy: nine through a home visit, one via a letter and one via a phone call. The remaining 18 women were asked about what they would have wanted from an antenatal contact. Three themes were identified: relationship building, information provision, and mode and time of contact. Some participants who had experienced a home visit reported building rapport with their health visitor before the postnatal period, but not everyone had this experience. Women reported requesting and receiving information about the health visiting service and the role of the health visitor. Finally, women suggested different modes of contact, suggesting a letter or that the information about health visiting could be provided by a midwife. A few women preferred a home visit. These study findings show women were unclear regarding the aim of the health visitor antenatal contact. As such, the contact is unlikely to reach its full potential in supporting parents-to-be

Thermodynamics of the Volatilization of Actinind metals in the High-Temperature Treatment of Radioactive Wastes

We are performing a detailed study of the volatilization behavior of U, Pu and possibly Am and Np under conditions relevant to the thermal treatment (destruction) of actinide containing organic-based mixed and radioactive wastes. The primary scientific goal of the work is to develop a basic thermochemical understanding of actinide volatilization and partitioning/speciation behavior in the thermal processes that are central to DOE/EM's mixed waste treatment program. This subject addresses at least two key technical needs/problem areas recently identified by DOE/EM's Office of Science & Technology: emission-free destruction of organic wastes, and interactions between actinides and organic residues in materials stabilization. A sound basis for designing safe and effective treatment systems, and the ability to allay public concerns about radioactive fugitive emissions, will be the principal benefits of the project. The proposed work is a combination of experimental studies and thermodynamic modeling. Vapor pressure measurements will be made to determine U, Pu and possibly Am volatile species and the extent of their volatilization when UO2/U3O8, PuO2 and AmO2 solids are heated to temperatures of 500 to1200 C under pyrolyzing (reducing) conditions or under oxidizing conditions in the presence of chlorine. Work on uranium volatilization under reducing conditions is being performed in a laboratory at UC Berkeley in a collaboration with Professor D.R. Olander. In parallel with the experimental effort, a complete thermodynamic database for expected actinide gaseous species will be developed from literature data, from the proposed measurements, and from data predictions using bond energy correlation and statistical thermodynamics estimation methods

Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

Objectives Both excessive and restricted fetal growth are associated with changes in cardiac geometry and function at birth. There are significant issues when indexing cardiac parameters for body size in the neonatal period. The aims of this study were to determine to what extent cardiac geometry is dependent on body size in term and preterm neonates with restricted or excessive fetal growth and how this is affected by adiposity. Methods This was a cross-sectional study of neonates born between 31 and 42 weeks of gestation, divided into three groups: (1) small-for-gestational age (SGA, birth weight > 2 SD below the mean); (2) large-for-gestational age (LGA, birth weight > 2 SD above the mean); and (3) appropriate-for-gestational-age controls (AGA, birth weight Results In total, 174 neonates were included, of which 39 were SGA, 45 were LGA and 90 were AGA. Body size was reflected in cardiac dimensions, with differences in cardiac dimensions disappearing between the SGA and AGA groups when indexed for body surface area (BSA) or thoracic circumference. The same was true for the differences in atrial and ventricular areas between the LGA and AGA groups. However, left ventricular inflow and outflow tract dimensions did not follow this trend as, when indexed for BSA, they were associated negatively with adiposity, resulting in diminished dimensions in LGA compared with AGA and SGA neonates. Adiposity was associated positively with left ventricular mass, right ventricular length and area and right atrial area. The SGA group showed increased right ventricular fractional area change, possibly reflecting differences in the systolic function of the right ventricle. We found evidence of altered diastolic function between the groups, with the mitral valve inflow E-to lateral E'-wave peak velocity ratio being increased in the LGA group and decreased in the SGA group. Conclusions Cardiac geometry is explained by body size in both term and preterm AGA and SGA infants. However, the nature of the relationship between body size and cardiac dimensions may be influenced by adiposity in LGA infants, leading to underestimation of left ventricular inflow and outflow tract dimensions when adjusted for BSA. Adjustments for thoracic circumference provide similar results to those for BSA. Copyright (C) 2020 ISUOG. Published by John Wiley & Sons Ltd.Peer reviewe

Three perspectives on the co-location of maternity services: qualitative interviews with mothers, midwives and health visitors

Maternity policy in England has recommended the establishment of Community Hubs, where health-care professionals who care for women during and after pregnancy are co-located and can provide care collaboratively. The aim this paper is to explore midwives,’ health visitors’ and postnatal women’s experiences and views of co-location of midwifery and health visiting services and collaborative practice. In total 15 midwives, 17 health visitors, and 29 mothers participated in a semi-structured interview, either via phone or face-to-face. Transcripts were analyzed thematically. Participants reported how care is currently provided in numerous settings, with home visits especially well liked. Co-location was perceived to be of benefit, however some mothers were not convinced of its necessity, suggesting that integrated services are more important than co-located services. Health-care professionals recognized that co-location aids but does not automatically improve interprofessional collaboration. These findings highlight the need for careful consideration before implementing co-located maternity services. Community Hubs may be apromising strategy to improve care for women and their families but to provide interprofessional care and collaboration appropriate managerial and organizational support is needed. With this support, midwives and health visitors have the potential to deliver the best care possible for women and their families

The Great Round Table: Writing The Land

Transcript from discussion at Olivieri bookstore in Montreal on June 1, 2018. Louis-Karl Picard-Sioui moderated the discussion. Isabelle Courteau, Director of La Maison de la Poésie de Montréal, provided an introduction. Translated by Peter Schulman

Women's views of continuity of information provided during and after pregnancy: A qualitative interview study

Straightforward transfer of care from pregnancy to the postpartum period is associated with health benefits and is desired by women worldwide. Underpinning this transfer of care is the sharing of information between healthcare professionals and the provision of consistent information to women. In this qualitative study, two aspects of continuity of information were examined; first the information passed on from midwife to health visitor regarding a woman and her baby before the health visitor meets the woman postnatally and second, the consistency of information received by women from these two healthcare professionals (the main healthcare providers during and after pregnancy in England). To be eligible for the study, women had to have had a baby in England within 12 months prior to the interview. Participants also needed to be able to read and speak English and be over 18 years old. Recruitment of participants was via word of mouth and social media. Twenty-nine mothers were interviewed of whom 19 were first time mothers. The interviews took place in the summer and autumn of 2016 and were transcribed verbatim and analysed using Framework Analysis. Two overarching themes were identified: not feeling listened to and information inconsistencies. Women reported little experience of midwives and health visitors sharing information about their care, forcing women to repeat information. This made women feel not listened to and participants recommended that healthcare professionals share information; prioritising information about labour, mental health, and chronic conditions. Women had mixed experiences regarding receiving information from midwives and health visitors, with examples of both consistent and inconsistent information received. To avoid inconsistent information, joint appointments were recommended. Findings from this study clearly suggest that better communication pathways need to be developed and effectively implemented for midwives and health visitors to improve the care that they provide to women

Qualitative exploration of health professionals' experiences of communicating positive newborn bloodspot screening results for nine conditions in England.

OBJECTIVE: To explore health professionals' experiences of communicating positive newborn bloodspot screening (NBS) results, highlight differences, share good practice and make recommendations for future research. DESIGN: Qualitative exploratory design was employed using semi-structured interviews SETTING: Three National Health Service provider organisations in England PARTICIPANTS: Seventeen health professionals involved in communicating positive newborn bloodspot screening results to parents for all nine conditions currently included in the newborn bloodspot screening programme in England. RESULTS: Findings indicated variation in approaches to communicating positive newborn bloodspot screening results to parents, largely influenced by resources available and the lack of clear guidance. Health professionals emphasised the importance of communicating results to families in a way that is sensitive to their needs. However, many challenges hindered communication including logistical considerations; difficulty contacting the family and other health professionals; language barriers; parental reactions; resource considerations; lack of training; and insufficient time. CONCLUSION: Health professionals invest a lot of time and energy trying to ensure communication of positive newborn bloodspot screening results to families is done well. However, there continues to be great variation in the way these results are communicated to parents and this is largely influenced by resources available but also the lack of concrete guidance. How best to support health professionals undertaking this challenging and emotive task requires further exploration. We recommend evaluation of a more cohesive approach that meets the needs of parents and staff while being sensitive to the subtleties of each condition. TRIAL REGISTRATION NUMBER: ISRCTN15330120