What are we measuring and why? Using theory to guide perinatal research and measurement

Background: A theory is a set of ideas that attempt to explain phenomena and can provide guiding principles on which to base practice. Many theories from biological and social sciences are relevant to women’s health and wellbeing during pregnancy and after birth, yet theory is not commonly explicitly reported in perinatal research. Method: This paper outlines the importance of theory to perinatal research and provides a pragmatic overview of when and how to use theory in research. In particular, we consider (i) deciding when it is appropriate to use theory, (ii) choosing which theory to use and (iii) how to operationalise theory in research. We give examples that illustrate how four different theories have been used in perinatal research to increase understanding and inform the development of interventions. Conclusion: Even when it is not appropriate to use theory in our research, careful consideration of pertinent theories contributes to greater clarity of concepts and understanding of different explanations or perspectives on what we are studying. It also prompts us to consider where our research fits in terms of contribution to knowledge or the development and evaluation of treatments. However, it is important that a critical approach is taken so that theories continue to be developed. In this way we will systematically advance our understanding of general factors or processes that are relevant to perinatal health, as well as those factors that are unique to perinatal health

On the Utility of the Molecular Oxygen Dayglow Emissions as Proxies for Middle Atmospheric Ozone

Molecular oxygen dayglow emissions arise in part from processes related to the Hartley band photolysis of ozone. It is therefore possible to derive daytime ozone concentrations from measurements of the volume emission rate of either dayglow. The accuracy to which the ozone concentration can be inferred depends on the accuracy to which numerous kinetic and spectroscopic rate constants are known, including rates which describe the excitation of molecular oxygen by processes that are not related to the ozone concentration. We find that several key rate constants must be known to better than 7 percent accuracy in order to achieve an inferred ozone concentration accurate to 15 percent from measurements of either dayglow. Currently, accuracies for various parameters typically range from 5 to 100 percent

Supporting women with postpartum anxiety: exploring views and experiences of specialist community public health nurses in the UK

Anxiety is common among postpartum women and can have adverse effects on mother's and child's somatic and psychological health if left untreated. In the UK, nurses or midwifes with a specialisation in community public health nursing, also called health visitors (HVs), work with families who have children younger than 5 years of age and are therefore in a key position to identify and support women with postpartum mental health issues. Until recently, postpartum mental health support provided by HVs mainly focused on identifying and managing depression, but the updated clinical guidance by the National Institute for Health and Care Excellence also includes guidance regarding screening and psychological interventions for perinatal anxiety. This study therefore aimed to explore HVs' experiences of supporting women with postpartum anxiety and their views on currently available care. Using a qualitative approach, in-depth semi-structured interviews were conducted with 13 HVs from the UK between May and October 2015. Participants were interviewed in person at their workplace or on the phone/Skype. Using thematic analysis, four main themes emerged: identification and screening issues; importance of training; service usage; and status of current service provision. Women with postpartum anxiety were commonly encountered by HVs in their clinical practice and described as often heavily using their or other related healthcare services, which puts additional strain on HVs' already heavy workload. Issues with identifying and screening for postpartum anxiety were raised and the current lack of perinatal mental health training for HVs was highlighted. In addition, HVs described a current lack of good perinatal mental health services in general and specifically for anxiety. The study highlights the need for HV perinatal mental health training in general and postpartum anxiety specifically, as well as better coverage of specialist mental health services and the need for development of interventions targeted at postpartum anxiety

Interest in web-based treatments for postpartum anxiety: an exploratory survey

Objective: This study aimed to explore women’s interest in web-based treatments for postpartum anxiety and determine the feasibility of reaching women with postpartum anxiety online. Background: Anxiety in the postpartum period is common and often untreated. One innovative approach of offering treatment during this period is through web-based self-help. Assessing women’s interest in new treatments, such as a web-based self-help, is an important step prior to development efforts. Methods: A cross-sectional online survey was created and promoted for 4 months via unpaid social media posts (Facebook and Twitter). To be eligible, women had to be over the age of 18, live in England, fluent in English, be within 12 months postpartum and self-report at least mild levels of anxiety. Results: A sample of 114 eligible women were recruited. The majority were Caucasian, well-educated, middle-class women. Seventy percent reported moderate or severe anxiety. Sixty-one percent of women expressed interest in web-based postpartum anxiety treatments. Women preferred treatment in a smartphone/tablet application format, presented in brief modules and supported by a therapist via email or chat/instant messaging. Conclusions: Based on the stated preferences of participating women it is recommended that postpartum anxiety web-based treatments include different forms of therapist support and use a flexibly accessible smartphone/tablet application format with content split into short sections. The findings also suggest that unpaid social media can be feasible in reaching women with postpartum anxiety, but additional efforts are needed to reach a more diverse population

Synergistic hemolysis-inhibition titers associated with caseous lymphadenitis in a slaughterhouse survey of goats and sheep in Northeastern Brazil.

Abstract: A survey of caseous lymphadenitis was conducted at a goat and sheep slaughterhouse in Northeastern Brazil One hundred and fifty-eight goats and 43 sheep were examined for the presence of abscesses, with bacterial culturing of purulent material to define the etiological agent. Blood was collected simultaneously for determination of serological titer via the synergistic hemolysis-inhibition test which measures antibodies to an exotoxin of Corynebacterium pseudotuberculosis. Thirteen and nine-tenths percent of the goats had abscesses, with a high proportion having mediastinal or pulmonary lesions (9.5%). Two sheep had abscesses, both with internal organ involvement. Corynebacterium pseudotuberculosis was the most frequently isolated organism. Of 22 goats with abscesses, 20 were positive via the synergistic hemolysis-inhibition test. Both of the sheep with abscesses had positive synergistic hemolysis-inhibition titers. The proportion of serological reactors was greater than the proportion of animals with abscesses. The synergistic hemolysis-inhibition test may be detecting subclinically infected animals

Bump start needed: linking guidelines, policy and practice in promoting physical activity during and beyond pregnancy

First paragraph: There is compelling evidence that regular physical activity (PA) during pregnancy benefits both mother and baby.1 2 Notably, physical and psychological benefits are evident in the literature, such as marked reductions in the development of gestational diabetes and hypertensive disorders, alongside improvements in depressive symptoms and cardiorespiratory fitness.1 2 The evidence base has been reflected by recent policy initiatives, for example, in 2017 (relaunched in 2019), the UK‘s chief medical officers (CMOs) published PA guidelines for pregnant women, which made substantial strides in unifying and translating the evidence into recommendations.1 The CMO guidelines are aimed at supporting health professionals to provide consistent, evidence-based PA messages to women throughout pregnancy.1 Recently, the Chartered Institute for the Management of Sport and Physical Activity have updated their professional standards for working with antenatal and postnatal clients to align with these CMO guidelines.3 However, not all women have access to professionals with this level of expertise and training, potentially limiting the impact of the CMO guidelines

Think Pink! a Pink Sticker Alert System for Women with Psychological Distress or Vulnerability During Pregnancy

The importance of good clinical communication to women during pregnancy and birth is clear. Poor communication in labour is associated with general dissatisfaction, more complaints and a range of perinatal mental health problems including posttraumatic stress disorder (PTSD) and postnatal depression. To communicate effectively, maternity staff needs information about which women are vulnerable and require extra support. To address this, we implemented and evaluated a pink sticker communication system to alert midwifery and obstetric staff to potential psychological difficulties experienced by some women. Evaluation showed this system was viewed positively by women and midwifery staff. Audit of referrals to the perinatal psychology service during this period suggests no woman with a pink sticker developed birth trauma as a direct result of perceived poor care. In addition, the proportion of referrals to perinatal psychology for birth trauma significantly reduced during this period

Internet-based interventions for postpartum anxiety: exploring health visitors’ views

Objective: This study aimed to explore health visitors’ (HVs) views on the acceptability and potential implementation of internet-based postpartum anxiety interventions in their practice. Background: Internet-based self-help has been shown to be effective and acceptable for postpartum depression. Recently, an internet-based intervention has been developed for postpartum anxiety. Before implementing new anxiety interventions in postpartum care, it is important to determine the acceptability and ways of implementing such interventions. This study therefore explored HVs’ views on this, as they are the some of the key healthcare professionals supporting women postpartum. Methods: Semi-structured interviews were conducted with 13 HVs across the UK. Audio-recorded interviews were transcribed verbatim and analysed using thematic analysis. Results: Five themes emerged – suitability; benefits; concerns; importance of one-to-one support; implementation. Internet-based interventions were seen as suitable as an additional option for a sub-group of postpartum women. Identified benefits included increased availability of a treatment tool for postpartum anxiety and treatment anonymity and flexibility. Reported concerns were the women’s state of mind, decreased human and professional contact, as well as IT access and literacy and language skills. HVs considered the most feasible way to implement internet-based interventions would be to have flyers for HVs to include with other information provided after birth or to hand out and discuss during their visits. The need for sufficient evidence of treatment efficacy and appropriate training was highlighted. Conclusion: This study highlights the opportunities and challenges that need to be considered before implementing internet-based interventions for postpartum anxiety in the postpartum care