Midwives' perceptions of being 'with woman': A phenomenological study

© 2019 The Author(s). Background: Being 'with woman' is a central construct of the midwifery profession however, minimal research has been undertaken to explore the phenomenon from the perspective of midwives. The aim of this study was to describe Western Australian midwives' perceptions of the phenomenon of being 'with woman' during the intrapartum period. Methods: Descriptive phenomenology was selected as the methodology for this study. Thirty one midwives working across a variety of care models participated in individual interviews. Giorgi's four stage phenomenological approach was employed to analyse data. Results: Three themes were extracted 1) Essential to professional identity; 2) Partnership with women; and 3) Woman-Centred Practice. Midwives described the importance of being 'with woman' to the work and identification of midwifery practice. Developing a connection with the woman and providing woman-centred care inclusive of the woman's support people was highlighted. Conclusions: For the first time, we are able to offer evidence of how midwives understand and perceive the phenomenon of being 'with woman' which has theoretical and practical utility. Findings from this study provide evidence that supports expert commentary and confirms that midwives conceptualise the phenomenon of being 'with woman' as essential to the identity and practice of the profession. Some previously identified 'good midwifery practices' were revealed as practical manifestations of the phenomenon. This new knowledge facilitates clarity and provides evidence to support statements of professional identity, which is useful for the development of educational curricula as well as supporting graduate and professional midwives. The findings emphasise the importance of the development of language around this important philosophical construct which permeates midwifery practice, enhances professional agency and supports the continued emphasis of being 'with woman' with new understanding of its applied practices in a variety of care models

Process description and evaluation of Canadian Physical Activity Guidelines development

<p>Abstract</p> <p>Background</p> <p>This paper describes the process used to arrive at recommended physical activity guidelines for Canadian school-aged children and youth (5-17 years), adults (18-64 years) and older adults (≥65 years).</p> <p>Methods</p> <p>The Canadian Society for Exercise Physiology (CSEP) Physical Activity Measurement and Guidelines (PAMG) Steering Committee used the Appraisal of Guidelines for Research Evaluation (AGREE II) Instrument to inform the guideline development process. Fourteen background papers and five systematic reviews were completed. Systematic review authors appraised and synthesized the data, and proposed specific recommendations at an international consensus conference of invited experts and key stakeholders. Independently, an international panel of experts interpreted the evidence from the systematic reviews and developed recommendations following attendance at the Consensus Conference.</p> <p>Results</p> <p>Using the AGREE II instrument as a guide, specific <it>foci </it>for each of the guidelines were defined and systematic review methodology was used to synthesize the evidence base. The expert panel, CSEP PAMG Steering Committee and methodological consultants reviewed the systematic reviews and Consensus Statement. The expert panel achieved consensus on the level of evidence informing the physical activity guidelines and developed a separate document outlining key recommendations, interpretation of the evidence and justification of each recommendation.</p> <p>Conclusion</p> <p>The CSEP and Public Health Agency of Canada followed a rigorous process to examine the evidence informing potential revisions to existing physical activity guidelines for Canadians. It is believed that this is the first physical activity guideline development process in the world to be guided and assessed by AGREE II and AMSTAR instruments.</p

A visual methods approach for researching children’s perspectives: capturing the dialectic and visual reflexivity in a cross-national study of father-child interactions

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Social Research Methodology on 18 Oct 2019, available online: http://www.tandfonline.com/https://doi.org/10.1080/13645579.2019.1672283.The paper presents a visual methods approach from a cross national methodological project that used digital visual technologies to examine young children's perspectives in father-child interactions. The approach combines capturing the dialectic with visual reflexivity. The notion of ‘capturing the dialectic’ specifically by analysing conflict to gather the child’s intention as their perspective, is underpinned by finding the contradictions in a situation of which children are a part. Visual technologies and in particular digital film does this, because it can identify difference, as it observes and captures the dialectic process. Researchers collected between 5–10 hours of film footage and twenty-four film elicitation interviews from young children and their fathers in twelve families within England, Hong Kong, Norway and India. In the study, participants took footage of routine father-child interactions chosen by the children; and researchers sampled the footage for situations of conflict and emotionally charged moments in order to capture the dialectic. Researchers then conducted film elicitation interviews with the children and fathers, which were recorded for the purpose of visual reflexivity. This visual methods approach can support social science researchers to address differences in representation and truth, for a better understanding of a young child’s perspective in cross-national projects

Double Stimulation and Transformative Agency through Video Modalities with Young Children:A cross-national study of pedagogic relationships in families

Our research community has limited understanding about the potential of video. This paper uses double stimulation and transformative agency to analyse two video modalities, extraction, and reflection; in a study about learning as it develops through family interactions. As researchers we were interested in children’s motives. However, the children were young; therefore, posing a methodological problem. Drawing on video footage and 24 film elicitation interviews with children and fathers from 12 families in Norway, England, Hong Kong and Mumbai, India; we present case study examples using double stimulation to analyse video. We gathered between 5-10 hours of footage about father-child interactions from each family.  To analyse video modalities through double stimulation, we identified the first stimulus, second stimulus, and manifestations of transformative agency. We found by combining double stimulation with video for the purposes of extraction, the non-visible becomes visible. The combination indicates opportunities for development that generate the kind of qualitative transformations, which imply child development can be seen in a new way. By combining double stimulation with video for reflection, researchers can trace outward affective and cognitive consequences of the ‘mirror effect’, back to children’s conflict of motives, and how they decide to interpret what they see. Double stimulation therefore widens the potential of video. It shows video as an effective auxiliary stimulus to address the problem of researching young children’s motives.</p

Establishing a Target Exposure for Once-Daily Intravenous Busulfan Given with Fludarabine and Thymoglobulin before Allogeneic Transplantation

AbstractA combination of fludarabine (Flu) and daily i.v. busulfan (Bu) is well tolerated and effective in patients undergoing allogeneic hematopoietic stem cell transplantation. Although there is some evidence that Bu exposures exceeding 6000 μM/min may lead to excessive toxicity, there is little information on the effect of exposures below this level on outcomes. We studied Bu exposure, as measured by area under the concentration-time curve (AUC), in 158 patients with various hematologic malignancies in an attempt to identify an optimal range for targeted therapy. The preparative chemotherapy regimen comprised Flu 50 mg/m2 on days -6 to -2 and i.v. Bu 3.2 mg/kg on days -5 to -2 inclusive. Graft-versus-host disease (GVHD) prophylaxis included methotrexate, cyclosporin A, and antithymocyte globulin. Patients with Bu exposures below the median AUC of 4439 μM/min were at increased risk for acute GVHD grade II-IV (hazard ratio [HR], 2.30; 95% confidence interval [CI], 1.19 to 4.49; P = .014). Those in the highest and lowest Bu exposure quartiles (daily AUC <3814 μM/min and >4993 μM/min) had an increased risk of nonrelapse mortality (subdistribution HR, 3.32; 95% CI, 1.46 to 7.54; P = .004), as well as worse disease-free survival (HR, 1.81; 95% CI, 1.09 to 2.99; P = .021) and overall survival (HR, 1.94; 95% CI, 1.12 to 3.37; P = .018). Bu exposures between 4440 and 4993 μM/min were accompanied by the lowest risk of both nonrelapse mortality and acute GVHD

Consequences of Internet Use in College Students

The purposes of the research project were to explore how much time college students spend on the Internet and the consequences for college students who use the Internet

The EMBL Nucleotide Sequence Database

The EMBL Nucleotide Sequence Database (http://www.ebi.ac.uk/embl), maintained at the European Bioinformatics Institute (EBI) near Cambridge, UK, is a comprehensive collection of nucleotide sequences and annotation from available public sources. The database is part of an international collaboration with DDBJ (Japan) and GenBank (USA). Data are exchanged daily between the collaborating institutes to achieve swift synchrony. Webin is the preferred tool for individual submissions of nucleotide sequences, including Third Party Annotation (TPA) and alignments. Automated procedures are provided for submissions from large-scale sequencing projects and data from the European Patent Office. New and updated data records are distributed daily and the whole EMBL Nucleotide Sequence Database is released four times a year. Access to the sequence data is provided via ftp and several WWW interfaces. With the web-based Sequence Retrieval System (SRS) it is also possible to link nucleotide data to other specialist molecular biology databases maintained at the EBI. Other tools are available for sequence similarity searching (e.g. FASTA and BLAST). Changes over the past year include the removal of the sequence length limit, the launch of the EMBLCDSs dataset, extension of the Sequence Version Archive functionality and the revision of quality rules for TPA data

EMBL Nucleotide Sequence Database: developments in 2005

The EMBL Nucleotide Sequence Database () at the EMBL European Bioinformatics Institute, UK, offers a comprehensive set of publicly available nucleotide sequence and annotation, freely accessible to all. Maintained in collaboration with partners DDBJ and GenBank, coverage includes whole genome sequencing project data, directly submitted sequence, sequence recorded in support of patent applications and much more. The database continues to offer submission tools, data retrieval facilities and user support. In 2005, the volume of data offered has continued to grow exponentially. In addition to the newly presented data, the database encompasses a range of new data types generated by novel technologies, offers enhanced presentation and searchability of the data and has greater integration with other data resources offered at the EBI and elsewhere. In stride with these developing data types, the database has continued to develop submission and retrieval tools to maximise the information content of submitted data and to offer the simplest possible submission routes for data producers. New developments, the submission process, data retrieval and access to support are presented in this paper, along with links to sources of further information

Canadian 24-hour movement guidelines for adults aged 18-64 years and adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep

The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized. Novelty First ever 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespa

"It's what midwifery is all about": Western Australian midwives' experiences of being 'with woman' during labour and birth in the known midwife model

Background: The phenomenon of being 'with woman' is fundamental to midwifery as it underpins its philosophy, relationships and practices. There is an identified gap in knowledge around the 'with woman' phenomenon from the perspective of midwives providing care in a variety of contexts. As such, the aim of this study was to explore the experiences of being 'with woman' during labour and birth from the perspective of midwives' working in a model where care is provided by a known midwife. Methods: A descriptive phenomenological design was employed with ten midwives working in a 'known midwife' model who described their experiences of being 'with woman' during labour and birth. The method was informed by Husserlian philosophy which seeks to explore the same phenomenon through rich descriptions by individuals revealing commonalities of the experience. Results: Five themes emerged 1) Building relationships; 2) Woman centred care; 3) Impact on the midwife; 4) Impact on the woman; and 5) Challenges in the Known Midwife model. Midwives emphasised the importance of trusting relationships while being 'with woman', confirming that this relationship extends beyond the woman - midwife relationship to include the woman's support people and family. Being 'with woman' during labour and birth in the context of the relationship facilitates woman-centred care. Being 'with woman' influences midwives, and, it is noted, the women that midwives are working with. Finally, challenges that impact being 'with woman' in the known midwife model are shared by midwives. Conclusions: Findings offer valuable insight into midwives' experiences of being 'with woman' in the context of models that provide care by a known midwife. In this model, the trusting relationship is the conduit for being 'with woman' which influences the midwife, the profession of midwifery, as well as women and their families. Descriptions of challenges to being 'with woman' provide opportunities for professional development and service review. Rich descriptions from the unique voice of midwives, provided insight into the applied practices of being 'with woman' in a known midwife model which adds important knowledge concerning a phenomenon so deeply embedded in the philosophy and practices of the profession of midwifery