bluuebunny/crossref_metadata_2025 huggingface dataset:
The Proliferation and Migration-Enhancing Effects of Vitronectin in SMMC 7721 Cells: A Pilot Study
Authors: Wei Zhu  , Konghe Hu  , WenXue Li  , Guangyu Yang  , Jianling Chen  , Chuanxi Fu  , Qiansheng Hu
Published: May 2014

To understand the effects of Vitronectin on cell proliferation and migration in the cell line of hepatocellular carcinoma, SMMC 7721, the effects of Vitronectin on cell proliferation rate or on the prevention of the cells from the apoptotic stimuli were appraised with WST-1 assay; and the morphology of b-Tubulin was observed with con-focal microscope. The effect on migration was detected with transwell chamber. The results show that Vitronectin helps the cells adhere to Petri dish as well as the sustaining of the morphology of b-Tubulin. Vitronectin could enhance the proliferation rate of SMMC 7721 with the concentration-effect mode, and could protect the cells from the stimuli of apoptosis inducer. As to cell migration, the results show that Vitronectin enhance cell migration across the membrane of transwell chamber. According the results, the conclusion could be made that Vitronectin might play important roles in the following biological effects, such as sustaining the morphology of the tumor cells, enhancing the proliferation as well as the migration.
Internment in the United Kingdom During the Twentieth Century and Its Links to the Evolution of Immigration Detention
Authors: Silverman Stephanie J.
Published: May 2014

Immigration detention is cementing into a permanent aspect of border and immigration control in the United Kingdom. This article uses a historical examination of internment to contribute to a larger literature that unsettles the official record of detention policy as a natural development in an otherwise functioning immigration and border control bureaucracy. In so doing, I present an original overview of the First World War, Second World War, and Gulf War internments. My research findings demonstrate that wartime powers legislated in times of national distress have been repackaged as seemingly quotidian tools of immigration and asylum control. The results of this normalisation have included the reinforcement of a false logic of differentiation between citizens and threats, and between “good” and “bad” migrants; and an instrumentalisation of national insecurity to curtail the movements and basic rights of all individuals.
Pesquisa etnográfica com crianças pequenas: reflexões sobre o papel do pesquisador
Authors: Buss-Simão Márcia
Published: May 2014

Nesse artigo, a partir de um recorte de uma pesquisa de doutorado já concluída em que a geração de dados foi realizada durante nove meses no ano de 2009 em uma instituição de Educação Infantil com crianças entre 2 e 3 anos de idade, procura-se problematizar questões referentes ao papel do pesquisador nas relações e interações que estabelece ao realizar pesquisa com crianças pequenas. Para abordar essa temática, inicialmente, procura-se destacar nuances nos usos de termos que marcam teórica e epistemologicamente o campo dos estudos sociais da infância nas pesquisas com crianças procurando refletir criticamente sobre essas nuances. Em seguida, com base em notas de registro de campo procura-se problematizar questões referentes ao papel de adulto pesquisador ao estabelecer relações e interações com as crianças pequenas e estas com ele no processo de geração de dados. Como indicação importante fica a necessidade de assumir o papel de um adulto pesquisador que não possui a autoridade e o poder comum aos adultos do contexto da pesquisa, bem como o cuidado para não ter comportamentos de uma tentativa duvidosa em ser uma criança. Outra indicação importante é a definição de que esse papel de pesquisador consiste na necessidade de um posicionamento em primeiro lugar como uma pessoa social e como um profissional com um propósito distinto e original, que procura marcar essa posição no dia-a-dia com as crianças.
Cuidado espiritual como fator de integralidade (saúde) do Ser: funções históricas do cuidado na tradição judaico-cristã
Authors: Sathler-Rosa Ronaldo
Published: May 2014

O artigo analisa, sucintamente, os sentidos de espiritual e espiritualidade como qualificadores dos modos de cuidar em seguida examinados. Com base em obras de referência, o artigo examina funções de cuidado espiritual, criadas pelas comunidades cristãs das origens, baseadas nas dinâmicas tradições da espiritualidade judaico-cristã. Essas modalidades de cuidado são descritas como curar, sustentar e orientar. Visam não apenas a lidar com sintomas, disfunções ou relacionamentos destrutivos; pretendem ajudar os humanos a conferir sentido a seu existir. Alguns exemplos são apontados para demonstrar as correlações entre espírito, espiritualidade e existência humana na história.[
Developing relational understandings of water through collaboration with indigenous knowledges
Authors: Somerville Margaret
Published: May 2014

Scholars around the world are increasingly taking up the imperative of the Anthropocene to develop new epistemologies beyond the nature culture binary in order to address escalating planetary problems. Water is one of the most urgent and extreme cases of global resource depletion and the failure of development to recognize the significance of indigenous water knowledges is cited as fundamental to this dire situation. In Australia, a thirteen year drought that threatened the survival of the Murray–Darling system was believed to be related to changing climatic conditions in the global south and intimately connected to the increasing impact of human species on planetary systems. Natural resource managers in Australia have a history of failing to incorporate Aboriginal knowledges into decisions about the management of water. This article explores how a collaborative study of water with five Indigenous artists in Australia's Murray–Darling basin can contribute to the development of new epistemologies of water. It identifies the possibilities of thinking through Australian Aboriginal concepts of Country for a contemporary methodology of water based on traditional epistemologies in which human and ecological systems are conceptualised as one. The methodology of thinking through Country was developed in multimodal forms including paintings, translations from Aboriginal languages, and oral explanations assembled in digital format. This methodology allowed shared contemporary understandings to emerge in the space between Aboriginal and non‐Aboriginal knowledge of water. Examples of art forms and stories reveal intimate local ecological knowledge of water embedded in contemporary cultural forms and languages. WIREs Water 2014, 1:401–411. doi: 10.1002/wat2.1030

This article is categorized under:

Human Water > Value of Water

Human Water > Water as Imagined and Represented
A comparative study of the use of selective digestive decontamination prophylaxis in living‐donor liver transplant recipients
Authors: Katchman E. , Marquez M. , Bazerbachi F. , Grant D. , Cattral M. , Low C.Y. , Renner E. , Humar A. , Selzner M. , Ghanekar A. , Rotstein C. , Husain S.
Published: May 2014

Introduction

Bacterial infections are major causes of early morbidity and mortality after liver transplantation. Selective digestive decontamination (SDD) can be used pre‐operatively for living‐donor liver transplant (LD‐LT), but its role in this setting remains controversial.

Methods

To evaluate this strategy, we retrospectively analyzed a cohort of consecutive LD‐LTs performed in our center from March 2007 to February 2011 and compared the incidence and nature of early infectious complications, length of intensive care unit stay and hospitalization, antibiotic use, and emergence of resistant bacteria in patients with or without SDD prophylaxis.

Results

Of 148 LD‐LTs in the study period, 111 received SDD prophylaxis while 37 did not. In a multivariate model, the independent factors associated with an increased risk of early post‐transplant infections were length of postoperative mechanical ventilation (for every additional day odds ratio [OR] = 2.37, 95% confidence interval [CI] 1.4–4.0; P = 0.002), and choledochojejunostomy (OR = 4.5, 95% CI 1.95–10.5; P < 0.001). Use of SDD did not affect the rate or distribution of infectious complications, duration of hospitalization, antibiotic use, or acquisition of resistant bacteria (OR = 3.52, 95% CI 0.43–15.17; P = 0.376).

Conclusion

In conclusion, the use of SDD prophylaxis in LD‐LT was not beneficial and should be avoided, as it offers no advantage and could potentiate the emergence of multidrug‐resistant organisms.
Training middle-level cadres: a solution or a quick fix?
Authors: Chirwa Maureen , Msidi Eleanor Daka
Published: May 2014

With high maternal mortality rates in African Countries, mostly in Subsaharan Africa, call for scaling up of midwives' training is real and urgent. Who are middle-level midwives? What level of midwives need to be trained and who should train them? How should the midwives be trained/what sort of programme should they follow? Midwives at middle-level in this paper refers to specialists in maternal, neonatal and women's health. Midwives play leading roles in family planning and playing an important role in fighting HIV/AIDS.
Ten steps to getting your paper published in a professional journal
Authors: Devitt Patric , Hardicre Jayne , Coad Jane
Published: May 2014

There is an increasing expectation that nurses and midwives, whether they work in clinical practice management, education or research, will publish. At the same time there remains a mystique about the best way to go about this. This article provides a simple commentary suggesting ten steps to help you publish in a professional journal.
Ten steps to convert your assignment into a journal article
Authors: Devitt Patric , Hardicre Jayne , Coad Jane
Published: May 2014

Nurses and midwives spend a great deal of time and effort in constructing a variety of assignments and dissertations as part of courses, both at undergraduate and postgraduate levels. It is not uncommon to read comments from lecturers such as ‘this requires only minimal work to be published’. It might be assumed that many assignments and dissertations would therefore go on to appear in print; however it is questionable just how many of them ever do materialize in journals. The reality is that this transition can be a challenging process. This is highlighted when, a search of the literature for use in preparation for this article, the authors discovered a dearth of advice to help potential authors make the transition from good quality assignment to published article. With this in mind we will try to guide you through a process that will assist you in converting your academic work into an article fit for publication.
Utilizing cost-effective interventions in promoting maternal and child health
Authors: Msidi Eleanor Daka
Published: May 2014

Key note address given at the sixth African Midwives' Research Network biennial conference held at the Safari Park Hotel in Nairobi, Kenya 5–9 November 2007
Dissemination of the safe motherhood advocacy package in Tanzania
Authors: Mlay Rose , Mtawa Agnes , Mdegella Mselenge , Nduasinde Jasper , Rugamira Mackrine , Mfalila Lena
Published: May 2014

The White Ribbon Alliance Tanzania, which is a coalition of 102 organizations and 800 individuals interested in making childbirth safe, has advocated for the reduction of maternal and newborn mortality ratios (MMR/MNR) since its inception in 2004. In August 2007 the alliance conducted a baseline assessment followed by advocacy with district authorities and community mobilization for skilled health workers in Sumbawanga and Monduli Districts. A follow-up assessment was carried out six months after the advocacy activity. Advocacy and mobilization resulted in an increase of three skilled workers and a 50% increase in facility deliveries at 17 dispensaries in Sumbawanga. Seven dispensaries in Monduli had an increase of five skilled workers and 18 deliveries compared to 0 deliveries before the advocacy. This assessment concludes that advocacy contributed to changes in employment/deployment policy, and that community mobilization changed behavior, for example, the villagers opted to give birth at dispensaries, something they did not do before the mobilization.
What motivates women?: following the PMTCT programme in Namibia
Authors: Nashandi Hilde K , Iipinge Scholastika Ndatinda , Hofnie Kathe
Published: May 2014

The objectives of the study were to determine the profile of mothers who join the prevention of mother to child transmission (PMTCT) of HIV programme and to describe the factors that motivate or de-motivate the mothers to stick to or drop out of the PMTCT programme.

Qualitative and quantitative research designs were used with exploratory and descriptive strategies. The study population included all the HIV/AIDS-positive mothers registered with the PMTCT programme at Katutura State Hospital and who delivered at the same hospital between March 2002 and December 2003. A total of 30 mothers were conveniently selected and interviewed as they came for their follow-up visits. A questionnaire was used for the data collection. In-depth interview was conducted with two cases (both mothers who did not keep to the follow-up visits given).

The results show that factors motivating mothers to stick to the programme included the health of their children, ensuring they stand a chance of receiving antiretroviral treatment and wanting their children to live longer. Factors identified as de-motivating mothers included family members who are still in denial that HIV/AIDS exists, stigma attached to people living with the disease, financial problems and domestic violence. All mothers stated that the counselling and education given during antenatal care influenced their decision about whether to adhere to the programme.

Most of the respondents stated that the support groups available for HIV/AIDS-infected persons are few, and there is no proper channel of communication and referral between the hospital and these groups.

The researchers concluded that the factors influencing the adherence of mothers to the follow-up visits are both sociocultural and health related. The Ministry of Health and Social Services also needs to formalize the referral system with all local organizations working in the HIV/AIDS areas.
Breastfeeding and HIV – the challenge for South Africa
Authors: Urwin Liz
Published: May 2014

Fikile* is a 20-year-old South African woman. When she was pregnant she and her boyfriend, Thabo*, learned the shocking news that they were both HIV-positive. Their baby, Precious*, is now almost 4-weeks-old. They all live in Alexandra Township, Johannesburg with Thabo's parents, who don't know that their son and his girlfriend are HIV positive. Thabo hopes his parents will accept the news about his and Fikile's HIV status, but the stigma around HIV remains very strong and many parents reject their HIV-positive children. As he can't be completely sure how they will react, he hasn't yet told them.
Hysterosalpingography pain and discomfort
Authors: Ugwu AC , Imo AO , Erondu OF
Published: May 2014

The objective was to determine the impact of demographic and psychosocial factors on hysterosalpingography pain and discomfort. One hundred hysterosalpingography referrals were recruited for this study. Verbal detector scales were used to assess pain perceptio and Likert scales were used to assess the psychosocial variables, while visual analogue scales were used to assess discomfort. Pearson's correlations were conducted. Tests were two-tailed with p<0.05 indicating statistical significance. Some of the patients (34%) indicated that administration of analgesics prior to the procedure could reduce the pain and discomfort associated with the procedure. Mean ± standard deviation of pain and discomfort were 2.82 ± 0.77 and 6.36± 2.19 respectively. Age significantly correlated with pain perception (r=-0.22, P<0.05), while pain correlated significantly with perception of discomfort (r=-0.46,P<0.05). Age significantly correlated with pain. This is a factor which could be harnessed for clinical use.
Active management of third stage of labour: misoprostol or oxytocin?
Authors: Wangwe Peter , Kidanto Hussein , Muganyizi Projestine , Roosmalen Jos van
Published: May 2014

The aim of this study was to compare the efficacy, safety and cost-effectiveness of rectal misoprostol and intramuscular oxytocin in the management of the third stage of labour using a randomized trial.

At Muhimbili National Hospital, Tanzania, 426 pregnant women in the active phase of labour were randomly selected to join the study. Twelve women were excluded from the study because their mode of delivery was caesarean section. Misoprostol 400 μg was administered rectally in 210 participants and intramuscular oxytocin at a dose of 5 IU in 204 participants respectively.

There was an equal mean estimated blood loss in both the misoprostol and oxytocin group (161 ml versus 169 ml) respectively. More women in the misoprostol group (18.1%) had a drop in haematocrit of >10% as compared to oxytocin (14.2%). A drop in haematocrit was more sensitive to detect postpartum hemorrhage as compared to estimated blood loss. Duration of the third stage of labour was similar in both groups: 8 minutes in the misoprostol group versus 8.7 minutes in the oxytocin group. The percentage of women who needed additional uterotonic drugs did not differ significantly: 7.4% in the oxytocin group and 4.3% in the misoprostol group (p=0.19).

Retained placenta occurred in 3.4% of the oxytocin group versus 1.4% of the misoprostol group (p=0.18). Shivering and nausea were the most prevalent side-effects in the misoprostol group (3.3%) and in the oxytocin group (2.9%).

Rectal misoprostol at a dose of 400 μg is as effective as 5 IU of oxytocin in the prevention of postpartum hemorrhage. The advantages of misoprostol are its heat stability and its ease in administration. It does not need storage in a refrigerator and can be used in both institutional and non-institutional deliveries.
Women's perceptions of midwifery care in Lusaka, Zambia
Authors: Kwaleyela Concepta Namukolo , Kearns Elaine Nicolene
Published: May 2014

Uncovering women's perceptions of maternity care provided give insight into their expectations and needs. This qualitative research study, using modified grounded theory approach, was done to explore views and experiences of women users of lowrisk maternity care services in Lusaka. In this city a series of maternity centres run by midwives were established to relieve pressure on an overworked maternity staff at the only tertiary hospital.

Data was collected through semi-structured tape-recorded interviews with eleven women who were determined by theoretical saturation.

Two categories of ‘trust in midwives’ and ‘recognition of the women’ were identified. These were integrated in one core category of ‘relationship between the midwife and the woman’. The findings demonstrated that for midwives to offer maternity services that are satisfactory to women, emphasis should not only be on a live baby and mother, but should also include building a good and trusting relationship with the mother.
Improving maternal health through research
Authors: Clift-Matthews Victoria
Published: May 2014

It has been two years since we launched the African Journal of Midwifery and Women's Health (AJM) at the Africa Midwives Research Network (AMRN) conference in Nairobi 2007. Since then we have had a number of valuable contributions from midwives and nurses in many different African countries, such as Nigeria, Kenya, Zambia and South Africa, to name only a few. We have also received contributions from midwives with a special interest in Africa from other countries, such as Sweden and the UK. Research by midwives and other health professionals in Africa is copious and the aim of the AJM since its inception has been to provide a forum for this knowledge to be shared, so that clinical practice can be influenced and improved.
Capacity building to reduce maternal and neonatal morbidity and mortality
Authors: Lavender T , Lugina H , Vidot P , Chimwaza A , Bedwell C , Donovan P , Kohi T , Dlammani P , Tsekiri E , Msuya M
Published: May 2014

In sub-Saharan Africa midwifery educators are in short supply and opportunities to pursue advanced education are severely restricted. Postgraduate programmes that encourage critical thinking and strategic planning in midwifery education, practice, management and research are required to empower midwives to lead their profession.

A unique user-led distance learning programme was developed by adopting a participatory approach to developing a curriculum for a Masters in Midwifery and Women's Health. Midwives from the East Central and South Africa (ECSA) region and the UK participated along with a representative from the Commonwealth Secretariat and International Confederation of Midwives (ICM). The curriculum was based on shared goals but adaptable to cultural and local context. Brainstorming sessions, informal workshops and formal consensus methods were used to reach decisions regarding modules and subsequent content.

This article describes the process of developing a shared curriculum, the challenges faced in working across and within regions, and participants’ views of contributing to the end product.
Exclusive breastfeeding and weaning practices among mothers in Ghana
Authors: Donkor Ernestina Safoa
Published: May 2014

The purpose of this study was to investigate exclusive breastfeeding and weaning practices among breastfeeding mothers. Purposive and convenience sampling methods were used to recruit 60 breastfeeding mothers at a child welfare clinic in one hospital in the northern part of Ghana. Questionnaires were used to collect data. The findings reveal that 65% of mothers exclusively breastfed their infants, whereas 35% of mothers added other foods such as porridge, herbal tea/water, baby formula and coconut water before six months of age. In addition, 98% of mothers put the baby to the breast within 24 hours of delivery. After six months mothers included mashed yam, soft cooked rice and ‘weanimix’. The findings suggest that health-care workers need to intensify education and support women on exclusive breastfeeding in view of its benefits to infants and mothers.
Caring for children with acute, treatable and preventable medical conditions
Authors: Makworo Drusilla , Laving Ahmed M R
Published: May 2014

Parents perceive quality paediatric nursing care and interpersonal interactions between nurses, children and their parents/ guardians as caring. This article explores the nature and extent of nurse–parent/guardian interaction in the care of children while in the ward. Parents/guardians of hospitalized children participated in the study and were selected through systematic random sampling using the admission registers, while the nurses were purposely selected. Data was analysed by use of the Statistical Package for Social Science (SPSS). The relationships were determined by use of chi-square test and Fishers exact test at 0.05 level of significance. A majority (74.4%, n=58) of the nurses acknowledged that they involved parents/guardians. The mode of involvement entailed the nurses instructing the parents/ guardians on what they should do but not planning with them. The study recommended that standards of paediatric nursing care be developed and the nurses working in the paediatric wards be trained in paediatric nursing.
National management guidelines for obstetric emergencies
Authors: Chodzaza Elizabeth , Bultemeier Kaye
Published: May 2014

National standards for the identification and management of obstetric emergencies have been established in Malawi. This study was conducted to determine the level of compliance with national standards and protocols. A cross-sectional descriptive prospective study was conducted. A total of 799 deliveries occurred during the observation period. Management of 42 women who experienced emergency obstetric complications was observed. Emergency complications observed included 12 with eclampsia/pre-eclampsia, 11 cases of postpartum hemorrhage, 8 cases of obstructed labour, 6 cases of ruptured uterus and 5 women with puerperal sepsis. Nine patients died secondary to obstetric emergencies.

This study revealed inconsistent and poor compliance with national standards for management of pre-eclampsia and postpartum hemorrhage (PPH). Compliance rates ranged from 0–67% for management of pre-eclampsia/eclampsia, and 9–81% for management of postpartum hemorrhage. This study reveals that there is need for stricter adherence to national standards.
Awareness of premarital genetic counselling in women in Nigeria Nigeria
Authors: Oyetunde Modupe Olusola
Published: May 2014

Preventive measures such as carrier screening and premarital counselling are the best ways of dealing with genetic disorders. This study assessed the awareness of premarital genetic counselling among female undergraduates in Ibadan, Oyo State, Nigeria. The study consisted of 240 randomly selected and consenting female undergraduates of the University of Ibadan. The instrument was a structured 31-item questionnaire covering social demographic data as well as the objectives of the study. Data were analysed using the Statistical Package for Social Sciences software.

The mean age of respondents was 23.3 years old. They had low level of awareness of premarital genetic counselling (68.3%). Only 23% were aware of genetic disorders and 77% were not. About 63% of the respondents claimed that awareness of genetic disorders and premarital genetic counselling would influence their choice of spouse.

The study concludes that genetic information is poor and this will influence the uptake of genetic counselling. Efforts should be directed at ensuring mass literacy on the importance of genetic counselling especially among young people.
Protecting Africa's future through health education
Authors: Clift-Matthews Victoria
Published: May 2014

Ever since the first issue of the African Journal of Midwifery and Women's Health back in October 2007, it has provided African midwives and nurses with a new voice and has been a forum for African authors, as well as interested writers from outside the continent. Three years on, the journal continues to address the prevalent issues that affect health professionals all over Africa. In this issue alone the authors tackle current challenges, such as how much information is reaching young poeple today about their sexual health? There is little known about the effectiveness of information dissemination among young poeple in African countries and the article on page 161 about young people's questions and knowledge of HIV and AIDS paints a shocking picture of their misconconceptions. It is quite clear that programmes for young people are either not reaching them or are not suitable for this demographic. It is vital that reseach is conducted around teaching young people about their health because they are the next generation and represent an opportunity for change. If Africa is losing the battle against HIV and AIDS, then teaching young people about prevention and the importance of knowing their HIV status is how it can be turned around.
China deny link between baby formula and premature puberty
Authors: Bainbridge Jane
Published: May 2014

Government officials in China have tested samples of a locally-produced baby formula for hormone levels after a child of 4 months old was reported to have grown breasts.
Birthing support and breastfeeding initiation in Somaliland
Authors: Pieh-Holder Kelly L.
Published: May 2014

Background:

Research has identified a relationship between birthing practices and breastfeeding initiation. Continuous support during labour and delivery is a key component to increasing breastfeeding initiation.

Objective:

The purpose of this project was to assess the impact of labour support on breastfeeding initiation in a setting in which women receive traditional birthing support from female family members.

Methods:

Research was conducted at the Edna Adan Maternity Hospital in Hargeisa, Somaliland using the grounded theory method of qualitative research. The CDC EZ-Text, a software programme developed by the Centers for Disease Control and Prevention, was used in managing and analyzing the data.

Results:

The results indicated that due to cultural influences, contradictory beliefs and practices, lack of critical thinking and lack of long-term planning, traditional birthing support was not always indicative of immediate breastfeeding initiation.

Conclusions:

The presence of a labour companion is a low-cost, preventative intervention that is consistent with the cultural practices of Somaliland. Breastfeeding education and support should, therefore, include a tertiary approach which involves pregnant and birthing women, labour support persons or family members and health care providers.
Absence and reliance: Liberian women's experience of vaginal fistula
Authors: Söderbäck Maja , Wilhelmsson Emma , Häggström-Nordin Elisabet
Published: May 2014

Childbirth entails considerable risk in developing countries. A prolonged labour process can cause the woman sustained injuries and lead to the death of the unborn child. Many women in africa suffer from vaginal fistulas, causing a constant leakage of urine and/or faeces. The aim of this study was to explore and describe women's experiences of living with fistulas and how the condition affects their daily life. An ethnographic-inspired design involving observation, group- and individual conversations, was carried out at a gynaecological ward at a rural hospital in Liberia with 14 women. The reflexive analysis during fieldwork revealed two main themes in the women's experiences: absence and reliance. The results demonstrate that the women felt a loss of control over a perceived traumatic birth, loss of the dead child, loss of status as a woman and wife and loss of social fellowship. They also felt a loss of self-confidence. In contrast, the women relied on their belief and trust in God to help them with the difficult situation.
Chiropractic care in women's health: A midwifery perspective
Authors: Ramasubramaniam Shanthi , Muliira Rhoda Suubi , Seshan Vidya , Noronha Judith , Raman Savithri
Published: May 2014

Introduction:

Chiropractic care is one of the newer concepts and treatment modalities available to women in coping with the physical stresses of pregnancy, other than pharmacotherapy. Chiropractic care can help to increase the chances of a healthy pregnancy and can ease labour. Therefore midwives in clinical practice may find it useful to know the basic facts about chiropractic care in order to increase awareness of options in midwifery and inter-professional acceptance of chiropractors.

Methods:

An integrative review was conducted using a multimodal search of databases such as CINAHL, Science Direct, SCOPUS, PubMed and Cochrane.

Results:

Twelve studies met the inclusion criteria and findings suggest that chiropractic care is beneficial to pregnant women with back pain and mal-presentation during labour.

Conclusion:

Although there is still limited empirical research about chiropractic care in midwifery practice, the available studies showed that chiropractic treatment can offer women relief from musculoskeletal complaints. To this end, midwives should be educated and given opportunities to learn chiropractic skills to aid the comfort of mothers during pregnancy.
Male involvement in family planning practice
Authors: Chuwa Mary
Published: May 2014

Historically, family planning (FP) programmes in Tanzania have had an inadequate focus on men. Consequently, little is known on men's knowledge and practices on family planning. Therefore, this study aimed to determine the factors that influence male involvement in family planning practice in Moshi rural district of Tanzania. A descriptive cross-sectional design was conducted. Recruitment of respondents was carried out at the household level. Information on factors influencing male involvement in family planning practice was obtained through administering a structured questionnaire and conducting in-depth interviews. A total of 218 men aged 18–60 years were interviewed.

The results indicated that respondents were highly (85.3%) aware of modern contraceptives but contraceptive use was low (47.0%). It was found that the most commonly used contraceptives were male condoms, pills, injectables, IUCD and implants. Respondents with no formal education were twice as likely not to use contraceptive than those with primary education. Moreover, the study showed that both users and non-users have positive attitudes towards family planning practice. Furthermore, less than half of the respondents (45.4%) reported that they discussed issues pertaining to family planning with their spouses.

There are multifaceted factors that influence male involvement in family planning practice, such as service provision, accessibility, inadequate contraceptive information, religious opposition, cultural issues, side effects and misconceptions.
Adverse perinatal outcomes in Chiradzulu, Southern Malawi
Authors: Kumbani Lily Caroline , Maluwa Alfred , Choko Augustine , Chirwa Ellen , Malata Address , Sundby Johanne , Odland Jon Øyvind
Published: May 2014

This study was conducted to investigate the relationship between perinatal care and perinatal outcomes of mothers who delivered at Chiradzulu District Hospital and in the community. The cross-sectional study prospectively reviewed 626 health passports and records of labouring mothers that presented at the health facility and those that delivered in the community. Most of the participants (75%) attended primary education, were aged 19–35 (77%) and were married (72.8%). Except for Malaria and HIV, which accounted for 69.8 and 18.1% of mothers, respectively, few maternal health problems were reported: preeclampsia (1.2%), antepartum haemorrhage (9.4%) and anaemia (13% for mild, 11.1% for moderate and 2.4% for severe). Birth weight was significantly associated with preeclampsia and eclampsia (P<0.05). Fetal distress was significantly associated with Apgar score (P<0.05). Prolonged second stage of labour was a significant risk factor for still birth (P<0.05). Results show that maternal complications caused adverse perinatal outcomes and intrapartum complications caused the most adverse effects. Therefore there is a need to manage the maternal complications to promote neonatal survival.
Partner's reaction towards prevention of mother–to–child transmission of HIV
Authors: Tilahun Marelign , Degu Getu
Published: May 2014

Background:

The male partner's reaction is an important determinant in the uptake of prevention of mother–to–child transmission of HIV (PMTCT) service. Without knowing the determinant factors of male partner's reaction on PMTCT programmes, change will be very difficult or impossible to implement. Therefore, this study was conducted to identify the determinant factors of male partner's influence on pregnant women towards the PMTCT programme in Gondar town, North West Ethiopia.

Methods:

A cross-sectional quantitative study based in a health institution was conducted in Gondar town from 22 July–18 August 2011. A total of 410 pregnant women attending antenatal care (ANC) were recruited to participate using stratified sampling technique. Data were collected using a structured interviewer administered questionnaire. Multiple logistic regression analysis was employed using SPSS version 16.

Results:

Of the 400 pregnant women who actively participated in this study, 314 (78.5%) expected a negative reaction for HIV positive test result from their partners. A positive reaction from the partner was associated with women having their own income (Adjusted odds ratio (AOR) (95% CI)=2.180(1.213, 3.920)), residing in the urban areas (AOR (95%CI)=2.259(1.210, 4.217)), having education level of secondary level and above (AOR (95%CI)=6.048(3.121, 11.720)), not having a stigmatising attitude towards people living with HIV (AOR (95%CI)=2.149 (1.240, 3.725)), having a positive attitude towards counsellors (AOR (95%CI)=2.455(1.419, 4.246)) and being able to access health facilities (AOR (95%CI)=2.345(1.223, 4.498)). Conclusions: Most of the participants in this study expected their partner to react negatively towards a positive HIV test result. Since having their own income is strongly associated with a positive partner's reaction to PMTCT services, emphasis should be given for education and economic empowerment of women. A well functioning and accessible health facility with PMTCT service is important, especially in rural areas.
Folic acid found to lower the risk of autism spectrum disorders
Authors: Bainbridge Jane
Published: May 2014

Researchers in Norway have discovered a link between mothers taking folic acid supplements around the time of conception and a reduced risk of autistic spectrum disorders
Assessment of Practising Midwives on the Management of the Third Stage of Labour
Authors: Hammah Juliana , Donkor Ernestina Safoa
Published: May 2014

The third stage of labour is the separation and expulsion of the placenta and membranes following the birth of a baby. The management of this stage can directly influence postpartum haemorrhage (PPH), which is one of the world’s leading causes of maternal mortality. This study investigates adherence to the active management of the third stage of labour (AMTSL) using the protocol of the International Confederation of Midwives (ICM) and the International Federation of Gynaecology and Obstetrics (FIGO) by practising midwives, and identifies major barriers to its use. A quantitative research design was used. All 50 midwives working in the labour wards of a hospital and a health centre in Accra, Ghana, were recruited for the study. Data collection tools comprised a checklist on AMTSL and a questionnaire for assessment of the knowledge and perception of midwives. One hundred and fifty facility-based deliveries were observed and the midwives were rated using a checklist, with each of the 50 midwives observed three times. Data were analysed using the Statistical Package for the Social Sciences (SPSS). The findings indicate that the majority (40; 80%) of the midwives stated that they practised AMTSL while the remainder (10; 20%) stated that they used both active and expectant management. Further research demonstrated that the majority (36; 72%) administered oxytocin within 1 minute after the delivery of the baby which conforms to the ICM/FIGO protocol. Additionally, more than half (26; 52%) of the midwives said the best time to deliver the placenta by controlled cord traction (CCT) is when the contraction of the uterus is felt by the midwife. The overall mean skill performance was 45.7 ± 3.1 suggesting that the midwives’ performance was average on the ICM/FIGO protocol for AMTSL on a five-point Likert Scale.

With respect to barriers to the correct use of AMTSL, the midwives cited various reasons including shortage and inadequate training of staff, improper storage of oxytocic drugs, lack of knowledge and skill on AMTSL, and decisions to adhere to other methods of managing the third stage of labour. The findings of this study have implications for midwives in managing the third stage of labour.
Women's age at childbirth affects their delivery outcomes
Authors: Bainbridge Jane
Published: May 2014

A study carried out in Ireland has found that very young mothers and those aged over 40 are more at risk of poor delivery outcomes in childbirth
Determinant factors for provider-initiated HIV counselling and testing among pregnant women in Cheha district, southern Ethiopia
Authors: Mohammed Shikur , Hussen Awol , Tamiru Dessalegn
Published: May 2014

Provider-initiated HIV testing and counselling provides a critical opportunity to diagnose HIV infection, begin chronic care and prevent mother-to-child transmission. Without knowing the determinant factors of HIV testing among pregnant women, it is very difficult to implement prevention of a mother-to-child transmission programme. Therefore, this study was conducted to identify the determinant factors for HIV testing among pregnant women in Cheha District, Southern Ethiopia. Methods: A case-controlled study was conducted among pregnant women in the health facilities of Cheha district, Southern Ethiopia. The study cases were pregnant women who refused HIV testing and controls were pregnant women who accepted HIV testing in their current pregnancy. A total of 327 pregnant women were involved in the study using a stratified sampling technique. Data were collected using an interviewer-administered questionnaire. Multiple logistic regressions were fitted to identify independent predictors for HIV testing. Results: In this study women who were living with their husbands at the same place were 76% less likely to refuse HIV testing compared to their counterparts, while mothers who had comprehensive knowledge on mother-to-child transmission of HIV were 66% less likely to refuse HIV testing. Similarly, women who attended at least two antenatal care visits were 64% less likely to refuse the test, and pregnant women who had a favourable attitude towards provider-initiated HIV testing were 55% less likely to refuse the test. Conclusion: Behavioural change communication on prenatal HIV transmission, consistent use of antenatal care service and the role of HIV testing on the prevention of mother-to-child transmission of the virus should be strengthened through community health workers. A well functioning and accessible health facility with prevention of mother-to-child transmission services is important, especially for rural communities.
Increased iron supplements offer no difference in birth outcomes
Authors: Bainbridge Jane
Published: May 2014

Australian researchers have found that increasing iron supplements from twice weekly to daily has no added benefits for mother and baby
An introduction to risk assessment and prevention in coronary heart disease
Authors: Riley Jillian
Published: May 2014

This article is the first in a series that will consider how to identify someone at risk of developing coronary heart disease (CHD) and risk factors in those who have already been diagnosed with this disorder. The series will also will address issues in care and management. Each month a different risk factor will be reviewed, and we will explain the ideas behind current management and identify ways in which the nurse can contribute towards reducing the chances of a person developing CHD.
An audit of a specialist nurse-led rapid-access chest pain clinic
Authors: Moore Helen , Caton Jane , Williams Susan , Houghton Patricia , Naqvi Nayyar , Metcalfe Claire
Published: May 2014

Objective: Rapid-access chest pain clinics, typically run by doctors, allow the rapid assessment of suspected new-onset angina. Five years ago specialist nurse-led rapid-access chest pain clinics were established at Royal Albert Edward Infirmary. The objective of this audit was to assess safety and effectiveness of these clinics.

Method: Retrospective data were collected from all patients from January 2002 to December 2006.

Results: GPs referred 1464 patients. Of those, 1349 (92.14%) patients were seen within the 14-day government target. The clinic had 1417 (96.8%) patients who under went exercise testing and 234 (16%) of these were positive. Of those patients 143 (61.8%) under went cardiac catheterization. Coronary artery disease was found in 110 patients. Eighty one patients under went revascularization and 29 patients were treated medically.

Conclusions: This audit demonstrates that specialist nurse–led rapid -access chest pain clinics are safe and effective. They identify patients who are more likely to have coronary artery disease, therefore allowing early medical/surgical intervention and reducing patient morbidity and mortality. The burden on doctors is reduced and government targets are met.
An introduction to dilated cardiomyopathy
Authors: Walker Rachel
Published: May 2014

Dilated cardiomyopathy is the most commonly occurring form of cardiomyopathy, and accounts for around 15% of cases of hear t failure. Patients can remain asymptomatic for many years. Symptom onset can be insidious or acute; for some, the first presentation for is with sudden death. Disease progression can be slowed or halted by early treatment. Family screening is a key tool in the early diagnosis and treatment of patients. Medical treatments and devices are used to slow the disease process and improve symptoms. Ultimately hear t transplantation is the only treatment option available to patients who do not respond to treatment.
Continuous ST-segment monitoring using EASI vector-derived ECG in suspected ACS
Authors: Greenfield Fiona
Published: May 2014

The standard 12-lead electrocardiograph (ECG) remains the ‘gold standard’ for documenting and comparing electrical evidence of cardiac ischaemia and acute coronary insufficiency, however the use of continuous ST-segment monitoring is essential if ongoing dynamic changes are to be captured. Information derived from continuous ST-segment monitoring provides for better assessment, prognostic indication of outcome and therefore treatment of these patients. These systems of monitoring often use vector-derived ECGs or vector-cardiography. In this article the use of vector-derived ST-monitoring is subsequently explored and any relative limitations identified. Specifically the EASI ECG, a form of vector-cardiography, is described and its uses discussed.
Caring for the sickest of patients
Authors: Castle Nick
Published: May 2014

Nick Castle describes how he came to specialize in resuscitation and emergency cardiac care, and how his cardiac nursing experience prepared him for his role.
The role of a lipid nurse specialist
Authors: Watkins Suzanne
Published: May 2014

Suzanne Watkins discusses her role working with patients with dyslipidaemias—particularly inherited high cholesterol levels.
Contesting cholesterol advice
Authors: Furniss Sarah
Published: May 2014

As the title suggests, this book aims to challenge the hypothesis that a diet high in fat and elevated cholesterol levels lead to coronary heart disease (CHD). In particular, Dr Kendrick (a GP with an interest in cardiology but little respect for cardiologists) strongly disputes the role of statins in reducing cholesterol, morbidity and mortality in CHD.
Introduction to cardiac catheterization part 1: Diagnostic coronary angiography
Authors: Edmond John , Strange Julian , Baumbach Andreas
Published: May 2014

Cardiac catheterization and diagnostic coronary angiography remains the gold standard for the investigation of many forms of coronary and structural heart disease, and as such is an extremely important component of the cardiac clinician’s diagnostic armamentarium.

It is, however, an invasive procedure with attendant risks, and therefore it is important for all members of the catheter laboratory team to understand the processes involved and work well together to ensure that the patient has as safe and painless a journey as possible.

In this article we review the indications for cardiac catheterization, the contra-indications and the important potential complications of this procedure, as well as discussing the basics of coronary anatomy demonstrated by coronary angiography.
The use and reliability of the third heart sound in the diagnosis of heart failure
Authors: Santhosh Reeja
Published: May 2014

This article reviews the evidence on the presence of the third heart sound (S3) in relation to heart failure. It emphasizes the usefulness of basic physical examination, which is readily available and costeffective. There are increasing numbers of nurse practitioners and specialist nurses who follow up patients with cardiovascular diseases. The use of physical examination skills, including auscultation, could help nurse practitiners to detect the possibility of heart failure at an early stage even if the patient is asymptomatic, as in the absence of fluid overload.
How can we stay positive?
Authors: Tagney Jenny
Published: May 2014

As we approach the new financial year, I wonder how many of you are having to think about new ways to justify your services or jobs, seek out potential new funding streams and identify priorities for service delivery? We are working in very challenging times and it is very easy to become ‘bogged down’ and negative, especially during these dark winter days!