bluuebunny/crossref_metadata_2025 huggingface dataset:
Race- and Income-Related Inequalities in Oral Health in Australian Children by Fluoridation Status
Authors: Do L.G. , Ha D.H. , Roberts-Thomson K.F. , Jamieson L. , Peres M.A. , Spencer A.J.
Published: January 2018

Inequality in child oral health exists by race and income. Water fluoridation (WF) is effective in caries prevention, but evidence for WF reducing inequality in caries experience is equivocal. This study tested the hypothesis that WF reduces race- and income-related inequality in child caries experience. A cross-sectional national population-based study of child oral health was conducted across 2012 to 2014 for Australian children aged 5 to 14 y, involving a parental questionnaire and an oral epidemiological examination. Children were stratified by fluoridated (F) and nonfluoridated (NF) area of residence, equivalized household income quartiles, and Indigenous and non-Indigenous status. Directly standardized caries experience (measured by the decayed, missing, or filled tooth surfaces [dmfs/DMFS] in both primary [age 5–10] and permanent dentitions [age 9–14]) was estimated for each stratum accounting for the complex sampling design. Differences in caries experience by Indigenous status and equivalized income quartiles were examined between F and NF strata. Socioeconomic inequality in caries experience was examined using the Absolute Concentration Index (ACI), Slope Index of Inequality (SII), Relative Concentration Index (RCI), and Relative Index of Inequality (RII). A total of 21,328 (86.5%) children had complete data. Caries experience was higher in NF than F strata. Race- and income-related gradients in caries experience were observed in both F and NF areas. All indexes of inequality indicated that caries experience was concentrated among lower income groups. Absolute inequalities were consistently lower in F than in NF areas. For the primary dentition, SII values were −4.18 versus –6.20 in the F and NF areas, respectively. The respective values were −0.60 versus −1.66 for the permanent dentition. Income-related inequality in caries was lower in F than in NF areas for both Indigenous and non-Indigenous children. WF was associated with lower caries experience and reduced inequality among children.

Knowledge Transfer Statement: The results of this study greatly increase the evidence base that water fluoridation is effective and socially equitable. Dental caries has remained one of the most prevalent chronic conditions in children worldwide. The presented evidence can be used by policy makers and the profession to support the maintenance or expansion of this important public health program to benefit those most at risk of dental caries, the groups at the lowest socioeconomic position in any society.
Copper 64–labeled daratumumab as a PET/CT imaging tracer for multiple myeloma
Authors: Caserta Enrico , Chea Junie , Minnix Megan , Poku Erasmus K. , Viola Domenico , Vonderfecht Steven , Yazaki Paul , Crow Desiree , Khalife Jihane , Sanchez James F. , Palmer Joycelynne M. , Hui Susanta , Carlesso Nadia , Keats Jonathan , Kim Young , Buettner Ralf , Marcucci Guido , Rosen Steven , Shively John , Colcher David , Krishnan Amrita , Pichiorri Flavia
Published: January 2018

Key Points

Daratumumab conjugated with 64Cu efficiently binds to CD38 on myeloma cells and was mainly detected in the bones of mice. PET/CT based on 64Cu-radiolabeled daratumumab displays a higher resolution and specificity for detecting myeloma than does 18F-FDG PET/CT.
Early and late outcomes after cord blood transplantation for pediatric patients with inherited leukodystrophies
Authors: van den Broek Brigitte T. A. , Page Kristin , Paviglianiti Annalisa , Hol Janna , Allewelt Heather , Volt Fernanda , Michel Gerard , Diaz Miguel Angel , Bordon Victoria , O'Brien Tracey , Shaw Peter J. , Kenzey Chantal , Al-Seraihy Amal , van Hasselt Peter M. , Gennery Andrew R. , Gluckman Eliane , Rocha Vanderson , Ruggeri Annalisa , Kurtzberg Joanne , Boelens Jaap Jan
Published: January 2018

Key Points

A 6-year overall survival of 61% was observed in leukodystrophy patients after cord blood transplantation. Mismatched cord blood donors, symptomatic disease, and lower PS before cord blood transplantation were predictors of lower survival.
Survival and associated risk factors in patients with diabetes and amputations caused by infectious foot gangrene
Authors: Huang Yu‐Yao , Lin Cheng‐Wei , Yang Hui‐Mei , Hung Shih‐Yuan , Chen I‐Wen
Published: January 2018

Background

Infectious gangrene of the foot is a serious complication of diabetes that usually leads to a certain level of lower‐extremity amputation (LEA). Nevertheless, the long‐term survival and factors associated with mortality in such patients have yet to be elucidated.

Methods

A total of 157 patients with type 2 diabetes who received treatment for infectious foot gangrene at a major diabetic foot center in Taiwan from 2002 to 2009 were enrolled, of whom 90 had major LEAs (above the ankle) and 67 had minor LEAs (below the ankle). Clinical data during treatment were used for the analysis of survival and LEA, and survival was tracked after treatment until December 2012.

Results

Of the 157 patients, 109 died, with a median survival time of 3.12 years and 5‐year survival rate of 40%. Age [hazard ratio 1.04 (95% confidence interval 1.01–1.06)], and major LEA [1.80 (1.05–3.09)] were independent factors associated with mortality. Patients with minor LEAs had a better median survival than those with major LEAs (5.5 and 1.9 years, respectively, P < 0.01). An abnormal ankle‐brachial index was an independent risk factor [odds ratio 3.12 (95% CI 1.18–8.24)] for a poor outcome (major LEA) after adjusting for age, smoking status, hypertension, major adverse cardiac events, and renal function.

Conclusions

Efforts to limit amputations below the ankle resulted in better survival of patients with infectious foot gangrene. An abnormal ankle‐brachial index may guide physicians to make appropriate decisions with regards to the amputation level.
The Relative Importance of Aggregate and Sectoral Shocks and the Changing Nature of Economic Fluctuations
Authors: Garin Julio , Pries Michael J. , Sims Eric R.
Published: January 2018

A principal components decomposition of sectoral IP data reveals that the contribution of aggregate shocks to the variance of aggregate output declined from about 70 percent in the period 1967–1983 to about 30 percent after 1983. We develop an “islands” model with two sectors and costly labor reallocation to investigate how this change in the relative importance of shocks alters business cycle moments. A version of the model with relatively more important sectoral shocks results in a sizeable decline in the cyclicality of labor productivity and is consistent with changes in several other business cycle moments observed in the data. (JEL E13, E23, E24, E32, J21, J24)
Sustainable Shadow Banking
Authors: Ordoñez Guillermo
Published: January 2018

Banking regulation is beneficial because it constrains banks' portfolios to prevent excessive risk taking. But given that regulators usually know less than a bank about its investment opportunities, regulation comes at the cost of foregoing profitable investments. I argue that shadow banking improves welfare because it provides a channel to escape excessive regulation that is asymmetrically more valuable for banks with access to efficient investment opportunities. I propose a novel intervention that improves welfare further by taxing shadow activities, subsidizing regulated activities and allowing banks to self-select into being regulated or not. (JEL D82, G21, G28, G31, G32, L25)
Firms and the Decline in Earnings Inequality in Brazil
Authors: Alvarez Jorge , Benguria Felipe , Engbom Niklas , Moser Christian
Published: January 2018

We document a large decrease in earnings inequality in Brazil between 1996 and 2012. Using administrative linked employer-employee data, we fit high-dimensional worker and firm fixed-effects models to understand the sources of this decrease. Firm effects account for 40 percent of the total decrease and worker effects for 29 percent. Changes in observable worker and firm characteristics contributed little to these trends. Instead, the decrease is primarily due to a compression of returns to these characteristics, particularly a declining firm productivity-pay premium. Our results shed light on potential drivers of earnings inequality dynamics. (JEL D22, D63, J24, J31, L25, M52, O15)
Measuring Job-Finding Rates and Matching Efficiency with Heterogeneous Job-Seekers
Authors: Hall Robert E. , Schulhofer-Wohl Sam
Published: January 2018

Matching efficiency is the productivity of the process for matching job-seekers to available jobs. Job-finding is the output; vacant jobs and active job-seekers are the inputs.We develop a framework for measuring matching productivity when the population of job-seekers is heterogeneous. We find that overall matching efficiency declined smoothly over the period from 2001 through 2013. Measures of matching efficiency that neglect heterogeneity among the unemployed and also neglect job-seekers other than the unemployed suggest a large 28 percent decline in efficiency between 2007 and 2009. Most of this apparent decline results from changes in the composition of job-seekers. (JEL E24, J22, J23, J24, J41, J63)
People reporting experiences of mediumship have higher dissociation symptom scores than non-mediums, but below thresholds for pathological dissociation
Authors: Wahbeh Helané , Radin Dean
Published: January 2018

Background: Dissociative states exist on a continuum from nonpathological forms, such as highway hypnosis and day-dreaming, to pathological states of derealization and depersonalization. Claims of communication with deceased individuals, known as mediumship, were once regarded as a pathological form of dissociation, but current definitions recognize the continuum and include distress and functional disability as symptoms of pathology. This study examined the relationship between dissociative symptoms and mediumship in a large convenience sample.

Methods: Secondary analyses of cross-sectional survey data were conducted. The survey included demographics, the Dissociation Experience Scale Taxon (DES-T, score range 0-100), as well as questions about instances of mediumship experiences. Summary statistics and linear and logistic regressions explored the relationship between dissociative symptoms and mediumship endorsement.

Results: 3,023 participants were included and were mostly middle-aged (51 years ± 16; range 17-96), female (70%), Caucasian (85%), college educated (88%), had an annual income over $50,000 (55%), and were raised Christian (71%) but were presently described as Spiritual but not Religious (60%). Mediumship experiences were endorsed by 42% of participants, the experiences usually began in childhood (81%), and 53% had family members who reported similar experiences. The mean DES-T score across all participants was 14.4 ± 17.3, with a mean of 18.2 ± 19.3 for those claiming mediumship experiences and 11.8 ± 15.2 for those who did not (t = -10.3, p < 0.0005). The DES-T threshold score for pathological dissociation is 30.

Conclusions: On average, individuals claiming mediumship experiences had higher dissociation scores than non-claimants, but neither group exceeded the DES-T threshold for pathology. Future studies exploring dissociative differences between these groups may benefit from using more comprehensive measures of dissociative symptoms as well as assessments of functional impairment, which would help in discerning between pathological and non-pathological aspects of these experiences.
Miltefosine inhibits Chikungunya virus replication in human primary dermal fibroblasts
Authors: Sharma Anuj , Bhomia Manish , Yeh Tze-Jou , Singh Jay , Maheshwari Radha K.
Published: January 2018

Background: Chikungunya virus (CHIKV) is a re-emerging pathogen that has caused widespread outbreaks affecting millions of people around the globe. Currently, there is no specific therapeutic drug against CHIKV, with symptomatic treatment only to manage the disease. Pi3-akt signaling has been implicated in infection of several viruses including that of CHIKV. Effect of Pi3-akt signaling inhibitors on CHIKV replication was evaluated in this study.

Methods: Human primary dermal fibroblast cells were treated with inhibitors of the Pi3-akt signaling pathway. Suppression of CHIKV replication was evaluated as reduction in virus titer in cell supernatants. Effect of miltefosine (MF) on CHIKV replication was evaluated in pre and post treatment regimen. Inhibition of virus replication was determined by cell growth, virus titer and western blot.

Results: Inhibition of Akt-phosphorylation significantly inhibited CHIKV replication. No effect on CHIKV replication was observed after treatment with Pi3-kinase and mTOR activation inhibitors. Further, MF, an FDA-approved Akt-inhibitor, inhibited CHIKV replication in pre- and post-infection treatment regimens.

Conclusion: Data suggests that Akt-phosphorylation can be an amenable target of therapy against CHIKV infection. This is the first study to show inhibition of CHIKV replication by MF, and presents a case for further development of MF as an anti-CHIKV drug.
NorLyr: A Scandinavian network in poetry research
Authors: Lilja Eva
Published: January 2018

NorLyr: A Scandinavian network in poetry research
Frontiers in Comparative Metrics III, 29–30 September 2017, Tallinn, Estonia
Authors: Novikov Kadri , Arukask Anni
Published: January 2018

Frontiers in Comparative Metrics III, 29–30 September 2017, Tallinn, Estonia
ESTABLISHING THE PRODUCT REALIZATION CONCEPT IN RAILWAY TECHNOLOGY
Authors: Öztürk Fatih
Published: January 2018

Railway industry owes its ever-growing importance to several factors, chiefly the fact that it is considered a relatively more comfortable and efficient mode of transit in the face of rapid urbanization. This study deals with the ways of improving the manufacturing process of components used in the railway industry.In this regard, IRIS plays a vital role in the process of ensuring the customer satisfaction, product quality, efficient process management and innovation for all components. Hence, the study attempts to investigate into the ways to obtain more optimized results drawing upon the IRIS standards.
Effects of psychological prejudices on communication and social interaction
Authors: Hicks Carolyn
Published: January 2018

To establish good working relationships and effective patterns of communication, all midwives should be aware of the psychological processes involved in initial meetings, and the impact of facial attractiveness on social interaction.
A new voice for midwives
Authors: Henderson Christine
Published: January 2018

According to Aristotle, midwives need to fulfil several criteria if they are to perform their duties effectively:

‘A midwife should be of middle age, neither too old nor too young, and of good habit of body, not subject to disease, tears or sudden fright, nor are the qualifications assigned to ‘a good surgeon’ improper for a midwife, viz. a lady’s hand, a hawk’s eye and a lion’s heart. She ought to be sober and affable, not subject to passion, but bountiful and compassionate, and her temper cheerful and pleasant… A midwife is the most necessary and honourable office, being indeed, a helper of nature.’ (Aristotle, 384-322 BC).
Redefining the midwife’s role: changes needed in practice
Authors: Page Lesley
Published: January 2018

The midwifery of the future will have certain hallmarks, and changes will be required in its organization and context of practice. In renewing midwifery we must combine clinical expertise based on scientific knowledge with the tradition of working ‘with women’.
Health promotion using a nursing model based on self-concept
Authors: Green Beryl
Published: January 2018

The new GP contract (DHSS, 1989) gives GPs financial incentives to provide health surveillance throughout the age continuum. The well-woman clinic in this care study was set up 2 years ago by a district nurse and the male GP to whose single-handed practice she is attached.
Book review supplement
Authors: Shortt Sue , Balen Adam , Jarvis Carol , Midgley Christine
Published: January 2018

Fetal Monitoring in Practice

CTG Made Easy

Women’s Problems in General Practice

Manual of High Risk Pregnancy and Delivery
Castledine adjudged as ‘paternalistic and patronizing’
Authors: Byrne CM , Roth Carolyn , Grant Jane , Donovan Pat , Kargar Ishhel
Published: January 2018

The first issue of British journal of Midwifery was both enjoyable and informative apart from the sour editorial by George Castledine (Vol. 1(1) 1993, p.4). It is amazing that Professor Castledine finds it necessary to criticize the midwifery profession in such a paternalistic and patronizing fashion. I am glad that the midwifery profession is secure and adult enough not to need to apply the same tactics to nursing.
Postnatal pain: a neglected area
Authors: Dewan Gita , Glazener Cathryn , Tunstall Michael
Published: January 2018

Postnatal pain has been paid scant attention by standard obstetric textbooks and obstetricians, yet it is a common ailment which is partly preventable and certainly treatable. The authors show that this is an important form of postnatal morbidity which should not be neglected.
Exploiting midwives’ energy resources to generate professional knowledge
Authors: Hillier Dawn , Sisto Sheila
Published: January 2018

An exciting new course leading to an ENB professional award has been designed for practising midwives. It centres upon knowledge generation in practice, and aims to develop mastery by tapping the energy resources of midwives in pursuit of excellence.
Road safety for babies
Authors: Jones Kathleen
Published: January 2018

How many of us, as midwives, have stood at the maternity unit door for the traditional farewell photograph with the mother and her baby? Most of us, many times, I would expect. Do we ever consider the consequences of our next act, which is to place the baby in the car with its mother? Increasing numbers of parents now purchase a car safety seat before the baby is born or at least while it is in hospital. However, the number of babies leaving hospital in their mothers’ arms, in the rear seat of a car, is alarming.
The inception and development of an antenatal day assessment unit
Authors: Hobbs Julie Ann
Published: January 2018

Antenatal day assessment units are emerging in many parts of the country, each one unique in its ability to cater for the specific needs of the locality. This article reviews the inception of such a development at Southmead Maternity Unit, Bristol, and suggests that this new phenomenon bridges a gap in service provision and improves understanding between midwife and obstetrician.
When things go wrong
Authors: Jackson Kate
Published: January 2018

When midwives are describing their profession, they tend to concentrate on the more enjoyable and rewarding aspects which, in many ways, make it the most extraordinary career. There are few other occupations that can provide an individual with such emotional highs and, at times, such an overwhelming sense of fulfilment.
Quality through supervision
Authors: Mayes Glynnis
Published: January 2018

Is the supervision of midwives a relevant issue? It has not been adopted outside the UK, and it does not apply to nurses or health visitors within the UK. But good supervision produces high quality care, and it is discussed here in relation to current issues such as consumer participation and choice, rising litigation and the influence of market forces on the provision of health services.
Altered body image in pregnancy and beyond
Authors: Price Adrienne
Published: January 2018

Understanding the changes in body contours, sensations and function during pregnancy, childbirth and the early postnatal months are important to the client, her partner and the midwife. Successful breastfeeding, satisfying sexual relationships and new patterns of family coping may depend upon a mutual understanding of such body experiences.
Changing Childbirth: a renewal of the maternity services
Authors: Page Lesley
Published: January 2018

Many of the needs of women and families using the maternity services are simple. They want care that is ‘respectful, personalized and kind.’ They want to see trusted and familiar faces. They want to know the pros and cons of various treatments and which of these are likely to be of benefit. They want to be given a choice of caregivers. They want services that are accessible: geared to meet their needs, not the needs of health care professionals.
Fetal abnormality: a moral defence for abortion?
Authors: Johnson Kath
Published: January 2018

The possibility of choosing an abortion to end an unwanted pregnancy is growing as the availability of prenatal tests increases. The question of when and whether a fetal abnormality is a morally defensible ground for performing an abortion will continue to be asked. It is essential that health care professionals understand the range of views and the very real dilemma that some parents face.
The value of cardiotocography for intrapartum monitoring
Authors: Balen Adam H
Published: January 2018

The cardiotocograph (CTG) was widely adopted for the assessment of antenatal and intrapartum fetal wellbeing before it had been properly evaluated and has consequently been subjected to very close scrutiny in recent years.
Letters
Authors: Benjamin Y , Jackson Sue , Kargar Ishbel , Hussain P , Jackaman Katie
Published: January 2018

Vitamin K prophylaxis in infancy

Concern over ultrasound

Ultrasound training

Double-gloving
Humanizing the ward round
Authors: Walsh Denis
Published: January 2018

The report Changing Childbirth (Department of Health, 1993) espouses the principle of woman-centred care; however, a central abuse of this principle occurs most days throughout the UK in the consultant obstetrician ward round.
Seeing mothers as partners in antenatal care
Authors: Thorley Kevan , Rouse Trish
Published: January 2018

Antenatal care could make more impact if it addressed the problems that are likely to affect women with normal pregnancies. This article describes a new approach, which developed through cooperation between mothers, midwives, doctors and other health care workers. This new style of antenatal care emphasizes sensitivity, flexibility, education and self-reliance.
A woman's choice: a midwife's dilemma?
Authors: Jackson Kate
Published: January 2018

Changing Childbirth (Department of Health, 1993a), takes as its primary focus the pregnant woman and her family. Its recommendations aim to provide a service that is responsive to the needs of women, providing care that is accessible and appropriate to their needs.
A manager’s view
Authors: Skipworth Ann L
Published: January 2018

The Expert Maternity Group (Department of Health, 1993) is to be congratulated, not only on its timely publication of the report, but also on the content, which is so closely aligned to the content of the Winterton report (House of Commons Health Committee, 1992). This repetition is not to be scorned, but to be welcomed as a reinforcement of the way forward for the maternity services.
Implications for clinical midwives at grass roots level
Authors: Long Louise
Published: January 2018

Having obtained a copy of the two-part report from the HMSO book shop, I was immediately impressed by how well presented it is and how clear and easy to read. It explains how and why it was commissioned. It sets out objectives and action points for each chapter. For those of us convinced of the benefits of individual relationship-oriented midwifery care, it makes refreshing reading. However, what does this mean for practising, clinical midwives working in the NHS?
A bridge too far
Authors: Partington Kate
Published: January 2018

On first viewing Changing Childbirth (Department of Health, 1993) I was impressed by its colour, format and content. As a midwife, I related to the ethos of what had been written and applauded the clear message that we should be creating a woman-focused service rather than an interprofessional battleground.
Midwifery knowledge: theory for action, theory for practice
Authors: Price Adrienne , Price Bob
Published: January 2018

The search for a conceptual framework that can reflect midwifery’s practice orientation, theory interests and professional skills has grown apace during recent years. Midwifery models have often owed something to nursing models, and the midwifery process to the nursing process. It is now time to evaluate whether the conceptual frameworks are sufficient for modern midwifery practice and education.
Dietary advice for women wishing to conceive
Authors: Balen Adam H , Challis Jasmine D
Published: January 2018

Much has been written on the need for an appropriate diet during pregnancy, but there has been little advice available for women who are trying to conceive. This article will review general health measures and specific dietary advice.
Need for improved antenatal classes
Authors: Priest Judy
Published: January 2018

Antenatal education has been discussed in several recent issues of your journal. Denis Walsh highlighted the political dimension inherent in running classes where parents set the agenda (Vol. 1 (3), pp 119-23), and Colin Rees asked: ‘Antenatal classes: has midwifery lost interest?’ (Vol 1 (2), pp 75-77). I would like to offer my own experience in trying to encourage health professionals to run classes that are effective, fun and satisfying for both parents and professionals.
Book reviews
Authors: Flanders Jane , Allen M Rose , O'Driscoll Muriel , Moore Sue , O'Driscoll Muriel , McDonnell Chery
Published: January 2018

Introduction to Doppler

Spiritual Midwifery (3rd edn)

To and Fro Children: A Guide to Successful Parenting After Divorce

Life Before Birth: And a Time to be Born

Bad Behaviour, Tantrums and Tempers

Midwifery Practice: A Research Based Approach
Breastfeeding: research and quality assurance issues
Authors: Parker Clare
Published: January 2018

The importance of breastfeeding and the midwife's role in promoting, supporting and encouraging it are established, yet there is still a shortfall in the Government's breastfeeding targets. Are midwives accountable for this and, if so, what should they be doing about it? This article shows that despite the availability of research-based guidelines for midwives there remains a theory-practice gap.
Normal and abnormal grief reactions: midwifery care after stillbirth
Authors: Greaves Julie
Published: January 2018

A stillbirth is a heartbreaking and tragic event. The grief process is similar to that experienced after a close loved one has died (Lake et al, 1983). Informed, sensitive midwifery care during the initial period can facilitate the normal grieving process, often preventing abnormal reactions.
Changes in childbirth: troubled times ahead
Authors: Jackson Kate
Published: January 2018

Events in 1993, particularly the publication of the report Changing Childbirth (Department of Health, 1993), gave midwives good reason to feel optimistic about 1994. The report focused on the provision of appropriate and accessible care for women and their families. It stressed the requirement to use audit and research to ensure that changes in care could be properly planned and evaluated. It highlighted the need for professionals to work together and provide an integrated service that would best serve the women who used it.
Midwives, childbirth and sexuality 2: men and sex
Authors: O'Driscoll Muriel
Published: January 2018

Witnessing birth can have a profound effect on men and their sexual relationships. Part 1 of this article considered the difficulties that women may encounter after childbirth; this article concentrates on the effects that becoming a father have on men. Midwives must consider the needs of both parents at the beginning of a new family.
Maternity audit in practice
Authors: Downe Soo
Published: January 2018

Recent changes in the NHS have increased the profile of audit as a mechanism for determining the most effective and efficient systems of care. This article reviews the progress of audit in the NHS since 1989 and outlines the development of a successful maternity audit project.
Entries in the diary from Kidoti
Authors: Millington Marian
Published: January 2018

This article is based on the author's experience as a midwife tutor working in Zanzibar, East Africa, on a Save the Children Fund project between 1988 and 1990. After an overview of the health services and training course (Figure 1) there are two accounts written by students while working in the village of Kidoti during their community allocation. These are used to illustrate the rich and varied experience available to students there.
So much for common sense
Authors: Jackson Kate
Published: January 2018

Until recently, there seemed to be a general consensus that obstetric practice was science-based, whereas midwifery practice was seen more as an art or a skill. The trend now is clearly for midwifery to develop as a researchbased profession.
Milks for the first year of life
Authors: Hennessy Kathy
Published: January 2018

While milk makes an important contribution to the nutritional intake of most children, it is of particular importance during the first year of life. This article reviews the composition, relative merits and appropriate use of some of the many milks available for today's under-ones.
Midwives should nurture PREP to enhance professional practice
Authors: Roch Sarah
Published: January 2018

The UKCC has, after a lengthy gestation period, finally agreed its policy on standards for education and practice following registration, and has now set out its position on policy and implementation. This is the first time that such a standards framework has been formulated. Midwives have always been advantaged by their very specific legislative position and have had a degree of statutory updating and refreshment together with a mechanism to achieve competence on return to practice. It was therefore essential for the UKCC to ensure that the results of this important project produced outcomes at least as good, and preferably much better, than those which currently exist for midwives. The other important component of this activity has been Council's determination to consult the professions, and to listen and respond positively to their responses.
Magnetic resonance imaging in pregnancy
Authors: Oláh Karl S , Garden Anne S
Published: January 2018

Magnetic resonance imaging (MRI) is a relatively new technique that has found a wide application in most branches of medicine. Because of the availability, ease of use and low cost of ultrasound, there are few absolute indications for the use of MRI. However, changes in MRI equipment and research developments have led to increasing application of MRI to obstetric practice.
Assessment of the antenatal care for Asian women
Authors: Narang Indra , Murphy Simon
Published: January 2018

Perinatal mortality statistics show disparities between children of mothers from the Indian subcontinent and those of mothers from the UK. This article describes a study of the antenatal care of women whose first language is not English, to ascertain whether they have adequate knowledge to be active participants and suggests improvements in service provision.
Preceptorship involves irreconcilable concepts
Authors: Jackson Kate
Published: January 2018

The UKCC has recently issued a questionnaire (UKCC, 1994) which is designed to assess the extent to which its recommendations about preceptorship for nurses, midwives and health visitors entering or re-entering registered practice have been put into practice. The first question asked is: ‘When did you become aware of the Council's policy on support and preceptorship?’
Book reviews
Authors: Gillespie Lyn , Pacanowski Lynne , Bates Carol
Published: January 2018

Parent Education: Guidance to Purchasers and Providers

Myles Textbook for Midwives (12th edn)

The Art and Science of Midwifery
Proposed management split of maternity services is unnecessary
Authors: Warwick Cathy
Published: January 2018

The proposed management split of maternity services into hospital-led obstetric services and community-led midwifery services in Tower Hamlets has the power to engender extreme feelings in midwives. Jackson (1994) and Hallworth (1994) are greatly concerned that it will have damaging consequences for women and midwifery. Jowitt (1994), however, sees it as a ‘welcome opportunity to humanise the midwifery services.’ Such polarisation of views surely indicates that this is an important area of discussion and debate in midwifery.
Care of a preterm baby
Authors: Irvine Margaret
Published: January 2018

Libby, born at 25 weeks gestation, was an extremely low birth weight baby weighing 960 g. Despite several life-threatening setbacks, she maintained her fragile hold on life. She was totally dependent on neonatal intensive care. This study explains how her care was planned and provided.
Menstrual cycle symptom reporting in PMS clinic attenders
Authors: van den Akker Olga , Steptoe Andrew
Published: January 2018

In a study of women attending a clinic for premenstrual tension, many reported only modest symptom changes, despite claiming to suffer badly. A number of variables were investigated to explain this, and the implications for clinical practice are discussed.
Midwifery and nursing: shared insights
Authors: Jackson Kate
Published: January 2018

Some years ago, I interviewed a candidate for midwifery training whose background was rather unusual. She was a registered nurse who had been a senior sister in an intensive care unit for about 5 years. She was bright and intelligent, probing gently to discover what we thought to be the strengths of our course.
Is continuing education dividing the profession?
Authors: Pansini-Murrell Julia
Published: January 2018

This article discusses the proposals for continuing education, professional development and keeping midwives' names on the professional register. The potential effect of continuing education on an individual's professional development is discussed in the light of PREP, the Higher Award, portfolios and funding.
Book reviews
Authors: Robson Laura , O'Driscoll Muriel , Millington Marian
Published: January 2018

Midwifery Teams and Caseloads

You can Teach your Child to Read

Contraception—Your Questions Answered (2nd edn)
The Patient's Charter: Maternity Services— how far does it go?
Authors: Prowse Jo
Published: January 2018

During the last 4 years, there has been growing momentum to implement change in the maternity services and to deliver quality health care according to the needs of the consumer. The Winterton Report (House of Commons Health Committee, 1992) paved the way for the Expert Maternity Group (Department of Health, 1993) to promote the ideal of a high-standard, woman-centred maternity service. The report, Changing Childbirth, established the following principles: for users of the maternity services to be actively involved in planning and evaluating services; for purchasers to be reviewing provision; for midwives to be raising their professional profiles, using their skills and knowledge to the full potential (Holt, 1994); and for choice, continuity and control to be maintained as the factors steering care.
Postnatal depression: identification, risk factors and effects
Authors: Taylor Alyx , Adams Diana , Glover Vivette
Published: January 2018

Postnatal depression can have a serious influence on family life and the development of the baby. Risk factors include a poor relationship with the partner and mood changes in the first postpartum week. A small survey of postnatally depressed women showed that 80% had not sought or received any medical help.
A total quality model for maternity services
Authors: Proctor Susan
Published: January 2018

Total quality management (TQM) is a philosophy that involves everybody in an organisation working towards continual improvement in service to the customer. It is particularly relevant to the maternity services, and this article explains how TQM principles can be applied to maternity care.
New educational horizons for assisted conception nursing
Authors: Walker Patricia I
Published: January 2018

Scientific progress and the associated growth of health care services for couples with infertility problems require the provision of a credible educational programme for midwives and nurses involved in assisted conception care. This article describes an investigatory survey, and the design and implementation of the first course in assisted conception nursing care, which recently started in the UK.
Letters
Authors: Taunt Ruth
Published: January 2018

Preregistration students respond to criticisms of naivety and negative attitudes

Community-based care

Nursing skills

Breadth of life experience

Joint learning
Book reviews
Authors: Ridgway Samantha Jay , Milan Pam , Davis Sam
Published: January 2018

The Midwife's Tale. An Oral History from Handywoman to Professional Midwife

Clinical Maternal-Fetal Nutrition

Pain and its Relief in Childbirth
Is statutory supervision central to our professional identity?
Authors: Davis Karlene C
Published: January 2018

The Department of Health is currently discussing the implementation of clinical supervision for nurses and health visitors (Butterworth and Faugier, 1994). The intention is that, as a result of clinical supervision and peer review, nurses and health visitors will be able to develop their practice through reflection. This new process will not be enshrined in legislation, unlike our own supervisory process.
Protecting the perineum in childbirth 2: risk of laceration
Authors: Floud Esther
Published: January 2018

The second article in this series examines factors that may be associated with the risk of perineal laceration in childbirth. Unfortunately, many of the studies that have been conducted to date have been methodologically flawed, and there is an urgent need for further research.
Neonatal problems of multiple births
Authors: Chaudhry AA , Harvey DR
Published: January 2018

The perinatal morbidity and mortality of a baby from a twin or triplet birth is much higher than that of a singleton. This article highlights the medical, emotional and logistic demands placed on the neonatal team and the parents by multiple births.
Breastfeeding and the ‘mysterious white spot’
Authors: Jackson Sue
Published: January 2018

Within the field of research, there is a dearth of literature relating to breastfeeding and the ‘mysterious white spot’. It seems that little is known about this condition, its aetiology, treatment and potentially detrimental effect on long-term breastfeeding.
Developing a strategy for change
Authors: Jackson Kate
Published: January 2018

One of the concerns that usually follows the publication of a major report is whether its recommendations will be implemented. This concern has been expressed about Changing Childbirth (Department of Health (DoH), 1993). It is easy to understand why such anxieties should be voiced: history is littered with reports that were warmly welcomed and quickly forgotten.
Letters
Authors: Cronk Mary , Elzubeir M , Stark S , Plummer Anni
Published: January 2018

Midwives do not need preceptorship

Course evaluation misunderstood

Role of supervisors in waterbirths
Changing childbirth resource pack for midwives by ENB
Authors: Thomas Meryl
Published: January 2018

The English National Board is contributing significantly to the achievement of the Government's targets for developing woman-centred maternity services. This article highlights the work undertaken by the Board in 1994 and which will be further developed in 1995.
Can midwifery be both art and science?
Authors: Bates Carol
Published: January 2018

There appears to be a tacit move towards encouraging midwifery to be perceived as both art and science. The RCM promotes itself as wanting to ‘advance the art and science of midwifery’, and notably a recent textbook was entitled ‘The Art and Science of Midwifery' (Silverton, 1993). How midwifery chooses to represent itself is an important issue for both midwives and women, and one that should require further exploration and debate before its designation becomes a fait accompli that we, as a profession, and ultimately as women, will regret.
ORACLE study: midwives will play a crucial part
Authors: Kenyon Sara , Taylor David J
Published: January 2018

This article describes a new national research study called ORACLE (Overview of the Role of Antibiotics in Curtailment of Labour and Early Delivery) and the vital part that midwives will play in making the study work. Pregnant women who are at high risk of poor pregnancy outcome and require medical supervision will be eligible to participate in the trial. Clinical midwives will be crucial to the study because they will offer ongoing supportive care to the women who agree to participate in the study.
Ethics and obstetric ultrasound
Authors: Proud Jean
Published: January 2018

Discussions regarding obstetric ultrasound usually centre around the safety of routine ultrasound and whether it improves fetal outcome. Ethical issues arising from routine ultrasound scanning in pregnancy also need to be addressed. One of these is whether the woman is offered the choice of having the scan or not. This article examines this and other ethical issues.
Management of acute uterine inversion
Authors: Oláh Karl S , Fishwick Kathy
Published: January 2018

The aetiology, clinical features and first-line management of acute uterine inversion are described here. Although this is a rare condition, the maternal mortality and morbidity are high if it is not recognised and managed correctly by those in attendance.
Developing a ‘standard’ for midwives for medically induced labour with prostaglandin prostaglandin E2 gel
Authors: Dharmasena Renate F , Salvage Christine , Godman Brian
Published: January 2018

The concept of a midwifery development unit leads one to review the overall aim of the service provided by midwives with regard to quality. The setting of standards for particular spheres of practice is perhaps one approach, but it requires an ongoing programme of improvement to ensure that they express advances in science, economic consideration and individual expectations of care.
An exploratory study of palliative care in bone marrow transplant patients
Authors: McDonnell Tara , Morris Monica
Published: January 2018

Quality of life – as opposed to quantity of life – raises important issues for all concerned. The legal and moral issues surrounding death, and our new abilities to delay it, are discussed frequently in the press and in professional journals. It was therefore felt important within an acute bone marrow transplant unit to identify the factors which would be considered important in palliative care for post bone marrow transplant patients, with specific reference to quality of life.

A questionnaire was designed to address certain issues surrounding the withdrawal of active treatment for this group of patients. The questionnaire content was derived from past experiences of caring for patients where death was imminent. It focuses on issues relating to patient advocacy, what is perceived as a good quality of life and the psychological implications for all concerned. This paper reports on a small exploratory study which aims to highlight key issues surrounding the withdrawal of active treatment when palliative care and symptom control take precedence.
Book Reviews
Authors: Ethell Angela , Copp Gina
Published: January 2018

Nursing the patient with cancer

Relating to the relatives: Breaking bad news, communication and support
Facing loss of dreams: a special kind of grief
Authors: Bowman Ted
Published: January 2018

Loss of dreams refers to grief experiences that do not easily fit into the images which colour an individual's preconceived ideas of life. The notion encompasses the loss of the imagined future as well as the loss of assumptions. For many persons receiving palliative care, and their families, attention to loss of dreams can be necessary before new dreams can be created and pursued, whereas grieving the old dream can be essential for acceptance, healing or recovery.

This paper will consider some of the perspectives on – and strategies of response useful to – palliative care.
The Japanese pilgrimage: not begun
Authors: Maruyama Teresa C
Published: January 2018

The modern Western hospice philosophy, with its Christian background, has tried to create a metaphorical connection between cancer patients and medieval pilgrims which implies an active attitude to an individual responsibility for pain, life and death – as one carries one's ‘own cross’. This approach is not strictly relevant to Japanese people, because their culture emphasises a family or community responsibility for – and sharing of – the matter of each person's life and death, and passive acceptance of death and pain.

This paper seeks to reveal the cultural differences between the Western and Japanese hospice movements in relation to the pilgrim-cancer patient metaphor, and the difficulties in bringing the Western hospice concept to Japan. The research also examines the possibility of how Japan might utilise some of the features of hospice care for its people without contaminating its own culture.
Measuring Teachers’ Assessment for Learning (AfL) Classroom Practices in Elementary Schools
Authors: Lysaght Zita , O’Leary Michael , Ludlow Larry
Published: January 2018

Assessment for Learning (AfL) may be conceptualized as minute-to-minute, day-by-day interactions between learners and teachers with the improvement of learning as the principal focus. This paper traces the development of an AfL measurement instrument (scale) that can be used for research purposes prior to, during and following professional development in the area. Rasch measurement procedures were applied to data drawn from a convenience sample of 594 teachers from 44 elementary schools in Ireland to create a scale consisting of 20 items distributed across four key AfL assessment strategies: learning intentions and success criteria, questioning and classroom discussion, feedback, and peer-and self-assessment.  This scale, the Assessment for Learning Measurement instrument (AfLMi), has good psychometric properties and is interpretable in a way that makes it potentially useful during system wide improvement initiatives focused on AfL.
Examining Mathematics Classroom Interactions: Elevating Student Roles in Teaching and Learning
Authors: Kent Laura
Published: January 2018

This article introduces a model entitled, “Responsive Teaching through Problem Posing” or RTPP, that addresses a type of reform oriented mathematics teaching based on posing relevant problems, positioning students as experts of mathematics, and facilitating discourse.  RTPP incorporates decades of research on students’ thinking in mathematics and more recent research on responsive teaching practices.  Two classroom case studies are presented.  A high school unit on functions is explored utilizing individual research on the part of the teacher to enact RTPP lessons.  A middle school teacher enacts a RTPP lesson on proportions and utilizes this model to bridge students’ incorrect additive reasoning strategies with correct multiplicative reasoning strategies.  The results showed that both teachers were able to elevate students’ roles in classroom discussions through implementation of RTPP.  Individual research conducted by the high school teacher informed his RTPP approach while participation in professional development sessions with a classroom embedded component influenced the middle school teacher’s enactment of RTPP lessons.  Both teachers used specific teacher moves within RTPP to relinquish their role as mathematics experts in order to elevate their students’ roles in classroom discussions.  The RTPP cycle is offered as a potential model for studying mathematics teaching and learning across a variety of secondary mathematics classrooms.