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There is growing evidence to show increased mental ill health in women compulsorily separated from their babies at birth (Cantwell et al., MBRRACE‐UK, 2018:56). For imprisoned women, the risk of self‐harm and suicide may be exacerbated. This article draws on in‐depth interviews with a sample of 28 imprisoned pregnant women/new mothers, 10 prison staff and observations to discuss the experience of separation from or anticipation of separation of women from their babies. Oakley (Signs, 4:607–631, 1980) reflected on the transition to motherhood with reference to the sociology of loss of identity. Women who have been compulsorily separated from their babies experience subjugated loss out of place with societal norms. The experiences of compulsory separation, in relation to concepts of disenfranchised grief, resonate with Lovell's (Social Science & Medicine, 17:755–761, 1983) research into the altered identities of mothers when loss occurs through late miscarriage or stillbirth. Additionally, this type of complex loss also denies a woman her identity as a 'mother'. This article offers a fresh sociological perspective on the ways loss and grief are experienced by women facing separation from their babies in prison, drawing on concepts of uncertainty, loss and disenfranchised grief. [ABSTRACT FROM AUTHOR]

There is growing evidence demonstrating increased mental ill-health in women compulsorily separated from their babies. For imprisoned women, the risk of self-harm and suicide may be further exacerbated. Birth supporters caring voluntarily for women in prison having their babies removed is valued and beneficial for wellbeing. Little is known about the effects on those supporting women in these circumstances. The aim of this study was to better understand the experiences of birth supporters when caring for imprisoned women experiencing compulsory separation from their babies. A qualitative approach explored the experiences of 12 birth supporters through: one to one in-depth online interviews. A thematic analytical method was utilised to analyse the data. Four key themes resulted from thematic analysis: vicarious trauma, transference of pain, standout cases and support networks. Birth supporters witnessing traumatic events such as the separation of imprisoned mother from her new-born baby may need additional supervision and therapeutic support. Birth supporters may experience Secondary Traumatic Stress (STS) and appropriate support and debriefing should be afforded to them equal to paid health and social care staff. The main argument of this paper is that strong support networks can serve as a benchmark for helping individuals affected by vicarious trauma, particularly in complex situations involving women who are being compulsorily separated from their babies. Due to the value clearly placed upon those who do volunteer by women, this kind of support should be consistent across criminal justice settings especially considering the impact on women’s mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: In the United Kingdom (UK), all prisoners must receive healthcare equivalent to that available in the community. However, evidence suggests that equality in healthcare provision for perinatal women in UK prisons is not always achieved. The aim of this research was to examine pregnant women prisoners' and custody staffs' experiences and perceptions of midwifery care in English prisons. Methods: A qualitative approach based on institutional ethnography was used to research women's experiences in three English prisons over a period of 10 months. In total, 28 women participated in audio‐recorded, semi‐structured interviews. Ten staff members were interviewed, including six prison service staff and four health care personnel. Ten months of prison fieldwork enabled observations of everyday prison life. NVivo was used for data organization with an inductive thematic analysis method. Results: Women's experiences included: disempowerment due to limited choice; fear of birthing alone; and a lack of information about rights, with a sense of not receiving entitlements. Some women reported favorably on the continuity of midwifery care provided. There was confusion around the statutory role of UK midwifery. Discussion: Experiences of perinatal prisoners contrast starkly with best midwifery practice—women are unable to choose their care provider, their birth companions, or their place of birth. In addition, a reliance upon "good behavior" in return for appropriate treatment may be detrimental to the health, safety, and well‐being of the pregnant woman and her unborn baby. Conclusion: Prison is an adverse environment for a pregnant woman. This study provides key insights into imprisoned women's experiences of midwifery care in England and shows that midwives play an essential role in ensuring that perinatal prisoners receive safe, high‐quality, respectful care. [ABSTRACT FROM AUTHOR]

Selecting books for young children can not only be a fun and rewarding experience but also a little daunting, considering the number of books available. Frequent collaboration between an author and a public librarian has produced valuable insights about how to begin reading with very young children. Suggestions are offered for how parents and educators can choose books that will encourage and motivate lifelong readers. Six research-based areas defined by the Every Child Ready to Read @ your library program provide the framework: vocabulary, narrative connections, print motivation, print awareness, letter knowledge, and phonological awareness. Parents and teachers can evaluate various books based on this model. Several examples of books are described, and strategies for instruction and engagement are included with each.

This article examines the unique experiences of pregnant women in prison, building on Sykes’ concept of the pains of imprisonment and Crawley’s notion of institutional thoughtlessness. Based on qualitative data from an ethnographic study of three English prisons, including interviews with 28 pregnant prisoners and 10 staff members and field observations, the study highlights the lack of basic provisions for pregnant women, such as adequate nutrition, fresh air and suitable bedding. The article argues that the lack of such rudimentary provisions leads to the unique experience of the pains of imprisonment for pregnant women. The article argues that the prison system needs to take a more considerate approach to prisoners who have specialist requirements, including pregnant women, rather than treating them as a homogenised group. [ABSTRACT FROM AUTHOR]

BACKGROUND: Along with quantitative measures, pain symptoms may help inform early interventions to prevent prolonged standing induced low back pain (LBP); however, the relationship between quantitative and qualitative measures has not been assessed. OBJECTIVE: Determine the relationship between qualitative and quantitative measures of pain development during prolonged standing induced LBP development. METHODS: Thirty-five participants performed two-hours of standing. A visual analog scale (VAS) and the Short-Form McGill Pain Questionnaire were used to assess the participant's LBP every 7.5-minutes. Participants were classified as a pain developer (PD) based on VAS scores or three consecutive pain symptom reports. RESULTS: Pain symptom reports occurred 31.3 (±24.8) minutes earlier than the VAS reports. Eight participants (44%) were non-PDs with the VAS and PDs with the symptom method (p = 0.0047). CONCLUSIONS: A subset of participants who were not categorized as LBP developers during prolonged standing using the VAS method still report LBP symptoms. The inclusion of pain symptom reporting could provide additional information for practitioners when identifying individuals who would benefit from early interventions for standing induced LBP. [ABSTRACT FROM AUTHOR]

With a prison population of approximately 9000 women in England, it is estimated that approximately 600 pregnancies and 100 births occur annually. Despite an extensive literature on the sociology of reproduction, pregnancy and childbirth among women prisoners is under‐researched. This article reports an ethnographic study in three English prisons undertaken in 2015‐2016, including interviews with 22 prisoners, six women released from prison and 10 staff members. Pregnant prisoners experience numerous additional difficulties in prison including the ambiguous status of a pregnant prisoner, physical aspects of pregnancy and the degradation of the handcuffed or chained prisoner during visits to the more public setting of hospital. This article draws on Erving Goffman's concepts of closed institutions, dramaturgy and mortification of self, Crewe et al.'s work on the gendered pains of imprisonment and Crawley's notion of 'institutional thoughtlessness', and proposes a new concept of institutional ignominy to understand the embodied situation of the pregnant prisoner. [ABSTRACT FROM AUTHOR]

Background: The United Kingdom has the highest incarceration rate in Western Europe. It is known that women in prison are a vulnerable female population who are at risk of mental ill-health due to disadvantaged and chaotic life experiences. Accurate numbers of pregnant women held in UK prisons are not recorded, yet it is estimated that 6%–7% of the female prison population are at varying stages of pregnancy and around 100 babies are born to incarcerated women each year. There are limited published papers that document the departure of the researcher following closure of fieldwork with women in prison. This article identifies the dilemmas and challenges associated with the closure of prison fieldwork through the interwoven reflections of the researcher. Departure scenarios are presented which illuminate moments of closure talk with five women, supported by participant reflections regarding abandonment and loss, making pledges for the future, self-affirmation, incidental add-ons at the end of an interview and red flags, alerting the researcher to potential participant harm through ill health or self-injury. Objectives: The primary intention of the study was to observe the pregnant woman's experience with the English prison system through interviews with pregnant women and field observations of the environment. Research design: Ethnographic design enabled the researcher, a practising midwife, to engage with the prisoners' pregnancy experiences in three English prisons, which took place over 10 months during 2015–2016. Data collection involved semi-structured, audio-recorded interviews with 28 female prisoners in England who were pregnant or had recently given birth while imprisoned, 10 members of staff and a period of non-participant observation. Follow-up interviews with 5 women were undertaken as their pregnancies progressed. Computerised qualitative data analysis software was used to generate and analyse pregnancy-related themes. Ethical considerations: Favourable ethical opinion was granted by National Offender Management Services through the Health Research Authority Integrated Research Application System and permission to proceed was granted by the University of Hertfordshire, UK. Findings: Thematic analysis enabled the identification of themes associated with the experience of prison pregnancy illuminating how prison life continues with little consideration for their unique physical needs, coping tactics adopted and the way women negotiate entitlements. On researcher departure from the field, the complex feelings of loss and sadness were experienced by both participants and researcher. Discussion: To leave the participant with a sense of abandonment following closure of fieldwork, due to the very nature of the closed environment, risks re-enactment of previous emotional pain of separation. Although not an ethical requirement, the researcher sought out psychotherapeutic supervision during the fieldwork phase with 'Janet', a forensic psychotherapist, which helped to highlight the need for careful closure of research/participant relationships with a vulnerable population. This article brings to the consciousness of prison researchers the need to minimise potential harm by carefully negotiating how to exit the field. Reflections of the researcher are interlinked with utterances from some participants to illustrate the types of departure behaviours. Conclusion: Closure of fieldwork and subsequent researcher departure involving pregnant women in prison requires careful handling to uphold the ethical research principle 'do no harm'. [ABSTRACT FROM AUTHOR]

It is understood that pregnant women make up around six per cent of the female prison population although precise numbers are not collated, this amounts to around 600 pregnant women held in prisons in England and Wales and some 100 babies born to women prisoners. There are limited qualitative studies published that document the experiences of pregnancy whilst serving a prison sentence. This study provides qualitative, ethnographic research of the pregnancy experience. The study took place during 2015-2016 and involved non-participant observation and semi-structured interviews with 28 female prisoners in three English prisons who were pregnant or had recently given birth. Ten members of prison and health care staff were also interviewed. Apart from the experiences of being on 'bed watch' with pregnant or labouring women, a new typology of prison officer has emerged from this study: the 'maternal'; a member of prison staff who accompanies pregnant, labouring women to hospital where the role of 'bed watch officer' can become that of a birth supporter. The officer (s) attending pregnant women in hospital have an important role to play and may have been 'chosen' by the woman. This paper provides narratives of these experiences and discusses the relationship of the bed watch officer who may be both guarding and supporting the woman. Pseudonyms are used throughout. [ABSTRACT FROM AUTHOR]

A patient with human immunodeficiency virus-1 infection presented with sub-acute liver failure, temporally related to commencement of an antiretroviral therapy regimen containing dolutegravir (Triumeq). The patient was not a carrier of HLA-B5701, and abacavir hypersensitivity was unlikely. We believe this is the first report of severe dolutegravir-related hepatotoxicity resulting in sub-acute liver failure and transplantation and highlights a potential need for closer monitoring after drug initiation. [ABSTRACT FROM AUTHOR]

A patient with human immunodeficiency virus-1 infection presented with sub-acute liver failure, temporally related to commencement of an antiretroviral therapy regimen containing dolutegravir (Triumeq). The patient was not a carrier of HLA-B5701, and abacavir hypersensitivity was unlikely. We believe this is the first report of severe dolutegravir-related hepatotoxicity resulting in sub-acute liver failure and transplantation and highlights a potential need for closer monitoring after drug initiation. [ABSTRACT FROM AUTHOR]

An audit of supervisors of midwives' (SoMs') experience of supervision and their understanding of their role as leaders in clinical practice was undertaken. Particular attention was paid to their experiences as newly appointed SoMs during the preceptorship period. The amount of protected time that SoMs have to undertake the role was explored, including how the SoMs achieved the expectations of being leaders in clinical practice. An online audit questionnaire was sent to all the SoMs within the local supervising authority. The findings of the audit demonstrated that a significant number of SoMs did not have preceptorship or supernumerary time as newly-appointed SoMs. The audit results confirmed the findings of previous research illustrating that SoMs had inadequate time to undertake their role. There was a variation in engaging with different leadership aspects of supervision depending on the SoM’s substantive post. The SoMs participating in the audit gave examples of factors that impede them in achieving the standards for their role as set out by the Nursing and Midwifery Council. The SoMs participating in the audit expressed the empowering effect of being able to facilitate women’s birth choices and supporting midwives to provide high quality midwifery care. [ABSTRACT FROM AUTHOR]

The article discusses a systematized approach to managing wound-associated pain that address pain relief, increase function and restore quality of life. Findings showed that wound related pain is a common biopsychosocial symptom that requires diverse management strategies. It also showed that selection of pharmacological agents for pain should consider the pain's severity, type, duration and timing.

Supervision of midwives is a statutory responsibility which provides a mechanism to support and guide practising midwives. The preparation course to become a supervisor of midwives (SoM) at the University of Hertfordshire requires a midwife to be nominated by her peers and to undertake a course at Masters level over two semesters. A learning strategy on the preparation course is 'action learning' (AL), whereby groups of six or seven student supervisors compulsorily attend six action learning sessions. AL requires skills of analysis, scrutiny and reflexivity. An exploration of AL as a teaching strategy on the SoM preparation course led to the conclusion that this is an appropriate and high-quality teaching method which develops the reflective skills of the participants as well as developing self awareness and communication skills to a high standard. INSET: Key points. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor concerning the new antenatal guidelines of the British National Institute for Clinical Excellence.

Background: Children being cared for in hospital undergo multiple painful procedures daily. However, little is known about the frequency of these procedures and associated interventions to manage the pain. We undertook this study to determine, for children in Canadian hospitals, the frequency of painful procedures, the types of pain management interventions associated with painful procedures and the influence of the type of hospital unit on procedural pain management., Methods: We reviewed medical charts for infants and children up to 18 years of age who had been admitted to 32 inpatient units at eight Canadian pediatric hospitals between October 2007 and April 2008. We recorded all of the painful procedures performed and the pain management interventions that had been implemented in the 24-hour period preceding data collection. We performed descriptive and comparative (analysis of variance, χ(2)) analyses., Results: Of the 3822 children included in the study, 2987 (78.2%) had undergone at least one painful procedure in the 24-hour period preceding data collection, for a total of 18 929 painful procedures (mean 6.3 per child who had any painful procedure). For 2334 (78.1%) of the 2987 children who had a painful procedure, a pain management intervention in the previous 24 hours was documented in the chart: 1980 (84.8%) had a pharmacologic intervention, 609 (26.1%) a physical intervention, 584 (25.0%) a psychologic intervention and 753 (32.3%) a combination of interventions. However, for only 844 (28.3%) of the 2987 children was one or more pain management interventions administered and documented specifically for a painful procedure. Pediatric intensive care units reported the highest proportion of painful procedures and analgesics administered., Interpretation: For less than one-third of painful procedures was there documentation of one or more specific pain management interventions. Strategies for implementing changes in pain management must be tailored to the type of hospital unit.

Ectopic pregnancy is the third biggest killer of pregnant women in the UK. Misdiagnosis and delay in treatment remain common problems, which feature in the Department of Health's last two confidential inquiries into maternal death. This article outlines the symptoms and management of ectopic pregnancy as well as high-lighting its psychological and physical effects.