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Becoming a competent midwife is a complex process. The aim of midwifery education is to support the development of competence in midwifery skills, knowledge and to prepare graduates to meet the responsibilities inherent in the midwifery role. To explore the experiences of our alumni midwives, ask how well they perceived their midwifery programme had prepared them for beginning midwifery practice and to identify any curriculum changes, or postgraduate study topics, that would support the transition to midwifery practice. An online survey was conducted with alumni of a Bachelor of Midwifery programme (New Zealand) who graduated between 2011 and 2014. The quantitative data were analysed using descriptive statistics, and a general inductive approach was used to develop themes from the qualitative data in the comment boxes. Forty-two alumni viewed becoming a midwife as a blend/combination of: (1) gaining the knowledge and practical skills required for the profession; (2) management skills in areas of running a business, working with other people, navigating local procedures and processes effectively, and balancing work with personal life; (3) gaining confidence in one's competence, and (4) having support along the way. Competence in current evidence-based midwifery knowledge and practice is important in educating midwifery students. However, to transition to practice, a supportive environment is needed to assist midwives to develop self-management, business skills, and the confidence to negotiate and collaborate with colleagues and other health professionals. Not only did midwifery knowledge and practice skills matter for alumni, but also the acquisition of management skills, strategies for building confidence, and ongoing support. Content that facilitates these requirements should be included in midwifery programmes to support the transition from student to practitioner. [ABSTRACT FROM AUTHOR]

Background Midwives have a professional, ethical and legal obligation to effectively and thoroughly document the care provided to women and the decisions made within the partnership relationship. To appreciate the best approach to documenting midwifery care, it is important to first understand the purpose of midwifery documentation. Aim The aim of this article is to explore the literature in relation to the purposes of midwifery documentation. Method A literature search was performed using the CINAHL and Pubmed databases. Hand searching of reference and citation lists was employed to deepen the literature pool. Findings and discussion No research articles with a midwifery focus were found addressing the purpose of documentation. Broader searching of literature from other healthcare fields was drawn on to identify the contribution of record keeping to: partnership and continuity of care; communication between health professionals; improved standards of care; audits and clinical reviews; research and education; the visibility of midwifery work; the reflective practices of midwives; professional accountability; the legal record of care; the narrative record of experience for women. Conclusion The purpose of midwifery documentation is complex and multi-factorial, involving much more than the recording of clinical and legal details of a woman’s care. Midwifery documentation may potentially enhance the maternity care experience for women, support the role of the midwife, positively impact collaboration between health professionals, and contribute to organisational processes and research. Further research is needed to clarify how to address the documentation priorities of women and midwives, within the context of the maternity record. [ABSTRACT FROM AUTHOR]

Studying undergraduate midwifery at a distance has advantages in terms of accessibility and community support but presents challenges for practice based competence assessment. Student -recorded videos provide opportunities for completing the assigned skills, self-reflection, and assessment by a lecturer. This research asked how midwifery students experienced the process of completing the Video Assessment of Midwifery Practice Skills (VAMPS) in 2014 and 2015. The aim of the survey was to identify the benefits and challenges of the VAMPS assessment and to identify opportunities for improvement from the students’ perspective. All students who had participated in the VAMPS assessment during 2014 and 2015 were invited to complete an online survey. To maintain confidentiality for the students, the Qualtrics survey was administered and the data downloaded by the Organisational Research Officer. Ethical approval was granted by the organisational ethics committee. Descriptive statistics were generated and students' comments were collated. The VAMPS provided an accessible option for the competence assessment and the opportunity for self-reflection and re-recording to perfect their skill which the students appreciated. The main challenges related to the technical aspects of recording and uploading the assessment. This study highlighted some of the benefits and challenges experienced by the midwifery students and showed that practice skills can be successfully assessed at distance. The additional benefit of accessibility afforded by video assessment is a new and unique finding for undergraduate midwifery education and may resonate with other educators seeking ways to assess similar skill sets with cohorts of students studying at distance. [ABSTRACT FROM AUTHOR]

Background Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of serious perinatal outcomes for these women is comparable to similarly low risk women, who choose to birth in hospital. New Zealand women have a choice of Lead Maternity Carer (LMC) and birthplace; home, primary birthing unit, or a base hospital, though not all women may have all these choices available locally. Women in rural and rural remote areas can also choose to birth in their rural primary maternity unit. A percentage of these women (approx. 15–17%) will require transfer during labour, an event which can cause distress and often loss of midwifery continuity of care. Objective To explore retrospectively the choice of birth place decisions and the labour and birth experiences of a sample of women resident in remotely zoned, rural areas of the lower South Island of New Zealand. Design A purposive sample of women living in remote rural areas, recruited by advertising in local newspapers and flyers. Individual semi-structured interviews were digitally recorded using a pragmatic interpretive approach. The data (transcripts and field notes) were analysed using thematic and content analysis. Ethical approval was obtained from the Health and Disability Ethics Committee (HEDC) MEC/06/05/045. Participants Thirteen women consented to participate. Each was resident in a remote rural area having given birth in the previous 18 months. The women had been well during their pregnancies and at the onset of labour had anticipated a spontaneous vaginal birth. Setting Rural remote zoned areas in Otago and Southland in the South Island of New Zealand Findings Five women planned to birth in a regional hospital and eight chose their nearest rural primary maternity unit. All of the women were aware of the possibility of transfer and had made their decision about their birthplace based on their perception of their personal safety, and in consideration of their distance from specialist care. Themes included, deciding about the safest place to give birth; making the decision to transfer; experiencing transfer in labour, and reflecting on their birth experience and considering future birthplace choices. Conclusions and implications for practice and policy The experiences of the women show that for some, distance from a base hospital influences their place of birth decisions in remote rural areas of New Zealand and increases the distress for those needing to transfer over large distances. These experiences can result in women choosing, or needing to make different choices for subsequent births; the consequences of which impact on the future sustainability of midwifery services in remote rural areas, a challenge which resonates with maternity service provision internationally. While choices about birth place cannot be reliably predicted, creative solutions are needed to provide rural midwifery care and birth options for women and more timely and efficient transfer services when required. [ABSTRACT FROM AUTHOR]

Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour. Ethics approval was obtained from the NZ National Ethics Committee. Objective: to explore midwives' decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. Design: individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. Setting: New Zealand. Participants: 15 midwives who provided LMC services to women in their rural areas. Findings: 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman's preferences and the distance and time involved in the transfer. Key conclusions and implications for practice: the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context. [ABSTRACT FROM AUTHOR]

The recent paper by Brettmann et al. provides insight as to how an RNA virus can persistently coexist in a protozoan with RNAi activity and how these two entities work to maintain balance. The authors were also able to successfully remove the virus and examine the role of the virus in parasitemia and the pathogenesis of leishmaniasis. [ABSTRACT FROM AUTHOR]

Abstract: Background: In Japan, most women manage labour pain without pharmacological interventions. However, New Zealand statistics show a high percentage of epidural use amongst Asian women. Entonox (a gas mixture of nitrous oxide and oxygen) and pethidine are also available to women in New Zealand. This article investigates how Japanese women in New Zealand respond to the use of pharmacological pain relief in labour. Questions: The study was guided by two research questions: (1) How do Japanese women experience and manage labour pain in New Zealand? (2) How do they feel about the use of pharmacological pain relief? Methods: Thirteen Japanese women who had given birth in New Zealand were interviewed individually or in a focus group. The conversations were analysed using thematic analysis. Findings: Although in Japan very few women use pain relief, nine women received epidural and/or Entonox out of 11 women who experienced labour pain. The contrast between their Japanese cultural expectations and their birth experiences caused some of the women subsequent personal conflict. Conclusion: Japanese women's cultural perspectives and passive attitudes were demonstrated to influence the decision-making process concerning pain relief. It was concluded that understanding Japanese cultural worldviews and approaches to the role of pain in labour would help maternity providers in their provision of appropriate care for Japanese women. [Copyright &y& Elsevier]

The common marmoset is a new world primate belonging to the Callitrichidae family weighing between 350 and 400g. The marmoset has been shown to be an outstanding model for studying aging, reproduction, neuroscience, toxicology, and infectious disease. With regard to their susceptibility to infectious agents, they are exquisite NHP models for viral, protozoan and bacterial agents, as well as prions. The marmoset provides the advantages of a small animal model in high containment coupled with the immunological repertoire of a nonhuman primate and susceptibility to wild type, non-adapted viruses. [Copyright &y& Elsevier]

Abstract: Lassa virus (LASV) is responsible for the deaths of thousands of people in West Africa annually. Genetic diversity among LASV strains is the highest among the Arenaviridae and represents a great challenge for vaccine development. Guinea pigs vaccinated with a ML29 reassortant vaccine experienced sterilizing immunity and complete protection when challenged on day 30 either with homologous virus or with the distantly related Nigerian isolate. Simultaneous vaccination–challenge or challenge on day 2 after vaccination also protected 60–100% of the animals against both strains, but without sterilizing immunity. These results indicate that simultaneous replication of ML29 and LASV attenuates the virulence of LASV infection. [Copyright &y& Elsevier]

Polycyclic indolic compounds containing the [6,5,6,5,6] ring system were prepared via an intramolecular furan Diels–Alder reaction of α,β-unsaturated amides generated by the N-acylation of 1-(2-furyl)-β-tetrahydrocarbolines. This chemistry can provide access to D(14)-noryohimban derivatives by exploiting the functionality on the C,D,E ring system of the corresponding cycloadducts. [Copyright &y& Elsevier]

Leishmaniavirus 1 is a double-stranded RNA virus that infects the New World kinetoplastid parasites , Leishmania braziliensis, and Leishmania guyanensis. The isolated virus particles contain an RNA-dependent RNA polymerase which exhibits both transcriptase activity for genome-length plus-strand synthesis and replicase activity for genome-length minus-strand synthesis. Recently, we identified a 320 nucleotide short RNA transcript of Leishmaniavirus 1-4, derived from the 5' end of the viral plus-strand, which is generated by the virus capsid via site-specific cleavage of the fulllength positive single-stranded RNA. We have hypothesized that this short RNA transcript functions to regulate the virus life cycle during the growth of its parasite host, Leishmania guyanensis. To address this hypothesis, we measured the relative amount of short RNA transcripts and the absolute number of viral genomes per infected cell from log through stationary phase of the parasite growth cycle. In vitro assays of the viral polymerase showed an overall increase in viral polymerase activity from log growth into stationary phase which mirrored an in vivo increase in the quantity of double-stranded genome as measured by agarose gel electrophoresis. We have developed competitive reverse transcription-polymerase chain reaction (RT-PCR) assays to measure the relative amounts of viral transcripts in infected cells as well as the number of viral genomes per infected cell. The results of these assays show that the amount of fulllength virus transcripts peaks in the parasite stationary phase (132 transcripts per cell), and that the short transcript is most abundant in the early stationary phase cells (24 transcripts per cell). [ABSTRACT FROM AUTHOR]

Abstract: Yellow Fever (YF) and Lassa Fever (LF) are two prevalent hemorrhagic fevers co-circulating in West Africa and responsible for thousands of deaths annually. The YF vaccine 17D has been used as a vector for the Lassa virus glycoprotein precursor (LASV-GPC) or their subunits, GP1 (attachment glycoprotein) and GP2 (fusion glycoprotein). Cloning shorter inserts, LASV-GP1 and -GP2, between YF17D E and NS1 genes enhanced genetic stability of recombinant viruses, YF17D/LASV-GP1 and -GP2, in comparison with YF17D/LASV-GPC recombinant. The recombinant viruses were replication competent and properly processed YF proteins and LASV GP antigens in infected cells. YF17D/LASV-GP1 and -GP2 induced specific CD8+ T cell responses in mice and protected strain 13 guinea pigs against fatal LF. Unlike immunization with live attenuated reassortant vaccine ML29, immunization with YF17D/LASV-GP1 and -GP2 did not provide sterilizing immunity. This study demonstrates the feasibility of YF17D-based vaccine to control LF in West Africa. [ABSTRACT FROM AUTHOR]

Abstract: A single injection of ML29 reassortant vaccine for Lassa fever induces low, transient viremia, and low or moderate levels of ML29 replication in tissues of common marmosets depending on the dose of the vaccination. The vaccination elicits specific immune responses and completely protects marmosets against fatal disease by induction of sterilizing cell-mediated immunity. DNA array analysis of human peripheral blood mononuclear cells from healthy donors exposed to ML29 revealed that gene expression patterns in ML29-exposed PBMC and control, media-exposed PBMC, clustered together confirming safety profile of the ML29 in non-human primates. The ML29 reassortant is a promising vaccine candidate for Lassa fever. [Copyright &y& Elsevier]

Abstract: Nonhuman primates are suitable and valid models to determine the safety, immunogenicity and efficacy of candidate vaccines that are being developed for human application. Among the nonhuman primates, baboons have been found to be ideal for vaccine studies because they are phylogenetically closer to humans, have a similar immune system and response and are available in large numbers. During the last two decades, numerous candidate vaccines have been evaluated in the baboon model. [Copyright &y& Elsevier]