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Background: Personal pronouns like ‘I’, ‘me’ or ‘mine’ are inextricably linked with ownership, with one key benefit of a counsellor inviting a client to consider their pronoun use being an invitation to change their awareness and understanding of a situation.\ud Objective: To gain greater understanding of the impact of inviting clients to use first person pronoun ‘I’, in place of second ‘you’ during therapy and its effects upon the client and therapeutic process.\ud Method: A constructivist qualitative approach using exploratory thematic analysis that engaged one-to-one counselling and follow-up interviews was used. Participants (n=11) were clients who had been referred for counselling via primary care with problems like depression, relationship break-up and/or stress. \ud Findings: Several themes were identified in the data: (1) Potential discomfort from switching to first position; (2) Awareness increased; (3) Avoidance of taking responsibility recognised; (4) Depersonalisation of events; (5) Initiating change; and (6) Effects on sense of self. Comments illustrate that reframing pronouns into first person removes distance between client emotions and problems, which provides them with an opportunity for development.\ud Discussion: Clients can be affected in productive ways when counsellors encourage them to alter their pronoun use during therapy. Through use of reflection, the counsellor can work with their client to explore more fully their attributions of responsibility within situations that are discussed.

This narrative review summarises findings of research that has shown use of Compassion-Focused Therapy (CFT) to improve psychological outcomes in clinical populations. This article reviews the research studies that have utilised CFT to treat clients experiencing a variety of mental health issues. The paper begins offering an overview of CFT theory and compassionate mind interventions. A literature search was conducted which included book chapters and articles that discussed compassion focused therapy. Twelve studies were identified which showed significant psychological improvements in clients with diagnosed trauma symptoms, brain injury, eating disorders, personality disorders, schizophrenia-spectrum disorder, chronic mental health problems and psychosis, both within groups and during one-to-one therapy. Within the contextof the reviewed studies, CFT has shown itself to be an effective therapeutic intervention when combined withapproaches such as Cognitive Behavioural Therapy (CBT).The research design of the majority of the studies examined precluded determining the extent of individual contributions that CFT made towards client recovery. Further research that uses more rigorous approaches are required to evaluate more effectively the role CFT plays in clients’ therapeutic recovery.

IntroductionThere is limited understanding of the type and extent of maternal postures that midwives should encourage or support during labor. The aims of this study were to identify a set of postures and movements commonly seen during labor, to develop an activity monitoring system for use during labor, and to validate this system design.MethodsVolunteer student midwives simulated maternal activity during labor in a laboratory setting. Participants (N = 15) wore monitors adhered to the left thigh and left shank, and adopted 13 common postures of laboring women for 3 minutes each. Simulated activities were recorded using a video camera. Postures and movements were coded from the video, and statistical analysis conducted of agreement between coded video data and outputs of the activity monitoring system.ResultsExcellent agreement between the 2 raters of the video recordings was found (Cohen's κ = 0.95). Both sensitivity and specificity of the activity monitoring system were greater than 80% for standing, lying, kneeling, and sitting (legs dangling).DiscussionThis validated system can be used to measure elected activity of laboring women and report on effects of postures on length of first stage, pain experience, birth satisfaction, and neonatal condition. This validated maternal posture-monitoring system is available as a reference—and for use by researchers who wish to develop research in this area.

Objective: To explore: (1) childbearing women’s experiences of ‘birth satisfaction’ and (2) identify contexts in which it is more appropriate to use the 30-item Birth Satisfaction Scale (BSS) or the 10-item BSS-Revised (BSS-R).Study design: A quantitative survey was conducted using the 30-item BSS. As a function of completing the 30-item BSS, participants also completed the short-form 10-item BSS-R.Participants: A convenience sample of post-natal women (n=228) attending for National Health Service (NHS) care at the Ayrshire Maternity Unit in the West of Scotland (UK) participated. Participants were within their first 10 post-natal days.Results: The 30-item BSS mean scores = 115.84 (SD 14.05). The thematically determined subscale mean scores of quality of care provision (BSS-QC; 8-items), women’s personal attributes (BSS-WA; 8-items) and stress experienced during labour (BSS-SL;14-items) subscales, were 32.2 (4.09), 31.9 (4.16) and 51.73 (8.04) respectively. Women experienced greater ‘birth satisfaction’ when they had a Spontaneous Vertex Delivery compared with a complicated delivery. Primigravidas were generally less ‘birth satisfied’ than multiparous women.Key conclusions: Overall assessment of care was complimentary, with global levels of ‘birth satisfaction’ generally high. In response to psychometric tests, the 30-item BSS has been trimmed down to a statistically robust, valid and reliable 10-item BSS-R.Implications for practice: Now that a valid and reliable 10-item BSS has been developed to measure women’s experiences of childbirth, it can be used to assess differences between variables such as home and hospital birth, or to establish correlates with other valid measures. We advance our study as an important contribution to person-centered maternal healthcare.

Background: low back pain (LBP) is a major cause of work absence. Assisting individuals back into work is an important part of rehabilitation. Objective: to explore the experiences of individuals returning to work after an episode of sickness absence due to LBP. Participants: Five women employed by a UK University who had returned to work. Method: in this qualitative study, participants underwent semi-structured interviews about their experiences. The transcripts were analysed using interpretative phenomenological analysis. Results: two primary themes emerged 1) perceived pressure to return to work and 2) strategies employed to relieve the pressure to return. Pressure to return to work arose from a number of sources including guilt and a personal work ethic, internally, and from colleagues and management, externally. This pressure led to the individual employing a number of strategies to reduce it. These ranged from a simple denial of health concerns and decision to return to work regardless of their condition, to placing the responsibility of the decision not to return to work onto a significant other, such as a family member or health care professional. Cconclusions: individuals returning to work with LBP experience considerable pressure to return and use a range of strategies to mediate that pressure.

At present there is lack of information about CMV transmission given to midwives, general practitioners, neonatal pediatricians and nurses, with intrauterine transmission having profound consequences in terms of outcomes for the infected neonate. To identify one particular group of midwives knowledge about CMV, the research question surveyed midwives' knowledge of CMV. A quantitative electronic survey was the research method utilized in this study. To assess midwives knowledge about CMV, the first author emailed colleagues in Hannover and was in receipt of 40 completed questionnaires. Results showed that midwives have gaps in their knowledge about CMV and that an educational program is necessary to enlarge their understandings. Given the catastrophic consequences to the neonate of contracting congenital CMV, it is imperative that both health care professionals and women receive the educational message about prevention. In response an education program for lecturers has been proposed, which consists of eleven learning objectives.

In the West there is a contemporary expectation that fathers should be present at the birth of their babies (Longworth and Kingdon 2011), with many unclear of their job description(Vehvilainen-Julkunen and Liukkkonnen 1998). A former Royal College of Midwives (RCM) survey established that roughly 98 per cent of UK fathers were inclined to participate at the birth (Reid 1994), with around 97 per cent embracing positive attitudes towards the impending event (Hollins Martin 2008a). Longworth and Kingdon (2011) identified that some fathers were unsure about their role and how to involve themselves more.

Purpose: this paper aims to critically explore the consequences of how Scotland interprets the UK Misuse of Drugs Act (1971). Scotland prosecutes 24 per cent of people found in possession of illegal drugs for drug “dealing” compared to less than 15 per cent in England and Wales and less than 16 per cent in Northern Ireland.Design/methodology/approach: the paper provides a narrative review in the context of the background of the economic and social costs of illegal drugs in Scotland and compares this with the UK and Northern Ireland.Findings: the explanation for such a wide disparity in numbers of dealers between these countries proposed is that the Scottish police force is comparatively more successful at persuading courts that small quantities of drugs rather than for personal use are in fact for onward sale or supply to others.Practical implications: the police in Scotland have a network of specialist drug units in which officers make decisions in the absence of benchmarks against which to judge quantities of repossessed drugs. Taking this approach, a devolved Scotland's commitment to drug prohibition has resulted in some very curious differences in classifications of prosecutions compared to other countries.Originality/value: the paper explores the consequences of how Scotland deals with the use of illegal drugs and the economic and social costs.

Turner syndrome (TS) is a cross-cultural genetic disorder that affects around 1 in 2500 women and is predominately associated with short stature and infertility. Classic TS occurs when one sex chromosome is missing (written as 45,X). In mosaic TS, there is a mix of cells, some with 45 chromosomes—missing one X chromosome, and some with all 46 chromosomes—missing part of the X chromosome. TS is characterised by short stature and non-functioning ovaries, which leads to impaired pubertal development and infertility. The majority of women with TS present with no behavioural or physical attributes that would distinguish them as different to the general population, and can be expected to live long and healthy lives. A midwife may have to care for a woman whose fetus has been diagnosed with TS, recognise and manage a newborn with TS, or manage a woman with TS who is pregnant with a donor ovum. To equip midwives with relevant knowledge, the objectives of this paper are to explain what TS is, how it may be recognised, and discuss medical and midwifery management of events.

A demographic survey of London sex-workers established age, nationality, alcohol/drug use, physical/mental health concerns and whether trafficked or optionally migrated into the industry. There are overt differences between sex-workers—implications for police, health and social workers are that welfare services tailor care to meet individual needs within this population.

This paper aims to provide a critical analysis of key concepts associated with post-natal depression (PND) to facilitate healthcare professionals with improving standards of care. Post-natal depression is often inadequately understood by healthcare professionals. The objective was to clarify and present understandings of PND. Post-natal depression may result in referral to Community Mental Health Teams and although initial contact and management is usually through Primary Care, increasingly there is involvement of liaison mental health nurses. A literature review and synthesis of research papers on PND was conducted. Using the keywords post-natal depression, post-partum, puerperium, perinatal, therapy, trial, review, systematic, 135 articles were yielded and limited to 57, which were critically reviewed and categorized into key concepts and themes. Synthesis of literature in relation to PND has facilitated construction of an evidence-based contemporary picture of clinical manifestation, aetiology, methods of screening, preventing, treating and managing PND. The veracity of the evidence surrounding the aetiology and treatment of PND is variable. Interventions are often ineffective and a vacuum in the evidence base exists leaving a dynamic environment for researchers to identify more successful ways of predicting, detecting, treating and managing PND.

This study analyzes the psychological processes involved when a midwife accepts directions from a senior person. A representative sample of 20 midwives were recruited from 7 maternity units in North Yorkshire. An inductive thematic analysis was used to interpret interview data. Results showed that midwives respond to social influence from senior people using two processes: obedience and/or conformity. Thirteen (65%) excerpts informed that participants' interpreted direction from the senior person as instructions they were expected to follow (obedience) and seven (35%) showed that others voluntarily changed their viewpoint to agree with the one offered by the senior person (conformity). Participants' behaviour has been explained in terms of 'legitimacy', 'perceived obligation to the organization' and 'social identification'. These pressures create conflict between the midwives' knowledge of how they would prefer to behave and concern to please authority or fit into the social group. Consequently, it may be difficult for midwives to support safe requests from women that conflict with what a senior person.

Obedience research has shown that under situational pressures and within hierarchical relationships, people have a propensity towards submission to authority (Milgram, 1974). Once they have done so, their actions are no longer guided by their own values but by the desire to fulfill authority's wishes (Meeus and Raaijmakers, 1995). When an authority figure gives direction, this may clash with a midwife's knowledge of a woman's preferred choice. Hollins Martin and Bull (2005) showed the success that a senior midwife had at socially influencing decisions of more junior midwives, even when the outcome contravened their established views of best practice. Hollins Martin and Bull (2006) showed that choice provision for childbearing women was difficult to provide because of the imposition of hospital protocols, the hierarchy and fears of challenging senior people. Acknowledging these identified constraints this paper poses eight plausible solutions to facilitate midwives with providing the choice that is advocated in social policy documents (Department of Health, 1993; DH, 2003; DH, 2004).

Most people will have observed the often impressive synchrony of the behaviour of fish in a school or birds in a flock. The fact that the behaviour of a fish is so well matched to that of the behaviour of others is straightforward: perception directly affects behaviour. When a fish perceives a change of direction in another fish it simply matches this change in direction. This direct link between perception and behaviour can be easily witnessed in humans as well. We too match the behaviour of others and we do this simply because perception directly affects action. The specific behavioural changes perception can bring about differ between humans and fish, but the underlying mechanism is essentially the same. Perhaps we share this important psychological mechanism with a haddock (Dijksterhuis 2001, p 105).

This paper addresses the issue of social attitudes. The purpose is to facilitate understanding of attitude structures and the application of this knowledge to midwifery practice. Attitudes have been defined and their development within individuals described. The above information has been applied to midwifery practice emphasizing the issue of respect for a client's attitudes and opinions which may differ considerably from our own. Attitude change has been addressed in relation to helping women change behaviours which promote obstetric damage. An explanation has been given to assist midwives' understanding of why women continue with damaging behaviour.