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Nausea and vomiting in pregnancy (NVP), which is known to affect nearly 70% of all pregnant women, has been associated with favourable pregnancy outcomes such as decreased risk of miscarriage, low birth weight and premature delivery. The aim of this research was to determine the mechanism by which these protective effects of NVP may be brought about. Women suffering from NVP may decrease their intake due to the symptoms, may increase their intake to alleviate symptoms, or may change the quality of their diet. Both a retrospective questionnaire survey (n=201) and a prospective cohort study (n=52) were carried out between April 1999 and August 2001. Women were recruited mainly from two GP clinics in Guildford. It was found from both studies that the prevalence of NVP in the Guildford area is similar to that reported in other studies. Although this study found no relationship between NVP and birth weight and gestational age, women with NVP had higher cord IGF-1 levels compared to women without NVP (p=0.044). In addition, duration of NVP was inversely related to birthweight to placental ratio (p=0.011). Forty three women provided complete dietary information. It was found that energy intakes did not differ between women who had NVP compared with women who had no NVP, however the quality of diet varied between women with NVP and those without NVP. This is probably due to the fact that women with NVP had a high risk of cravings and aversions in pregnancy, leading to the difference in intake of certain nutrients such as riboflavin, calcium, zinc and copper. The strong association between NVP and aversions in pregnancy (P= 0.026) found in the retrospective study could lend further support to the "Embryo protection" hypothesis, which states that NVP is a protective mechanism, which has evolved to prevent the mother from the ingestion of foods that could be harmful to the fetus. Further studies using larger sample sizes, covering a range of socio-economic status and different regions are needed before definite conclusions can be drawn.

The position in which a woman births her baby is considered to be influenced by her social environment. The position adopted by a woman in labour has not only physiological stimuli but socio-cultural ones as well. Throughout the twentieth century women have been encouraged to remain in bed during labour and for the birth, which can be viewed as a position more convenient for the accoucheur, as this enabled easier access to undertake continuous fetal monitoring, intravenous therapy, vaginal examinations and to administer analgesia. A review of history however suggests today's birth postures were decreed and adopted on the basis of custom and convenience rather than physiological and anatomical indications and scientific data. There has been no study to examine the social context of women's choice of birth position or the influence of birth setting. This study was undertaken to explore what concerns, principles and environmental factors guide women in their choices regarding birth positions. The study used qualitative methods of data collection and employed induction rather than deduction in the analysis. Clarification of these factors may influence the future provision of care by midwives, in addition to highlighting factors which may enhance maternal satisfaction. A grounded theory approach was utilised in this study by means of antenatal and postnatal interviews in two different hospital settings. Several factors that influenced women's choice of birth position were identified, some of which were interrelated. These included physicial and social environment, disciplinary power present in the medical system and related technology. The midwife and her support are also important factors affecting women's choice of birth position. A decision making typology that can be utilised by midwives to enhance their practice and assist women in their choice of birth position had been developed from this study.

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There is increasing evidence supporting the efficacy of cognitive behavioural therapy as a treatment for a wide range of adult psychological disorders. The use of cognitive behavioural therapy with young children has however been questioned, as it is deemed that they lack the cognitive abilities required to engage with this treatment approach. There is however no empirical evidence to support this assumption and recent research has focused upon identifying core skills which young children may require to engage with cognitive behavioural therapy. The current research examines the presence of core cognitive behaviour therapy skills in a non-clinical population of 96 children aged 4-7 years. It examines young children's abilities to distinguish thoughts from feelings and behaviour and the effect of providing visual cues to assist with this task. Children were read 6 stories and asked to sort different parts of the stories into categories of 'thought' 'feeling' and 'behaviour'. Half of the children were provided with visual cue post boxes to assist with this task and half were not. The research also examines young children's abilities to link thoughts to feelings and thoughts to behaviours in the context of prior experience. Children were told 8 stories, elaborated with picture cards, and asked to explain why focal characters felt a particular emotion or performed a certain action / behaviour at the end of the stories, when they saw a cue which reminded them of a previous experience. All of the measures used in this study were designed specifically to test the abilities being researched, apart from shortened forms of standardised intelligence tests (WISC III UK and WPPSI-R UK) to measure ability level. The results indicated increased competence in these skills between the age of 4 and years. In particular children aged 6 and 7 possessed considerable skill at these tasks. The findings also demonstrated that visual cues significantly improved children's scores on a task requiring them to distinguish thoughts, feelings and behaviours. The effects of visual cues and age band remained after adjusting for the effect of IQ on all of the tasks. It is suggested that cognitive behavioural therapy may be an appropriate form of treatment for young children, once cognitive tasks have been adapted to the child's developmental needs. The findings are discussed with reference to a broad range of clinical and theoretical implications and further research ideas are proposed.

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