No description available.

Our limited understanding of the molecular mechanisms driving the onset of normal human parturition makes it difficult to identify ‘what goes wrong’ in conditions such as preterm labour (PTL), preterm prelabour rupture of membranes (PPROM) and postpartum haemorrhage (PPH). This incomplete understanding seriously hampers the development of effective ways to predict, prevent and treat parturition complications, which are a cause of significant neonatal and maternal morbidity. Two principal barriers to improving our understanding are 1) the great complexity of both the molecular interactions initiating parturition and the aetiology of parturition complications, and 2) the difficulty in generating relevant high quality molecular and epidemiological data. To help make sense of this complexity, data should be analysed comprehensively to maximise the amount of useful information gleaned from it. This thesis aimed to explore the use of specialist methods to analyse novel and previously published data to study the molecular mechanisms initiating human parturition and the epidemiology of parturition complications. The molecular mechanisms initiating parturition were explored through a gene expression microarray of labouring and non-labouring myometrial tissue. This is the largest microarray of its kind to date. Functional analysis and a network graph approach were used to reveal genes and molecular pathways associated with labour. The first ever meta-analysis of similar myometrial microarray datasets was also conducted to assess the reliability and generalisability of the results. This work supported the hypothesis that labour is associated with inflammatory events in the myometrium. A computer model of an inflammatory signalling pathway associated with infection-induced PTL was then built to provide proof of concept that such models can be used to study parturition. The model was based on published data and described lipopolysaccharide-induced activation of the transcription factor Nuclear Factor kappa B (NF-κB). This is the first attempt to generate a dynamic kinetic model that has relevance to the molecular mechanisms of PTL, and the first model of this pathway to explicitly include molecular interactions upstream of NF-κB activation. The epidemiology of complications at parturition was explored using three methods. Firstly, a novel approach was developed to use network graphs to visualise and analyse a dataset of nearly 50,000 birth records. The approach provided a quick and effective way to preliminarily explore relationships between exposures and pregnancy outcomes in an unbiased data-driven manner. Secondly, a record-linkage study of two datasets of birth records was conducted to determine risk factors for PPH, including intergenerational transmission of risk. This confirmed several known risk factors of PPH and showed that women whose mothers or grandmothers had PPH do not appear to be at increased risk themselves. Finally, a systematic review and meta-analysis of three randomised controlled trials investigated the effectiveness of fetal assessment methods in improving maternal and neonatal outcomes following PPROM. The review concluded that there is currently insufficient evidence on the benefits and harms of any method of fetal assessment, and further randomised controlled trials are required.

No description available.

Calving is an essential event in dairy production, as lactation only begins after calving and cows must give birth at regular intervals in order to maintain milk production. Careful management is important during the weeks around calving as this is when dairy cows most frequently experience health problems. Experienced stockmen use judgements based on physical and behavioural changes in order to recognise when cows may be about to calve, and subsequently be available to offer assistance when required. With increasing herd sizes and large numbers of cows per stockman, individual attention is often difficult. An automated system that monitors behavioural or physiological changes before calving could potentially be used to predict the time of calving, and help improve supervision by farm staff. Data comprising two years of records from Langhill Farm were used to identify any variables which could be used for calving prediction or as risk factors for various calving problems. Records kept by stockmen detailing the signs of calving and time of observation were compared with quantitative behavioural data. Observations from video recordings were used to identify any consistent behavioural changes occurring the day before calving that could be used to predict the onset of calving. The frequencies of lying and tail raises proved to be the most useful indicators, as they showed consistent changes in the final six hours before calving. Differences between heifers and cows, and between those experiencing calving difficulties and those which did not, were also investigated. Differences between heifers and cows were shown which should be taken into account when predicting calving times. However, no early-warning signs of difficulties were identified for cows and heifers assisted with a calving jack. Cows were also fitted with collars containing accelerometers to investigate if features in tri-axial accelerometer data could be shown to correspond to specific behaviours. Some success was achieved in identifying eating behaviour and postural changes, demonstrating that there is potential for monitoring behaviour using this method. Weekly heart rate recordings were also taken to establish if there was a change in the heart rate or heart rate variability during the final six weeks of gestation. Changes were found but, although they were statistically significant, they were considered too subtle for any practical application. Consistent changes in behaviour were observed in the six hours before calving, some of which could be measured using accelerometers. These changes have the potential to be used as the basis of an automated monitoring system to predict calving.

No description available.

Osteological studies have identified scarring on the bone surface of the human pelvic bone as evidence of childbirth, termed parturition scarring. It remains unknown whether a single or multiple births cause parturition scarring. Such scarring has also been found on male pelvic bones. This study examines parturition scarring within the broader morphometric and musculoskeletal context of the pelves of both sexes. This project investigates the influence of body size (stature and body mass) and pelvic size (individual pelvic measurements and pelvic canal size) and shape (pelvic canal shape) on the presence of parturition scarring on the pelvic bones of females and males. Two skeletal collections of known-age and sex were chosen for this project on the basis of access to parity (childbirth) records: the Maxwell Museum Documented Skeletal Collection and the Christ Church, Spitalfields collection. The dimensions of articulated and disarticulated pelves, femoral measurements and scores for six types of parturition scarring were recorded for all individuals (n=292). Skeletal proxies for body mass and stature were calculated for all individuals. Univariate, bivariate and multivariate statistical analyses were used to identify significant differences in parturition scarring between sexes, correlation between body size variables, parity status, pelvic canal size and pelvic canal shape (as represented by principal components analysis) and parturition scarring. Parity status and pelvic canal shape do not associate with parturition scarring. Pubic tubercle variables associated variously with femoral head diameter and pelvic canal size in females or males only. Dorsal pitting correlates weakly with four pelvic dimensions in females. The results of this study suggest that the term parturition scarring should be revised to reflect its non-connection with parity status and that future investigations should examine musculoskeletal interactions based on body and pelvic size variation that affect the presence of such scarring in males. / Graduate / 0327 / 0287 / decrausa@uvic.ca

Osteological studies have identified scarring on the bone surface of the human pelvic bone as evidence of childbirth, termed parturition scarring. It remains unknown whether a single or multiple births cause parturition scarring. Such scarring has also been found on male pelvic bones. This study examines parturition scarring within the broader morphometric and musculoskeletal context of the pelves of both sexes. This project investigates the influence of body size (stature and body mass) and pelvic size (individual pelvic measurements and pelvic canal size) and shape (pelvic canal shape) on the presence of parturition scarring on the pelvic bones of females and males. Two skeletal collections of known-age and sex were chosen for this project on the basis of access to parity (childbirth) records: the Maxwell Museum Documented Skeletal Collection and the Christ Church, Spitalfields collection. The dimensions of articulated and disarticulated pelves, femoral measurements and scores for six types of parturition scarring were recorded for all individuals (n=292). Skeletal proxies for body mass and stature were calculated for all individuals. Univariate, bivariate and multivariate statistical analyses were used to identify significant differences in parturition scarring between sexes, correlation between body size variables, parity status, pelvic canal size and pelvic canal shape (as represented by principal components analysis) and parturition scarring. Parity status and pelvic canal shape do not associate with parturition scarring. Pubic tubercle variables associated variously with femoral head diameter and pelvic canal size in females or males only. Dorsal pitting correlates weakly with four pelvic dimensions in females. The results of this study suggest that the term ‘parturition scarring’ should be revised to reflect its non-connection with parity status and that future investigations should examine musculoskeletal interactions based on body and pelvic size variation that affect the presence of such scarring in males. / Graduate / 0327 / 0287 / decrausa@uvic.ca

No description available.

This dissertation examines how American writers in the 1920s demonstrated the eugenic influence on motherhood through fictional representations of violent resistance. My project charts the ways in which fictional, dramatic, and cinematic texts displayed negative visualizations of maternity as a response to the early twentieth-century preoccupation with eugenics. In this project, I argue that these methods of opposition took place through actions of child abuse, maternal neglect, and infanticide. Part of this dissertation identifies eugenically motivated cultural discourse, including various forms of the media, that used both overt and subliminal messages to encourage pronatalism among the white upper and middle classes while promoting sterilization and the use of birth control for minority populations. By addressing this rhetoric, I draw attention to the pervading dialogue that influenced and shaped the texts used in the dissertation. In addition, to analyze depictions of positive and negative eugenics is to reveal a social policy powerful enough to go beyond issues of class and race and drastically impact American mothers as a united group; instead of being labeled as a problem of race, color, or class, I argue instead that these American modernist writers interpreted eugenic rhetoric as a problem of gender, common to any woman who found herself with child. While many studies exist on eugenics and literature, as well as on motherhood and literature, the combination of the two topics is one that has previously gone unanalyzed. Therefore, addressing the problems raised by this subject also highlights how both male and female writers were compelled to construct situations of subversive mothering. By situating my project in the 1920-1930 time frame, I limit my commentary to how writers approached eugenics during its most popular and influential time period in the United States. My chapters argue that these constructs of subversive motherhood appear through cinematic portrayals of dysgenic children and the negative effects on their maternal figures (The Phantom of the Opera and The Black Stork), unhappiness in the role of mother and outward expressions of anger toward the offspring in question (Edith Summers Kelley's Weeds), decisive participation in the act of abortion and infanticide (Nella Larsen's Quicksand), and daughters who refuse to participate in the act of mothering because of their negative upbringings (Edith Wharton's The Children). By incorporating the genres of fiction, drama, and cinema alongside historical and cultural documents, I inform my audience of the threatening and harmful realities of childbearing during this time period, and will show that the connection between eugenics and motherhood reflects a desire of American writers to reveal the grim repercussions of eugenic practice.

O estudo teve como objetivo construir e validar quanto ao conteÃdo e aparÃncia uma hipermÃdia educativa sobre parto para a graduaÃÃo em Enfermagem. Para embasar o desenvolvimento deste estudo, adotou-se a Teoria da InteraÃÃo Social de Vygotsky, que ressalta que o conhecimento surge a partir da interaÃÃo social entre no mÃnimo duas pessoas e que isto torna o compartilhamento de conhecimentos possÃvel e facilitado. Tratou-se de uma pesquisa metodolÃgica. Para realizaÃÃo do estudo, seguiram-se as etapas: 1.levantamento do conteÃdo e planejamento dos mÃdulos; 2. produÃÃo das mÃdias e organizaÃÃo das unidades tutoriais; 3. organizaÃÃo do espaÃo do aluno, tutor e de comunicaÃÃo entre eles; 4. elaboraÃÃo da hipermÃdia; 5. disponibilizaÃÃo da hipermÃdia; 6. avaliaÃÃo por especialistas em Enfermagem e InformÃtica e implementaÃÃo das sugestÃes propostas. Realizou-se, inicialmente, o levantamento das produÃÃes cientÃficas que tratassem da temÃtica assistÃncia de enfermagem aos perÃodos clÃnicos do parto, tendo sido incluÃdos livros didÃticos da Ãrea de obstetrÃcia, manuais tÃcnicos do MinistÃrio da SaÃde do Brasil e da OrganizaÃÃo Mundial de SaÃde e trabalhos e artigos publicados em periÃdicos nacionais e internacionais. A hipermÃdia construÃda foi intitulada âAssistÃncia de Enfermagem aos perÃodos clÃnicos do partoâ, abordando os cuidados que o profissional de enfermagem deve ter durante o trabalho de parto e parto normal sem distÃcia. Na etapa de elaboraÃÃo da hipermÃdia, foram organizados os textos a partir das informaÃÃes levantadas na pesquisa bibliogrÃfica e consultada uma empresa especialista em informÃtica para desenvolver o website. Para a validaÃÃo de conteÃdo e aparÃncia, optou por fazer o cÃlculo amostral com base na fÃrmula de populaÃÃo infinita, sendo a amostra composta por 22 juÃzes, selecionados por meio de critÃrios prÃ-estabelecidos, sendo 11 juÃzes especialistas em Enfermagem obstÃtrica (avaliaÃÃo de conteÃdo) e 11 juÃzes especialistas em InformÃtica (avaliaÃÃo de aparÃncia). A construÃÃo e a validaÃÃo tÃcnica da hipermÃdia ocorreram no perÃodo de julho de 2014 a janeiro de 2015. Para a coleta de dados, foram utilizados dois instrumentos, um direcionado aos juÃzes especialistas em Enfermagem obstÃtrica e outro para os juÃzes especialistas em InformÃtica. Para a anÃlise da validaÃÃo da hipermÃdia foi utilizado o Ãndice de Validade de ConteÃdo (IVC), com ponto de corte de 0,78 e o teste binomial. As sugestÃes e opiniÃes foram compiladas e descritas. A hipermÃdia educativa mostrou-se como um material validado, visto que apresentou um Ãtimo IVC global de 0,97 e significÃncia estatÃstica no teste binomial para o conteÃdo e aparÃncia. Diante das sugestÃes e contribuiÃÃes durante o processo de validaÃÃo, a hipermÃdia passou por modificaÃÃes, ajustes e acrÃscimos a fim de tornÃ-la mais eficaz. Acredita-se que o uso deste material com alunos da graduaÃÃo de enfermagem contribuirà com a assistÃncia obstÃtrica, tendo em vista que se constitui em uma tecnologia ilustrada capaz de favorecer o ensino-aprendizagem sobre parto normal humanizado, bem como a qualidade da assistÃncia de enfermagem à parturiente. / The study aimed to construct and validate the contents and appearance in an educational hypermedia applying for undergraduate nursing. To support the development of this study, we adopted the Theory of Social Interaction Vygotsky, which emphasizes that knowledge arises from the social interaction between at least two people and this makes knowledge possible and sharing facilitated. It was a methodological research. This study was followed by some steps, which are: survey content and planning of the modules; production of media and organization of tutorials units; spatial organization of the student, tutor and communication between them; development of hypermedia; availability of hypermedia; reviewed by technical experts in Nursing and Informatics and implementation of the proposed suggestions. The survey of scientific production implemented initially was addressed by the theme nursing care to clinical parturition periods, including textbooks of obstetrics, technical manuals of the Ministry of Health of Brazil and the World Health Organisation, also works and articles published in national and international journals. The hypermedia constructed was entitled "Nursing Care to clinical parturition periods", addressing the care that nursing professionals should have during labor and vaginal parturition without distorting. The texts prepared in the hypermidia were organized from the information raised in the literature and consulted a computer specialist company to develop the website. For the validation of content and appearance was chosen sample calculation based on the infinite population formula. The sample is composed of 22 judges, selected through pre-established criteria, 11 expert judges in obstetric nursing and 11 expert computer specialists (assessment of content). The construction and technical validation of the hypermedia occurred from July 2014 to January 2015. For data collection was utilized two instruments, which are one directed to the expert judges in obstetric nursing and another one for specialist judges in Computer. For the analysis of validation of hypermedia, we used the Content Validity Index (CVI) with a cutoff point of 0.78 and the binomial test. The suggestions and opinions were compiled and discussed. The educational hypermedia proved to be a validated material, as presented a great global CVI 0.97 and statistically significant in the binomial test for content and appearance.The suggestions and contributions, which were given during the validation process contributed to hypermedia modifications, adjustments and additions to make it more effective. It is believed that the use of this material with students of nursing degree will contribute to obstetric care in order to constitutes an illustrated technology to facilitate the teaching and learning process of humanized normal birth, favoring the quality of nursing care for parturient.