Thesis (Ph.D.)--York University, 2007. Graduate Programme in Sociology. / Typescript. Includes bibliographical references (leaves 217-233). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39000

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed June 17, 2008). PDF text: xi, 251 p. ; 1 Mb. UMI publication number: AAT 3293887. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis (M.A. Rel.)--Anderson School of Theology, 1986. / Abstract. Includes bibliographical references (leaves 166-171).

M.A. / This study was conducted in light of several feminist texts that have critiqued the diagnostic criteria for posttraumatic stress disorder in the DSM-IV-TR. These texts have argued that the current criteria, particularly Criterion A, are gender-biased and exclude many of the kinds of life events that are unique to women. This study sought to conduct an in-depth exploration of life events that do not meet the DSM-IV-TR‟s Criterion A but that nevertheless precipitated all of the other manifestations of PTSD. For the purpose of this study, two gender-specific traumatic events were selected, namely childbirth and miscarriage or stillbirth. A feminist and phenomenological approach was taken and the study was formulated as a critique of the DSM-IV-TR diagnostic criteria of PTSD. The research question was formulated as follows: Should the Criterion A definition of a traumatic event be expanded to include any experience that an individual defines as traumatic? A semi-structured interview was conducted with three participants complying with the specific population criteria. The interviews were transcribed and analysed through qualitative data analysis processes. The research methodology and analysis processes needed to be adapted due to the phenomenological nature of the research study. A comparison between the symptoms presented by the participants and the diagnostic criteria of PTSD, revealed that all three participants complied with all the DSM-IV-TR criteria except for Criterion A(1) and therefore could not be formally diagnosed with PTSD. It was also revealed that the women‟s experiences and reactions to the traumatic events were very similar, especially the fear caused due to feeling out of control. Therefore it was concluded that the essence of the traumatic experience was loss of control. The research question was positively answered, because it was concluded that each individual experiences events differently due to internal perceptions and the individualised meanings which are allocated to the event. Therefore the Criterion A definition of a traumatic event should be expanded to include any experience that an individual defines as traumatic.

Many researchers in the academic and clinical communities theorise that inflammation may underpin the placental dysfunction to which the majority of fetal growth restriction (FGR) and stillbirth cases are attributed. Villitis of unknown etiology (VUE) is an inflammatory condition of the placenta characterised by lesions of macrophages and T cells in the villous stroma. This study addressed the hypothesis that VUE is a maternal-mediated immune reaction that contributes to FGR and stillbirth by detrimentally affecting placental function. The hypothesis was tested by: 1) completing a systematic review of the literature to confirm implied links of VUE to poor pregnancy outcome, 2) performing a detailed characterisation of the cellular phenotype of VUE in stillbirth, 3) developing an in vitro model of VUE and 4) examining the functional effects of VUE using this model. A systematic review of the literature revealed that VUE occurred in 28.6% of placentas from FGR pregnancies compared to 15.6% of placentas from appropriately grown infants (p < 0.0001), confirming the implied association. There were insufficient published studies to be able to corroborate a link with stillbirth. Elevated numbers of macrophages, CD4 and CD8 T cells were quantified in VUE lesions. There were significant increases in pan-placental CD4 and CD8 T cell presence in placentas from stillborn infants with VUE (p < 0.0001). A greater staining area of pro-inflammatory cytokines interleukin (IL)-2 (p < 0.05) and IL-12 (p < 0.0001) was recorded in VUE lesions and a reduction in the anti-inflammatory cytokine IL-4 in the stillbirth with VUE cohort. Dual immunofluorescence of cell markers and cytokines implies that the immune response in VUE is directed towards Th1-type cell-mediated immunity. An in vitro model of VUE was developed that enabled co-culture of explants with fluorescently labelled T cells isolated from matched maternal whole blood samples. Placental tissue and T cells could be maintained in culture for the required duration of the experiment and placental function was not affected by preparation and culture conditions. In vitro co-culture with maternal T cells resulted in a significant reduction in placental function as measured by hCG secretion (p=0.015). There were significant increases in culture supernatant concentrations of IL-1β (p=0.008), IL-10 (p=0.02), interferon-γ (p=0.02) and IL-1Ra (p=0.05) and tissue lysate concentrations of IL-6 (p=0.008) and IL-1β (p=0.02). Culture of explants with a combination of IL-2, IL-12 and anti-IL-4 significantly reduced hCG secretion compared to control (p=0.03).These studies indicate that VUE involves a Th1-type immune response that may affect placental function, the impact of which might be impaired fetal growth that could contribute to stillbirth. The novel in vitro model facilitates future investigations into the pathophysiology of VUE.

Thesis (MPH.) --University of Limpopo, 2018 / Background: When pregnant women deliver fresh stillbirths, their expectations and happiness are heartlessly substituted by mourning for their loss. The consequences are psychosocial and physiological. Mothers begin to search for answers while feeling guilt and shame; some accept blame for their babies‟ death. Their experiences are determined by the care they received from healthcare workers during delivery and grieving period. They complain that doctors and nurses care about the fact that the baby has been delivered and do not care about the emotional trauma that the mother is experiencing. Objectives: To identify, explore and describe experiences of women who delivered fresh stillbirths at a public hospital. Methods: A qualitative and descriptive phenomenological study was conducted using an in-depth phenomenological interview technique to collect data. Due to data saturation, nine purposively selected mothers participated. Interviews were conducted in the local language, and field notes were also collected. Interview recordings were transcribed and translated and analysed using open coding thematic analysis. Results: Some women experienced feelings of guilt, sadness, hurt, sense of failure, shock and self-blame. Some needed counselling whereas others were doing fine without it. Some experienced lack of sympathy from healthcare workers. Conclusions: Giving birth to a stillborn baby is a painful experience for women and their families. Healthcare workers should care for such mothers after delivery. Keywords: Stillbirth; postnatal care, phenomenological study design, field notes / AMREF

Thesis (M.Sc. Agriculture (Animal Production)) -- University of Limpopo, 2020 / Stillbirth is a trait of high economic importance in dairy cattle and is increasingly being included in dairy cattle breeding objectives worldwide. In South Africa, however, there is limited information on stillbirth that can be used to improve this trait genetically. Currently, there are no estimated breeding values (EBVs) for any measures of calving performance produced under the national genetic evaluation programme. The current study was, therefore, conducted to assess the incidence of stillbirth and estimate the genetic and environmental influences on maternal effects for stillbirth in South African Holstein cattle, to enable estimation of breeding values for the trait. Data used in the study comprised 13 143 calving records of 7 723 Holstein cows, from 41 herds, participating in the National Dairy Animal Recording and Improvement Scheme during the period 2014 to 2018. Incidence of stillbirth was determined using the PROC FREQ procedure and environmental effects were tested by the General Linear Models (GLM) procedure of Statistical Analysis System (SAS 9.4, 2016). Maternal heritability of stillbirth was estimated by the Restricted Maximum Likelihood (REML) procedure, using the ASReml software (Gilmour et al., 2018). The analyses were carried out using a threshold animal model and a repeatability animal model, where the latter considered stillbirth in different parities as repeated measures of the same trait. Environmental effects significantly influencing stillbirth (p<0.05) were herd-year season of calving, dam parity and calf sex, and these were included in the model for variance component estimation. Estimates of maternal heritability effects from the threshold animal model were 0.12±0.04, 0.15±0.08 and 0.14±0.06 for parities 1 to 3, respectively. The repeatability animal model gave a heritability estimate of 0.09±0.03 and a repeatability of 0.18±0.03. The moderate estimates of maternal heritability indicate scope for reducing incidence of stillbirth by selectively breeding cows that are less genetically predisposed to calving dead calves. Stillbirth in different parities should not be considered as the same trait, as indicated by the low repeatability estimate. Results of the current study estimate genetic parameters that are required to compute accurate estimated breeding values (EBVs) for stillbirth, which will enable South African Holstein farmers to select for reduced stillbirths, thus improving calving performance / National Research Foundation (NRF), University of Limpopo (UL) and Department of Agriculture Forestry and Fisheries (DAFF)

Aim: To explore how pregnant women experience fetal movements in late pregnancy. Specific aims were:  to study women’s experiences during the time prior to receiving news that their unborn baby had died in utero (I), to investigate women’s descriptions of fetal movements (II), investigate the association between the magnitude of fetal movements and level of prenatal attachment (III), and to study women’s experiences using two different self-assessment methods (IV). Methods: Interviews, questionnaires, and observations were used. Results: Premonition that something had happened to their unborn baby, based on a lack of fetal movements, was experienced by the participants. The overall theme “something is wrong” describes the women’s insight that the baby’s life was threatened (I). Fetal movements that were sorted into the domain “powerful movements” were perceived in late pregnancy by 96 % of the participants (II). Perceiving frequent fetal movements on at least three occasions per 24 hours was associated with higher scores of prenatal attachment in all the three subscales on PAI-R. The majority (55%) of the 456 participants reported average occasions of frequent fetal movements, 26% several occasions and 18% reported few occasions of frequent fetal movements, during the current gestational week.  (III). Only one of the 40 participants did not find at least one method for monitoring fetal movements suitable. Fifteen of the 39 participants reported a preference for the mindfetalness method and five for the count-to-ten method. The women described the observation of the movements as a safe and reassuring moment for communication with their unborn baby (IV). Conclusion:  In full-term and uncomplicated pregnancies, women usually perceive fetal movements as powerful. Furthermore, women in late pregnancy who reported frequent fetal movements on several occasions during a 24-hour period seem to have a high level of prenatal attachment. Women who used self-assessment methods for monitoring fetal movements felt calm and relaxed when observing the movements of their babies. They had a high compliance for both self-assessment methods. Women that had experienced a stillbirth in late pregnancy described that they had a premonition before they were told that their baby had died in utero.

Aim: To explore how pregnant women experience fetal movements in late pregnancy. Specific aims were:  to study women’s experiences during the time prior to receiving news that their unborn baby had died in utero (I), to investigate women’s descriptions of fetal movements (II), investigate the association between the magnitude of fetal movements and level of prenatal attachment (III), and to study women’s experiences using two different self-assessment methods (IV). Methods: Interviews, questionnaires, and observations were used. Results: Premonition that something had happened to their unborn baby, based on a lack of fetal movements, was experienced by the participants. The overall theme “something is wrong” describes the women’s insight that the baby’s life was threatened (I). Fetal movements that were sorted into the domain “powerful movements” were perceived in late pregnancy by 96 % of the participants (II). Perceiving frequent fetal movements on at least three occasions per 24 hours was associated with higher scores of prenatal attachment in all the three subscales on PAI-R. The majority (55%) of the 456 participants reported average occasions of frequent fetal movements, 26% several occasions and 18% reported few occasions of frequent fetal movements, during the current gestational week.  (III). Only one of the 40 participants did not find at least one method for monitoring fetal movements suitable. Fifteen of the 39 participants reported a preference for the mindfetalness method and five for the count-to-ten method. The women described the observation of the movements as a safe and reassuring moment for communication with their unborn baby (IV). Conclusion:  In full-term and uncomplicated pregnancies, women usually perceive fetal movements as powerful. Furthermore, women in late pregnancy who reported frequent fetal movements on several occasions during a 24-hour period seem to have a high level of prenatal attachment. Women who used self-assessment methods for monitoring fetal movements felt calm and relaxed when observing the movements of their babies. They had a high compliance for both self-assessment methods. Women that had experienced a stillbirth in late pregnancy described that they had a premonition before they were told that their baby had died in utero.

With approximately 65 stillbirths occurring each day in the United States, a significant number of parents are left to navigate a difficult grieving process. An event like stillbirth presents many individual and relational challenges. For this study, researchers focused on the hospital experience for couples following notification of stillbirth. Interviews were held with 8 couples that had experienced stillbirth within the past 10 years. Researchers wanted to know what similarities and differences existed in how mothers and fathers described the clinical encounter. The data for this study were collected through interviews. Couples were encouraged to share as much or as little as they’d like about the hospital experience. Couples were also asked to describe how they experienced the clinical encounter as individuals and as a couple. Participants in this study were also given the opportunity to provide feedback on what doctors and other hospital staff could do to assist individuals and couples during this difficult time. Participants discussed how hospital staff helped to shape the experience. This was done both in their interactions with staff and the accommodations that were made. Some parents described hospital staff as “gems” or their “angels” while others reported the pain of hospital staff invalidating their experience. While similarities existed in how parents experienced the clinical encounter, each participant’s experience was unique. Studies should continue to be conducted in an effort to further develop evidence-based practices in hospitals meant to help parents navigate this difficult experience.