Becoming a mother — an analysis of women's experience of early motherhood

This paper presents the results of a qualitative study conducted by midwife researchers into women's experience of new motherhood. Data were collected using focus groups involving 55 first-time mothers and analysed using grounded theory method. The analysis produced six categories: 'realizing', 'unready', 'drained', 'aloneness', 'loss' and 'working it out'. The core category, 'becoming a mother', integrates all other categories and encapsulates the process of change experienced by women. Also explained are factors mediating the often distressing experience of becoming a mother. The analysis provides a conceptualization of early motherhood enabling the development of strategies for midwives, nurses and others helping women negotiate this challenge.     

Effects of antepartal stress on health status during early motherhood

A group of high-risk women who were hospitalized for a pregnancy-risk complication, and a group of low-risk women experiencing normal pregnancy were compared for differences in health status and the effects of antepartal stress on their health status from pregnancy through early motherhood. High-risk women reported a statistically significant poorer health status during pregnancy, early postpartal hospitalization, and at eight months following birth. High-risk women reported greater stress from negative life events in addition to their greater pregnancy risk. Among both groups of women, negative life events' stress had indirect effects on health status over time through either self-esteem, family functioning, mate relationships or perceived support. The effects of a high-risk pregnancy on health status were evident at eight months following birth; high-risk women's feelings about their pregnancy and the extent of stress from hospitalization had direct effects on their health status, while negative life events had indirect effects.     

Juggling identities of rheumatoid arthritis,motherhood and paid work – a grounded theory study

Purpose: To explore how women with rheumatoid arthritis manage their illness, motherhood, and work life.

Methods: A constructivist, grounded theory approach based on individual interviews and participant observations with 20 women with rheumatoid arthritis who participated in work life and had children living at home or were pregnant. After initial and focused coding Goffman’s concepts of social identity were applied.

Results: A core category: “Juggling meaningful identities” and three conceptual categories were developed: (1) Work life as the strongest identity marker; (2) Motherhood: a two-sided act; (3) Living with rheumatoid arthritis as an identity? Paid work, motherhood, and illness are linked to the women’s social identities. The women construct and change their identities in interactions with children, partners, other parents, colleagues, and employers.

Conclusion: The women attribute the highest priority to their professional identity, spending the majority of their time and energy in an effort to appear as “good stable workers”. The disease is seen as a hindrance in this regard, and the illness identity is almost completely rejected. In motherhood, the women prioritize close interaction with their children, and deprioritize external activities. Extended outbreaks of the disease and issues regarding the children force the women to deprioritize working life.

• Implications for rehabilitation

• Juggling meaningful identities of rheumatoid arthritis, motherhood, and paid work challenge women in managing their everyday lives. Therefore, rehabilitation professionals should support individuals to develop new strategies to manage the challenges they experience regarding juggling motherhood and work ability.

• Work is a dominant identity marker for women with rheumatoid arthritis therefore, rehabilitation professionals have an important role to play in investigating possible ways for the individual to maintain employment or return to work.

• Living with rheumatoid arthritis and being a paid worker challenge women’s role performance and thereby their identification as mothers. Therefore, rehabilitation professionals have to support the women and their families.

     

Adolescent motherhood: a meta-synthesis of qualitative studies

PURPOSE: To synthesize qualitative studies on the phenomenon of adolescent motherhood. METHODS: Databases were searched for qualitative studies regarding the experience of adolescent motherhood (years 1990-2001). Noblit and Hare's (1988) meta-ethnographic comparative method was used for synthesizing the research. A total of 251 citations were found, with a subgroup of 50 studies on "adolescent motherhood" and "qualitative studies." Twenty-five studies conducted in the United States, Canada, China, England, and Australia met the sample inclusion criteria. The combined sample of participants across studies was 257 adolescent mothers. RESULTS: Certain characteristics are common to the studies of adolescent motherhood. Five overarching metaphors were found: (1) the reality of motherhood brings hardship; (2) living in the two worlds of adolescence and motherhood; (3) motherhood as positively transforming; (4) baby as stabilizing influence; and (5) supportive context as turning point for the future. CLINICAL IMPLICATIONS: Nurses working in hospital, home care, community, and school settings can use the results of this metasynthesis to obtain a clearer picture of how adolescents feel during pregnancy, and the types of nursing interventions that can be developed to help them.     

Regulating molecular diagnostic assays: developing a new regulatory structure for a new technology

Molecular diagnostics are playing an increasingly important part in the practice of medicine. However, molecular diagnostics have not yet made the clinical impact that many had predicted. Multiple factors affect the uptake and utilization of molecular diagnostics, including government regulation. Current regulatory systems were not developed to optimize regulation of molecular diagnostics. This article recommends areas that should be carefully evaluated and appropriately revised, including risk assessment, review criteria and facilitating product improvements. The adoption of molecular diagnostics will be advanced as regulatory criteria become more predictable and their application becomes more consistent between products and over time.     

Nucleocapsid protein of SARS‐CoV‐2 is a potential target for developing new generation of vaccine

BackgroundSARS‐CoV‐2 has spread worldwide causing more than 400 million people with virus infections since early 2020. Currently, the existing vaccines targeting the spike glycoprotein (S protein) of SARS‐CoV‐2 are facing great challenge from the infection of SARS‐CoV‐2 virus and its multiple S protein variants. Thus, we need to develop a new generation of vaccines to prevent infection of the SARS‐CoV‐2 variants. Compared with the S protein, the nucleocapsid protein (N protein) of SARS‐CoV‐2 is more conservative and less mutations, which also plays a vital role in viral infection. Therefore, the N protein may have the great potential for developing new vaccines.MethodsThe N protein of SARS‐CoV‐2 was recombinantly expressed and purified in Escherichia coli. Western Blot and ELISA assays were used to demonstrate the immunoreactivity of the recombinant N protein with the serum of 22 COVID‐19 patients. We investigated further the response of the specific serum antibodies and cytokine production in BALB/c mice immunized with recombinant N protein by Western Blot and ELISA.ResultsThe N protein had good immunoreactivity and the production of IgG antibody against N protein in COVID‐19 patients was tightly correlated with disease severity. Furthermore, the N protein was used to immunize BALB/c mice to have elicited strong immune responses. Not only high levels of IgG antibody, but also cytokine‐IFN‐γ were produced in the N protein‐immunized mice. Importantly, the N protein immunization induced a high level of IgM antibody produced in the mice.ConclusionSARS‐CoV‐2 N protein shows a great big bundle of potentiality for developing a new generation of vaccines in fighting infection of SARS‐CoV‐2 and its variants.     

Rural nursing: developing the theory base

Many health care needs of rural dwellers cannot be adequately met through the use of existing nursing models alone but require unique approaches emphasizing the special needs of this population. The development of an integrated theory base for rural nursing is necessary. A retroductive approach, building upon both qualitative and quantitative research data, is being used to develop a theory of rural nursing. Key concepts identified are: work beliefs and health beliefs; isolation and distance; self-reliance; lack of anonymity; outsider/insider; and old-timer/newcomer. Implications for practice include the importance of relating health care to work practices and the need to intervene indirectly through established informal systems.     

Treatment of early rheumatoid arthritis in developing countries. Biologics or disease-modifying anti-rheumatic drugs?

Biologics are highly effective in the treatment of rheumatoid arthritis (RA), but they are very expensive. The costs of biologics should limit their usage in patients with RA, especially in the developing countries. Therefore, it is necessary to develop suitable strategies for treating RA patients in these countries. In this article, the efficacy, toxicity, and cost-effectiveness of conventional DMARDs and biologics will be investigated. The therapeutic strategies for treating early RA will also be proposed.