The spiritual and professional impact of stillbirth

Stillbirth is without question one of the most devastating experiences of grief for parents and families. The death of a baby is also a distressing experience for healthcare professionals who share hopes of a live healthy baby at the end of pregnancy. It is a sad reality however, that in Ireland one in 238 babies will die before birth. The creation and nurture of new life in pregnancy is a spiritual experience as a new baby is at the same time experienced and anticipated. There is little in the published literature concerning the spiritual impact of stillbirth on healthcare chaplains who are the main providers of spiritual care for parents and staff colleagues in Irish maternity units. In addition there are few qualitative studies that explore the impact of stillbirth on consultant obstetricians and no published studies on the spiritual impact of stillbirth on bereaved parents. This study explored the spiritual and professional impact of stillbirth on Irish maternity healthcare chaplains, consultant obstetricians and bereaved parents. Following an overall review of spiritual care provision following stillbirth in the Irish maternity services, thematic analysis was used in the first phase of the study following in-depth interviews with maternity healthcare chaplains. Interpretative Phenomenological Analysis was used in the second and third phases with consultant obstetricians and bereaved parents respectively. The data from both maternity healthcare chaplains and consultant obstetricians revealed that stillbirth posed immense personal, spiritual and professional challenges. Chaplains expressed the spiritual and professional impact of stillbirth in terms of perception of their role, suffering, doubt and presence as they provided care for bereaved parents. A review of spiritual care provision in the Irish maternity services revealed a diversity of practice. The data from consultant obstetricians identified considerable personal, professional and spiritual impact following stillbirth that was identified in superordinate themes of human response to stillbirth, weight of professional responsibility, conflict of personal faith and incongruence between personal faith and professional practice. Data from bereaved parents revealed that stillbirth was spiritually challenging and all parents expressed that stillbirth posed considerable challenge to their faith/ belief structure. The parents of only three babies felt that their spiritual needs were adequately addressed while in hospital. The data had six superordinate themes of searching for meaning, maintaining hope, importance of personhood, protective care, questioning core beliefs and relationships. Other findings from the data from bereaved parents outlined the importance of environment of care and communication. This study has revealed the immense impact of stillbirth on healthcare chaplains, consultant obstetricians and most especially the spiritual impact for bereaved parents. Recommendations are made for improvements in clinical and spiritual care for bereaved parents following stillbirth and for staff wellbeing and support initiatives. Further research areas are recommended in the areas of spiritual care, theological reflection, bereavement care, post-mortem consent procedures and staff wellbeing.

Development of miniaturized antennas and adaptive tuning solutions for body sensor network applications

Wireless Sensor Networks (WSNs) are currently having a revolutionary impact in rapidly emerging wearable applications such as health and fitness monitoring amongst many others. These types of Body Sensor Network (BSN) applications require highly integrated wireless sensor devices for use in a wearable configuration, to monitor various physiological parameters of the user. These new requirements are currently posing significant design challenges from an antenna perspective. This work addresses several design challenges relating to antenna design for these types of applications. In this thesis, a review of current antenna solutions for WSN applications is first presented, investigating both commercial and academic solutions. Key design challenges are then identified relating to antenna size and performance. A detailed investigation of the effects of the human body on antenna impedance characteristics is then presented. A first-generation antenna tuning system is then developed. This system enables the antenna impedance to be tuned adaptively in the presence of the human body. Three new antenna designs are also presented. A compact, low-cost 433 MHz antenna design is first reported and the effects of the human body on the impedance of the antenna are investigated. A tunable version of this antenna is then developed, using a higher performance, second-generation tuner that is integrated within the antenna element itself, enabling autonomous tuning in the presence of the human body. Finally, a compact sized, dual-band antenna is reported that covers both the 433 MHz and 2.45 GHz bands to provide improved quality of service (QoS) in WSN applications. To date, state-of-the-art WSN devices are relatively simple in design with limited antenna options available, especially for the lower UHF bands. In addition, current devices have no capability to deal with changing antenna environments such as in wearable BSN applications. This thesis presents several contributions that advance the state-of-the-art in this area, relating to the design of miniaturized WSN antennas and the development of antenna tuning solutions for BSN applications.