Exploring the perspective of midwives involved in offering serum screening for Down's syndrome in Northern Ireland

Aims. To explore the perspective of midwives offering serum screening for Down’s syndrome.

Background. Previous literature has indicated that the offer and discussion of prenatal serum screening tests with women is complex, and health professionals may influence women’s decisions to accept or decline screening. Midwives are usually the key professional to offer serum screening for Down’s syndrome in the UK but their perspective is relatively neglected in the literature.

Design. An explorative qualitative interview study with 15 midwives employed in a maternity unit in Northern Ireland involved in offering prenatal screening to pregnant women. Data were collected from 1 July 2005–31 October 2005.

Methods. A focused ethnographic approach was used to explore the perspective of midwives.

Results. Midwives reported difficulty in explaining the test to women and felt unable to provide the necessary information to adequately inform women within their appointment time. The test offered (the triple test) and potential pathway of subsequent care, were identified as sources of professional and personal conflict by midwives. The expectation that midwives would provide a universal offer of Down’s syndrome serum screening but be unable to support women regarding termination of pregnancy also created dissonance.

Conclusions. The feasibility of proceeding with a universal serum screening programme for Down’s syndrome is questionable in countries which legally or culturally oppose termination of pregnancy. Professionals practising within environments such as this experience conflict in their role, which affects communication with women when discussing screening tests.

Relevance to clinical practice. As midwives are often, the primary health professional providing information to women, it is important that midwives are key participants in ongoing planning and discussions about screening policy to ensure programmes are implemented successfully.

Negotiating difference in post-conflict Northern Ireland: an analysis of approaches to integrated education

In this article, the author critically examines a variety of approaches to multicultural education noted in integrated (mixed Catholic and Protestant) schools in Northern Ireland and considers their implications in the context of the wider debate around multiculturalism. She argues that educators should challenge sectarianism, but should also resist the essentialization of group identities.

Professional perspectives on decision making about the long-term care of older people

With the increasing pressure on social and health care resources, professionals have to be more explicit in their decision making regarding the long-term care of older people. This grounded theory study used 19 focus groups and nine semi-structured interviews (99 staff in total) to explore professional perspectives on this decision making. Focus group participants and interviewees comprised care managers, social workers, consultant geriatricians, general medical practitioners, community nurses, home care managers, occupational therapists and hospital discharge support staff. The emerging themes spanned context, clients, families and services. Decisions were often prompted by a crisis, hindering professionals seeking to make a measured assessment. Fear of burglary and assault, and the willingness and availability of family to help were major factors in decisions about living at home. Service availability in terms of public funding for community care, the availability of home care workers and workload pressures on primary care services influenced decision 'thresholds' regarding admission to institutional care. Assessment tools designed to assist decision making about the long-term care of older people need to take into account the critical aspects of individual fears and motivation, family support and the availability of publicly funded services as well as functional and medical needs.

The Israeli-Palestinian Conflict: A People's War

The conflict between Israelis and Palestinians is one of the most enduring and complex in the modern world. But, why did the conflict break out? Who is demanding what, and why is peace so difficult to achieve?

The Israeli-Palestinian Conflict tackles the subject and analyses the conflict from its historical roots in the late nineteenth century to the present attempts at conflict resolution in the twenty-first century.

Framing the debate and analysis around issues such as Zionism, Palestinian nationalism, international peace efforts, the refugees, state-building, democracy and religious opposition and highlighted by first hand quotes and sources of the conflict from its major participants, Beverley Milton-Edwards explores the deep impact of the conflict on regional politics in the Middle East and why the enmity between Palestinians and Israelis has become a number one global issue drawing in the world’s most important global actors.

An essential insight into the complexities of one of the world’s most enduring conflicts between Israelis and Palestinians, this textbook is designed to make a complex subject accessible to all. Key features include a chronology of events and annotated further reading at the end of each chapter.

The Israeli-Palestinian Conflict is an ideal and authoritative introduction into aspects of politics in Israel, among the Palestinians – a vitally important issue for those studying the politics of the Middle East.

Culture and the Irish Border:Spaces for Conflict Transformation

The Irish border has been described as a ‘natural’ cultural divide between the island's two dominant indigenous ethno-national communities. However, an examination of key resources of ethno-national group culture - religion, sport and language - provides evidence to challenge this representation. Moreover, in the post-1994 period of conflict transformation, evidence is also presented to support the proposition that the Irish border region has developed into a cultural space in which Irish nationalist and Ulster unionist ethno-national communities can explore cultural differences and commonalities through cross-border, cross-community contact and communication in small group encounters. This space underpins the reconfiguration of the border from barrier to political bridge between North and South. European Union (EU) Peace programmes for Ireland, beginning in 1995, provided the support for a cross-border approach to escaping the cage of ethno-national conflict in Northern Ireland. However, post-2004 EU enlargement signalled the beginning of the end for EU Peace funding and severe economic recession has undermined the expectation of British-Irish intergovernmental intervention to support cross-border partnerships and their work. Therefore, the outlook for the sustainability of this cross-border cultural space is gloomy with potentially deleterious consequences for the continued reconfiguration of the border from barrier to bridge.

Masks as self-study. Challenging and sustaining teachers’ personal and professional personae in early–mid career life phases

Drawing on previous research identifying how teachers’ capacities to sustain their effectiveness in different phases of their professional lives are affected positively and/or negatively by their sense of identity, this paper illuminates three early–mid career teachers’ self-study inquiries, centring on mask work. The creative development of individual masks discloses teachers’ complex, occasionally
dislocated narratives of personal/professional identity. Subsequent improvisation with their masks is shown to engage teachers emotionally with tensions and dissonances within and between their various personae and personal, professional and political contexts at each of their respective career life phases. Storylines ultimately become reframed and, in a number of instances, lay claim to reinvigorated commitment, self-determination and initiatives for change.

The integrated school in a conflict society: a comparative analysis of two integrated primary schools in Northern Ireland

The purpose of this paper is to compare the approach to promoting positive relationships between Catholics and Protestants in two types of integrated primary school in Northern Ireland. Drawing on qualitative interviews with teachers, governors and parents in one transforming school and one grant maintained integrated school, i.e. one representative of each of the two types, the paper shows that whilst there are distinctions in the ways that the schools promote their image and ethos, the ‘lived reality’ of the schools, as reported by the research participants, is almost indistinguishable. The paper suggests that both schools tend not to refer to or explore cultural difference and that this tendency to ‘minimise difference’ seems to have the potential to silence school members who do wish to explore their own and other cultures. It is argued that such practices are likely to impede rather than facilitate the progress of good inter-community relations.