Creating continuity out of the disruption of a diagnosis of HIV during pregnancy

AIM: To understand the uniqueness of the experience of testing HIV positive from the perspective of pregnant women.

BACKGROUND: As more people learn of their HIV diagnosis through routine screening processes, it is timely to reflect on the impact of receiving an unexpected positive result.

DESIGN: A prospective qualitative study.

METHODS: This paper draws on the case studies of four women who were participating in a larger prospective qualitative study of reproductive decision-making, pregnancy and childbirth following HIV diagnosis. Multiple interviews were conducted following diagnosis during pregnancy, and, after the birth of their babies. Thematic data analysis was undertaken.

RESULTS: Drawing on Becker's theory of disruption, we document the 'sudden disjuncture' of their antenatal diagnosis and the embodied emotional struggle the women engaged in to create continuity in their lives. A diagnosis of HIV disrupted the women's biographies in terms of their health, relationships and social identity. As pregnant women, the threat of HIV was experienced most significantly in relation to their unborn child. However, their narratives also revealed how a diagnosis of HIV in the context of pregnancy, whilst traumatic, provided a focus for regaining continuity in their lives, as the baby became a metaphor for hope and orientation toward the future.

CONCLUSIONS: As HIV testing becomes more 'routine', the findings of this study serve to remind health professionals that a positive diagnosis continues to constitute a major trauma to individuals and families.

RELEVANCE TO CLINICAL PRACTICE: We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives.

Developmental care for high-risk newborns:Emerging science, clinical application, and continuity from newborn intensive care unit to community

Neonatology has optimized medical outcomes for high-risk newborns yet neurodevelopmental outcomes continue to be a concern. Basic science, clinical research, and environmental design perspectives have shown the impact of the caregiving environment on the developing brain and the role of professional caregivers in providing supportive intervention to both infants and their families. This recognition has prompted a focus on early developmentally supportive care (DSC) for high-risk newborns both in the hospital and in community follow up. DSC has emerged as a recognized standard of care in most neonatal intensive care units. Still, many questions remain and much integrative research is needed.

Viscoelastic properties of bioadhesive, chlorhexidine-containing semi-solids for topical application to the oropharynx

Purpose. This study examined the viscoelastic properties of bioadhesive, chlorhexidine-containing semi-solid formulations, designed for topical application to the oropharynx.

Semi-empirical methods for determining the efflux velocity from a ship's propeller

The present study proposed the semi-empirical methods for determining the efflux velocity from a ship's propeller. Ryan [1] defined the efflux velocity as the maximum velocity taken from a time-averaged velocity distribution along the initial propeller plane. The Laser Doppler Anemometry (LDA) and Computational Fluid Dynamics (CFD) were used to acquire the efflux velocity from the two propellers with different geometrical characteristics. The LDA and CFD results were compared in order to investigate the equation derived from the axial momentum theory. The study confirmed the validation of the axial momentum theory and its linear relationship between the efflux velocity and the multiplication of the rotational speed, propeller diameter and the square root of thrust coefficient. The linear relationship of these two terms is connected by an efflux coefficient and the value of this efflux coefficient reduced when the blade number increased.

Asymptotic modeling of short plane-parallel high-pressure glow discharge

Here a self-consistent continuum model is presented for a narrow gap plane-parallel dc glow discharge. The set of governing equations consisting of continuity and momentum equations for positive ions, fast (emitted by the cathode) and slow electrons (generated by fast electron impact ionization) coupled with Poisson's equation is treated by the technique of matched asymptotic expansions. Explicit results are obtained in the asymptotic limit: (chi delta) much less than 1, where chi = e Phi(a)/kT, delta = (r(D)/L)(2) (Phi(a) is the applied voltage, r(D) is the Debye radius) and pL much greater than 1(Hg mm cm), where p is the gas pressure and L is the gap length. In the case of high pressure, the electron energy relaxation length is much smaller than the gap length, and so the local field approximation is valid. The discharge space divides naturally into a cathode fall sheath, a quasineutral plasma region, and an anode fall sheath. The electric potential distribution obtained for each region in a (semi)analytical form is asymptotically matched to the adjoining regions in the region of overlap. The effects of the gas pressure, gap length, and applied voltage on the length of each region are investigated. (C) 2000 American Institute of Physics. [S1070-664X(00)01302-1].

Serviceability design of a cold-formed steel portal frame having semi-rigid joints

Details are given of a cold-formed steel portal framing system that uses simple bolted moment-connections for both the eaves and apex joints. However, such joints function as semi-rigid and, as a result, the design of the proposed system will be dominated by serviceability requirements. While serviceability is a mandatory design requirement, actual deflection limits for portal frames are not prescribed in many of the national standards. In this paper, a review of the design constraints that have an effect on deflection limits is discussed, and rational values appropriate for use with cold-formed steel portal frames are recommended. Adopting these deflection limits, it is shown through a design example how a cold-formed steel portal frame having semi-rigid eaves and apex joints can be a feasible alternative to rigid-jointed frames in appropriate circumstances.