Family centered nursing practices towards women and their families in the birthing context: A qualitative systematic review

AIM

Synthesize qualitative evidence examining how nurses' attitudes, beliefs, and sense of efficacy and the context surrounding birth facilitate or hinder family-centered nursing practice.

DESIGN

Thematic synthesis of qualitative studies.

METHODS

A literature search was conducted in CINAHL, MEDLINE, PsycINFO, SCOPUS, SCIENCE DIRECT, REPÈRES, CAIRN, and ÉRUDIT from October 2020 to June 2021. The PRISMA guidelines were followed, and studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted by two independent reviewers, and Thomas and Harden's qualitative thematic synthesis method was performed for data analysis.

RESULTS

Thirteen studies were included. Three analytical themes were generated: (1) sharing power: opposing beliefs, (2) feeling a sense of efficacy in fulfilling one's role, and (3) managing a challenging work environment.

PATIENT OR PUBLIC CONTRIBUTION

Synthesizing nurses' experience is essential to promote implementation of favourable changes for care that is more focused on the needs of families.

Couples' experiences of pregnancy resulting from assisted reproductive technologies: A qualitative meta-synthesis

Background

Across the world, a growing number of couples are directly or indirectly affected by infertility. Advances in assisted reproductive technologies are now enabling many of them to plan to have a child. As pregnancies resulting from assisted reproductive technologies are being experienced by a growing number of couples, it is important to better understand their experiences and the difficulties they encounter during the prenatal period.

Objective

This literature review aims to synthesize the qualitative results of primary studies in order to better understand couples' experiences of pregnancy resulting from assisted reproductive technologies, after having experienced infertility.

Design

A meta-synthesis was conducted in accordance with the guidelines put forth by Sandelowski and Barroso in order to carry out an integrative analysis of the knowledge resulting from qualitative studies on this phenomenon.

Data sources

The literature search was carried out between October and November 2020. Seven electronic databases were searched (CINAHL, Medline, PsycNet, SCOPUS, ScienceDirect, CAIRN, ERUDIT) and 14 eligible articles were selected.

Review methods

The data from the "results" and "findings" sections of each of the articles were synthesized through thematic analysis to examine and summarize the topics found in the articles selected and develop the main themes.

Results

The thematic analysis is structured around four themes to describe and interpret different aspects of the experience of pregnancy resulting from ART, namely: 1) travelling a long and complex journey; 2) moving on with paradoxical emotions; 3) struggling with an emerging identity; and 4) reorganizing relationships. These results shed light on the complex issues faced by couples previously affected by infertility during a pregnancy resulting from assisted reproductive technologies.

Conclusion

The journey of a pregnancy resulting from assisted reproductive technologies must be recognized in order to offer support in line with the challenges faced by couples. This research will allow for a deeper understanding of women's experience, as well as that of their partner's, in a more specific way, and to better understand the impact on family and loved ones.

Expression of classical HLA class I molecules: regulation and clinical impacts: Julia Bodmer Award Review 2015

Human leukocyte antigen (HLA) class I genes are ubiquitously expressed, but in a tissue specific-manner. Their expression is primarily regulated at the transcriptional level and can be modulated both positively and negatively by different stimuli. Advances in sequencing technologies led to the identification of new regulatory variants located in the untranslated regions (UTRs), which could influence the expression. After a brief description of the mechanisms underlying the transcriptional regulation of HLA class I genes expression, we will review how the expression levels of HLA class I genes could affect biological and pathological processes. Then, we will discuss on the differential expression of HLA class I genes according to the locus, allele and UTR polymorphisms and its clinical impact. This interesting field of study led to a new dimension of HLA typing, going beyond a qualitative aspect.

First functional polymorphism in CFTR promoter that results in decreased transcriptional activity and Sp1/USF binding

Growing evidences show that functionally relevant polymorphisms in various promoters alter both transcriptional activity and affinities of existing protein-DNA interactions, and thus influence disease progression in humans. We previously reported the -94G>T CFTR promoter variant in a female CF patient in whom any known disease-causing mutation has been detected. To investigate whether the -94G>T could be a regulatory variant, we have proceeded to in silico analyses and functional studies including EMSA and reporter gene assays. Our data indicate that the promoter variant decreases basal CFTR transcriptional activity in different epithelial cells and alters binding affinities of both Sp1 and USF nuclear proteins to the CFTR promoter. The present report provides evidence for the first functional polymorphism that negatively affects the CFTR transcriptional activity and demonstrates a cooperative role of Sp1 and USF transcription factors in transactivation of the CFTR gene promoter.

Update on orbital anatomy

The orbit is a confined space bounded by four bony walls. Apart from the globe, orbital fat, and extraocular muscles it contains many important neurovascular structures. It is intimately related to the paranasal sinuses as well as the anterior and middle cranial fossae. Consequently, sinus pathology and intracranial disease may spread to involve the orbit and the converse applies. A thorough understanding of orbital anatomy is essential to fully appreciate the effects of disease on the orbit and is of paramount importance for performing safe orbital surgery. The anatomy of the orbit is discussed with reference to relevant orbital disease.

Interactions between carbamazepine and polyethylene glycol (PEG) 6000: characterisations of the physical, solid dispersed and eutectic mixtures

The influence of a hydrophilic carrier (PEG 6000) on the polymorphism of carbamazepine, an antiepileptic drug, was investigated in binary physical mixtures and solid dispersions by means of differential scanning calorimetry (DSC), thermal gravimetry, hot-stage microscopy (HSM), and X-ray diffractometry, respectively. This study provides also an attempt to develop a method to calculate more precisely the eutectic composition. In rather ideal physical mixtures, carbamazepine was found as monoclinic Form III. In solid dispersions, the drug was found to crystallize as trigonal Form II; a eutectic invariant in the PEG 6000-rich composition domain (6% of carbamazepine mass) was evidenced by DSC experiments and confirmed by HSM observations. In the binary phase diagram the ideal carbamazepine liquidus curve was located at temperatures higher than the respective experimental ones. This suggests that drug can be maintained in the liquid state in the temperature-mass fraction (T--x) region between the two carbamazepine liquidus curves. This indicates in turn that attractive interactions occur between carbamazepine and PEG 6000-chains. These interactions have been also claimed to prevent carbamazepine from degradation into iminostilbene (a compound resulting from the chemical degradation of carbamazepine which is postulated to be responsible for the idiosyncratic toxicity of the drug) and thought to lead to the crystallization of metastable Carbamazepine II from melt. The negative excess entropy for eutectic mixtures indicated that the drug crystals are finely dispersed in the bulk of polymer chains.