UNews - Illness

Birth experiences often fail to meet mothers' expectations

trevor.kenney — Mon, 17 Jun 2013 21:18:22 +0000

What expectant mothers envision for their birth experiences often isn't what they realize, according to a ��Ѹ��Դ��߿�Ƭ of Lethbridge study.

The result is a drastic rise in Caesarean section rates that has alternative health-care providers, feminist advocates for women's health and mainstream medical providers all expressing serious concerns about the medicalization of childbirth.

In a paper titled "Best Laid Plans? Women's Choices, Expectations and Experiences in Childbirth," ��Ѹ��Դ��߿�Ƭ of Lethbridge sociology researcher Dr. Claudia Malacrida and co-author, doctoral candidate Tiffany Boulton of the ��Ѹ��Դ��߿�Ƭ of Leeds, UK, found that, contrary to the belief that modern birthing experiences are consumer driven because women have the capacity to plan for, make decisions about and choose a particular type of birth experience, a woman's capacity to 'drive the machine' of birth is severely limited.

"In women's prenatal education, in their conversations with their friends and in the books and online media pregnant women read, there is a consistent sense that, if women simply prepare and inform themselves appropriately, they will be in a position to make the right choices when giving birth," says Malacrida.

"We may think that natural birth advocates have little in common with medical practitioners when it comes to discussing women's birth choices. However, each perspective assumes women can and will make appropriate birth choices. Our study found that in practice, such choice is often illusory."

Dr. Claudia Malacrida finds that as much as women prepare and educate themselves before the birth process, they still lack control of the experience once it begins.

Malacrida and Boulton interviewed 22 recent mothers as part of a larger project examining the culture of birthing in southern Alberta.

Every woman they interviewed was well informed about the birthing process, had attended prenatal classes, sought out information online and read popular books or magazines about what to expect in the birthing room.

From these interviews, it was clear that all the mothers expected to make birthing choices based on the knowledge they had acquired.

"In our interviews, virtually all of the mothers described hoping to achieve 'as natural a birth as possible', which for most meant a vaginal birth with no intervention," says Malacrida. "A lot of the medical and lay discussion seems to assume that the rise in C-section rates, for example, rests with women who are 'too posh to push'. On the contrary, much medical and popular writing positions natural birth as the ideal, responsible choice. Thus, women are given a strong message that natural is best for mom, and especially best for baby."

Many women prepared birth plans, hired doulas and attended classes on non-traditional birthing methods, all in seeking a sense of control over the birthing process and to limit medical intervention.

"Once in the hospital, however, women described a cascade of intervention that began with induction or epidurals and spiraled outward," says Malacrida.

In the end, Malacrida and Boulton contend that although the majority of women plan to have as natural a birth as possible, their lived experiences differ significantly from their birth plans.

Further, the implication that women have choices in the birth experience, rather than empowering expectant mothers as effective and active consumers, creates a situation where they are instead culpable for the increasing medicalization of childbirth.

"Because women are so pressured to work towards this idealized natural birth, when their hospital experiences do not work out as planned, they often blame themselves," says Malacrida. "Women in our study expressed distress about failing as mothers, and not living up to their expectations, or the expectations of family and friends. The magic of birth seemed to elude them. Instead, they felt like they had let themselves and their babies down."

The paper was recently published in Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine.

This story first appeared in the June 2013 edition of the Legend. For a look at the full issue in a flipbook format, follow this link.

Community care

trevor.kenney — Tue, 25 Jan 2011 22:54:10 +0000

They are former airline pilots, Olympic athletes, police recruits and liquor store managers. They've earned degrees ranging from kinesiology to biology, psychology and more, and yet they all have one thing in common – they're back at university to become nurses.

The ��Ѹ��Դ��߿�Ƭ of Lethbridge's Bachelor of Nursing After Degree (BNAD) program attracts a diverse array of students, but the goal they share is the same – to contribute to the community by caring for its people.

"When the U of L introduced the BNAD program, it was perfect for me because I looked at it as an opportunity to invest two years and then get back to helping people," says 31-year-old Justin Gatner, a psychology grad who was managing a liquor store before he came back to the U of L.

BNAD student, Sarah Calnan, works with a resident of Martha's House during a free clinic offered by the U of L program.

The Monarch, Alta. native was on a path to become a police officer, having also earned his criminal justice diploma from Lethbridge College, before a broken leg dashed his hopes of passing the physical requirements for the job.

"I reassessed my world and started looking around at other careers where I could still help people," says Gatner. "Some of the options included were fire fighting and working as an EMT, but nursing was also a part of that."

The BNAD program has many similar stories, graduate students who have acquired experience by being out in the workforce, and then turned their focus to nursing. One of the faculty members helping them achieve their goal is Em Pijl-Zieber, who, like her students, found community nursing after having taken a different path.

A registered nurse who previously worked in advanced practice, Pijl-Zieber never saw herself working in a community-nursing role, and as for teaching, she jokingly calls herself the "accidental professor".

"I never wanted to teach and yet I've found that it's really a lot of fun," says Pijl-Zieber, a Vancouver native who followed her husband and fellow faculty member, Mark, to Alberta. "To inspire students to greatness is always my hope. I want them to get passionate about something."

With Pijl-Zieber, students are able to take knowledge learned in the classroom into community settings. They now provide a unique level of care to homeless and marginalized populations, as well as seniors in assisted living residences.

One of the initiatives in which they are involved is a foot-care program that Pijl-Zieber began three years ago.

The program initially had her students involved with homeless persons utilizing Streets Alive, and has grown to where her students now participate in Project Homeless Connect, are active in visiting long-term care facilities in both Lethbridge and Coaldale, and will set up outpatient clinics for drop-in foot-care services.

"The work that students do during this course is often not bedside nursing, as much as it is program planning and population health promotion," says Pijl-Zieber. "By doing the foot-care clinics, students can have that interaction with members of the population. They like it because they can practice one-to-one care, something that's hands-on and practical. It's why they went into nursing in the first place – to do real things with real people."

Foot care is a real concern for homeless and marginalized populations. They generally have little access to health services, are constantly on their feet with inadequate footwear and may suffer from aggravating health concerns such as diabetes. Frostbite, ingrown toenails and other problems, if left untreated, can lead to amputations.

"Who else is going to look after their feet? Our goal is to be able to do a proper assessment and then to provide foot care so that hopefully they can keep their limbs attached," she says.

This past year, the foot-care program took her group into Martha's House seniors' residence.

"I've been very pleasantly surprised with what they've brought to us," says registered nurse Elda Barva, Martha's House administrator and the previous director of care at St. Michael's Hospital. "They are very motivated, they have some life experience behind them and they've come in here and taken this place by storm."

More than simply providing foot care clinics, the students created an entire health-care program for the facility, breaking off into four groups (health promotion, injury prevention, illness prevention and health maintenance) of focus.

"Em is phenomenal in creating a bunch of opportunities that we never really expected," says Sarah Calnan, a biology grad in her second year of BNAD.
"Our goal when we came here was to ensure that what we were doing was sustainable to the seniors in the future. We're hoping that everything each of our groups has worked towards, they can continue to do after we leave."

Calnan worked with the health maintenance group that created a health resource manual and facilitated a "Puzzled About Pills" seminar in which they helped seniors understand how to best manage the many medications they use.

Vicki Hughes, a kinesiology graduate, worked with the health promotion group. Their focus was to help seniors better utilize the exercise room, educate about fall prevention strategies and help implement a program designed around the new vibration wave machine that promotes better balance, strength and circulation.

"The main thing for me with this experience is that it has really prepared me for nursing in terms of improving my communication skills," says Hughes. "We came in here to assess their needs, and working with them and empowering them has been wonderful."

The BNAD program doesn't just teach nursing, it promotes the basic tenets of care and contributing to the betterment of a community.

"When we are given these kinds of opportunities to come and work with these people, we're basically practising that community element of nursing," says Gatner. "When you work with the nursing program inside the community rotation, it gets you out the front door and into the world, helping people. That's always what I've wanted to do."

This story first appeared in the Legend. For a full look at the January issue of the Legend in a flipbook format, follow this link.

Brain cell re-growth confirmed at CCBN

trevor.kenney — Fri, 30 Jul 2010 16:02:34 +0000

A research team at the ��Ѹ��Դ��߿�Ƭ of Lethbridge's Canadian Centre for Behavioural Neuroscience has confirmed -- through extensive research and peer-reviewed testing -- the world's first successful example of brain cell re-growth in an adult mammal.

CCBN Researcher Robert Sutherland, postdoctoral trainee Jen Lai , and doctoral candidates Simon Spanswick and Fraser Sparks -- along with a large number of undergraduate and graduate student assistants -- spent the past five years on a project funded by the Canadian Institute for Health Research (CIHR) to refine a definitive demonstration to confirm how cortical cells can be encouraged to re-grow in the adult brain.

The implications are significant for further research into dementia-related diseases such as Alzheimer's Disease, involving death of cerebral cortex cells, which affects thousands of people each year in Canada.

Other diseases that can have memory deficit at their core include stroke, the side-effects of most cancer therapies, epilepsy, chronic stress and substance abuse. Their funding was recently renewed by the CIHR at more than $680,000 over the next five years to continue the project.

"At the current rate, in 30 years someone will develop dementia every two minutes," Sutherland said.

"The total cost of dementia could reach $153 billion dollars per year by 2038, up from the current cost of $15 billion dollars per year. Without fundamental scientific advances such as ours, it is certain that the burdens will grow dramatically. It is urgent that we find ways of preventing, reversing, and repairing injured brains, and our findings are a significant advance in that direction."

Sutherland stressed that at this time the research focuses on the reliability of a specific method to re-grow damaged cells in the hippocampus -- and while successful in rats, requires significant further research to be useful to humans in the future.

"Re-growing brain cells has been a central challenge in neuroscience and has been explored in many forms since the late 19th century," Sutherland said.

We took the approach that we should look for a simple way to prove that cells can be re-grown and restore lost functions."

The researchers focused on the hippocampus, a seahorse-shaped area of the brain which is responsible for short and long-term memory storage and retrieval.

"The hippocampus is very similar in rats and humans, and generally is the part of the brain where cells governing memory die first, or are affected by illness or injury," Sutherland said.

"Another important fact about this part of the hippocampus is that it has the ability to produce a small number of new brain cells, even in adults, so we knew that the process to make cell re-growth happen was there, but was not able to be turned on or increased at will," Sutherland said.

In Sutherland's experiments the loss of cells was caused by eliminating a hormone called corticosterone that is necessary for keeping alive certain brain cells in the hippocampus.

After these cells died Sutherland and his students showed that the rats had memory problems that resemble dementia.

Through a combination of exercise, an enriched living environment, and a specific protein therapy, the rats, when tested on a complicated exercise field, were proven to have fully recovered their memory, and showed regrowth of the damaged hippocampus parts.

Sutherland said people should be heartened by the fact that there is now a lot more definition to the process of testing cell re-growth. "The long-term goals are to develop treatments for cognitive disorders, especially due to anti-cancer therapies, age-related dementias, and related forms of brain injury."

Parts of this research have been presented at several international neuroscience conferences and published in several peer-reviewed journals, referenced below.

Utilizing online learning to manage health

trevor.kenney — Thu, 11 Mar 2010 16:51:52 +0000

When it comes to chronic diseases like diabetes, the key to warding off complications lies in the daily management of the illness – that's why education is so important.

But a face-to-face meeting with a nurse educator isn't the only way to learn self-management techniques. A research study by Faculty of Management professor Dr. Helen Kelley and her research collaborators, Dr. Mike Chiasson (Lancaster ��Ѹ��Դ��߿�Ƭ) and Dr. Angela Downey (��Ѹ��Դ��߿�Ƭ of Victoria), is revealing that e-health technologies – when used strategically – can boost health outcomes in the ever-growing population of people with Type II diabetes.

"As incidents increase, there's definitely a cost to our health-care system. Given concerns with the cost of healthcare, how do we provide the education that's needed so people develop good self-care management practices?" she asks.

Kelley and her colleagues led a 12-month, longitudinal study involving three groups of newly diagnosed diabetes patients from the former Chinook Health Region, who were given different combinations of learning tools. The first group of patients had face-to-face meetings with clinicians, as well as Internet access for independent searches for information. The second group was given electronic versions of educational material developed for the Chinook Health Region, e-messaging for communicating with clinicians and an electronic blood glucose journal, but no face-to-face coaching. Like the second group, the third had access to educational materials, e-messaging for communicating with clinicians and the journal, but also a list of educational websites, bulletin boards for posing questions to clinicians and chat rooms for speaking with other newly diagnosed diabetics and clinicians.

The study, which wrapped up in December, monitored a special biomedical indicator in the patients' blood (hemoglobin A1c) in order to determine whether the use of the various electronic features for education was having positive health outcomes. Early analysis shows that the third group made the biggest health gains.

"Early results from our study suggest that if you're mindful of the type of technology you develop, you can get very positive results – as good as face-to-face outcomes and perhaps even better," Kelley says.

However, the key is using technology strategically.

"You can't just slap materials on a website and say, 'Here you go – go ahead and manage your disease.' It's much more involved than that."

New service better addresses health issues

trevor.kenney — Tue, 09 Mar 2010 21:11:31 +0000

The ��Ѹ��Դ��߿�Ƭ of Lethbridge has recently signed up with Occupational Injury Service (OIS), a new service for staff and faculty who experience a work related injury or illness.

The OIS program aligns with medical clinics that provide timely and appropriate medical care and disability management services specifically for
occupational injuries, with an emphasis on immediate (i.e., same day) communication with the employer to facilitate a safe return to work.

This service is specifically for non-emergent injuries/illnesses and provides the following benefits to staff/faculty:

• Same-day access to a physician with a background in occupational medicine and WCB-Alberta training (within 15 to 30 minutes of arrival)

• Same-day completion and submission of reports

• Identification and co-ordination of required medical services

• Earlier access to required medical and diagnostic tests, specifically MRI, CT and bone scans

• Earlier access to specialists and surgical procedures

• Completion of disability management reports that detail physical work capabilities and limitations to help determine return to work dates and tasks

• Worker and employer injury management education

• Development of a safe return-to-work plan

• Ongoing communication with the employee's family physician (OIS is a voluntary program). Staff/faculty will be given the option of attending an OIS clinic or other medical care if needed

If you experience a work related injury or illness, follow the incident/accident reporting process as usual. Report any work related injuries or illnesses to your direct supervisor, and complete the online campus incident/accident report form: http://www.uleth.ca/hum/archives/riskandsafetyservices/Services/report_form.html

If you require first aid, contact Security Services at 2345 or other appropriate responder in your area. If you require medical treatment, contact the wellness co-ordinator at 403-332-5217 and the OIS clinic of your choice will be contacted for an appointment (same day in most cases).

The OIS clinics are available Monday through Friday from 8:30 a.m. to 5 p.m.

If your injury occurs outside of these hours, you would need to access medical services through a walk-in clinic or emergency services at the hospital.
There are currently two service providers for OIS in Lethbridge:

• CBI Health – Dr. Gibb, Bigelow Fowler West; Dr. Ukrainitz, Bigelow Fowler South; Dr. Mellor

• LifeMark Health – Dr. Allen, Piedmont Clinic west; and/or Dynamic Physiotherapy

For those who work on the Calgary or Edmonton campuses, there are service providers for the program in both cities.

Calgary
• CBI Health – Midpark, Deerpark or Sunridge
• Wellpoint Health Corp
• Life Mark

Edmonton
• Medicentres Canada Inc – Westgrove, Ellerslie, Capilano, Castledowns or Millard Health

A few employees have had the opportunity to use this service already and the feedback has been very positive. Statistics show that the sooner someone is treated for an injury or illness, the sooner they are able to get back to work and participate in the other activities that make life enjoyable!

If you have any questions or would like more information, please contact Suzanne McIntosh, wellness co-ordinator at 403-332-5217.

Horns forced to postpone series

trevor.kenney — Wed, 28 Oct 2009 22:46:44 +0000

The ��Ѹ��Դ��߿�Ƭ of Lethbridge and the ��Ѹ��Դ��߿�Ƭ of Saskatchewan athletics departments have jointly announced that the upcoming Canada West women's hockey series scheduled for October 30th and 31st has been postponed because more than one quarter of the U of L team is currently experiencing flu-like symptoms.

"It was very important to postpone this series to ensure that our team members and our visitors were not further exposed to the flu-like symptoms that have been spreading through the community," said assistant coach Deb Marek. "We currently have 6 players and coach Chandy Kaip away ill, and their health and well-being is critical."

The Pronghorns will face the Huskies January 2 and 3, 2010 instead of October 30 and 31, 2009.

U of L Health Centre manager Lori Weber, RN, said the team illness is unfortunate, but not a surprise considering that there are currently more than 300 students, staff and faculty listed as ill on the U of L's flu registry – about three percent of the school's student and employee population.

"The teams are doing the right thing in postponing their games and asking their players to self-isolate if they exhibit flu-like symptoms," Weber said. "This reinforces the fact that this illness, whether it is the seasonal flu or H1N1, is to be taken seriously."

Weber said that symptoms may include fever over 100 degrees, sore throat, cough, fatigue, headache, body aches, runny or stuffy nose, vomiting and diarrhea.

"You can be contagious for one day before symptoms begin and possibly seven or more days after. A person is more contagious on days with fever," she said.
"I applaud the actions taken to protect the health of the sports teams involved. As a reminder, all those involved in any sport should be taking extra vigilance with cleaning sports equipment, not sharing water bottles, mouth guards or other equipment and notifying their coach/team when they are ill."

Weber added that staying at home and resting aids the ill person in their recovery and protects their teammates from exposure to influenza.

"Vaccination clinics are being held in Lethbridge, so please consider getting vaccinated."

To view complete information on flu-like illness and steps to take if ill please visit the U of L website at http://www.uleth.ca and click on the "Be Fluless, Not Clueless!" icon.

Student ill with tuberculosis

trevor.kenney — Sat, 30 May 2009 04:16:47 +0000

The ��Ѹ��Դ��߿�Ƭ of Lethbridge is co-operating fully with Alberta Health Services Public Health officials to help connect them with students and members of the campus community who may have been in contact with a ��Ѹ��Դ��߿�Ƭ of Lethbridge student living off campus who was recently diagnosed with tuberculosis (TB).

The student supervised one exam near the end of the school term, and was in limited contact with an estimated 75 students.

The U of L Registrar's Office has provided a complete list of names and contact information to public health officials so they can contact those individuals.

Public Health officials have contacted the student's roommates and immediate contacts on campus as well, and they are in the process of being assessed.

"We moved swiftly to co-operate with public health officials when they contacted us Thursday," says U of L Vice-President, Academic,
Dr. Andy Hakin.

"We are very grateful the student is receiving treatment and is recovering. At the same time, we are also concerned about the well-being of our students and employees on campus, so we are working quickly to ensure that public health officials can contact them to determine their level of exposure."

The case poses no risk to the general population.

As a special note to the campus community, only those individuals directly contacted by Alberta Health officials are affected. Freedom of Information and Privacy guidelines preclude releasing any information that would identify the student.

Only those individuals deemed to be in close contact with the ill person will be advised to have a TB skin test to help determine whether or not they are affected.

Tuberculosis (TB) is a disease caused by a bacteria called mycobacterium tuberculosis. The bacteria can infect any body organ, but it only spreads to other people when it infects the lungs.

People may have a cough lasting longer than 3 weeks, fever, loss of appetite, unexplained weight loss, night sweats and constant tiredness.

A person can get TB when someone with TB coughs, sneezes or talks, placing the TB bacteria in the air. Another person may breathe in the bacteria.

An average healthy person needs to spend several hours a day over a few months with an infected person to get TB. In some cases the infection may be passed on in less time.

In most people exposed to TB the body seals off the infection. Only 10 per cent of people exposed to TB will develop an active disease.

Students or any member of the public with a concern about this illness can contact the Alberta Health Link hotline at 1-866-408-5465.

Kulig receives grant to study Mennonite attitudes

trevor.kenney — Thu, 14 May 2009 15:48:42 +0000

A ��Ѹ��Դ��߿�Ƭ of Lethbridge Faculty of Health Sciences researcher will receive more than $180,000 from the Canadian Institutes of Health Research (Palliative and End of Life Peer Review Committee within the Population and Public Health Institute) over the next three years to study a little known, but significant population of Canadians and their beliefs about death and dying.

Over the next three years, Dr. Judith Kulig will study beliefs and practices about death and dying among Low German Speaking (LGS) Mennonites in southern Alberta and southern Manitoba.

Nation-wide, there are an estimated 80,000 individuals in this group, but the large concentration of LGS Mennonites in southern Alberta and rural Manitoba allows for a large population to be sampled, as well as relevant information to be gathered from health regions and care providers.

Two of her key goals are to identify any policies and standards regarding how palliative care services are provided for this unique population, and to create best practice guidelines for the palliative care of LGS Mennonites.

"Low German Speaking Mennonites are a religious group with beliefs ranging from conservative to liberal outlooks," Kulig said. "Their unique spiritual beliefs impact their perspectives on health, illness and expectations of care, but little is known about their viewpoints on death and dying."

Kulig says that regardless of what people die from, it is how LGS families and communities respond to the deaths and what their expectations are of palliative care that are not understood. As well, she added that over the next 10 to 15 years, the current population will have aged and will likely be experiencing any number of chronic and terminal conditions which also enhance the need for palliative care, but with adjustments that factor in their particular culture and belief systems.

"Because LGS Mennonites live in rural areas, the demands on the existing health regions are already great and will only increase," Kulig says. "Collecting information about death and dying among LGS Mennonites will allow for the development of policies, care guidelines and understanding among health professionals who care for this population."

The research will be conducted through collaboration with partners in two relevant health regions in southern Alberta (the former Chinook Health and Palliser Health Regions, which now fall under the administrative umbrella of Alberta Health Services) and in southern Manitoba (Central Regional Health Authority) as well as the Mennonite Central Committee. Personal interviews will take place with caregivers, health professionals and members of the LGS community in addition to an analysis of palliative care documents.

UNews - Illness

Birth experiences often fail to meet mothers' expectations

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