Pregnant women's use of information and communications technologies to access pregnancy-related health information in South Australia.

This paper examines how pregnant women living in South Australia use information and communication technologies (ICTs), principally Internet and mobile phones, to access pregnancy-related information. It draws on 35 semistructured interviews conducted as part of the 'Health-e Baby' project, a qualitative study designed to assess the information needs and ICT preferences of pregnant women cared for at a South Australian metropolitan teaching hospital. Our research shows that although ICTs offer exciting possibilities for health promotion and the potential for new forms of communication, networking and connection, we cannot assume the effectiveness of communicating through such channels, despite near universal levels of ICT access. In turn, this highlights that if e-mediated health promotion is to be effective, health promoters and practitioners need to better understand ICT access, usage and content preferences of their clients.

Can you elaborate on that? Addressing participants' need for cognition in computer-tailored health behavior interventions.

Computer-tailored interventions, which deliver health messages adjusted based on characteristics of the message recipient, can effectively improve a range of health behaviours. Typically, the content of the message is tailored to user demographics, health behaviours and social cognitive factors (e.g., intentions, attitudes, self-efficacy, perceived social support) to increase message relevance, and thus the extent to which the message is read, considered and translated into attitude and behaviour change. Some researchers have suggested that the efficacy of computer-tailored interventions may be further enhanced by adapting messages to suit recipients' need for cognition (NFC) - a personality trait describing how individuals tend to process information. However, the likely impact of doing so, especially when tailored in conjunction with other variables, requires further consideration. It is possible that intervention effects may be reduced in some circumstances due to interactions with other variables (e.g., perceived relevance) that also influence information processing. From a practical point of view, it is also necessary to consider how to optimally operationalise and measure NFC if it is to be a useful tailoring variable. This paper aims to facilitate further research in this area by critically examining these issues based on relevant theories and existing evidence.

How midwives tailor health information used in antenatal care.

OBJECTIVE: to examine the informal approaches taken by midwives and other antenatal staff to adapt health communication to the needs of their patients, as well as their perception of the barriers faced when trying to provide tailored health promotion. DESIGN: qualitative research methods (participant observation, individual and group interviews) were utilised to gain an understanding of how media and communication resources were used in practice within the study hospital. SETTING: a major metropolitan teaching hospital located in the Northern suburbs of Adelaide, South Australia. PARTICIPANTS: individual semi-structured interviews with antenatal staff (n=8) were combined with group interviews (n=2; total number of staff=13), and observational research. FINDINGS: midwives and other antenatal staff use a range of strategies to meet the perceived health literacy level of their patients. However, their attempts to tailor health information to individual needs are frequently based on incomplete information about patients' health literacy, may be inconsistent in delivery and content and are seldom assessed to determine whether communication has been understood or led to patient behaviour change. KEY CONCLUSIONS: midwives fully recognise the need to adapt standard printed materials to meet the diverse health literacy needs of patients but lack the resources required to evaluate whether these adaptations have positive effect. IMPLICATIONS FOR PRACTICE: midwives' commitment to improving health communication provides a latent resource that institutions can build on to improve health outcomes for patients with low health literacy. This requires improvements in health communication training, willingness to use a range of validated instruments for measuring health literacy, and commitment to use of innovative approaches to health promotion where these have been shown to have a positive impact on health behaviours.

Ultrastructural, histochemical and immunohistochemical features of porcine intestinal lamina propria macrophages, peripheral blood monocytes and splenic adherent cells.

Ultrastructural, histochemical and immunohistochemical features of porcine intestinal lamina propria macrophages (LPMs), peripheral blood fibronectin-adherent cells (FACs) and splenic-adherent cells (SPACs) were compared. Freshly isolated FACs and SPACs were small and showed small cytoplasmic processes, little evidence of endocytic vacuoles, few lysosomes and sparse rough endoplasmic reticulum (RER). Fresh FACs were negative for acid phosphatase, non-specific esterase (NSE) and beta-galactosidase activity. Of the SPACs, 20-40% were positive for acid phosphatase, < 5% for NSE and 5-10% for beta-galactosidase. Pre-cultured FACs and SPACs were large and showed an abundance of endocytic vacuoles; they possessed dilated and prominent RER and > 95% were positive for the three enzyme activities. LPMs exhibited abundant endocytic vacuoles or vesicles and lysosomes but sparse RER, and > 85% were positive for the three enzymes. LPMs (24%), FACs (49%) and SPACs (40%) expressed MHC (major histocompatibility complex) class II glycoproteins. Macrophage-granulocyte antigens were detected in LPMs (14%), FACs (50%) and SPACs (33%). The results thus suggest that freshly isolated FACs differ from LPMs morphologically and in enzymic features, and the differences may represent part of the cell maturation process.

Fibrillary glomerulonephritis and pulmonary haemorrhage in a Woolly monkey (Lagothrix lagotricha).

Fibrillar deposits, distinct from amyloid deposits, were demonstrated by electron microscopy in the glomeruli and lung of an Amazonian Woolly monkey (Lagothrix lagotricha) which had died with extensive pulmonary haemorrhage. The renal lesions were typical of fibrillary glomerulonephritis in man, and IgG deposition was also demonstrated in the kidney. The association of renal and pulmonary lesions has been reported previously in man, but this is the first report of fibrillary glomerulonephritis, and a pulmonary-renal syndrome, in non-human animals.

"Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information.

BACKGROUND: Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. AIM: The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. METHODS: Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. FINDINGS: Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. CONCLUSION: Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts.

Epidermolysis bullosa in calves in the United Kingdom.

Epidermolysis bullosa (EB) was diagnosed in eight calves from four farms in the United Kingdom on the basis of clinical, histological and ultrastructural findings. In three affected herds, pedigree Simmental bulls had been mated with Simmental-cross cows. In a fourth herd two Holstein-Friesian calves were affected. Lesions included multifocal erosion and ulceration of the hard and soft palates, tongue, nares and gingiva, with onychomadesis (dysungulation). There was alopecia, erosion and crusting of the coronets, pasterns, fetlocks, carpi, hocks, flanks and axillae. Histopathological findings included segmental separation of full thickness epidermis from the dermis, with formation of large clefts containing eosinophilic fluid, extravasated red blood cells and small numbers of neutrophils. Follicular and interfollicular areas of skin were affected, with clefts extending around hair follicles and sometimes involving whole follicles. Ultrastructurally, there was evidence of vacuolar change within basal keratinocytes, corresponding to areas of histological clefting. Preliminary genetic screening of the candidate keratin genes (bKRT5 and bKRT14) has excluded mutations of these as the cause of this condition.