Women's views on the impact of operative delivery in the second stage of labour: qualitative interview study

Objective To obtain the views of women on the impact of operative delivery in the second stage of labour.Design Qualitative interview study.Setting Two urban teaching hospitals in the United Kingdom.Participants Purposive sample of 27 women who had undergone operative delivery in the second stage of labour between January 2000 and January 2002.Key themes Preparation for birth, understandings of the indications for operative delivery, and explanation or debriefing after birth.Results The women felt unprepared for operative delivery and thought that their birth plan or antenatal classes had not catered adequately for this event. They emphasised the importance of maintaining an open mind about the management of labour. They had difficulty understanding the need for operative delivery despite a review by medical and midwifery staff before discharge. Operative delivery had a noticeable impact on women''s views about future pregnancy and delivery.Conclusions Women consider postnatal debriefing and medical review important deficiencies in current care. Those who experienced operative delivery in the second stage of labour would welcome the opportunity to have a later review of their intrapartum care, physical recovery, and management of future pregnancies.     

Immunopharmacology: a new frontier

Immunopharmacology is a hybrid science which has been founded upon the principles, theory, and technical developments of both immunology and pharmacology, but which has a unique identity incorporating both basic and applied areas of research. Basic immunopharmacological research is concerned with the underlying mechanisms by which endogenous and synthetic chemicals interact with the cells of the immune system. Important areas of research include the actions of chemicals such as lymphokines, cytokines, complement, kinins, autacoids, drugs, and even neuropeptides on immune function. Applied immunopharmacology is concerned with the development and testing of new immunomodulatory drugs which will be of benefit to clinical medicine but also as basic research tools. In the past, the two fields of immunology and pharmacology have contributed to each other in many significant ways. Immunology has contributed to pharmacological research by the development of antibodies which are frequently used today as specific probes for the quantitative and qualitative analysis of many different classes of chemicals of interest. Pharmacology has contributed to the field of immunology by providing basic pharmacological information on subjects such as the mediators of hypersensitivity reactions and inflammation. In the future, the truly hybrid field of immunopharmacology promises to have an expanding role in clinical medicine and basic research. This prediction is based on the observation that recombinant lymphokines and newly discovered immunomodulatory substances have begun to enter the clinic in ever increasing numbers. Future immunopharmacological research will include the study of the pharmacology of these lymphokines but also the rational development of new drugs that act as antagonists or agonists for the endogenous lymphokines that normally regulate the immune response.(ABSTRACT TRUNCATED AT 250 WORDS)     

On the ordering of N-alkane and N-alcohol solutes in phospholipid bilayer model membrane systems

²H-NMR measurements of the ordering of several n-alkane and one n-alcohol solutes in lipid bilayers formed from dimyristoyl lecithin (DML) are reported. The results are consistent with orientation of the solutes between the lipid chains, the n-alkanes having a preference for the bilayer interior, while the n-octanol is anchored at the bilayer surface. Solubility of the short chain n-alkanes, n-hexane and n-octane as an ordered component in the L_α phase is more limited than that of n-dodecane. The NMR data are supported by low angle X-ray diffraction results which confirm that n-octanol has a more dramatic influence on bilayer area than the n-alkanes.