Background: It is acknowledged that health professionals have difficulty with breaking bad news. However, relatively little research has been conducted on the experiences of women who have had a fetal anomaly detected at the routine pregnancy ultrasound examination. The study objective was to explore women's experiences of encounters with caregivers after the diagnosis of fetal anomaly at the routine second trimester ultrasound scan. Methods: The theoretical perspective of symbolic interactionism guided this study design. A purposive sample of 38 women, at low risk of fetal abnormality, who received a diagnosis of a fetal abnormality in a tertiary referral center in Ireland, were recruited to participate. An in-depth interview was conducted within 4-6 weeks of the diagnosis. Data were collected between April 2004 and August 2005 and analyzed using the constant comparative method. Results: Six categories in relation to women's encounters with caregivers emerged: information sharing, timing of referral, getting to see the expert, describing the anomaly, availability of written information, and continuity of caregiver. Once an anomaly was suspected, women wanted information quickly, including prompt referral to the fetal medicine specialist for confirmation of the diagnosis. Supplementary written information was seen as essential to enhance understanding and to assist women in informing significant others. Continuity of caregiver and empathy from staff were valued strongly. Conclusions: The way in which adverse diagnoses are communicated to parents leaves room for improvement. Health professionals should receive specific education on how to break bad news sensitively to a vulnerable population. A specialist midwifery or nursing role to provide support for parents after diagnosis is recommended. (BIRTH

Objective -To investigate the relation between injury profiles -including assessment, treatment, severity, and the perceived reason for the injury -and participation in competitive netball. Methods -Between 1985 and 1989, approximately 11228 netball players participated in a 14 week netball competition held at the major competitive centre in Western Australia; 608 netball players presented to the first aid room with an injury and were assessed and treated by the same physiotherapist and St John First Aid officer. Results -The overall incidence rate during competition was 5.4 %, with more injuries occurring in the A grade level of play. Ankle injuries (84%) were most frequent, with 67% of these injuries diagnosed as lateral ligament sprains while a further 10% of players who suffered this classification of injury sustained a fracture to the ankle or foot. Few injuries occurred at the knee joint (8.3%) and only 1.8% of these injuries were diagnosed as an injury to the anterior cruciate ligament. The direct probability of a netball players' risk estimate was 0.054 per person per match which implied that netball was a relatively safe game. Injuries sustained during practice were not included in this study. Conclusions -Netball is a relatively safe game though the potential for injury increases with the level of competition. (Br J Sports Med 1995; 29: 223-228)

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The leadership activities identified provide greater clarity in distinguishing between professional and clinical leadership and in specifying the nature and scope of leadership activities.

Title. A grounded theory study of information preference and coping styles following antenatal diagnosis of foetal abnormality. Aim. This paper is a report of a study to explore the information-seeking behaviour of women following an antenatal diagnosis of foetal abnormality. Background. The identification of a foetal abnormality on routine ultrasound in pregnancy is both shocking and distressing for women, and seeking information in this stressful situation is a common response. There is evidence that women's information needs are not always adequately met, and in some cases they recall little from the initial consultation. Method. A longitudinal study involving 42 women was conducted using a classical grounded theory design. Data were collected in 2004-2006 through in-depth interviews at three time intervals: within 4-6 weeks of diagnosis, 4-6 weeks before the birth and 6-12 weeks postnatally. Findings. Women described their main concern from diagnosis until the time to give birth in terms of regulating the information received in order to cope with the situation. Two main categories were identified: 'Getting my head around it' and 'I'll cross that bridge when I come to it'. These two differing information-seeking preferences are described as monitoring and blunting. Conclusion. Matching of information preferences with coping styles may support individuals to cope with this stressful event. Women with high information needs (monitors) respond well to detail. However, those with information avoidance behaviours (blunters) should be facilitated to 'opt-in' to information when they are ready, in order to reduce the stress caused by perceived information overload.