NUMW1220
Midwifery Therapeutics
Aisling Vaughan – Midwifery Lecturer
Winter 2024 Class 1
Introduction
3
Agenda
Course Outline
10
Assessments
11
Homeostasis
14
Summary
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Meet your Educators
AISLING VAUGHAN
ERIN DEAN
Midwifery Lecturer
Clinical Instructor
Office: 20.2.71
Office: 20.2.74C
Office hours: Tuesday 10.30am to 12.00pm
and Wednesday 10.30am to 12.00pm
Office hours: Tuesday 12:30pm –
2pm / Wednesday 1:30pm – 3pm
aisling.vaughan@udst.edu.qa
Erin.dean@udst.edu.qa
Email request for appointments are encouraged – please use your
UDST account!
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Hello!
Education
• BSc in General Nursing (with Honours)
- University College Cork, Ireland (2012)
• PG-Dip in Midwifery (with Honours)
- City University London, England (2015)
• MSc in Midwifery (Distinction)
- City University London, England (2018)
• MBA (Distinction)
- University of London (2022)
Work Experience
• Staff Nurse, Cork University Hospital, Cork, Ireland
- Sep 2012-Mar 2013
• Staff Nurse, Whipps Cross University Hospital, London, UK
- Feb 2013- Sep 2013
• Midwife (Band 6), Homerton University Hospital, London, UK
- May 2015-Feb 2018
• Clinical Midwife (Obstetric Triage), Sidra Medicine, Doha, Qatar
- Apr 2018-Aug 2023
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Fun fact
about me
I gave birth to twins in
October 2022 at Al Wakra
Hospital – a boy and a girl.
Classroom Guidelines
MISSED LECTURE
If you miss a lecture, you can only
attend that week's lab if you make up
the assigned activities prior to the lab.
PHONES
Should be on silent and can only be
used for classroom activities.
***PUNCTUALITY***
Be on time! If you are more than
10 minutes late, you may be denied
entry to the class and/or marked as
absent for the class.
ABSENCE
RESPECT
Kindly offer respect to all peers and
instructors.
Please email me/your clinical
instructor as early as possible if you
will be absent for a class.
Missed Assessments
o If a student misses an
exam, they must
follow school policy to
ensure student
services amends their
attendance record to
mark them as
excused.
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o The student may redo the
assessment in the same or
different format as the
original assessment.
o The instructor may choose
to grade the student
assessment based on the
grade received on the final
exam assessment.
NUMW1220 Introduction & Homeostasis
o Instructors reserve the
right to conduct
interviews (additional
verbal assessments)
with any student to
clarify the details or
authenticity of
submitted student's
work.
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Attendance
➢ If you miss more than 15%, you are at risk for an attendance
FAILURE.
➢ If you are late for class, this will count towards absenteeism.
➢ More than 24hrs sick leave should be sent to the attendance office
and copy me.
➢ If you are more than 10 minutes late, you will be prevented from
participating in the class and will be marked as absent. If you are late
when there is planned group learning, you may not be permitted to
enter after the class has started as this may interrupt the learning.
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MIDWIFERY THERAPEUTICS
Students are introduced to the theoretical bases and application of
midwifery therapeutics that underpin midwifery practice. The focus
is understanding foundational midwifery biophysical and
psychosocial concepts, homeostatic adaptive responses, and the
application of women- and person-centred approaches and
midwifery therapeutics that balance, support, and sustain the health
of mothers and newborns.
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Student Syllabus
NUMW1220 Student
Syllabus.docx
▪
Available on D2L
▪
Please read it carefully!
▪
Follow topic planner week by
week
Assessments
Type of Assessment
Assessment Weight
D2L Quiz (2 quizzes x 5% each)
10%
Midterm Laboratory Exam
20%
Midterm Theory Exam
20%
Due Date
Week 4: January 29th 2024 at
9.30am
Week 11: March 18th 2024 at
9.30am
Week 6: Week commencing
February 11th 2024
Week 7: Week commencing
February 18th 2024
Final Laboratory Exam
20%
Week 13: Week commencing
March 31st 2024
Final Theory Exam
30%
Week 16: Week commencing
April 21st 2024
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Texts
CORE
POTTER, P., PERRY, A. G., STOCKERT,
P., HALL, A., ASTLE, B. J., &
DUGGLEBY, W. (2019). CANADIAN
FUNDAMENTALS OF NURSING (6TH
ED.). MOSBY.
GIDDENS, J.F. (2021). CONCEPTS
FOR NURSING PRACTICE (3RD ED.).
ELSEVIER.
BOWEN, R. & TAYLOR, W. (2021).
SKILLS FOR MIDWIFERY PRACTICE
(5TH ED.). ELSEVIER.
RECOMMENDED
CORE
BOWEN, R. & TAYLOR, W. (2021).
SKILLS FOR MIDWIFERY PRACTICE
(5TH ED.). ELSEVIER.
MACDONALD, S., & JOHNSON, G.
(2023). MAYES’ MIDWIFERY (16TH
ED.). ELSEVIER.
Homeostasis
Learning Outcomes
1
Define the terms “internal environment” and “homeostasis”.
2
Compare and contrast negative and positive feedback control mechanisms.
3
Outline the potential consequences of homeostatic imbalance.
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Homeostasis
The body’s ability to
maintain a stable
internal environment in
response to various
internal and external
challenges.
Herlihy, B. (2022). The human body in health and illness (7th ed.). Elsevier.
Homeostasis: Staying (stasis) the Same (homeo)
“The term refers to the body’s ability to maintain a stable internal
environment in response to a changing environment.”
o For example, in a healthy person, body temperature stays at
approximately 37°C, even when room temperature increases
to 40°C or decreases to 5°C.
o The amount of water in your cells stays the same whether you
drink 2, 3, or 4 L of water per day.
o Your blood sugar remains within normal limits whether you
have just eaten a biryani or have fasted for 6 hours.
o Mechanisms that help to maintain homeostasis are called
homeostatic mechanisms.
o Homeostatic imbalance results in disease or dysfunction.
Herlihy, B. (2022). The human body in health and illness (7th ed.). Elsevier.
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External vs Internal Environment
THE EXTERNAL ENVIRONMENT
❖ The external environment is the collection of
physical, chemical and biological conditions
external to a living organism.
THE INTERNAL ENVIRONMENT
❖ The internal environment is the water-based
medium in which body cells exist.
❖ Cells are bathed in fluid called interstitial or tissue
❖ It is the source of oxygen and nutrients
required by all cells, but it is constantly
fluid, from which they absorb oxygen and nutrients
and into which they excrete their wastes.
changing and is often hostile to the body.
❖ The composition of the interstitial fluid is largely
determined by the circulating blood, which supplies
oxygen and nutrients and absorbs and carries away
Waugh, A., & Grant, A. (2023). Ross & Wilson Anatomy
and Physiology in Health and Illness (14th ed.). Elsevier.
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wastes.
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Homeostasis
❖ The composition of the internal environment is tightly
controlled, and this fairly constant state is called
homeostasis.
❖ Literally, this term means ‘unchanging’, but in practice it
describes a dynamic, ever-changing situation where a
multitude of physiological mechanisms and measurements
are constantly adjusted to keep them within narrow limits.
❖ When this balance is threatened or lost, there is a serious
risk to the well-being of the individual.
Waugh, A., & Grant, A. (2023). Ross & Wilson Anatomy
and Physiology in Health and Illness (14th ed.). Elsevier.
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Homeostasis
Box 2.1 lists some important physiological variables maintained within narrow limits by
homeostatic control mechanisms:
Waugh, A., & Grant, A. (2023). Ross & Wilson Anatomy
and Physiology in Health and Illness (14th ed.). Elsevier.
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Control Systems
* Homeostasis is maintained by control systems that detect and respond to changes in the internal
environment.
* A control system has three basic components: sensor (detector), control centre and effector.
* The control centre determines the limits within which the variable factor should be maintained.
* It receives and integrates information from the sensor.
* When the incoming information indicates that an adjustment is needed, the control centre
responds and changes its output to the effector, which actually makes the change.
* This dynamic process allows constant, flexible readjustment of many physiological variables.
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Negative Feedback Mechanisms
o Negative feedback (Fig. 2.12) means that any movement
of a control system away from its normal set point is
negated (reversed).
o If a variable rises, negative feedback brings it down again,
and if it falls, negative feedback brings it back up to its
normal level.
o The response to a change therefore reverses the change,
keeping the system in a steady state and maintaining
homeostasis.
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Negative Feedback Mechanisms
Body temperature is one example of a physiological
variable controlled by negative feedback (Fig. 2.13).
A fall in body temperature below the preset level
(close to 37°C) is detected by specialised
temperature-sensitive nerve endings, mainly in the
skin.
They relay this information to the body’s temperature
control centre, found in the hypothalamus of the
brain. The hypothalamus then activates mechanisms
that raise body temperature (effectors).
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Homeostasis and Negative/Positive
Feedback
Homeostasis and Negative/Positive Feedback – YouTube
6.23 minutes
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Activity: High-Low-Haha
Instructions:
1. High: Think of a positive experience or
something good that happened to you
recently.
2. Low: Reflect on a challenging situation or
something you found difficult recently.
3. Haha: Recall a funny moment or
something that made you laugh recently.
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Positive Feedback
Mechanisms
There are only a few of these cascade or amplifier systems in the
body. In positive feedback mechanisms, the stimulus progressively
increases the response, so that as long as the stimulus is continued,
the response is progressively amplified. Examples include blood
clotting and uterine contractions during labour.
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Positive Feedback Mechanisms
o During childbirth, the posterior pituitary releases increasing
amounts of oxytocin into the bloodstream in response to
increasing stimulation of sensory stretch receptors in the
uterine cervix as the baby’s head progressively dilates it.
o Sensory impulses are generated and transmitted to the
hypothalamus, stimulating the posterior pituitary to release
more oxytocin. In turn, this stimulates more forceful uterine
contractions and greater stretching of the uterine cervix as
the baby’s head is forced further downwards.
o This is an example of a positive feedback mechanism, which
stops soon after the baby is delivered and cervical stretching
stops (Fig. 9.5).
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Positive Feedback Mechanisms
o Ejection of milk also involves a positive feedback mechanism. Suckling generates
sensory impulses that are transmitted from the breast to the hypothalamus,
triggering release of oxytocin from the posterior pituitary.
o On reaching the lactating breast, oxytocin stimulates contraction of the milk ducts
and myoepithelial cells around the glandular cells, ejecting milk.
o Suckling also inhibits the release of prolactin inhibiting hormone (PIH), prolonging
prolactin secretion and lactation.
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Homeostatic Imbalance
o The body’s homeostatic mechanisms are sophisticated and highly efficient, but
their capacity to adapt to stress is limited.
o If the change in a system is excessive, especially if it happens rapidly, they may
not be able to adapt and the system may shift outside the normal
physiological range.
o This can lead to disruption or disease if it is not corrected.
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Quiz
Time
Let’s see what you
remember.
Microsoft Forms
(office.com)
Summary
Negative Feedback Mechanisms
Positive Feedback Mechanisms
Homeostatic Imbalance
o Negative feedback works like
a thermostat.
o If our body temperature gets
too cold, mechanisms such as
shivering help warm us up.
o On the other hand, if we
become too hot, our body
sweats to help us cool down,
bringing us back to a
comfortable temperature.
o Positive feedback builds on
itself until a goal is reached.
o During childbirth, for
example, contractions
become stronger and more
frequent until the baby is
born.
o Similarly, when a baby feeds,
the mother produces more
milk in response to the
baby's suckling.
o If our body's natural
balance mechanisms are
overwhelmed and can't
adapt quickly enough, it
can lead to illnesses or
other health issues.
o It's like a seesaw that
can't find its balance.
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Reference List
o Herlihy, B. (2022). Chapter 1: Introduction to the human body. In B. Herlihy, The human body in health
and illness (7th ed., pp. 6-7). Elsevier.
o Waugh, A., & Grant, A. (2023). Chapter 2: Physiological chemistry and processes. In A. Waugh & A.
Grant, Ross & Wilson anatomy and physiology in health and illness (14th ed., pp. 36-37). Elsevier.
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Thank You
Have a great week!
Don’t forget to do your reading!