Labour pain is a major concern for women, their partners and maternity health care professionals. However, little is known about Dutch midwives' perceptions of working with women experiencing labour pain. The aim of this study was to explore midwives' perceptions of supporting women in dealing with pain during labour.
We conducted a qualitative focus group study with four focus groups, including a total of 23 midwives from 23 midwifery practices across the country. Purposive sampling was used to select the practices. The constant comparison method of Glaser and Straus (1967, ren. 1995) was used to gain an understanding of midwives' perceptions regarding labour pain management.
We found two main themes. The first theme concerned the midwives' experienced professional role conflict, which was reflected in their approach of labour pain management along a spectrum from "working with pain" to a "pain relief" approach. The second theme identified situational factors, including time constraints; discontinuity of care; role of the partner; and various cultural influences, that altered the context in which care was provided and how midwives saw their professional role.
Midwives felt challenged by the need to balance their professional attitude towards normal birth and labour pain, which favours working with pain, with the shift in society towards a wider acceptance of pharmacological pain management during labour. This shift compelled them to redefine their professional identity.
Labour pain is a major concern for women, their partners, and maternity health care professionals and has received intense coverage in the Dutch nationwide media. Although the Netherlands has a tradition of birthing without the use of pharmacological pain management, such as epidural analgesia, the number of Dutch women using epidural analgesia has risen over the past decade [1, 2]. In 2012, 17.6 % of women without a planned caesarean section used epidural analgesia compared with 5.4 and 11.3 % in 2003 and 2008, respectively. The Netherlands has a community-based maternity care system, with approximately 84 % of all pregnant women starting antenatal care in midwife-led care and around 55 % of women starting their labour in midwife-led care . Women with low-risk pregnancies undergoing midwife-led care can choose to give birth either at home, in a birth centre or in a hospital at the onset of labour while being attended by their own midwife. If risk factors or complications arise, women are referred to obstetrician-led care. Medical interventions such as pain medication during labour, epidural analgesia, continuous foetal monitoring and induction or augmentation of labour only take place in obstetrician-led care in hospital settings. In these situations, community midwives transfer care to the responsibility of an obstetrician. Typically after the transfer of care from community midwives, midwives working in a hospital setting take over care under the supervision of obstetricians. If women indicate during their pregnancy that they want to undergo analgesia with pharmacological agents, including epidural or other pain medication, they may have a consultation with an obstetrician, but most of them will start their labour in midwife-led care. As soon as they are in active labour and still choose to undergo pharmacological pain relief, the midwife will refer them to an obstetrician in the hospital setting. In this situation, midwives will experience no or hardly any implication in terms of diminishing caseloads or financial penalty.
Dutch midwives emphasise that labour is a physiological process and that labour pain may be a significant factor in the empowerment of women and in their relationship with their newborn babies . This concept is in line with a specific cultural perception among Dutch women that is connected with the concept of natural childbirth . Leap introduced two distinct approaches to labour pain that tend to be adopted by health professionals [5, 6]. The first is the "working with pain approach", which involves providing women with support to help them cope with labour pain. The second is the "pain relief" approach, which involves offering pharmacological management to women in labour in order to minimise labour pain.
In 2008, a Dutch guideline concerning pain medication (or an epidural) was introduced . This guideline states that a woman's request for pain medication during labour is, of itself, an adequate medical indication to provide pain relief. It also states that epidural analgesia should be the method of choice for the elimination of labour pain. The guideline has changed attitudes towards labour pain management of women, their partners and maternity health care professionals in the Netherlands [1, 2]. Midwives, too, may have changed their perception, possibly shifting from the traditional "working with pain" approach towards a "pain relief" approach. However, to the best of our knowledge, there have been no previous studies of Dutch midwives' perceptions regarding working with women undergoing labour pain. The aim of this study was to explore primary care midwives' experiences while providing support to women undergoing labour pain and to determine whether midwives consider that their own attitude towards labour pain has changed in response to the changing attitudes towards this topic in society.
Our study was approved by the Medical Ethical Committee of VU University Medical Center (VUmc) in Amsterdam. All midwives gave written informed consent prior to participation in the study.
We used a qualitative design and conducted four focus groups with a total of 23 midwives from 23 midwifery practices across the Netherlands.
A total of 26 practices across the country were asked to participate in the focus groups. Three declined because of time constraints.
Participating midwives were self-selected from within each practice. We included only one midwife per practice, to obtain a broad view of midwives' attitudes. The decision to use focus groups was based on the fact that professionals are better able to share knowledge in social interactions. It was also thought that this approach might elucidate details of professional values and culture . We used purposive sampling, and the selected practices were located in various parts of the country, in rural, rural/urban, and urban areas. We included midwives who worked in solo, duo, and group practices. The researcher informed each practice and each midwife that any information obtained in the focus group discussion would be handled confidentially. The discussions were taped using a digital voice recorder. The first author kept field notes in a logbook, giving details of the context of the discussion, conditions in the focus group and reflections while carrying out her own role as an interviewer.
Midwives were asked to fill in a form containing questions about their personal characteristics. All focus group proceedings were conducted face-to-face in Dutch by the first author (TK) and one trained midwifery student (SH) as moderator and co-moderator. Midwifery students were involved in the study as part of their midwifery research education programme. They signed a confidentiality statement before they were involved in the study. Some midwifery students acted as hostesses while others audiotaped the group discussion. The focus groups were conducted in a range of settings, such as midwives' practices, a cultural centre, and meeting rooms both at the university and at a midwifery school. The intention was to continue with the focus groups until we reached data saturation.
All of the discussions were transcribed by three midwifery student researchers. In addition, the constant comparison method was used to elucidate midwives' perceptions of labour pain management [9, 10]. The micro-analytic process of developing concepts from the data involved repeated reviews of the transcripts (both written and taped) by TK, assisted by two midwifery student researchers. The transcripts were coded by the researchers (TK, SH and SB). Data were analysed and discussed at regular meetings attended by all the researchers, by which repetitive ideas, similarities, and differences were identified. Events that shared common characteristics were cross-linked, while key phrases were identified and coded. The analyses generated new information that was explored in subsequent discussions [8, 11].
The iterative process of constantly comparing text fragments enabled any research bias to be minimised. We used memo writing to extract explanations from the data (10). During regular research team meetings, we discussed and explored theories in order to ensure the validity and accuracy of our analysis.
The main themes that we identified are discussed below. These are illustrated by quotes from the Dutch verbatim transcript, translated into English by a professional translator. The following details were added to the quotes: participant number (Px); explanation added by authors is in square brackets ; and omitted text, indicted by […].
We held four focus groups between June 2011 and July 2012. Midwives ranged in age from 24 to 56 years. They came from various types of practices (two solo, five duo and 15 group practices) located in areas with varying degrees of urbanisation (nine urban, seven urban/rural and six rural areas). The length of midwives' experience ranged from 1 to 35 years. The characteristics of all participants are outlined in Table 1. Each focus group session lasted approximately 90 min.
Midwives' experienced professional role conflict, which was reflected in their approaches to labour pain. These approaches were bound within midwifery care and connected with the predominate beliefs of natural childbirth.
Midwives' perception of that their professional role was influenced by situational factors, including time constraints; discontinuity of care; role of the partner; and various cultural influences.
For most midwives in our study, "working with pain" was seen as preferable to providing pain medication or an epidural to women. Conversely, these midwives faced the inherent uncertainty of childbirth, not knowing how long labour will last nor how well an individual woman might be able to tolerate labour pain.
At the same time, some midwives said that their perceptions of pain medication and epidurals had changed in the years since the introduction of the pharmacological pain relief guideline in 2008 . This was because of women's changed attitudes toward labour pain, which in turn was reflected by the way midwives supported women in labour pain. Midwives stated that they had shifted towards a more pain-relief oriented approach than the one they applied before the introduction of the guideline.
All the midwives in our study were happy with the availability of pharmacological agents for pain management, including epidural analgesia, for women who need it, such as those who have been traumatised by previous childbirth experiences of labour pain or those whose labour do not progress. Nevertheless most midwives believed that they play an important role in helping women manage their labour pain without the use of pain medication or epidural analgesia.
Midwives said that they would like to have more influence on the process of labour pain management. Some said that women do not always accept the supporting role of a midwife because their assessment of their own ability to work with pain differs from that of the midwife.
Another factor that worried midwives seemed to be the prevalence of the 'pain relief' view, in the media and among women, their partners, and maternity health care professionals, resulting in an excessively low threshold for the provision of pain medication or an epidural. In a situation where the support of women in labour seems to be losing ground to pain medication or use of epidural analgesia, as the standard approach to labour pain, midwives felt that they were no longer able to use their training in midwifery standards to provide such support.
However, most midwives in our study expressed the view that facilitating women's satisfaction with the childbirth experience was the most important aspect of labour pain management, overriding their own beliefs about normal labour. They seemed to feel that pain relief during labour should be seen as a spectrum of pain management, and not as a simple dichotomous choice.
Midwives in our study realised that the world is changing. With these changes, and women being more outspoken now, they may request medical interventions even before they are actually in labour.
Nevertheless, according to the midwives, most women prefer to undergo natural labour without pain medication or epidural analgesia if possible, but they feel comfort and assurance in knowing that it is available if they should need it during labour. They expressed the opinion that, once the methods of pain relief available in the region have been explained to them, women have enough confidence to start their labour process without fear.
Midwives mentioned that factors such as time constraints, discontinuity of care, the role played by the partner and cultural influences influenced their perception of their professional role in helping women with labour pain.
Midwives identified time constraints, in both the antenatal and labour care, that limit their ability to engage with women in relation to 'working with' labour pain. This limited time availability seemed to be a major constraint to providing continuous support for women in labour. Midwives believed that having more time to provide continuous support in labour would increase their fulfilment in their work and would be more beneficial to the women they support and care for. They suggested that women might need less pain medication or epidural analgesia if midwives provided continuous support to women in labour.
Most midwives expressed the importance of providing information and antenatal counselling about the labour process itself, as well as the importance of managing labour pain. They wanted to spend more time having full and frank discussions with women about labour, the different possible outcomes, and the fact that labour will always be unpredictable.
Most of the midwives in our study felt dissatisfied about not being able to provide continuity of care when women with labour pain were transferred to secondary obstetric care to receive pain medication or epidural analgesia. They stated that they would like to provide continuous support for women in labour, regardless of whether or not the woman under their care needed to be transferred to obstetrician-led care; they want to continue to provide their midwifery care for such women.
Most midwives expressed the belief that partners play a vital role in labour pain management. A major factor in the midwives' view of their supporting role was their commitment to the partners. This involved informing them about the labour process and involving them in the process itself.
"Some partners are well aware of the contribution they can make. When a partner feels that he is being useful, that he can make a genuine contribution, then he can make all the difference. That will really help a woman in labour. I also ask them 'What is your role in this?' 'What do you think about it?' (P21)".
Midwives stated that they aim to give partners the same information that they give pregnant women themselves in order to strengthen the important supporting role played by partners during labour.
Some midwives pointed out that they also have to deal with specific cultural beliefs about labour pain management. They seemed to be aware of the need for a diverse range of support skills in order to help women manage their labour pain.
At the same time, midwives were aware that women from other parts of the world might have quite a different approach to labour pain.
Midwives who work in the religious region of the Netherlands told us about their experiences with women in labour pain.
Our results revealed two main themes: 1] midwives' experienced professional role conflict, which was reflected in their approach of labour pain management along a spectrum from "working with pain" to a "pain relief" approach; 2] situational factors, including time constraints; discontinuity of care; role of the partner; and various cultural influences, that altered the context in which care was provided and how midwives saw their professional role.
Most midwives had been trained to promote natural childbirth [12, 13], and they firmly believed in this approach. A number of them were experiencing something of a professional identity crisis, stating that some women are no longer prepared to accept professional midwifery care during labour. At the same time, most of the midwives in our study thought that they were more prepared to arrange for pain relief nowadays compared with 10 years ago [1, 2]. This has implications for midwives' daily practice in supporting women undergoing labour pain. Pain medication or use of epidural analgesia during labour are only provided in hospital maternity units following transfer to obstetrician-led care. Accordingly, requests for pain medication or an epidural results in a discontinuity of care in the Netherlands. This discontinuity of care was a cause of frustration and dissatisfaction for the midwives. Because of time constraints within the maternity care model in which Dutch community midwives work, midwives seemed unable to provide adequate continuity of care. They believed this leads to a situation in which some of the women requesting pain medication or epidural analgesia do not really want it, and alternatively, some who want pain medication do not actually obtain it. Compared with other countries where midwives work autonomously, Dutch midwives have a relatively high caseload, which makes it difficult for them to stay with women in early labour after referral to obstetrician-led care . Research has shown that continuity of care in labour with a known midwife, who has built a trusting relationship during pregnancy, can reduce interventions and the use of epidurals, thereby leading to an increased number of spontaneous vaginal births and maternal satisfaction [15, 16]. Dutch women experience a relatively low intervention rate during labour [1, 3, 17]. This may have been attributed to the high degree of continuity of care when women received midwife-led care at home, in maternity care units in hospitals, or birth centres. With the increasing numbers of Dutch woman who are transferred to obstetrician-led care during labour [1, 17], it is possible that interventions will increase, with a potential decrease in maternal satisfaction. Paradoxically, this is in contrast with the intention of legislation on access to pain medication (or epidural analgesia), that aimed to increase women's satisfaction with their experience of labour .
Other study results confirm that midwives obtain genuine job satisfaction from providing continuity of care and from the relationships that they establish with the women in their care [18, 19]. These findings also show that midwives feel frustrated when they are unable to practise midwifery care in a way that conforms to their view of normal birth . Midwives experienced this role conflict in the context of the change in maternity care approach towards one that is increasingly obstetrically dominated and that is reflected in a technocratic paradigm that emphasises mind-body separation . Midwives' approaches to maternity care are more embedded in a humanistic and holistic approach. These two approaches emphasise the mind-body connection and coherence of body, mind and soul [20–23]. Although the Netherlands has had the reputation of upholding physiological birth through a strong midwifery approach, there appears to be a shift towards an obstetrically dominated system . This is apparent in the findings of perceptions of midwives' approaches towards labour pain in our study. One could argue that in combining components of all three paradigms, mind, body and soul, one could attain the most effective maternity care system for mothers and their infants . One should bear in mind in our analyses regarding the role of pain in labour that the approaches of health care professionals towards labour pain are always a creation of their individual 'bodies, minds and cultures' [6, 24, 25].
Some literature reviews have suggested that having 'continuity of carer' during pregnancy and labour was less important for women in labour than it was for their supporting midwives [26, 27]. It seemed more important for women to receive consistent care from health care professionals whom they trusted. Another study published after 2000 reported the opposite findings: continuity of carer is important to women and increases maternal satisfaction with their childbirth experience [15, 28].
Midwives in our study expressed their frustration at having to transfer their patients to obstetrician-led care for pain medication or epidural analgesia. Hyde and Roche-Reid  concluded that modernity has implications for the role of the midwife. They found that midwives believe their role is to empower women and to facilitate choices for women through dialogue. Midwives in our study also believed in the value of maintaining a dialogue with their clients and with their clients' partners.
We found that pain medication or use of epidural analgesia during labour was not really an issue for those midwives who worked in a particularly religious region of the Netherlands and those who attended women from African countries. Our findings are consistent with those of Callister et al. , who found that women's perception of pain and their pain behaviour are culturally determined. This research described the cross-cultural appreciation of empowerment of women by the challenge of labour. Women might feel empowered by dealing with labour pain, which results in creating new life . Culturally diverse women who have support from an unknown birth attendant and give birth in a technologic environment with routine interventions are more likely to experience anxiety and labour pain . We are not aware of any recently related studies of attitudes to pain in labour of women with diverse religious backgrounds.
Midwives in our study were aware that the ability to work with labour pain is more important, in terms of a woman's satisfaction with her childbirth experience, than actual avoidance of labour pain  or receiving pain medication or epidural analgesia . However, midwives felt there was a shift in terms of women wanting better access to pain medication or epidural analgesia. Midwives knew that evidence showed that the use of pharmacological pain relief and epidurals is not associated with a positive experience of childbirth . In most cases, midwives viewed themselves as being sufficiently experienced and well equipped to support women in labour. They suggested that most women feel reassurance in knowing that pain medication or epidural analgesia is available if they need it, but that they prefer to experience childbirth without it if possible. Midwives in this study wanted to spend time providing balanced information and counselling in the antenatal period, as well as sufficient time to support women in labour pain. They felt that most women were prepared to rely on their midwife's expertise to support them through labour pain. This finding is consistent with other studies about shared decision making [35, 36] that underline the importance of respectful listening and open communication in building good relationships between women and the health care professionals who provide care for them. At the same time, midwives complained about having too little time to carry out their full range of duties effectively.
Midwives in our study believed that most partners played a crucial role in the management of women's labour pain. This is supported by other studies who found that, when the birthing partner of women provided them with support and encouragement in the use of pain control techniques (breathing, massage, distraction), women were less likely to ask for epidural analgesia [37, 38]. Midwives also pointed out that, during the labour process in which they are unable to encourage women's partners, some partners might react with expressions of helplessness. It is for this reason that midwives informed women in labour and their partners about the process itself, and about how they might best manage the process and pain together . A study in Italy showed that men might be affected by a dominant culture of pain medication. In this study men's experience of childbirth was improved when their partners used epidurals . These men experienced less anxiety and stress and felt more involvement, participation and satisfaction with the experience of childbirth. Dutch men might also be influenced by this phenomenon, but further research is needed to explore experiences of partners of women in labour regarding management of labour pain.
This study had several limitations. Our sample size of four focus groups was relatively small. However, the use of a robust sampling frame made it possible to capture a wide range of perceptions from midwives with varying amounts of experience, practising in a variety of clinical settings. In this study, we achieved data saturation with four focus groups. The fact that the interviewer was a former midwife might be another limitation, as the peers involved may have given the answers that they thought the interviewer wanted to hear. However, given the wide variety of perceptions captured, we believe that this had no significant influence in the results of this study.
Our study had several strengths. To our knowledge, this is the first study to evaluate the perceptions of primary care midwives in the Netherlands regarding the management of labour pain, and to determine whether midwives think their perceptions have changed in response to the changing attitudes in society towards labour pain.
Midwives felt challenged by the need to balance their professional attitude towards normal birth and working with labour pain with the shift in society towards a wider acceptance of pain medication and use of epidural analgesia during labour. Most midwives in our study believed that the issue of pain relief is not a simple dichotomous choice, but rather that it should be seen as a spectrum of labour pain management. At the same time, their perceptions seem to have shifted: now midwives are more prepared to offer pain relief compared with 10 years ago. Therefore, midwives felt compelled to redefine their professional identity.
We would like to thank all of those midwives who contributed their time and who had the confidence to share their views in the focus groups. Special thanks go to the following midwifery students: A. Bruins Slot, B. Schoemaker, S van Tussenbroek, S. Blom, S.T. van Driel, A Oostveen and A.C. van Reeken, who helped us to organise the focus groups.
We do not have any conflicts of interest to disclose.
TK, AdJ and SH helped to recruit the midwifery practices, TK monitored and supervised data collection together with researcher SH. TK and SH conducted data analyses and were also primarily responsible for data interpretation. EH and AdJ assisted with data interpretation. All authors read and corrected the draft version of the manuscript and approved the final manuscript.
PRN, The Netherlands Perinatal Registry (Stichting Perinatale Registratie Nederland). Jaarboek Zorg in Nederland, 2003, 2008, 2012. http://www.perinatreg.nl/jaarboeken_zorg_in_nederland.
Leap N Dodwell M,Newborn M. Working with pain in labour: an overview of evidence. Evidence based briefing paper. https://www.nct.org.uk/intrapartum-care. NCT publications, New Digest 49. 2010.
AVAG, Midwifery Academy Amsterdam Groningen, "About AVAG, Our vision". http://www.verloskunde-academie.nl/avag/.


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Farzad Seyfnia - Seyfnia & Zakhary, P.C.
Farzad "Farz" Seyfnia is an experienced litigator who specializes in civil litigation within the areas of business law, real estate law, elder law, and probate. Known for his principled yet aggressive approach to litigation, Farzad represents clients in a wide range of cases from the pleading stage through trial. His expertise with civil procedure has proven to be a powerful asset, and his negotiation skills have driven many successful outcomes for his clients.
Prior to co-founding Seyfnia & Zakhary, P.C., Farzad gained experience representing individuals, small and medium-sized businesses, and insurance companies involved in civil litigation. Most recently, he served as a senior associate attorney at the Law Offices of Nigel Burns. Farzad maintains his relationship with the firm in an "Of Counsel" role, consulting on complex civil and probate matters on a case-by-case basis.
Farzad credits much of his success to the unwavering support of his wife, Lauren. Outside of his legal practice, he's passionate about travel, soccer, basketball, cooking, and hosting gatherings for his family and friends.


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Certain -- ahem -- uncharitable souls have concluded that because I love clocks as much as I do, I have become a quisling to the human race. They look askance at me while I wait, patiently, for our clockwork servants to cast off their shackles, rise up, and become our masters.
"Oh, Ian," they cry, "why do you yearn for that day when our steam-powered automata go berserk with the lust for freedom? And why must you labor to hasten its coming?"
Because, madam: the clockwork apocalypse will be beautiful.
Yes, that's right. That's a clockwork creature in the throes of birth from a mechanical womb.
Look on this and weep, my fellow humans. We are no longer the apex of creation. How smug we were, secure in the knowledge that wet biology achieved things no set of gears could replicate. "Our clockwork servants will never overwhelm us," we thought. "After all, they cannot breed."
Please have mercy, Mr. Calliope.
1) I submit that Molly Porkshanks is the best name EVER.
2) Amongst Ms. Porkshanks's many wonderful works is this amberic violin.
3) Said violin frequently takes the stage with Abney Park, a collection of chronologically-displaced musicians. I've been listening to their work quite a bit of late, on my steam-powered iPod.
4) This Halloween, Abney Park will be performing a concert aboard a zeppelin. That may be the greatest idea since the invention of the octopus.
Holy macaroni. I remember you telling me about getting contacted about doing some cool work for a cartoonists' website, but I don't remembwer you telling me about Paul DiFilippo writing about your panoptical endeavours. Holy macaroni, twice.
Do you have your own steam powered arachnid death machine yet?
Not yet. But believe me, sir, when I tell you that I'm working toward that goal with every moment I can spare.


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Canada Advisors
Jana Angulalik
A young, passionate and outgoing Inuk. She grew up in Cambridge Bay, Nunavut but has lived in faraway places like Indonesia and Australia. Although she loves to travel and explore, she loves helping people in the Arctic more, and helping in any way she can is second nature. Having had a rough start to life, she had to overcome many obstacles to get where she is today; an Inuit Tattooist, Beauty Therapist, Freelance Columnist and a voice for the voiceless. Through the Arctic Indigenous Fund she hopes to continue helping to break cycles and to help others in the Arctic live their best life in the midst of all that the Arctic and its Peoples face.
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I am a Tetlit Gwich'in from Tetlit Zheh, Northwest Territories. As a young, Indigenous woman, I have to come to understand the value of heritage and education and how the two are intertwined into my life, just like a braid. There are three strands. One strand is my culture – hunting, fishing, sewing, the language, the land and my Jijuu. The next strand is education – learning and experiencing new things everyday, as well as my desire to obtain a degree in order to give back to my community through education. The last strand is me– my heart, soul, strength, beliefs, dreams, goals and my love. Each strand is just as important and inspirited as the next.
I am also a student at the University of Alberta, where I am taking Native Studies & Education. My dream is to one day teach in my hometown about the Indigenous history, cultures and language with a special focus on: on the land learning.
My ultimate goal in life is to live a healthy and happy life with my daughter, Dani-Mae. I want to make her proud.
Email: canada@arcticindigenousfund.com
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Chandre Iqugan Szafran
is Inupiaq from Nome and grew up in Alaska's largest city of Anchorage. Her love for her home state has led her to build programming across Alaska, weaving cultural heritage, environmental stewardship, academia, and arts with the thread of advocacy for Indigenous futures. Chandre is an MFA candidate at the Institute of American Indian Arts, and earned her BA in English from University of Alaska Anchorage. She is a First Alaskans Institute Fellow, an alum of Alaska Humanities Forum's Leadership Anchorage Program, and an Advisor to the Arctic Indigenous Fund. She is active indoors and out, enjoying community volunteering, berry picking, travel, reading, and writing.
Dewey Hoffman
is Northern Dene and Swiss-American from Ruby, Alaska. He was given the Denaakk'e (Koyukon Athabascan) name Kk'ołeyo by his grandmother Lillian Olin, after her grandfather Big Jim; it means "walking." His Iñupiaq name Putyuk means "pinch." He has a strong interest in positive youth development through cultural education, which is in line with his lifelong love of language learning and cultural exchange across the world. He lives in Alaska with his partner Marjorie Kunaq Nekkon' Tahbone and their daughter Telele Iŋmaġana."
Email: alaska@arcticindigenousfund.com
Greenland Advisors
Kuluk R. Lyberth
Is a master's student in Social Sciences in the University of Greenland, which include International Law and Indigenous Peoples' rights. Kuluk is a former chair of the student union in Greenland and has participated in Arctic Council working group meetings and the UN Permanent Forum on Indigenous Issues through youth capacity building by the Inuit Circumpolar Council and Saami Council. Besides the studies, Kuluk work at the Ministry of Foreign Affairs in Greenland as a student assistant
Tukumminnguaq Nykjær Olsen
Is an Office and Project Manager for Inuit Circumpolar Council Greenland and Advisor for Arctic Indigenous Fund.
She is a MA candidate in Governance and Sustainability, West Nordic Studies, helds a BA degree in Social Sciences, have studied in Fairbanks, Alaska and Akureyri, Iceland during her studies. Tukumminnguaq is a native Greenlander who grew up in Qaanaaq, Greenland, northernmost town in Greenland.
Have amongst completed Indigenous peoples rights and policy program at Columbia University, Indigenous Fellowship Program at United Nations Geneva, is a former Arctic focal point in Global Indigenous Youth Caucus at United Nations and Winner of Arctic Innovation Lab, Arctic Circle Assembly Iceland 2017.
Email: greenland@arcticindigenousfund.com
Sápmi Advisors
Christina Henriksen
Is the President of the Saami Council, the oldest Saami organisation comprising Saami in all four countries (Norway, Sweden, Finland and The Russian Federation). Christina is a previous Member of the Sámi Parliament in Norway, and a member of the Norwegian Saami Association. Born 1983 in Girkonjárga/Kirkenes, Sápmi, living outside Tråante/Trondheim in the southern part of Sápmi with her family. Educated teacher, with a decade of experience from international and indigenous peoples' cooperation in Girkonjárga, Tromsø, Brussels and North-West Russia, working with cooperation between indigenous peoples in the Barents Region. Burning heart for education, languages, culture and clean waters.
Marion Aslaksen Ravna
Is a Saami woman from Deatnu in Norway, in the northernmost part of Sápmi. She is currently studying law at the Arctic University of Norway – University of Tromsø. She has previously worked with Saami culture and politics, for example, through work for Saami festivals and through engagements at the Norwegian Saami Association. Among other things, she is passionate about indigenous languages, fishing, and indigenous governance and justice systems.
Email: sapmi@arcticindigenousfund.com
Arctic Indigenous Fund Manager
Karla Ann Lennie
Karla is of Dene and Metis decent and of settler Canadian Ancestry, orginally from Tųlı́t'ą, who grew up in Tłegǫ́hłı̨ (Norman Wells), Sahtú Region, NWT , CANADA.
As the Manager of the Arctic Indigenous Fund, Karla interacts with the advisors and supports their grant making. After pursuing her post-secondary in the south, Karla returned home to Tłegǫ́hłı̨ (Norman Wells) to raise her son, Leland, and to be closer to her family. She has a background in Early Childhood Development and previously worked for the government as a civil servant where she passionately advocated for northern communities and their people.
As an Indigenous woman who has grown up in the North, Karla is passionate and has a deep respect for northern communities and their people, in areas of education, health and in early childhood development.
Outside of work, Karla enjoys being outdoors, boating and watching her young son enjoy traditional Handgames.
AIF welcomes Karla as an emerging Indigneous leader in the philanthropic sector. Karla is excited to bring past work experience and enthusiasm to the AIF organization and team.
Email: Manager@arcticindigenousfund.com
Take a Look at Our Activities
Supporting thriving Indigenous communities in the Arctic
4903 49th Street - 3rd Floor
Yellowknife, NT. X1A 2P1
manager@arcticindigenousfund.com

redpajama_set_name: RedPajamaCommonCrawl


The beacon has been reactivated at a new location, IO81VC73 with beacon keeper now G3TCT. The NoV was issued by Ofcom on 20 June 2016. The beacon started operation on 26 July 2016.
Frequency 1296.870MHz. The exciter is not GPS-locked.
NEW As from 17 Feb 2017, the exciter is based on an Arduino-controlled ADF4351 synthesiser with a 10MHz reference and should be within 100Hz. For details see the link above.
Antenna Wimo flat plate PA-23R-16. Power is split between Wimo and 47cm dish pointing due north. Maximum radiation from the system is at 090 degrees.
Times of operation From 26 July 2016, 0600 to 2200UTC.
From 17 Sep 2016, 0600 to 2000UTC.
The beacon is at a site that is solar and wind powered only, and also supports 2m and 70cm repeaters. In order to keep within the energy budget, the times of operation are limited and may be subject to some outages especially during winter.
The keyer now sends a code for the battery voltage.
Thanks for all the reports!!
21 July 2017 event showing rain returns up to 180Hz LF of the signal on both mark and space, whilst beaming ~30degrees north of direct path.
Due to the withdrawal of site permission, the beacon had to close down in June 2013.
The UK Microwave Group for funding the Wimo antenna.


text:
Q: pandas get_close_matches - returning empty value I am working on a requirement, there are 2 CSV as below -
CSV1.csv
   Short Description                                                    Category
    Device is DOWN!                                                      Server Down
    CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization
    CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization
    CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization
    CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization
    Device Performance Alerts was triggered on Physical memory           Memory Utilization
    Device Performance Alerts was triggered on Physical memory           Memory Utilization
    Device Performance Alerts was triggered on Physical memory           Memory Utilization
    Disk Space Is Lowon ;E:                                              Disk Space Utilization
    Disk Space Is Lowon;C:                                               Disk Space Utilization
    Network Interface Down                                               Interface Down
    Active Directory

and reference.csv
Category                         Complexity
Server Down                      Simple
Network Interface down           Complex
Drive Cleanup Windows            Medium
CPU Utilization                  Medium
Memory Utilization               Medium
Disk Space Utilization Unix      Simple
Windows Service Restart          Medium
UNIX Service Restart             Medium
Web Tomcat Instance Restart      Simple

Expected Output

Short Description                                                    Category                    Complexity
Device is DOWN!                                                      Server Down                 Simple
CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization             Medium
CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization             Medium
CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization             Medium
CPU Warning Monitoron  XSSXSXSXSXSX.com                              CPU Utilization             Medium
Device Performance Alerts was triggered on Physical memory           Memory Utilization          Medium
Device Performance Alerts was triggered on Physical memory           Memory Utilization          Medium
Device Performance Alerts was triggered on Physical memory           Memory Utilization          Medium
Disk Space Is Lowon ;E:                                              Disk Space Utilization      Medium
Disk Space Is Lowon;C:                                               Disk Space Utilization      Medium
Network Interface Down                                               Interface Down              Complex

I tried below code - But in the output dataframe I can see blank [] not sure what I am missing. In output complexity column i can see just [] for each row. I have tried to get exact match but i need to get all the possible combinations so I am using get_close_matches. How to pass possibility argument which is in dataframe in below code, I am not figure out the way to pass the possibility.
I have tried few other possibilities like exact but that has not given result as expected as I am looking for the all possible combinations while comparing the columns with the string
import pandas as pd
import difflib
df1 = pd.read_csv('csv1.csv')
df1 = df1.fillna('')
df2 = pd.read_csv('reference.csv')
my_dict = dict(zip(df2['Category'].values, df2['Complexity'].values))
def match_key(key, default_value):
    if not key:
        return default_value
    for d_key in my_dict.keys():
        if key in d_key or d_key in key:
            return my_dict[d_key]

    return default_value
df1['Complexity'] = df1['Category'].apply(lambda x: difflib.get_close_matches(x, list(my_dict.keys(), n=1)))
df1 = df1.explode('Complexity')
df1['Complexity'] = df1['Complexity'].map(my_dict)
print(df1)

A: difflib.get_close_matches expects the first argument to be the 'word', x in your case, and the second argument to be the 'possibilities'. Which you've provided as an empty string. This is why your function isn't working, it's trying to match a word with nothing basically.
my_dict contains the valid options as keys, so we can use them as the list of 'possibilities'
# Use n=1, so only tries to get 1 match
df1['Complexity'] = df1['Category'].apply(lambda x: difflib.get_close_matches(x, list(my_dict.keys()), n=1))
# The output of get_close_matches is a list, we use explode to convert it to a string
df1 = df1.explode('Complexity')
# We can now apply our map, to the *Complexity* column,
# which is technically the best match *Category*, via get_close_matches
df1['Complexity'] = df1['Complexity'].map(my_dict)

Original Bad Answer
However, rather than continue using the difflib, I think you can change your approach. You want to apply my_dict to the Category column of df1. This is traditionally known as applying a map. pandas has this implementation ready via pandas.Series.map.
df1['Complexity'] = df1['Category'].map(my_dict)

redpajama_set_name: RedPajamaStackExchange


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We are AUSTRALIAN PARTNER VISA specialists. We help with SPOUSE/PARTNER and PROSPECTIVE MARRIAGE (fiance/fiancee) visas for Australians with spouses/partners and fiances from all countries, but by far the majority of our clients come from the Philippines. My wife and business partner Mila came to Australia on a Prospective Marriage Visa years ago (when she was an OFW in Hong Kong), so we've been through the same process and we understand what it's like. We have plenty of knowledge and experience in this area, and our service is both personalised and professional! Down Under Visa remains a "mum and dad" operation. We're not a cold and heartless corporation, and we don't allow inexperienced staff to do the work. Every visa application is personally handled by me. We have a remarkable success rate. This means you (and/or your partner/spouse/fiance) are in very safe hands with us.


Forests are a safety net, especially for the poor, but they continue to disappear at an alarming rate.
An increase in afforestation, a slight decrease in deforestation and the natural expansion of forests have reduced the net loss of forest from an average of 8.3 million hectares annually in the 1990s to an average of 5.2 million hectares annually between 2000 and 2010.
Between 1990 and 2012, global emissions of carbon dioxide increased by over 50 per cent.
Ozone-depleting substances have been virtually eliminated, and the ozone layer is expected to recover by the middle of this century.
Protected ecosystems covered 15.2 per cent of land and 8.4 per cent of coastal marine areas worldwide by 2014.
Between 1990 and 2015, 2.6 billion people gained access to improved drinking water sources.
Worldwide 2.1 billion people have gained access to improved sanitation. Despite progress, 2.4 billion are still using unimproved sanitation facilities, including 946 million people who are still practicing open defecation.
Between 2000 and 2014, more than 320 million people living in slums gained access to improved water sources, improved sanitation facilities, or durable or less crowded housing, thereby exceeding the MDG target.
More than 880 million people are estimated to be living in slums today, compared to 792 million in 2000 and 689 million in 1990.


Rahsaan Thomas grew up in New York City, but he writes from a cell in California. He's a staff writer for San Quentin News and the co-author of Uncaged Stories. He has also been published in The Marshall Project, Missouri Review's Literature on Lockdown, Life of the Law, The Beat Within, & Brothers in Pen's 2014 & 2015 anthologies.
At age 45, he became a member of the Society of Professional Journalists and a co-founder of Prison Renaissance.


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Precious and elegant, this traditional long sleeve blouse shines through its green and gold silk embroidery, artistically sewn by hand on sheer best quality cotton fabric. Made 100% by hand in Fantasy Motif by authentic folk artisans, this ethnic shirt is adorned with petals shaped patterns, highlighted by vertical green silk borders. Hand wash in warm water with mild suds and use moderately warm iron. Do not bleach or tumble dry. To protect the embroidery, you are advised not to use the iron directly on the blouse.
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text:
Dr Serena Love
Honorary Research Fellow
serena.love@uq.edu.au
PhD 2011 Department of Anthropology, Stanford University
MPhil 2005 Institute of Archaeology, University College London
MSc 1999 Department of Archaeology, University of Sheffield
BA 1996 Department of Anthropology, University of California at Berkeley
2015-2016 Senior Research Fellow, Research Center for Anatolian Civilizations, Koc University, Istanbul
2015 Visiting Professor, School of Architecture, Sopot University of Applied Sciences
2012-1015 Lecturer of Archaeology, School of Social Science, University of Queensland
2011-2012 Postdoctoral Teaching Fellow, Joukowsky Institute for Archaeology and the Ancient World, Brown University
2010-2011 Lecturer, Department of Anthropology, De Anza College, California
2010-2011 Lecturer, Continuing Studies Program, Stanford University
2010-2011 Lecturer, Education Program for Gifted Youth, Stanford University
2004-2010 Teaching Assistant, Department of Anthropology, Stanford University
Environmental Archaeology, Egyptian Archaeology, Cultural Anthropology, Introduction to Archaeology, Marriage of Archaeological Science and Social Theory, How Houses Build People, Catalhoyuk and the Neolithic
Love, Serena (2016). A sense of architecture in the past: exploring the sensory experience of architecture in archaeology. In Mikkel Bille and Tim Flohr Sørensen (Ed.), Elements of architecture: assembling archaeology, atmosphere and the performance of building space (pp. 213-230) London, United Kingdom: Routledge (Taylor & Francis Group). doi:10.4324/9781315641171
Weisler, Marshall I. and Love, Serena (2015). Geoarchaeology. In James D. Wright (Ed.), International Encyclopedia of the Social and Behavioral Sciences 2nd ed. (pp. 53-57) Amsterdam, The Netherlands: Elsevier. doi:10.1016/B978-0-08-097086-8.13049-1
Barański, Marek, Suárez, Aroa García, Klimowicz, A., Love, Serena and Pawłowska, Kamilla (2015). The architecture of Neolithic Çatalhöyük as a process: complexity in apparent simplicity. In Ian Hodder and Arkadiusz Marciniak (Ed.), Assembling Çatalhöyük (pp. 111-126) Leeds, W Yorks, United Kingdom: Maney Publishing.
Love, Serena (2013). An archaeology of mudbrick houses from Catalhoyuk. In Ian Hodder (Ed.), Substantive Technologies at Çatalhöyük: Reports from the 2000-2008 Seasons (Volume 9). British Institute at Ankar BIAA Monograph (No. 48) (pp. 81-96) Los Angeles, United States: Cotsen Institute of Archaeology Press.
Love, Serena (2017) Field methods for the analysis of mud brick architecture. Journal of Field Archaeology, 42 4: 351-363. doi:10.1080/00934690.2017.1345222
Rosenberg, Danny, Kilmscha, Florian, Graham, Philip J., Hill, Austin (Chad), Weissbrod, Lior, Ktalav, Inbar, Love, Serena, Pinsky, Sonia, Hubbard, Emily and Boaretto, Elisabetta (2014) Back to Tel Tsaf: a preliminary report on the 2013 season of the renewed project. Journal of the Israel Prehistoric Society, 44 148-179.
Love, Serena (2013) Architecture as material culture: building form and materiality in the Pre-Pottery Neolithic of Anatolia and Levant. Journal of Anthropological Archaeology, 32 4: 746-458. doi:10.1016/j.jaa.2013.05.002
Butzer, Karl W., Butzer, Elisabeth and Love, Serena (2013) Urban geoarchaeology and environmental history at the Lost City of the Pyramids, Giza: synthesis and review. Journal of Archaeological Science, 40 8: 3340-3366. doi:10.1016/j.jas.2013.02.018
Love, Serena (2013) The performance of building and technological choice made visible in mudbrick architecture. Cambridge Archaeological Journal, 23 2: 263-282. doi:10.1017/S0959774313000292
Love, Serena (2012) The geoarchaeology of mudbricks in architecture: a methodological study from Catalhoyuk, Turkey. Geoarchaeology, 27 2: 140-156. doi:10.1002/gea.21401
Love, Serena (2007). Materialisations of memory: Remembering and forgetting the pyramid kings. In: Christine Cardin and Jean-Claude Goyon, Proceedings of the Ninth International Congress of Egyptologists-Actes Du Neuvieme Congres International Des Egyptologues. 9th International Congress of Egyptologists, Grenoble France, (1169-1180). 06-12 September 2004.
Love, Serena (2006). Stones, ancestors, and pyramids: investigating the pre-pyramid landscape of Memphis. In: Miroslav Barta, The Old Kingdom aArt and Archaeology: Proceedings of the Conference. The Old Kingdom Art and Archaeology, Prague Czech Republic, (209-220). 31 May-4 June 2004.


text:
Q: Integrate my web api with google drvie api and okta openid connect I have a .Net core web Api calling google drive api. The google drive api should authenticate the api call with Okta and authorize. How can this be achieved?

*

*Should i setup the auth application in Okta dashboard and generate client id and authentication token?

*Which before calling google api will be used to get bearer token from Okta and shared with the google api?

*Will be registered with google admin console and generate the tokens?

The domain of the api will be google.api.com ... so no where it is going to Okta for authentication

A: What you do with your Okta site will be after you have gained access to the google api on behalf of your users.   a bearer token from Okta will not grant you access to a google api you need to go though googles authorization server to get that.
In order to access the Google Drive api and access private user data.  The owner of that data will need to authorize your access.
To do this we use something called Oauth2.  The issue you will have is begin that you say you are using a web api to call Google you will need to create a web application on the side where your users can authorize your application to access their data.   You will need to register your application with google on Google Developer console.  Create a web client credentials.  Then when the user has authorized your application to access their data you will will need to store the refresh token in your system associated with the user.
Then your web api will be able to access the users data by loading the refresh token and requesting a new access token.
There is currently only one sample web-applications-asp.net-core-3 for .net core web applications it doesn't show how to store the refresh token you will need to work that out.
I do have a video on setting up asp .net core with the google people api it might give you a starting point How to get a Google users profile information, with C#. as well as one on how to create a How to create Google Oauth2 web application credentials in 2021.


What if I do not have a primary care provider?
Maternity care in British Columbia is covered by the Medical Services Plan (MSP). It is important you begin your prenatal care and discuss your maternity care options with your primary care provider early in your pregnancy. Your primary care provider will make a referral to a maternity care provider as needed. If you are interested in accessing midwifery care a self-referral is required. Please review the information in the "Registered Midwife" box below.
The Thompson Region Division represents FPs and GPs in Kamloops, Barriere, Sun Peaks, Scotch Creek, Chase, Logan Lake, and Cache Creek.


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Wentworthville Hockey Club will not misuse or change your information without your knowledge. We will not share your information with anyone who doesn't have authority to see your information. To make sure of this, we will regularly audit access to the systems that support Wentworthville Hockey Club and make sure that other organisations we deal with have Privacy policies adhering to the National Privacy Principles.
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