Tag Archives: Perinatal Mental Health

Perinatal Mental Health Workshop Links + Resources 2018

When you’re doing education sessions, it’s handy to have the links/resources in one place. It makes info much easier to share.

This is a quick and dirty updated and cutdown version of a 2014 blog post called Perinatal Mental Health Workshop Links and Resources. Anyway, with no further ado:

Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline
It handy to know how to find the October 2017 guideline and companion documents
cope.org.au


Using the Edinburgh Postnatal Depression Scale

Tips for midwives, child health nurses, Indigenous health workers and other clinicians
meta4RN.com/epd

Perinatal Jargon Busting
If you haven’t already, get your head around the lingo, and maybe become Facebook friends with Perry Natal 🙂
meta4RN.com/jargon

Nurturing the Nurturers
Info about guided reflective practice/clinical supervision as a self-care mechanism for health professionals
meta4RN.com/nurturers

Nurses, Midwives, Medical Practitioners, Suicide and Stigma
This companion piece to “Nurturing the Nurturers” presents alarming data about the high suicide rate amongst nurses and midwives compared to other professions
meta4RN.com/stigma

Still Face Experiment
Edward Tronick’s demonstration of how infants respond to changes in interaction from primary caregivers is often cited in infant mental health education

Here’s Looking at You – Connecting with Bubs Our Way
This is a terrific video to use/share with parents-to-be or new parents.
The only people on screen and doing the talking are Aboriginal and Torres Strait Islanders, which makes a welcome change. 🙂

Circle of Security
The current “go to” model of attachment theory and affective neuroscience.
www.circleofsecurityinternational.com

Head to Health
Find the right Australian digital mental health resources for the family you’re working with (includes info sheets, websites, apps + helplines)
headtohealth.gov.au

.

End

That’ll do for the quick and dirty 2018 version. You’re welcome to browse the more detailed 2014 version here, but be warned: there’s quite a few dud/dead links there now. 😦

You’re also very welcome to share this page, the resources above and/or leave a comment below.

Thanks for dropping-in.

Paul McNamara, 12 July 2018

Short URL: meta4RN.com/perinatal

Post Script

Whiteboard from the perinatal and infant mental health session with CQU Student Midwives on 13 July 2018

 

Developing, designing and deploying a perinatal mental health referral pathway

Abstract

Mental health nurses have the skills to collaborate with primary health providers, work side-by-side with tertiary health providers, and provide support and information to those who experience mental health difficulties and their families. But how do we communicate this? How do we make it easy for referrers and consumers to find the ‘best fit’ for identified needs? How do we promote collaborative care? How do we reach our audience?

This poster presentation is the third iteration of a referral pathway that has undergone the usual quality improvement measures of consultation and review. The poster is also a showcase for collaboration: the content was gathered in collaboration with service providers and consumers; this information was then organised, revised and presented in collaboration with a graphic designer; the completed pathway was then deployed, reviewed and made accessible in collaboration with a web designer.

This perinatal mental health referral pathway does not purport to be a template for others, but may serve as one example of how to develop, design and deploy accessible information about local service options. The poster presentation hopes to serve as a starting point for those who are interested in articulating a service’s relationship to the consumer and other agencies. The poster also demonstrates a clinically relevant use for Quick Response (QR) Code – please bring your smart phone if you intend to view the perinatal mental health referral pathway.

NB: This 2011 Version is redundant. NOT for clinical use. Please use only as an example.

Printable/downloadable PDF version here: referralpathwayworkflow2011

Reference/Citation

McNamara, P., Horn, F. & Dalzell, M. (2012) Developing, designing and deploying a perinatal mental health referral pathway. Poster presented at ‘The fabric of life’, the 38th Annual International Conference of the Australian College of Mental Health Nursing, Darwin. http://dx.doi.org/10.1111/j.1447-0349.2012.00878.x

or, if you want to cite/see the journal entry

McNamara, P., Horn, F. & Dalzell, M. (2012) Developing, designing and deploying a perinatal mental health referral pathway. International Journal of Mental Health Nursing, volume 21, issue S1, pages 16-17. http://dx.doi.org/10.1111/j.1447-0349.2012.00878.x

Notes

This flowchart first began to be mapped-out in 2010, the version above was finalised in November 2011, and presented at a mental health nursing conference in October 2012. The workflow and the position that developed/supported it became redundant in 2013.

My versions were smudged pencil on paper versions. Freya Horn, now working as Graphic Artist at www.designerinyourpocket.com.au, turned it into the legible and attractive flowchart you see above. Thanks Freya!

There is some optimism about money flowing back in to perinatal mental health services in Australia. With that in mind, I’m releasing this old work from my USB drive to my website. Hopefully it will save others wasting time “reinventing the wheel”. Updating the wheel will be required, of course, but there’s no need to start from scratch. 🙂

Just to reiterate: This 2011 Version is redundant. It is NOT for clinical use. Please use only as an example for how you/your local service may want to might develop a map of the local referral pathway and workflow.

End

That’s it. Hopefully this will be of interest/use to someone in future.

As always, your feedback is welcome via the comments section below.

Paul McNamara, 14th June 2018

Short URL: meta4RN.com/pathway

2018 ACMHN Consultation Liaison / Perinatal Infant Mental Health Conference on Twitter

The 16th ACMHN Consultation Liaison Special Interest Group annual conference, held in conjunction with the 7th ACMHN Perinatal Infant Mental Health Special Interest Group annual conference, was held at the Royal Brisbane and Womens Hospital from Wednesday 6 June to Friday 8 June 2018. The theme of the conference was “The Art of Applying the Science: Consultation Liaison and Perinatal & Infant Mental Health Nurses in Action”. As is typical of healthcare conferences, a conference hashtag was announced; #ACMHN was used on Twitter by six of the fifty-ish conference participants.

One of the observations made by Martin Salzmann-Erikson in his paper Mental health nurses’ use of Twitter for professional purposes during conference participation using #ACMHN2016 was that conference participants who do not engage with Twitter may feel that they’re excluded from a “privileged backchannel” of communication. On one hand this is complete nonsense. No conference participants are excluded from Twitter. Those who do not use Twitter/the conference hashtag are just exercising a choice. On the other hand, they may not be using Twitter and/or a conference hashtag simply because they have not been exposed to a reason to do so. It is with the latter in mind that the Tweets using the #ACMHN hashtag over the course of the conference are collated below.

#ACMHN Tweets

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.

84.

85.

86.

87.

88.

89.

90.

91.

92.

93.

94.

95.

96.

97.

98.

99.

100.

#ACMHN Tweeps

If you’ve scanned through the content above you’ll see that two Tweeps (ie: people who use Twitter) generated the vast majority of the #ACMHN Tweets. It’s not obvious from a quick glance, but many of the #ACMHN Tweets were retweeted (ie: shared). Seventeen Tweeps used/retweeted the #ACMHN hashtag 167 times over the course of the conference [data source], they are:
Cynthia Delgado @Cyn4CLMH*
Kim Foster @FostKim*
#HELLOMYNAMEISBJ @FewingsBj*
Anabel de la Riva @AnabeldelaRiva*
Chris Egginton @ChrisEgginton*
NWMH Graduate Nurses @NWMHgrads*
Peta Marks @petamarks*
Sharene Duncan @brisequine*
Chelesee @Chelesee1*
Veriti @Veritihealth*
A/Prof Rhonda Wilson @RhondaWilsonMHN*
Australian College of Mental Health Nurses @ACMHN*
Melissa Sweet @croakeyblog*
#HelloMyNameIs Kenny (RN) @kennygibsonnhs*
International Network of Nurse Leaders @inNurseLeaders*
Dr. Anja K. Peters @thesismum*
Paul McNamara [me] @meta4RN*
Key
* #ACMHN conference delegates [n = 6]
* Australian #ACMHN retweeters [n = 7]
* International #ACMHN retweeters [n = 4]

Many thanks to all who shared conference info with the #ACMHN hashtag. Thanks also to those who commented on/interacted with Tweets using the hashtag, but did not use the hashtag themselves (these Tweeps are not listed above).

Final Notes

  1. Each of my Tweets that announced a workshop or presentation were pre-scheduled using Hootsuite (ie: I wasn’t as busy Tweeting during the conference as it seems).
  2. Collating Tweets on a web page is irritatingly time-consuming. It used to be much quicker and easier (missing you Storify!). The upside of collating Tweets on a web page is that they serve as a record/brief notes of the conference, so if I need to come back to anything it’s all in one easy-to-find place.  Hopefully others will find it of interest too.
  3. Just in case you skipped-over it: watching the vid attached to Tweet 92 is definitely worth it – a highlight of the conference!
  4. Previous visitors to meta4RN.com may be experiencing a sense of déjà vu. To rid yourself of spooky feels, visit this same-same-but-different companion piece:
    #ACMHN Looking back at the 2013 Consultation Liaison / Perinatal Infant Conference through a Social Media Lens meta4RN.com/noosa 

End

That’s it. Thanks for visiting. As always your thoughts and feedback are welcomed in the comments section below.

Paul McNamara, 10th June 2018

Short URL: meta4RN.com/Brisneyland

PS:

https://platform.twitter.com/widgets.js

@WePublicHeath

For the week Monday 27th January to Sunday 2nd February 2014 I was able to use the @WePublicHealth Twitter handle, thanks to the generosity of Melissa Sweet (aka @croakeyblog).


Here’s what happened:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

72.

73.

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.

84.

85.

86.

87.

88.

89.

90.

91.

92.

93.

94.

95.

96.

97.

98.

99.

100.

101.

102.

103.

104.

105.

106.

107.

108.

109.

110.

111.

112.

113.

114.

115.

116.

117.

118.

119.

120.

121.

122.

123.

124.

125.

126.

127.

128.

129.

130.

131.

132.

133.

134.

135.

136.

137.

138.

139.

140.

141.

142.

143.

144.

145.

146.

147.

148.

149.

150.

151.

152.

153.

154.

155.

156.

157.

158.

159.

160.

161.

162.

163.

164.

165.

166.

167.

168.

169.

170.

171.

172.

173.

174.

175.

176.

177.

178.

179.

180.

181.

182.

183.

184.

185.

186.

187.

188.

189.

190.

191.

192.

193.

194.

195.

196.

197.

198.

199.

200.

201.

202.

203.

204.

205.

205.

206.

207.

208.

209.

210.

211.

212.

213.

214.

215.

216.

217.

218.

219.

220.

221.

222.

223.

224.

225.

226.

227.

228.

229.

230.

231.

232.

233.

234.

235.

236.

237.

238.

239.

240.

241.

242.

243.

244.

245.

246.

247.

248.

249.

250.

251.

252.

253.

254.

255.

256.

257.

258.

259.

260.

261.

262.

263.

264.

265.

266.

267.

268.

269.

270.

271.

272.

273.

274.

275.

276.

277.

278.

279.

280.

281.

282.

283.

284.

285.

286.

287.

288.

289.

290.

291.

292.

293.

294.

295.

296.

297.

298.

299.

300.

301.

302.

303.

Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
storify.com/meta4RN/wepublichealth

Unfortunately, Storify is shutting-down on 16 May 2018 and all content will be deleted.

I’m using my blog as a place to mimic/save the Storify pages I created and value.

End

 

A big shout-out to Melissa Sweet. I am very grateful to Melissa for inviting a mental health nurse to have a stint on @WePublicHealth.

Melissa is a rockstar of public health and health social media in Australia. If you’re not familiar with her work read-up about Melissa here, and “croakey“, the social journalism project of which she is the lead editor, here. More info re @WePublicHealth, the rotated curation Twitter account that Melissa coordinates, here.

As always, please use the comments section below for any feedback/questions.

Paul McNamara, 2nd April 2018

Short URL: meta4RN.com/WePublicHealth

Stay Connected, Stay Strong

“Stay connected, stay strong… before and after baby” is a really cool DVD featuring Aboriginal and Torres Strait Islander parents. Using social media (YouTube, Facebook, Twitter, Instagram and WordPress) I’ve promoted the video with the goal of improving access to it.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

Explanation

These Tweets were initially compiled using a social media aggregation tool called Storify
https://storify.com/meta4RN/stay

Unfortunately, Storify is shutting-down on 16 May 2018 and all content will be deleted.

I’m using my blog as a place to mimic/save the Storify pages I created and value.

End

As always, please use the comments section below for any feedback/questions.

Paul McNamara, 11th March 2018

Short URL: meta4RN.com/connected

Social Media and Digital Citizenship: A CL Nurse’s Perspective

This post is a companion piece to my keynote presentation at the 5th Annual Queensland Consultation Liaison Psychiatry Symposium “Modern Approaches in CL Psychiatry”, on 2nd November 2017,

The function of this page is to be a collection point to list references/links that will be mentioned in the presentation. The Prezi is intended as an oral presentation, so I do not intend to include a full description of the content here.

Click on the picture to see the Prezi

Bio/Intro (you know speakers write these themselves, right?)

Paul McNamara is a CL CNC in Cairns.

Paul has been dabbling in health care social media since 2010. He established an online portfolio in 2012 which includes Twitter, Facebook, Instagram, YouTube and a Blog.

In 2016 Paul was appointed to the Editorial Board of the International Journal of Mental Health Nursing specifically because of his interest in social media.

This morning’s presentation “Social Media & Digital Citizenship: A CL Nurse’s Perspective” aims to encourage the converts, enthuse the curious, and empower the cautious.

Disclaimer/Apology/Excuse

Regular visitors to meta4RN.com will recognise some familiar themes.

Let’s not call it self-plagiarism (such an ugly term), I would rather think of it as a new, funky remix of a favourite old song.

Due to this remixing of old content I’ve included lots of previous meta4RN.com blog posts on the reference list.

This, in turn, makes the reference list look stupidly self-referential. #TrumpBrag

 

Anyway, with that embarrassing disclosure out of the way, here is the list of references and links cited in the Prezi prezi.com/user/meta4RN

References + Links

Altmetric Attention Score [example] https://wiley.altmetric.com/details/23964454

Australian College of Nursing (n.d.) Social media guidelines for nurses. Retreived from http://www.rcna.org.au/WCM/…for_nurses.pdf

Australian Health Practitioner Regulation Agency. (2014, March 17). Social media policy. Retrieved from http://www.ahpra.gov.au/News/2014-02-13-revised-guidelines-code-and-policy.aspx

Casella, E., Mills, J., & Usher, K. (2014). Social media and nursing practice: Changing the balance between the social and technical aspects of work. Collegian, 21(2), 121–126. doi:10.1016/j.colegn.2014.03.005

Facebook. (2015). Facebook logo. Retrieved from https://www.facebookbrand.com/

Ferguson, C., Inglis, S. C., Newton, P. J., Cripps, P. J. S., Macdonald, P. S., & Davidson, P. M. (2014).  Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013. Collegian, 21(2), 89–93. doi:10.1016/j.colegn.2014.03.002

Fox, C.S., Bonaca, M.P., Ryan, J.J., Massaro, J.M., Barry, K. & Loscalzo, J. (2015). A randomized trial of social media from Circulation. Circulation. 131(1), pp 28-33

Gallagher, R., Psaroulis, T., Ferguson, C., Neubeck, L. & Gallagher, P. 2016, ‘Social media practices on Twitter: maximising the impact of cardiac associations’, British Journal of Cardiac Nursing, vol. 11, no. 10, pp. 481-487.

Instagram. (2015). Instagram logo. Retrieved from https://help.instagram.com/304689166306603

Li, C. (2015). Charlene Li photo. Retrieved from http://www.charleneli.com/about-charlene/reviewer-resources/

lifeinthefastlane. (2013). #FOAMed logo. Retrieved from http://lifeinthefastlane.com/foam/

My Tweets = my lecture notes. Other people’s Tweets also = my lecture notes. 🙂

McNamara, P. (2017, October 16) Delirium risks and prevention. Tweets re the guest lecture by Prof Sharon Inouye at Royal Brisbane and Women’s Hospital (and Cairns via videolink) collated on Storify. Retrieved from https://storify.com/meta4RN/delirium-risks-and-prevention

McNamara, P. (2016, November 18) Twitter is a Vector (my #ACIPC16 presentation). Retrieved from https://meta4RN.com/ACIPC16

McNamara, P. (2016, October 21) Why on earth would a Mental Health Nurse bother with Twitter? (my #ACMHN2016 presentation). Retrieved from https://meta4RN.com/ACMHN2016

McNamara, P. (2016, October 15) Learn about Obesity (and Twitter) via Nurses Tweeting at a Conference. Retrieved from  https://meta4RN.com/obesity

McNamara, P., & Meijome, X. M. (2015). Twitter Para Enfermeras (Spanish/Español). Retrieved 11 March 2015, from http://www.ausmed.com.au/es/twitter-para-enfermeras/

McNamara, P. (2014). A Nurse’s Guide to Twitter. Retrieved from http://www.ausmed.com.au/twitter-for-nurses/

McNamara, P. (2014, May 3) Luddites I have known. Retrieved from http://meta4RN.com/luddites

McNamara, P. (2013) Behave online as you would in real life (letter to the editor), TQN: The Queensland Nurse, June 2013, Volume 32, Number 3, Page 4.

McNamara, P. (2013, October 25) Professional use of Twitter and healthcare social media. Retrieved from http://meta4RN.com/NPD100

McNamara, P. (2013, October 23) A Twitter workshop in tweets. Retrieved from http://meta4RN.com/tweets

McNamara, P. (2013, October 1) Professional use of Twitter. Retrieved from http://meta4RN.com/poster

McNamara, P. (2013, July 21) Follow Friday and other twitterisms. Retrieved from http://meta4RN.com/FF

McNamara, P. (2013, June 29) Thinking health communication? Think mobile. Retrieved https://meta4RN.com/mobile

McNamara, P. (2013, June 7) Omnipresent and always available: A mental health nurse on Twitter. Retrieved from http://meta4RN.com/twit

McNamara, P. (2013, January 20) Social media for nurses: my ten-step, slightly ranty, version. Retrieved from http://meta4RN.com/rant1

Moorley, C., & Chinn, T. (2014). Using social media for continuous professional development. Journal of Advanced Nursing, 71(4), 713–717. doi:10.1111/jan.12504

Nickson, C. P., & Cadogan, M. D. (2014). Free Open Access Medical education (FOAM) for the emergency physician. Emergency Medicine Australasia, 26(1), 76–83. doi:10.1111/1742-6723.12191

Nursing and Midwifery Board of Australia (2010, September 9) Information sheet on social media. Retrieved from http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2F3224&dbid=AP&chksum=qhog9%2FUCgKdssFmA0XnBlA%3D%3D

Office of the eSafety Commisioner (2017). eSafety logo. Retrieved from https://www.esafety.gov.au

Read, J., Harper, D., Tucker, I. and Kennedy, A. (2017), Do adult mental health services identify child abuse and neglect? A systematic review. International Journal of Mental Health Nursing http://onlinelibrary.wiley.com/doi/10.1111/inm.12369/abstract

Screenshot 1 “Trump: Twitter helped me win but I’ll be ‘restrained’ now” from http://money.cnn.com/2016/11/12/media/donald-trump-twitter-60-minutes/

Screenshot 2: “Melania Trump rebukes her husband “all the time” for Twitter use” from http://www.cbsnews.com/news/donald-trump-melania-trump-60-minutes-interview-rebukes-twitter-use/

The Nurse Path (facebook) https://www.facebook.com/theNursePath

Tonia, T., Van Oyen, H., Berger, A., Schindler, C. & Künzli, N. (2016). International Journal of Public Health. 61(4), pp 513-520. doi:10.1007/s00038-016-0831-y

Twitter. (2015). Twitter logo. Retrieved from https://about.twitter.com/press/brand-assets

Wilson, R., Ranse, J., Cashin, A., & McNamara, P. (2014). Nurses and Twitter: The good, the bad, and the reluctant. Collegian, 21(2), 111–119. doi:10.1016/j.colegn.2013.09.003
https://www.sciencedirect.com/science/article/pii/S1322769613000905

Wozniak, H., Uys, P., & Mahoney, M. J. (2012). Digital communication in a networked world. In J. Higgs, R. Ajjawi, L. McAllister, F. Trede, & S. Loftus (Eds.), Communication in the health sciences (3rd ed., pp. 150–162). South Melbourne, Australia: Oxford University Press

End 

Finally, a big thank you to the organisers of the 5th Annual Consultation Liaison Psychiatry Symposium, especially Stacey Deaville for suggesting this session, and Dr Paul Pun for pulling on all the right strings.

That’s it. As always your comments are welcome.

Paul McNamara, 19th October 2017

Short URL: meta4RN.com/CLPS

First Thyself

First Thyself – Surviving Emotionally Taxing Work Environments

On 28th April 2017 I’ll be presenting a session at the Ausmed “Breaking Point: Ice & Methamphetamine Conference” in Cairns. More info about the conference here: https://www.ausmed.com.au/course/ice-methamphetamine#overview

The nature of nursing will mean that we are likely to be are exposed to a range of challenges.

Feeling unsafe, witnessing violence, tragedy and dealing with trauma are some examples.

This emotionally taxing environment can result in tension with colleagues, family and friends.

This session will begin day two of the conference by creating an opportunity to discuss the following:

What are the professional implications of working in challenging areas of nursing and healthcare?

How can we maintain unconditional positive regard?

Why self-care matters and how to practice what we preach!

What’s all this then?

“First Thyself” is planned as an interactive session accompanied by visual cues to give the discussion a bit of structure. Consequently, the transcript/dialogue of the presentation can not be included here.  The visual presentation itself doesn’t use powerpoint slides. It uses the prettier (and free!) platform Prezi instead: prezi.com/skmu0lbnmkm5/first-thyself/#

This page serves as a one-stop directory to the online resources used to support the discussion.

I’m recycling and combining a lot of old ideas for the session (there’s that self-plagiarist vs groovy remix of favourite old songs thing again).

Here is the online presentation: Prezi

Here are the resources and references used in the presentation:

Emotional Aftershocks (the story of Fire Extinguisher Guy & Nursing Ring Theory) meta4RN.com/aftershocks

Football, Nursing and Clinical Supervision (re validating protected time for reflection and skill rehearsal) meta4RN.com/footy

Hand Hygiene and Mindful Moments (re insitu self-care strategies) meta4RN.com/hygiene

Lalochezia (getting sweary doesn’t necessarily mean getting abusive) meta4RN.com/lalochezia

Nurse & Midwife Support nmsupport.org.au  phone 1800 667 877
– we have specifically targeted 24/7 confidential support available

Nurses, Midwives, Medical Practitioners, Suicide and Stigma (re the alarming toll of those who undertake emotional labour) meta4RN.com/stigma

Nurturing the Nurturers (the Pit Head Baths and clinical supervision stories) meta4RN.com/nurturers

Spector, P., Zhiqing, Z. & Che, X. (2014) Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies. Vol 50(1), pp 72-84. www.sciencedirect.com/science/article/pii/S0020748913000357

Zero Tolerance for Zero Tolerance (a reframing of reducing aggression) meta4RN.com/zero

It’s OK if you forget everything about today’s talk, just don’t forget that there is 24 hour support available via 1800 667 877 or https://nmsupport.org.au

End

Please have a play with the pretty Prezi prezi.com/skmu0lbnmkm5/first-thyself/#

Thanks for visiting. As always your comments are welcome.

Paul McNamara, 30 March 2017

Short URL: meta4RN.com/thyself