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1.

Problem

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems.

Background

Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear.

Question

How do professionals develop competence and expertise in physiological breech birth?

Methods

Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition.

Results

Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners.

Discussion

The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices.

Conclusion

Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way.  相似文献   
2.
Summary. This study investigates whether there was evidence of increasing risk of still-birth with increasing paternal exposure to ionizing radiation received during employment at the Sellafield nuclear installation before the child was conceived. A significant positive association is found between the total paternal preconceptional exposure to external ionizing radiation and the risk of still-birth (after adjustment for year of birth, social class, birth order and paternal age, odds ratio at 100 mSv 1.24 (95% confidence interval 1.04–1.45)). A summary of the principal scientific findings of this study has been published in the Lancet . This paper describes in detail the statistical methods that were used in the investigation and presents the results in full.  相似文献   
3.
Modelling daily multivariate pollutant data at multiple sites   总被引:7,自引:1,他引:6  
Summary. This paper considers the spatiotemporal modelling of four pollutants measured daily at eight monitoring sites in London over a 4-year period. Such multiple-pollutant data sets measured over time at multiple sites within a region of interest are typical. Here, the modelling was carried out to provide the exposure for a study investigating the health effects of air pollution. Alternative objectives include the design problem of the positioning of a new monitoring site, or for regulatory purposes to determine whether environmental standards are being met. In general, analyses are hampered by missing data due, for example, to a particular pollutant not being measured at a site, a monitor being inactive by design (e.g. a 6-day monitoring schedule) or because of an unreliable or faulty monitor. Data of this type are modelled here within a dynamic linear modelling framework, in which the dependences across time, space and pollutants are exploited. Throughout the approach is Bayesian, with implementation via Markov chain Monte Carlo sampling.  相似文献   
4.
The effects of sectoral shifts, measured by dispersion in the growth rates of employment or earning across industries or regions, on unemployment are tested in a specification controlling for the effects of other labor-market variables and shifts in the demographic composition of the labor force. Interindustry and geographical shifts in labor demand have significant unemployment effects, with adult males the group most strongly affected. The estimated equations imply that most of the fluctuation in unemployment over the period 1956-87 was been due to microeconomic causes rather than aggregate demand.  相似文献   
5.
The importance of establishing effective inter‐agency working between adult mental health services and child care services in order to safeguard children has been repeatedly identified by research, policy, inquiries and inspection reports. This article reports on the evaluation of an initiative in one health and social care trust in Northern Ireland that aimed to facilitate joint working and so improve service provision and protection for children and families. The Champions Initiative involved identifying a Champion in each multidisciplinary community mental health team and in each family and child care team that would have responsibility for providing information, promoting joint working and identifying any obstacles to better cooperation. The evaluation of this Initiative assessed levels of experience, training, confidence, understanding and awareness in the Champions and their team members at baseline. The Champions and their Team Leaders were then followed up after six months to obtain their qualitative views of the impact of the initiative. The results include comparisons between mental health and child care staff, and crucially, views about whether the initiative has had any impact on working together. This study also generated recommendations for further service development in this complex and important area of practice. Copyright © 2010 John Wiley & Sons, Ltd.
‘Identifying a Champion in each multidisciplinary community mental health team and in each family and child care team’

Citing Literature

Number of times cited according to CrossRef: 15

  • Kerry McVeigh, The Think Family Social Work Assessment: outcomes of a family-focused initiative using The Family Model, Advances in Mental Health, 10.1080/18387357.2020.1825969, (1-15), (2020). Crossref
  • Billie Lever Taylor, Liberty Mosse, Nicky Stanley, Experiences of social work intervention among mothers with perinatal mental health needs, Health & Social Care in the Community, 10.1111/hsc.12832, 27 , 6, (1586-1596), (2019). Wiley Online Library
  • Lelia Fitzsimons, The role of champions in promoting family focused practice across adult mental health and children's services, Advances in Mental Health, 10.1080/18387357.2019.1661783, (1-10), (2019). Crossref
  • Nicky Stanley, Khatidja Chantler, Rachel Robbins, Children and Domestic Homicide, The British Journal of Social Work, 10.1093/bjsw/bcy024, 49 , 1, (59-76), (2018). Crossref
  • Sanne Rumping, Leonieke Boendermaker, Doret J. Ruyter, Stimulating interdisciplinary collaboration among youth social workers: A scoping review, Health & Social Care in the Community, 10.1111/hsc.12589, 27 , 2, (293-305), (2018). Wiley Online Library
  • Robin Mason, Janice Du Mont, Maeve Paterson, Ilene Hyman, Experiences of child protection workers in collaborating with adult mental health providers: An exploratory study from Ontario, Canada, Children and Youth Services Review, 10.1016/j.childyouth.2018.02.005, 86 , (271-276), (2018). Crossref
  • Andani Thakhathi, Champions of Change and Organizational Development: A Return to Schön and Typology for Future Research and Practice, Research in Organizational Change and Development, 10.1108/S0897-301620180000026007, (265-306), (2018). Crossref
  • Phillip Tchernegovski, Andrea E. Reupert, Darryl J. Maybery, How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study, Child & Family Social Work, 10.1111/cfs.12426, 23 , 3, (381-389), (2017). Wiley Online Library
  • Eeva Timonen-Kallio, Juha Hämäläinen, Eila Laukkanen, Interprofessional Collaboration in Finnish Residential Child Care: Challenges in Incorporating and Sharing Expertise Between the Child Protection and Health Care Systems, Child Care in Practice, 10.1080/13575279.2016.1158153, 23 , 4, (389-403), (2016). Crossref
  • Barry Luckock, Jane Barlow, Chris Brown, Developing innovative models of practice at the interface between the NHS and child and family social work where children living at home are at risk of abuse and neglect: a scoping review, Child & Family Social Work, 10.1111/cfs.12228, 22 , S4, (62-69), (2015). Wiley Online Library
  • Joe Duffy, Gavin Davidson, Damien Kavanagh, Applying the recovery approach to the interface between mental health and child protection services, Child Care in Practice, 10.1080/13575279.2015.1064358, 22 , 1, (35-49), (2015). Crossref
  • Estela Arcos, Ximena Sanchez, Maria Cecilia Toffoletto, Margarita Baeza, Patricia Gazmuri, Luz Angélica Muñoz, Antonia Vollrath, Social protection systems in vulnerable families: their importance for the public health, Revista de Saúde Pública, 10.1590/S0034-8910.2014048005131, 48 , 3, (398-405), (2014). Crossref
  • Oi Ling Wong, Integrative Family and Systems Treatment with Parental Mental Illness: A Hong Kong Chinese Family, Contemporary Family Therapy, 10.1007/s10591-014-9298-2, 36 , 2, (242-249), (2014). Crossref
  • Peter Sidebotham, Rethinking Filicide, Child Abuse Review, 10.1002/car.2303, 22 , 5, (305-310), (2013). Wiley Online Library
  • Jane V. Appleton, Peter Sidebotham, Child Protection and Mental Health, Child Abuse Review, 10.1002/car.2220, 21 , 3, (153-156), (2012). Wiley Online Library

Volume 21 , Issue 3 May/June 2012

Pages 157-172  相似文献   

6.
In recent years sport-based interventions have been implemented as a mechanism via which to target marginalised youth in relation to the development of social inclusion. Much of the political rhetoric surrounding social inclusion programmes highlights engagement with education, employment, or training, as key metrics. This has led some scholars to observe that conceptualising social inclusion in this way can act to further marginalise young people who fail to engage with these metrics. In contrast, this paper seeks to employ an alternative understanding of social inclusion, which uses the concepts of recognition and acceptance, to infer how participation in sports-based programmes may enable marginalised youth to meet mainstream societal expectations and aid with social assimilation. Drawing upon findings from two small-scale studies of sport-based interventions located in three UK cities, this paper places participant accounts at the centre of the analysis to explore broader notions of pro-social development in relation to recognition and interpersonal acceptance. The paper concludes by suggesting that within contexts in which young people are able to generate strong interpersonal relationships with key personnel (such as coaches), and which are built upon trust, recognition and developing self-worth, there is clear potential for sport-based programmes to incubate social assimilation.  相似文献   
7.
In this note, it is shown that the finite-sample distributions of the Wald, likelihood ratio, and Lagrange multiplier statistics in the classical linear regression model are members of the generalized beta model introduced by McDonald and Xu (1995a McDonald, J.B., Xu, Y.J. (1995a). A generalization of the beta distribution with applications. J. Econom. 66:133152.[Crossref], [Web of Science ®] [Google Scholar]). This is useful for examining the properties of these test statistics. For example, this characterization makes it easy to find distribution, quantile, and density functions for each test statistic, makes it clear why Wald tests may overreject the null hypothesis using asymptotic critical values, and formalizes the fact that the Lagrange multiplier statistic follows a distribution with bounded support.  相似文献   
8.
Neighbourhood planning (NP) as enabled by the 2011 Localism Act in England has precipitated a considerable literature discussing its potential, limitations and likely shortcomings referenced against government rhetoric and the reporting of initial experiences of the process. This paper provides an overview of the current literature on neighbourhood planning and sets out how it has been received and practised across England drawing on empirical evidence. The extent of take-up and the experience of those involved in the first five years of neighbourhood planning is used to consider how community-led planning may be designed and used following operational principles of inclusivity, capacity-building and adding value.  相似文献   
9.
10.
We consider the task of generating discrete-time realisations of a nonlinear multivariate diffusion process satisfying an Itô stochastic differential equation conditional on an observation taken at a fixed future time-point. Such realisations are typically termed diffusion bridges. Since, in general, no closed form expression exists for the transition densities of the process of interest, a widely adopted solution works with the Euler–Maruyama approximation, by replacing the intractable transition densities with Gaussian approximations. However, the density of the conditioned discrete-time process remains intractable, necessitating the use of computationally intensive methods such as Markov chain Monte Carlo. Designing an efficient proposal mechanism which can be applied to a noisy and partially observed system that exhibits nonlinear dynamics is a challenging problem, and is the focus of this paper. By partitioning the process into two parts, one that accounts for nonlinear dynamics in a deterministic way, and another as a residual stochastic process, we develop a class of novel constructs that bridge the residual process via a linear approximation. In addition, we adapt a recently proposed construct to a partial and noisy observation regime. We compare the performance of each new construct with a number of existing approaches, using three applications.  相似文献   
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