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1.
Shawn Walker Mandie Scamell Pam Parker 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e170-e177
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.
Mark S. Pearce Heather O. Dickinson Murray Aitkin Louise Parker 《Journal of the Royal Statistical Society. Series A, (Statistics in Society)》2002,165(3):523-548
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.
Medical fraud and overservicing are estimated to cost the Australian community between $130 and $200 million per annum, a figure far greater than the national cost of burglary and almost the same as the total property loss from all conventional crime. An examination of the social antecedents of medical fraud and overservicing suggests that the predisposition of some doctors to engage in these practices occurs because of the following: (1) medical training and professional socialization that orientate student doctors away from altruistic health issues towards narrower self-interested professional concerns; (2) career expectations of a high pattern of material consumption that are often frustrated by an increasingly competitive medical market place; and (3) professional medical organizations that lobby for national health policies which reflect the mercenary self-interest of doctors rather than the health interest of the nation. 相似文献
4.
Jeffrey Parker 《Economic inquiry》1992,30(1):101-116
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 article contrasts two programmes aimed at improving thequality of life for older women in Australia. The CommunityOptions programme is a wellfunded Government initiative directedat personal care within the home. The Older Women's Networkis a grass-roots community development initiative. The articleexamines the relationship between control and resourcing interms of preventative and crisis care. 相似文献
6.
Using ethnographic and interview data, this article explores hopes for the future of young Indonesian musicians. The young people are seen to consider their future trajectories in multiple, hierarchical music fields. The article also takes into account the ontological insecurity of jobs as a professional musician, arguing that there is continuous reproduction of a doxa, namely ‘survival of the fittest’ in Indonesia. Yet despite abundant risks to livelihoods, young Indonesian musicians expressed optimistic views about the future. The analysis of data below bridges the gap between the traditionally separate youth studies fields of youth transitions and youth cultures. Our interpretation critically contextualises the dialogue between these two fields based on the experiences of young Indonesian musicians as a part of the Global South. 相似文献
7.
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
8.
Thomas Parker 《统计学通讯:理论与方法》2017,46(11):5195-5202
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). 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
9.
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
10.