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71.

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   
72.
In this paper, I analyze the discourse of what I argue are two moral panics that played out in the Australian media during the period 2004–2015: the sexualization of children debate, and the sexting panic, which appeared some years later. I argue that while the issue of the alleged sexualization of children is nothing new, the way that the issue has been constructed in the media has shifted during the last decade, with greater focus on children’s use of technology. By comparing these two panics, we can diagnose a shift in the nature of mass-media-based panics, from concerns about external sources of sexualization to concerns about children’s own practices of self-representation via contemporary technologies. Both panics mobilized a range of broader social anxieties about the commodification and sexualization of culture and the increasing agency of children, and panics in relation to contemporary mobile technologies are a collective response to shifts in the power relations between children, their parents, and other figures of authority.  相似文献   
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人口计生宣传教育为“先导”的重心和支点   总被引:1,自引:0,他引:1  
宣传教育为先导的战略决策,是国家人口计生委党组书记、主任李斌同志2007年年底在河南召开全国农村人口文化建设工作现场会和在宁波市召开全国婚育新风进万家活动经验交流会上提出的重大战略思想。宣传教育为先导战略决策的提出,是在科学发展观指引下尊重思想政治工作、精神文明建设和人口计生工作客观规律,总结正反两方面工作经验教训的必然产物,是今后做好人口计生工作的元点工程。本文主要论述了为什么要先导,先什么、导什么,如何先导三个重大问题。  相似文献   
76.
本文主要探讨当代中国的两种音乐活动形式——京剧票友会以及摇滚乐队派对。这两种音乐形式虽然在风格上截然不同,但是两种社团在结构上却存在着一定的相似性。这两种活动形式基本上都具有我们所称之为"为位"(positioning)的行为,参与者由此在音乐活动中找到他们各自的位置。而且,两种活动形式都涉及到"外来者的融入"(outsider integration),即允许陌生人的参与并在活动中找到他们的位置。  相似文献   
77.
Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.  相似文献   
78.
This paper reports on the first phase of a larger study aimed at investigating factors hindering family work and exploring ways to improve the amount and quality of family contact within a community aged mental health service in Melbourne, Australia. During the first phase of the project, 28 mental health professionals were interviewed about their views and experiences. Interviews were transcribed, coded, and analysed in terms of repeating themes. The range of attitudes, beliefs and feelings about family work is summarised in this paper. Polarities emerged around questions of whether or not to engage family members, and if so, what function family work fulfils. The interviews also provided useful information on clinicians' beliefs about what would increase the possibility of family work. The paper concludes with a discussion about how to recognize and value family work in this area and target sustainable interventions during the second phase of the study.  相似文献   
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Substance use among college-age adults is of interest due to high levels of use and low levels of treatment access and engagement relative to other adults. Data collected from 1,972 clients in residential services were analyzed to investigate differences in use patterns, treatment outcomes, and other life area problems. Participants completed an Addiction Severity Index (ASI) and the University of Rhode Island Change Assessment (URICA) at baseline, and an ASI and Treatment Services Review at 1-month and 6-month postdischarge interviews. Almost a quarter (24.1%) of participants were college age (18–25 years old). They were more likely to be White and male, and less likely to complete treatment although they had a longer average length of stay. College-age adults improved on all outcome measures, and posttreatment service use shows significant difference between college-age and older participants. Implications for practice are discussed.  相似文献   
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