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Robin S. Cronin Minglan Li Kate Culliney Robyn Maude Katherine Nelson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):422-429
Background
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.Aim
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.Methods
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.Findings
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.Conclusions
Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education. 相似文献43.
Kate D’Arcy 《Race Ethnicity and Education》2017,20(5):636-649
AbstractCritical Race Theory (CRT) is formed from a series of different methodological tools to expose and address racism and discrimination. Counter-stories are one of these tools. This article considers the potential of counter-stories as a methodological, theoretical and practical tool to analyse existing educational inequalities for Traveller communities. Although discrimination towards Traveller communities is well documented, there has been limited use of CRT to examine this position and challenge the social injustice they experience. In this article ‘stock stories’, or commonly held assumptions and stereotypes about Traveller communities are highlighted and refuted with Travellers’ own accounts. It is hoped this article will dispel stock stories, raise awareness of the real inequalities Travellers face and inform methodological debate. 相似文献
44.
Jennifer L. Walsh Robyn L. Fielder Kate B. Carey Michael P. Carey 《Journal of sex research》2014,51(2):145-158
Alcohol and marijuana use are thought to increase sexual risk taking, but event-level studies conflict in their findings and often depend on reports from a limited number of people or on a limited number of sexual events per person. With event-level data from 1,856 sexual intercourse events provided by 297 college women (M age = 18 years; 71% White), we used multilevel modeling to examine associations between alcohol and marijuana use and condom use as well as interactions involving sexual partner type and alcohol-sexual risk expectancies. Controlling for alternative contraception use, partner type, regular levels of substance use, impulsivity and sensation seeking, and demographics, women were no more or less likely to use condoms during events involving drinking or heavy episodic drinking than during those without drinking. However, for drinking events, there was a negative association between number of drinks consumed and condom use; in addition, women with stronger alcohol-sexual risk expectancies were marginally less likely to use condoms when drinking. Although there was no main effect of marijuana use on condom use, these data suggest marijuana use with established romantic partners may increase risk of unprotected sex. Intervention efforts should target expectancies and emphasize the dose-response relationship of drinks to condom use. 相似文献
45.
Robyn L. Fielder Jennifer L. Walsh Kate B. Carey Michael P. Carey 《Journal of sex research》2014,51(2):131-144
“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression. 相似文献
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Laura Keyes AICP MS Deborah R. Phillips PhD CPM Evelina Sterling PhD MPH MCHES Tyrone Manegdeg Maureen Kelly MSW Grace Trimble BA MA 《Journal of aging & social policy》2014,26(1-2):117-130
Most cities, counties, and neighborhoods are not designed for an aging population. By providing a range of services to all residents, Lifelong Communities allow individuals to age in place. Although the Lifelong Communities Initiative is based on established guiding principles, little information exists regarding the realities of moving from policy to implementation. The Atlanta Regional Commission conducted a case study in Mableton, Georgia, and found successful implementation requires a combination of support from local citizen groups and government. The Atlanta Regional Commission is replicating these best practices in other communities and providing support to those aspiring to launch or expand Lifelong Communities. 相似文献
49.
Elizabeth Ozanne PhD Simon Biggs PhD William Kurowski MSW 《Journal of aging & social policy》2014,26(1-2):147-165
The Ageing in the Growth Corridors Project was initiated as a partnership between the University of Melbourne and the Department of Health in the Northwest Metropolitan Region of Melbourne, Australia. It involved a research team working with six project officers appointed to stimulate development in relation to an aging population in the sprawling outer metropolitan growth corridors. This article identifies the key lessons learned in terms of project implementation relating to attitudinal and structural barriers to the development of an age-friendly environment in areas of rapid urban growth. The findings illustrate some of the dilemmas raised by competing program conceptions, a dynamic and changing federal/state policy context, and local resource and strategic management constraints. The partnership with the university, nevertheless, provided a point of stability and continuity for the project officers in implementing their mandate. 相似文献
50.
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