Women’s reports of satisfaction and respect with continuity of care experiences by students: Findings from a routine,online survey

BackgroundPre-registration midwifery students in Australia undertake a minimum of ten continuity of care experiences with childbearing women. However, women are rarely asked to formally evaluate this care by students.AimTo evaluate data from a routine, web-based survey of women about having a midwifery student provide a continuity of care experience.MethodsAll women (n = 886) recruited by a midwifery student for a continuity of care experience during a 12 month period received an email inviting them to complete an online survey. The survey included personal details, experiences of care, and two scales on Respect and Satisfaction.ResultsA response rate of 57% (n = 501) was achieved. On average students attended six antenatal visits (mean = 5.83) and had six postnatal contacts with women. Most students attended labour and birth (92.6% n = 464). Most women rated overall satisfaction with care by their student as ‘better than they had hoped’. Positive correlations were found between number of antenatal visits and postnatal contact with students on both levels of satisfaction and respect felt by women. Women felt more satisfied when their midwifery student attended labour and birth.ConclusionsThe online survey was feasible and provided valid and reliable feedback from women about their student during a continuity of care experience. Women valued having an ongoing relationship with a student during pregnancy, labour and birth, and postpartum. Pre-registration midwifery education programs should continue to privilege relationship-based care and national standards should support the effective integration of continuity of care experiences.     

Continuity of f-projections and applications to the iterative proportional fitting procedure*

This paper proves continuity of f-projections and the continuous dependence of the limit matrix of the iterative proportional fitting procedure (IPF procedure) on the given matrix as well as the given marginals under certain regularity constraints. For finite spaces, the concept of f-projections of finite measures on a compact and convex set is introduced and continuity of f-projections is proven. This result is applied to the IPF procedure. Given a nonnegative matrix as well as row and column marginals the IPF procedure generates a sequence of matrices, called the IPF sequence, by alternately fitting rows and columns to match their respective marginals. The procedure is equivalent to cyclic f-projections. If the IPF sequence converges, the application of the continuity of f-projections yields the continuous dependence of the limit matrix on the given matrix. By generalized convex programming and under some constraints, it is shown that the limit matrix of the IPF sequence continuously depends not only on the given matrix but also on the marginals.     

人口红利、产业承接与农村劳动力就近转移——以成都城乡统筹试验区为背景

随着西部经济发展及中部地区的崛起。东部地区产业向中西部转移,中西部地区参与人口红利再分配成为必然。鉴于此。有必要及时调整农村就业政策,将农村劳动力就近转移作为一项主要的就业政策,以促进产业转移的顺利进行和人口红利的高效再分配。     

Trait-Based Personality Theory,Ontogenic Behavioral Continuity,and Behavior Analysis

Abstract

SHACKLETON'S WAY: LEADERSHIP LESSONS FROM THE GREAT ANTARCTIC EXPLORER. by Morrell, M. and Capparell, S. (2001). New York: Penguin, 215 pp. Reviewed by Philip N. Chase.     

Combinatorics and Statistical Issues Related to the Kruskal–Wallis Statistic

We explore criteria that data must meet in order for the Kruskal–Wallis test to reject the null hypothesis by computing the number of unique ranked datasets in the balanced case where each of the m alternatives has n observations. We show that the Kruskal–Wallis test tends to be conservative in rejecting the null hypothesis, and we offer a correction that improves its performance. We then compute the number of possible datasets producing unique rank-sums. The most commonly occurring data lead to an uncommonly small set of possible rank-sums. We extend prior findings about row- and column-ordered data structures.     

Clinical outcomes for women who had continuity of care experiences with midwifery students

BackgroundPre-registration midwifery students in Australia are required to engage in a minimum of ten continuity of care experiences (CoCE). Students recruit and gain consent of each woman to provide CoCE under direct supervision of a registered health professional, usually a midwife. Clinical outcomes for women who had CoCE with a midwifery student placed in a continuity of midwifery care (CMC) or fragmented models are rarely reported.Aims1. analyse clinical outcomes for women experiencing CMC with CoCE by students; 2. analyse clinical outcomes for women in a fragmented care model with CoCE by students; and 3. compare clinical outcomes according to women’s primary model of care.MethodsStudents undertaking a Bachelor of Midwifery program at one Australian university recorded clinical outcomes for women experiencing CoCE during pregnancy [n = 5972] and labour and birth [n = 3933] in an e-portfolio. A retrospective, cohort design compared student recorded maternal data with National Core Maternity Indicators and Queensland Perinatal Data.ResultsMidwifery students providing CoCE reported better or equal clinical outcomes for women compared to population data. Women receiving CoCE had reduced likelihood of tobacco smoking after 20 weeks of pregnancy, episiotomy, and third and fourth degree tears.ConclusionsClinical outcomes for women in fragmented models of care and receiving CoCE by undergraduate, pre-registration midwifery students are equal to or better than State data across 12 variables. CoCE should be offered to all women early in their pregnancy to ensure optimal benefits. Acknowledging midwifery students’ potential to make positive impacts on women’s clinical outcomes may prompt more health services to reconceptualise and foster CoCE.     

“Whatsapping” the continuity of postpartum care in Switzerland: A socio-anthropological study

BackgroundDigital media such as Apps, Internet and social networks have become integral parts of the maternity experience for more than a decade. These media can support or undermine women’s experiences as has been shown in digital sociology research. Using Immediate Messaging Applications to provide information and support to women during the perinatal period is an emerging practice.AimThis article analyses how health and social care professionals – with a focus on community midwives – and women communicate between postpartum home visits through Immediate Message Applications in Switzerland.MethodsA socio-anthropological study that relied on qualitative methods including semi-directed interviews with midwives and health and social care professionals (n = 30) and immigrant women (n = 20).FindingsSince the introduction of Immediate Messaging Applications, women and their carer converse more regularly between post-partum home visits. Women send questions, pictures and videos to them, often allowing swift responses to their concerns. Midwives encounter difficulties answering women’s questions when they cannot be solved through quick communication (e.g. infant crying). To them, texting frequency forms a clinical clue to women’s mental health. Not all women contact their carer through digital messages; immigrant women are less likely to know and use this service.Discussion and conclusionImmediate Messaging Applications form a promising communication tool, complementary to home visits, and contribute to woman-centered care and continuity of care. As an emergent practice, it has not been framed by a guideline yet. Policy makers and practitioners should ensure that its use does not contribute to unequal access to care.