Revising acute care systems and processes to improve breastfeeding and maternal postnatal health: a pre and post intervention study in one English maternity unit

Background Most women in the UK give birth in a hospital labour ward, following which they are transferred to a postnatal ward and discharged home within 24 to 48 hours of the birth. Despite policy and guideline recommendations to support planned, effective postnatal care, national surveys of women’s views of maternity care have consistently found in-patient postnatal care, including support for breastfeeding, is poorly rated. Methods Using a Continuous Quality Improvement approach, routine antenatal, intrapartum and postnatal care systems and processes were revised to support implementation of evidence based postnatal practice. To identify if implementation of a multi-faceted QI intervention impacted on outcomes, data on breastfeeding initiation and duration, maternal health and women’s views of care, were collected in a pre and post intervention longitudinal survey. Primary outcomes included initiation, overall duration and duration of exclusive breastfeeding. Secondary outcomes included maternal morbidity, experiences and satisfaction with care. As most outcomes of interest were measured on a nominal scale, these were compared pre and post intervention using logistic regression. Results Data were obtained on 741/1160 (64%) women at 10 days post-birth and 616 (54%) at 3 months post-birth pre-intervention, and 725/1153 (63%) and 575 (50%) respectively postintervention. Post intervention there were statistically significant differences in the initiation (p = 0.050), duration of any breastfeeding (p = 0.020) and duration of exclusive breastfeeding to 10 days (p = 0.038) and duration of any breastfeeding to three months (p = 0.016). Post intervention, women were less likely to report physical morbidity within the first 10 days of birth, and were more positive about their in-patient care. Conclusions It is possible to improve outcomes of routine in-patient care within current resources through continuous quality improvement

An evaluation of the efficacy of a social skills training program with young multiply handicapped students

This study was designed to analyze the efficacy of a formal social skills training (SST) program on a group of self-contained, multiply handicapped students. The treatment group, consisting of 24 students, underwent five months of formal SST, at least three times a week for a 30 to 50 minute period. The participating teachers were trained in, and followed, Elias and Clabby\u27s Social Decision Making and Problem Solving: Revised Readiness Curriculum (1988). They were asked to complete pre- and post test Likert scales (Social Problem Solving Skills Checklist) on the presence of specific social skills in each student. Average gains in the areas of self control skills, group and social awareness, and getting along with self and others were calculated, totaled, and analyzed against three comparison groups representing a Regular Education sample (22 students), a Resource Center sample (17 students), and a Self Contained, Multiply Handicapped comparison sample (21 students). Results indicated that formal SST not only improved the acquisition of specific skills, but enabled the Self-Contained Treatment group to obtain the highest percentage gains in all areas, progressing at a faster rate than any of the comparison groups. This study emphasized the importance of a SST program, and it\u27s efficacy on young, multiply handicapped students

The relationship between members\u27 perceptions of self, the church, and their listening skills

https://place.asburyseminary.edu/ecommonsatsdissertations/1663/thumbnail.jp

Creating an Institutional Repository: LEADIRS Workbook

The Learning About Digital Institutional Repositories Seminars programme (LEADIRS) aims to describe and illustrate how to build an online institutional repository. The LEADIRS series of seminars present specialists from the UK and abroad sharing their expertise and experiences in building institutional repositories. This workbook book supplements the seminar presentations and offers practical advice as well as work sheets yo u can use to get started with your own repository programme. Where possible, we point you to real-world examples of planning aids or presentations used by university library teams in the UK and around the world

Special Libraries, March 1961

Volume 52, Issue 3https://scholarworks.sjsu.edu/sla_sl_1961/1002/thumbnail.jp

An anxious time? exploring the worries experienced by people with a mild to moderate intellectual disability at the stage of transition to adulthood.

Background: This exploratory study examined the content and salience of worries experienced by young people with mild intellectual disabilities (ID) at transition to adulthood. Self-efficacy and anxiety in relation to worry was also examined. Fifty-two participants (17-20 years) took part; 26 with mild ID and 26 typically developing adults. Participants were recruited from a college in Glasgow. Materials and Methods: Of interest were potential differences between groups in i) worries described, ii) salience of worries, and iii) relationship between self-efficacy, anxiety, and worry within groups. Participants completed a ‘worry’ interview, the General Self Efficacy Scale-12, Glasgow Anxiety Scale-LD, and Wechsler Abbreviated Scale of Intelligence. Results: People with ID identified different worries from typically developing people. There were also significant differences in rumination and distress between groups, and associations between anxiety and distress. Conclusions: Obtaining insight into worries at transition may facilitate guidance opportunities. Clinical applications of the findings are discussed

Guidelines for Science: Evidence and Checklists

Problem: The scientific method is unrivalled as a basis for generating useful knowledge, yet research papers published in management, economics, and other social sciences fields often ignore scientific principles. What, then, can be done to increase the publication of useful scientific papers? Methods: Evidence on researchers’ compliance with scientific principles was examined. Guidelines aimed at reducing violations were then derived from established definitions of the scientific method. Findings: Violations of the principles of science are encouraged by: (a) funding for advocacy research; (b) regulations that limit what research is permitted, how it must be designed, and what must be reported; (c) political suppression of scientists’ speech; (d) universities’ use of invalid criteria to evaluate research—such as grant money and counting of publications without regard to usefulness; (e) journals’ use of invalid criteria for deciding which papers to publish—such as the use of statistical significance tests. Solutions: We created a checklist of 24 evidence-based operational guidelines to help researchers comply with scientific principles (valid inputs). Based on the definition of science, we then developed a checklist of seven criteria to evaluate whether a research paper provides useful scientific findings (valuable outputs). That checklist can be used by researchers, funders, courts, legislators, regulators, employers, reviewers, and journals. Originality: This paper provides the first comprehensive evidence-based checklists of operational guidelines for conducting scientific research and for evaluating the scientific quality and usefulness of research efforts. Usefulness: Journals could increase the publication of useful papers by including a section committed to publishing all relevant and useful papers that comply with science. By using the Criteria for Useful Science checklist, those who support science could more effectively evaluate the contributions of scientists

Evaluation of a Computer-Based Version of Child Planned Activities Training

Challenges to implementation, such as engagement in intervention activities and maintaining implementation fidelity, exist within traditional delivery systems of evidenced-based parenting programs that can impact either the effectiveness of or the wide-spread adaptation and use of an intervention. Given these challenges, research is needed to explore and identify additional delivery methods, and examine their impact on feasibility, acceptability, and effectiveness. Researchers have looked to technology as a promising supplement or alternative to traditional methods of delivery. Two studies examined the effects of a computer-based version of Child Planned Activities Training (cPAT), an evidence-based home visitation program that focuses on improving parent-child interactions, on parent’s use of intervention strategies, parent-child interaction skills, and child behavior. The program combined computer-based tutorials with in-home coaching. Parent satisfaction, engagement during home visits, parental stress, and depressive symptoms were measured. Seven mothers and their children aged 3 to 5 years participated. Study 1 evaluated the pilot presentation of the intervention with one family as a means of understanding program feasibility and usability using an A-B design. Feedback from Study 1 informed revisions to the computer-based presentation and intervention procedures used in Study 2. Study 2 evaluated the effects of the revised computer-based intervention on parent and child outcomes using a multiple baseline design with six families, divided into two cohorts. The computer-based cPAT intervention was feasible to implement and parents reported high rates of satisfaction and usability. Results from Study 2 support the use of the computer-based cPAT intervention in improving parent use of cPAT strategies. Parent-child interaction skills and appropriate child behavior increased for all parents who completed the post-intervention observation (n = 5). Additionally, parent engagement in intervention activities increased or remained high across all participants (n = 6). Changes in parent stress and depressive symptoms were observed in some but not all families. These findings contribute to the existing body of literature on the use of technology-based interventions for teaching positive parenting skills to families from low-income backgrounds with preschool-aged children. Additionally, the findings expand upon the body of research evaluating technology-based versions of cPAT by incorporating computer-based delivery of the intervention. Limitations and implications for future research are discussed