Decision making about breech presentation :exploring women's experiences and developing decision support

PhD ThesisBreech presentation affects 3-4% of women pregnant with a single baby after 37 weeks of pregnancy. These women face two key decisions: firstly, whether or not to attempt to turn their baby by external cephalic version (ECV). Secondly, if they decide not to attempt this, or it is unsuccessful, then they need to decide how to give birth to their baby, either by planned caesarean section (CS) or vaginal breech birth (VBB). This thesis explores the process of decision making about breech presentation from both women’s and health professionals’ perspectives and documents the development of a patient decision aid (PDA), consisting of an animated film and website, for women facing these decisions in the future. In this qualitative study, data were collected using observed consultations, semi-structured interviews, with both women and professionals, and user-centred design workshops. Thirty nine women and 30 health professionals were respondents. Data were analysed using constant comparison. The results show that the diagnosis of breech presentation often comes late in pregnancy and begins with uncertainty, partly because many professionals are reluctant to provide information about options until the diagnosis is confirmed by ultrasound examination. Professionals are concerned about causing unnecessary anxiety to women who do not have a breech presentation confirmed, but such an approach fails to take account of women’s clear preference for information as soon as the possibility of breech presentation is raised. Women report researching options online and amongst their social contacts, as they strongly value experiential accounts. However they may struggle to find trustworthy information from these sources as they are frequently told horror stories. Women may also be directively counselled by professionals who have a clear preference for attempting ECV. In response to these themes, a PDA was developed which is freely available to women and includes a website summarising the evidence about the different options. In relation to decision making, women described five key values: wanting to keep their baby safe; wanting to experience a natural birth and to breastfeed; preferring to avoid surgery; needing to be able to care for other children; and wanting to have control. Postnatally, they shared vivid accounts of their experiences of ECV and birth, which were used to inform the script for the animated film that aims to provide the experiential information women wanted and also help them to explore their own values about decision making.National Institute for Health Researc

A Comparative Analysis of Data Collection Systems Used in Radiography Educational Programs and the Role Mobile Electronic Devices Play

Each radiography program has a system to collect important data from didactic and clinical settings in order to accurately assess the progress and success of students, provide the needed student intervention, and provide accreditation agencies with appropriate documentation that demonstrates student success in reaching program learning outcomes. The purpose of this research study was to determine the method of data collection and documentation used by radiography programs to evaluate student progress and to examine if MEDs play a role in evaluating and documenting student skills at the point of care. The majority of radiography programs in this study were using paper methods for data collection and program directors reported value in using MEDs in clinical education but revealed that barriers still exist and will need to be addressed in order to increase their usage in clinical education

Factors influencing the uptake of memory compensations following acquired brain injury

The use of memory strategies can promote independence in people who have an acquired brain injury but people often do not take readily to using such strategies. Certain demographic variables have been associated with the use of memory strategies these variables cannot be changed through therapeutic interventions. The aim of this thesis is to explore variables that may be modifiable through rehabilitation e.g. health beliefs and perceptions of aids, to see whether they help us understand factors influencing the uptake of memory strategies. The thesis consists of three studies. The first uses Interpretative Phenomenological Analysis to explore how people feel about using memory strategies. The second is a cross sectional questionnaire design exploring the predictive power of variables identified in the first study to predict the use of strategies together with demographic variables. The third is a single case study utilising findings from the first two studies to help an individual use a mobile phone and Google calendar as a memory aid. A key factor in the use of memory compensations is the need to ‘fit’ the aid to an individual’s lifestyle. Consequently, there is greater optimism for those who may otherwise be regarded as unlikely to use aids

Why isn't group work inspiring your students?

When we put students into groups, we sometimes find that the tasks work well, while at other times they fail to live up to their full potential. Does the problem lie within the design of the task, does it depend on the physical environment of the classroom, is it a result of the individuals in the particular group or is it something about the formation of the group itself? This presentation examined the elements included in a good group task, the theoretical background behind the stages in the formation of groups and what lessons we can learn from the literature in terms of why groups may not function effectively in classroom tasks. The literature will then be compared to responses gathered from action research conducted on what learners feel about participating in cooperative group tasks and why they think such tasks are effective or not

Professional English for the students of Electronic Education Institute in specialty of «Informatics and Computer Technologies»

Пособие предназначено для студентов 3 курса ИнЭО, изучающих профессиональный курс английского языка по направлению 09.03.01 «Информатика и вычислительная техника»

Professional English for the students of Electronic Education Institute in specialty of «Informatics and Computer Technologies»

Пособие предназначено для студентов 3 курса ИнЭО, изучающих профессиональный курс английского языка по направлению 09.03.01 «Информатика и вычислительная техника»

Health Technology Scenarios and Implications for Spectrum

Supporting Informatio

Doctor of Philosophy

dissertationChildren with attention-deficit/hyperactivity disorder (ADHD) and high-functioning autism spectrum disorder (HFASD) have organizational skills deficits. Organizational skills include the ability to manage materials (e.g., belongings, books, homework) and temporal skills such as organizing, planning, and managing tasks to completion. This study was a usability test of a prototype mobile technology designed to improve organizational skills. The prototype was assessed for usability and feasibility for future development. A field-based mixed methods usability test was conducted. Sixteen children with ADHD and HFASD aged 8 to 12 years and their parents participated. The study was conducted in an 8-week summer treatment program. The usability test lasted 15 days, with data collected via observation, child and parent daily logs, surveys, and focus groups. During the usability test, children brought the prototype technology to camp 95% of the time and used it to record items to bring to camp 85% of the time. Parents completed a daily log simulating mobile functions 88% of the time. Using the prototype device for homework tracking resulted in three times the likelihood that homework was completed. Establishing a contingency between device game time and homework completion resulted in four times the likelihood that homework was completed. Qualitative results suggested that children valued carrying the device and children were motivated by having game time on the device as a reward. In addition, qualitative results showed that parents valued the device as a contingent reward, desired novelty in the device's games and features, and expressed an urgent need for help with their children's organizational skills. Children will utilize a mobile technology intended for task tracking with game time having a high reward value. Parents value the concept of using a mobile technology to improve their children's organizational skills. The use of mobile technology for building and sustaining organizational skills via performance rewards is a promising intervention for effective home and school-related task management. The effectiveness of a more fully developed mobile technology needs to be assessed in future research

The impact of an intervention to introduce malaria rapid diagnostic tests on fever case management in a high transmission setting in Uganda: A mixed-methods cluster-randomized trial (PRIME).

Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low. Three rounds of Interviews were conducted with caregivers of children under five years of age as they exited health centers (N = 1400); reference mRDTs were done in children with fever (N = 1336). Health worker perspectives on mRDTs were elicited through semi-structured questionnaires (N = 49) and in-depth interviews (N = 10). The primary outcome was inappropriate treatment of malaria, defined as the proportion of febrile children who were not treated according to guidelines based on the reference mRDT. There was no difference in inappropriate treatment of malaria between the intervention and control arms (24.0% versus 29.7%, adjusted risk ratio 0.81 95\% CI: 0.56, 1.17 p = 0.24). Most children (76.0\%) tested positive by reference mRDT, but many were not prescribed AL (22.5\% intervention versus 25.9\% control, p = 0.53). Inappropriate treatment of children testing negative by reference mRDT with AL was also common (31.3\% invention vs 42.4\% control, p = 0.29). Health workers appreciated mRDTs but felt that integrating testing into practice was challenging given constraints on time and infrastructure. The PRIME intervention did not have the desired impact on inappropriate treatment of malaria for children under five. In this high transmission setting, use of mRDTs did not lead to the reductions in antimalarial prescribing seen elsewhere. Broader investment in health systems, including infrastructure and staffing, will be required to improve fever case management