The EMAS and Its Role in the ESL Instruction to Immigrants in England

This chapter presents the results of a quantitative research carried out through the administration of a questionnaire to the Multilingual Education Assistants who are part of the Ethnic Minority Achievement Service (EMAS) at the Coventry City Council (UK). Authors investigate the importance and impact the EMAS service has in the reception of foreign students newly arrived in England. In particular, the strategies implemented to promote students’ integration within the new socio-cultural context are analysed. A revision of the most important theories related to the teaching-learning process of an L2 is carried out. An overview of migration in the 21st century and how intercultural education can foster the coexistence of cultures, ethnic groups, and languages is provided. This chapter concludes that Multilingual Education Assistants can help to encourage dialogue between individuals, promoting the overcoming of linguistic obstacles and developing the linguistic competence of foreign children who have just arrived in England.2019-2

Women’s Perception of Quality of Maternity Services: A Longitudinal Survey in Nepal

Background: In the context of maternity service, the mother’s assessment of quality is central because emotional, cultural and respectful supports are vital during labour and the delivery process. This study compared client-perceived quality of maternity services between birth centres, public and private hospitals in a central hills district of Nepal. Methods: A cohort of 701 pregnant women of 5 months or more gestational age were recruited and interviewed, followed by another interview within 45 days of delivery. Perception of quality was measured by a 20-item scale with three sub-scales: health facility, health care delivery, and interpersonal aspects. Perceived quality scores were analysed by ANOVA with post-hoc comparisons and multiple linear regression.Results: Within the health facility sub-scale, birth centre was rated lowest on items ‘adequacy of medical equipment’, ‘health staff suited to women’s health’ and ‘adequacy of health staff’, whereas public hospital was rated the lowest with respect to ‘adequacy of room’, ‘adequacy of water’, ‘environment clean’, ‘privacy’ and ‘adequacy of information’. Mean scores of total quality and sub-scales health facility and health care delivery for women attending private hospital were higher (p < 0.001) than those using birth centre or public hospital. Mean score of the sub-scale interpersonal aspects for public hospital users was lower (p < 0.001) than those delivered at private hospital and birth centre. However, perception on interpersonal aspects by women using public hospital improved significantly after delivery (p< 0.001). Conclusions: Overall, perception of quality differed significantly by types of health facility used for delivery. They rated lowest the supplies and equipment in birth centres and the amenities and interpersonal aspects in the public hospital. Accordingly, attention to these aspects is needed to improve the quality

Determinants of the exclusive breastfeeding abandonment: psychosocial factors

OBJECTIVE To assess the determinants of exclusive breastfeeding abandonment. METHODS Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period. RESULTS The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care. CONCLUSIONS Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process

Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives in Jordan.

INTRODUCTION:Episiotomy is still performed routinely by clinicians in many countries. The aim of this study was to determine the knowledge of, attitudes towards and experience of episiotomy practice among clinicians working in public hospitals in Jordan. METHODS:A cross-sectional study, using a self-administered survey questionnaire, was conducted among midwives and obstetricians in three public hospitals in Jordan. RESULTS:112 (87.5%) clinicians responded to the questionnaire. Low knowledge level of evidence about overuse and risk of episiotomy was identified among participants with a significant difference among obstetricians and midwives (P<0.05). Results revealed that both obstetricians and midwives have limited access to evidence which is not emphasised in their learning, practice, or hospital policy. The majority of obstetricians (80%) and midwives (79%) thought an episiotomy rate of 81% is about right. The most common reason for performing episiotomy identified by both obstetricians (83.1%) and midwives (75.5%) was to reduce the risk of 3rd and 4th degree perineal laceration. The most common obstacle to reducing episiotomy rate reported by obstetricians (78.0%) was lack of training on preventing perineal tears, while the most common obstacles reported by midwives were insufficient time to wait for the perineum to stretch (56.6%) and difficulty changing the conventional practices in the labour ward (52.8%). CONCLUSION:This study identifies that obstetricians and midwives in Jordan rely on non evidence-based beliefs to guide their practice on performing an episiotomy. Training, continuing education, and developing evidence based clinical policies and guidelines for surgical procedures, such as in an episiotomy, are needed

A comparison of labour and birth outcomes in Jordon with WHO guidelines: A descriptive study using a new birth record

Aim to examine data collected during the testing of a new birth record in Jordan from 1 July to 31 August 2004, and to compare these practices with guidelines from the World Health Organization (WHO) and evidence-based recommendations. This was part of a larger study that used an action research approach to engage practitioners in implementation of the new record. Design descriptive, comparative design. Setting three Ministry of Health hospitals in Jordan. Participants the birth records of 1254 mothers and babies were used. Measurements data on selected labour and birth practices were collected from the records. Comparisons were made using recognised evidence-based guidelines. Findings the rates of a number of labour and birth practices were inappropriately high, and differed from WHO guidelines and evidence-based recommendations. The rates of augmentation of labour (46%) and episiotomy (53%) were particularly high, and seem to be in excess of the WHO recommendations, which state that neither of these practices should be undertaken routinely

Caring behaviours by midwives: Jordanian women's perceptions during childbirth

© 2019 Elsevier Ltd Background: It is agreed internationally that caring is a central part of nursing and midwifery. There is a growing concern about the lack of caring in childbirth settings in developing countries including Jordan. The aim of this study was to explore women's perceptions of midwives’ caring behaviours during childbirth to assist develop strategies for improvement. Methods: An exploratory and qualitative design utilizing semi-structured interviews was used to explore women's perceptions of midwives’ caring behaviours during childbirth. Interviews were digitally recorded and transcribed verbatim. Data were analysed by using thematic coding. Repetitive themes that described commonalties between the women's perceptions were identified and described. Findings: Twenty-one women participated in the interviews. Three main themes were identified: (1) Women's feelings during childbirth: they felt frightened, humiliated, ignored, and disrespected. Negative actions in term of tangible or physical non-caring behaviours and emotional behaviours were reported. (2) Women's perceptions of the caring behaviours of midwives during childbirth: women had negative experiences during childbirth, they reported disrespectful manners and physical and empathetic abandonment by midwives during childbirth. (3) Women's preferred caring behaviours: women wanted the midwives to listen to what they say, to demonstrate respect for them, and be truly ‘present’ for women when they needed them. Key conclusions and implications for practice: The absence of caring behaviours from a group of Jordanian midwives’ elicited negative responses from women in labour, who found this distressing. Devising strategies, informed by the study, focused on the preferred caring behaviours identified by women, could improve the standard of care provided by midwives currently working in labour wards in public hospitals in Jordan. These strategies should recognise that core competencies for midwifery care must go beyond skills training alone and highlight the importance of the psychosocial and emotional components of caring as well as routine procedural activities

Childbirth practices in jordanian public hospitals: Consistency with evidence-based maternity care?

Background: In 1996, the World Health Organization stated that 'childbirth is a natural process and in normal birth, there should be a valid reason to interfere with this natural process' and encouraged practices that are evidence-based. The practices encouraged included avoiding unnecessary augmentation of labour, facilitating upright position for birth and restricting the use of routine episiotomy. Many countries have been slow to fully implement evidence-based practice in maternity care. The aim of this study was to examine maternity hospital practices in Jordan and assess their consistency with evidence-based maternity care. Methods: An explorative research design with non-participant observation was used. Data were collected from low-risk women during labour and birth using a questionnaire for maternal characteristics and an observational checklist. A proportional stratified sample was selected to recruit from three major public hospitals in Jordan. Data were analysed using descriptive statistics. Results: A total of 460 women were observed during labour and birth. The majority were multiparous (80%). A range of interventions were observed in women having a normal labour including augmentation (95%), continuous external fetal monitoring (77%), lithotomy position for birth (100%), and more than one third (37%) had an episiotomy with varying degrees of laceration (58%). Conclusions: Childbirth practices were largely not in accordance with the World Health Organization evidencebased practices for normal birth. High levels of interventions were observed, many of which may not have been necessary in this low-risk population. Further work needs to occur to explore the reasons why evidence-based practice is not implemented in these hospitals. © 2011 The Authors. International Journal of Evidence-Based Healthcare © 2011 The Joanna Briggs Institute