A participatory approach for assessing alternative climate change adaptation responses to cope with flooding risk in the upper Brahmaputra and Danube river basins

This article describes the research process used to develop and evaluate an Internet-based resource aimed at improving access by health professionals to Australian Aboriginal cultural knowledge specific to pregnancy and childbirth. As a result of the research, women's stories from Maningrida were recorded and presented on the `Birthing Business in the Bush Website' which provided a platform for Aboriginal Australian women from Maningrida to present cultural and other information to maternity care practitioners. In particular, this article describes the development of the participatory action research combined with an Aboriginal research process, and how this was guided by the Aboriginal co-researchers and participants

Modelli di razionalità e investimento formativo

Il saggio inserito nella pubblicazione affronta l'analisi dei paradigmi di razionalità che caraterizzano oggi l'investimento formativo all'interno della società della conoscenza

Childbirth in Australia: Aboriginal and Torres Strait islander women

Across rural and remote Australia women are being relocated so that they can give birth at regional settings. Many of these women are Aboriginal and Torres Strait Islander Australians, who are birthing alone in a hospital where staff do not speak their language. They may have to wait weeks in a hostel where they are lonely and at times do not feel safe

The experiences of parents and nurses of hospitalised infants requiring oxygen therapy for severe bronchiolitis : A phenomenological study

Bronchiolitis is a major cause of children’s admission to hospital. The study aim was to describe the experiences of parents who had, or nurses who cared for, a child admitted to hospital for severe bronchiolitis requiring oxygen therapy. A descriptive phenomenological approach was used to interview 12 mothers and 12 nurses. The findings were clustered into three domains: fear, parent–child interaction and technical caring. The mothers found the experience to be extremely frightening, based on their fear that their child could die. This was compounded by their lack of knowledge and understanding about what was happening and their inability to fulfil their mothering role. Although nurses recognised that parents were anxious, they did not seem to appreciate fully the depth of fear and emotion that mothers were experiencing and tended to describe procedural aspects of their role. The mothers’ relationship with their child was focused upon physical contact and the desire to comfort their child. Their ability to do so was significantly impacted upon by the method of oxygen delivery to their child. For nurses, although they recognised the psychosocial dimension, their emphasis was on health and safety aspects of oxygen therapy, both for the child and themselves

Midwifery group practice and mode of birth

Background: Midwifery-led models of care, specifically Midwifery Group Practices (MGPs), have been promoted as one way to address the increasing caesarean rate. Whilst women report a high level of satisfaction, and experience lower rates of induction and epidural analgesia, a Cochrane review reported no differences in mode of birth. Method: A retrospective cohort study was performed using routinely collected de-identified data of all term births between 2006 and 2010. Outcomes for 1545 women under MGP model were compared with 13,880 women cared for in all other models. Primary outcome measure was unassisted vaginal birth. Predictors investigated were model of care, induction and epidural analgesia. Both bivariate analysis and multivariate logistic regression analysis was undertaken (controlling for important confounders) with adjusted odds ratios (aOR) and 95% confidence intervals (CI) presented. Findings: Significant differences were demonstrated in the demographic and clinical characteristics of the groups. Compared with those in other models of care, women in MGP care had similar rates of induction but significantly fewer received epidural analgesia (28.4% vs 33.5%;

Is a randomised controlled trial of a maternity care intervention for pregnant adolescents possible?: An Australian feasibility study

Background: The way in which maternity care is provided affects perinatal outcomes for pregnant adolescents; including the likelihood of preterm birth. The study purpose was to assess the feasibility of recruiting pregnant adolescents into a randomised controlled trial, in order to inform the design of an adequately powered trial which could test the effect of caseload midwifery on preterm birth for pregnant adolescents. Methods. We recruited pregnant adolescents into a feasibility study of a prospective, un-blinded, two-arm, randomised controlled trial of caseload midwifery compared to standard care. We recorded and analysed recruitment data in order to provide estimates to be used in the design of a larger study. Results: The proportion of women aged 15-17 years who were eligible for the study was 34% (n=10), however the proportion who agreed to be randomised was only 11% (n = 1). Barriers to recruitment were restrictive eligibility criteria, unwillingness of hospital staff to assist with recruitment, and unwillingness of pregnant adolescents to have their choice of maternity carer removed through randomisation. Conclusions: A randomised controlled trial of caseload midwifery care for pregnant adolescents would not be feasible in this setting without modifications to the research protocol. The recruitment plan should maximise opportunities for participation by increasing the upper age limit and enabling women to be recruited at a later gestation. Strategies to engage the support of hospital-employed staff are essential and would require substantial, and ongoing, work. A Zelen method of post-randomisation consent, monetary incentives and 'peer recruiters' could also be considered