Continuity of Care and Shared Decision-Making in Interprofessional Collaborative Maternity Practices in Canada

Problem: The number of maternity care providers varies across Canada. Women from rural communities or those marginalized due to physical, psychological or social issues including newcomers, often experience challenges accessing health care (Fraser Health, 2014; Rogers, 2003). Interprofessional collaborative maternity care [IPCMC] has been credited as a means of increasing access and promoting sustainability of services (Miller et al., 2012; Society of Obstetricians and Gynecologists of Canada, 2008). Midwifery could play a greater role in delivery of services through IPCMC. However, little is known about collaboration in these practices. The purposes of this study are to explore factors influencing enactment of IPCMC and understand whether and how midwives can provide relational care in these practices in ways that are positively evaluated by women and staff. Method: A qualitative multiple case study design was used to explore variations in 4 IPCMC practices in British Columbia, Canada. Sources of data included: observation and semi-structured interviews with staff (n=40) and women receiving care (n=33). Thematic analysis was applied to interview transcripts, observational field notes and analytic notes. Findings and Conclusions: Collaborative care was well received by patients when expectations were clear and continuity of information and philosophy were exercised. Contextual factors influenced development and implementation requiring adaptation over time. Communication, organization, mutual respect and commitment enabled collaboration and relational care. Policy changes to promote and sustain IPCMC include broader definitions of continuity of care; increased support and adoption of integrated funding models. Interprofessional education is needed to develop skills for effective collaboration

Multicultural Counselor Training: Assessment of Single-Course Objectives and Pedagogical Strategies

The purpose of this study was to examine the extent to which multicultural counseling courses throughout the United States include course objectives and pedagogical strategies recommended in the literature (Arredondo et al., 1996) and in professional counseling standards and guidelines. Findings from 277 participants indicate that most, not all, courses include the recommended objectives and strategies. The most common (85.9%) objective was self- awareness of own values and biases, whereas only approximately 50 percent included an objective related to critiquing counseling theories. The most common pedagogical strategies were classroom discussions/debates (95.3%), whereas fewer than half integrated cross-discipline readings and student research. The authors suggest dialogue and empirical investigations necessary to further the practice of multicultural counselor training

A cross-country survey of attitudes toward childbirth technologies and interventions among university students

Problem & Aim: Cultural beliefs that equate birth technology with progress, safety and convenience contribute to widespread acceptance of childbirth technology and interventions. Little is known about attitudes towards childbirth technology and interventions among the next generation of maternity care users and whether attitudes vary by country, age, gender, childbirth fear, and other factors. Methods: Data were collected via online survey in eight countries. Students who had never had children, and who planned to have at least one child were eligible to participate. Findings: The majority of participants (n= 4569) were women (79.3%), and the median age was 22 years. More than half of students agreed that birth technology makes birth easier (55.8 %), protects babies from harm (49.1 %) and that women have a right to choose a medically non-indicated cesarean (50.8 %).Respondents who had greater acceptance of childbirth technology and interventions were from countries with higher national caesarean birth rates, reported higher levels of childbirth fear, and were more likely to report that visual media or school-based education shaped their attitudes toward birth. Positive attitudes toward childbirth technology and interventions were also associated with less confidence in knowledge of birth, and more common among younger and male respondents. Discussion/Conclusion: Educational strategies to teach university students about pregnancy and birth in ways that does not frighten them and promotes critical reflection about childbirth technology are needed. This is especially true in countries with high rates of interventions that reciprocally shape culture norms, attitudes, and expectations

Being punk in higher education: subcultural strategies for academic practice

Since its beginnings in the late 1970s, punk culture has been associated with counter-mainstream ideology and anti-institutional antagonism. In particular, formal education has been criticised in punk for sustaining oppressive social and conceptual orders and associated behavioural norms. Drawing on literature and interviews, this paper focuses on the experiences of higher education teachers who self-identify as punks, and considers how they negotiate and reconcile their subcultural and academic identities in their academic practice. The findings reveal that participants’ affiliations with punk subculture give rise to counter-cultural pedagogies in which both the ethics and aesthetics of punk are applied in classroom contexts. Furthermore, the participants draw upon subcultural ethical and epistemological narratives to formulate and rationalise their responses to the state of contemporary UK higher education

Ontological transparency, (in)visibility, and hidden curricula:Critical pedagogy and contentious edtech

AbstractThe steady migration of higher education online has accelerated in the wake of Covid-19. The implications of this migration on critical praxis—the theory-in-practice of pedagogy—deserve further scrutiny. This paper explores how teacher and student-led educational technology research and development can help rethink online critical praxis. The paper is based on a recent research project at the University of Edinburgh that speculatively explored the potential for automation in teaching, which generated insights into current and future pedagogical practice among both teachers and students. From this project emerged a series of pedagogical positions that were centred around visions of the future of teaching in response to automation: the pedagogical potential of visibility and invisibility online, transparency, and interrogating the hidden curricula of both higher education and educational technology itself. Through the surfacing of these pedagogical positions, this paper explores how critical pedagogy can be built into the broader teacher function and begins to identify the institutional structures that could potentially impede or accelerate that process.</jats:p

Using the Mystery Motivator to Improve Child Bedtime Compliance

Child bedtime problems are commonly reported by parents. A number of behavioral techniques, including extinction of tantrum behaviors, reinforcement of compliant bedtime, and implementation of consistent bedtime routines have been successful in improving bedtime compliance. The present study examined the effects of the Mystery Motivator (MM), a behavioral contract designed to remediate bedtime problems by delivering random reinforcement. Emphasis was placed on the optimal use of clinical intervention by enlisting parents as primary change agents in the home setting. Three adults and their four children, aged 3-5 years, participated. Three of the four children showed substantial changes in both time out of bed and bedtime noncompliance between baseline and treatment phases. A fourth child showed less improvement. Parent participants demonstrated understanding of the materials and successfully implemented the home program. Both parent and child participants rated the Mystery Motivator reinforcement system as an acceptable intervention

A Unique Regulator Contributes to Quorum Sensing and Virulence in Burkholderia cenocepacia

Burkholderia cenocepacia causes chronic and life-threatening respiratory infections in immunocompromized people. The B. cenocepacia N-acyl-homoserine lactone (AHL)-dependent quorum sensing system relies on the production of AHLs by the synthases CepI and CciI while CepR, CciR and CepR2 control expression of many genes important for pathogenesis. Downstream from, and co-transcribed with cepI, lies BCAM1871 encoding a hypothetical protein that was uncharacterized prior to this study. Orthologs of B. cenocepacia BCAM1871 are uniquely found in Burkholderia spp and are conserved in their genomic locations in pathogenic Burkholderia. We observed significant effects on AHL activity upon mutation or overexpression of BCAM1871, although these effects were more subtle than those observed for CepI indicating BCAM1871 acts as an enhancer of AHL activity. Transcription of cepI, cepR and cciIR was significantly reduced in the BCAM1871 mutant. Swimming and swarming motilities as well as transcription of fliC, encoding flagellin, were significantly reduced in the BCAM1871 mutant. Protease activity and transcription of zmpA and zmpB, encoding extracellular zinc metalloproteases, were undetectable in the BCAM1871 mutant indicating a more significant effect of mutating BCAM1871 than cepI. Exogenous addition of OHL restored cepI, cepR and fliC transcription but had no effect on motility, protease activity or zmpA or zmpB transcription suggesting AHL-independent effects. The BCAM1871 mutant exhibited significantly reduced virulence in rat chronic respiratory and nematode infection models. Gene expression and phenotypic assays as well as vertebrate and invertebrate infection models showed that BCAM1871 significantly contributes to pathogenesis in B. cenocepacia

Ethnic Label Use in Adolescents from Traditional and Non-Traditional Immigrant Communities

Understanding adolescents’ use of ethnic labels is a key developmental issue, particularly given the practical significance of identity and self-definition in adolescents’ lives. Ethnic labeling was examined among adolescents in the traditional immigrant receiving area of Los Angeles (Asian n = 258, Latino n = 279) and the non-traditional immigrant receiving area of North Carolina (Asian n = 165, Latino n = 239). Logistic regressions showed that adolescents from different geographic settings use different ethnic labels, with youth from NC preferring heritage and panethnic labels and youth from LA preferring hyphenated American labels. Second generation youth were more likely than first generation youth to use hyphenated American labels, and less likely to use heritage or panethnic labels. Greater ethnic centrality increased the odds of heritage label use, and greater English proficiency increased the odds of heritage-American label use. These associations significantly mediated the initial effects of setting. Further results examine ethnic differences as well as links between labels and self-esteem. The discussion highlights implications of ethnic labeling and context

Educational archaeology and the practice of utopian pedagogy

This paper explores the idea, and some elements of the (potential) practice, of utopian pedagogy. It begins by outlining the general aims of ‘utopian pedagogy’ and notes the shift within contemporary writings away from the metaphor of the architect (armed with a utopian ‘blueprint’) towards that of the archaeologist. The ontological underpinnings of educational archaeology are discussed before attention turns to a critical examination of the pedagogical process of excavation. The key questions here are (to labour the metaphor) where to dig and how to identify a utopian find. The paper argues that, without a substantive normative vision to serve as a guide, utopian archaeology is conceptually flawed and practically ineffectual, romanticising an endlessly open process of exploration. The final section suggests that the fears associated with utopian architecture (authoritarian imposition, totalising closure) are misplaced and that drawing up a ‘blueprint’ should be the aim and responsibility of utopian pedagogy