Constructive alignment and the research skills development framework: using theory to practically align graduate attributes, learning experiences, and assessment tasks in undergraduate midwifery

Midwifery educators have to provide students with stimulating curricula that teach academic and vocational content, as well as transferable skills. The Research Skills Development (RSD) framework provides a conceptual model that allows educators to explicitly scaffold the development of their students’ research skills. This paper aims to demonstrate the effective use of the RSD framework and constructive alignment theory to redesign a second-year Midwifery assessment task.The assessment task was changed into a scenario-based question to better reflect the unit learning objectives and expected graduate attributes. Students were provided with extra time in class to explore the assessment task in a peer environment. Following the return of their assessments, students were asked to complete a questionnaire to evaluate the effectiveness of the assessment redesign. We show that using a constructively aligned scenario-based assessment task in a second year unit more successfully articulated the expected graduate attributes of midwives. Qualitative and quantitative feedback suggested that students and staff appreciated a more clinically- relevant assessment task. This paper demonstrates that the use of the RSD framework to constructively aligngraduate attributes, learning experiences, and assessment tasks allows for the transformation of undergraduate assessment into a learning experience relevant to clinical practice

Exploring midwives' practice and experience of episiotomy

Aim: This study explored Australian midwives' experience and practice of performing an episiotomy. Background: Evidence underpins the recommended angle and length of episiotomy to avoid morbidity for the woman, yet there is limited research regarding midwives' episiotomy knowledge, skill and attitudes. Methods: A cross-sectional anonymous survey of Australian midwives with current birthing experience was employed. The survey contained items modified from validated instruments with Likert scales, a diagram, categorical responses and open ended responses. Data was analysed using descriptive statistics and thematic analysis. Results: A total of 360 surveys responses were analysed. Approximately half (46%) midwives were in senior clinical positions. Experience varied considerably, with approximately half of the midwives (55.6%) having undertaken <4 episiotomies independently and 20% 'very confident' in the procedure. Only 28% midwives identified the episiotomy length correctly while 73% midwives identified the angle correctly. Two thirds of participants (n=236) identified the correct angle on the pictorial representation. Overall, only 15% of midwives identified the three characteristics of a correctly performed episiotomy. The three most common clinical reasons for performing an episiotomy were fetal distress, perineal 'buttonhole' and previous severe perineal trauma. Analysis of attitudes revealed themes such as lack of confidence and experience, fear, and limited evidence supporting episiotomy explaining midwives' use/non-use of episiotomy. There was significant variation in health service requirements to establish a midwife's competence to perform episiotomy. Most midwives (75%, n=270) wanted further education regarding episiotomy, with face-to-face workshops as the preferred format for education. Conclusion: Knowledge and practice gaps demonstrated the need for continuing professional development to translate evidence to practice and promote optimal outcomes for women. Many midwives are inexperienced with the procedure and simulation in workshops may assist midwives feel more confident to perform an episiotomy when is clinically indicated

Sitio web de la organización de mujeres Voces Caribeñas de la ciudad de Bilwi

Voces Caribeñas es una organización de mujeres que trabaja en visibilizar y fortalecer los derechos de la mujer, la igualdad de género y la lucha contra el racismo por lo que la presente investigación consistió en la creación de un sitio web, ya que se identificó la necesidad de un medio virtual que pueda presentar todo el quehacer de la organización en un alcance nacional e internacional para facilitar la comunicación con las organizaciones aliadas, Instituciones Cooperantes y su audiencia, logrando generar la opinión pública y potenciando la participación de las mujeres ante esta temática de gran valor social que se presenta en la vida cotidiana

Complementary and Alternative Medical Therapies for Chronic Low Back Pain: What Treatments are Patients Willing to Try?

Background: Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. Methods: We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Results: Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5–16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Conclusions: Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating their effectiveness and suggests that researchers conducting clinical trials of these therapies may not have difficulties recruiting patients

Perinatal mental health education for midwives in Victoria

Perinatal mental health issues affect women and their families world-wide. Midwives can make a difference to women and families lives with early and prompt detection of perinatal mental health issues

Vascular α1A Adrenergic Receptors as a Potential Therapeutic Target for IPAD in Alzheimer’s Disease

Drainage of interstitial fluid from the brain occurs via the intramural periarterial drainage (IPAD) pathways along the basement membranes of cerebral capillaries and arteries against the direction of blood flow into the brain. The cerebrovascular smooth muscle cells (SMCs) provide the motive force for driving IPAD, and their decrease in function may explain the deposition of amyloid-beta as cerebral amyloid angiopathy (CAA), a key feature of Alzheimer's disease. The α-adrenoceptor subtype α1A is abundant in the brain, but its distribution in the cerebral vessels is unclear. We analysed cultured human cerebrovascular SMCs and young, old and CAA human brains for (a) the presence of α1A receptor and (b) the distribution of the α1A receptor within the cerebral vessels. The α1A receptor was present on the wall of cerebrovascular SMCs. No significant changes were observed in the vascular expression of the α1A-adrenergic receptor in young, old and CAA cases. The pattern of vascular staining appeared less punctate and more diffuse with ageing and CAA. Our results show that the α1A-adrenergic receptor is preserved in cerebral vessels with ageing and in CAA and is expressed on cerebrovascular smooth muscle cells, suggesting that vascular adrenergic receptors may hold potential for therapeutic targeting of IPAD.</p

Loss of Free Fatty Acid Receptor 2 leads to impaired islet mass and beta cell survival

The regulation of pancreatic β cell mass is a critical factor to help maintain normoglycemia during insulin resistance. Nutrient-sensing G protein-coupled receptors (GPCR) contribute to aspects of β cell function, including regulation of β cell mass. Nutrients such as free fatty acids (FFAs) contribute to precise regulation of β cell mass by signaling through cognate GPCRs, and considerable evidence suggests that circulating FFAs promote β cell expansion by direct and indirect mechanisms. Free Fatty Acid Receptor 2 (FFA2) is a β cell-expressed GPCR that is activated by short chain fatty acids, particularly acetate. Recent studies of FFA2 suggest that it may act as a regulator of β cell function. Here, we set out to explore what role FFA2 may play in regulation of β cell mass. Interestingly, Ffar2(-/-) mice exhibit diminished β cell mass at birth and throughout adulthood, and increased β cell death at adolescent time points, suggesting a role for FFA2 in establishment and maintenance of β cell mass. Additionally, activation of FFA2 with Gαq/11-biased agonists substantially increased β cell proliferation in in vitro and ex vivo proliferation assays. Collectively, these data suggest that FFA2 may be a novel therapeutic target to stimulate β cell growth and proliferation

The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study

Background Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law’s role in (a) her daughter-in-law’s ANC uptake; and (b) the decision-making process about using ANC services in Nepal. Methods In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Results Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/ encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Conclusion Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family resources