Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review

BACKGROUND: Life transitions often involve complex decisions, challenges and changes that affect diabetes management. Transition to motherhood is a major life event accompanied by increased risk that the pregnancy will lead to or accelerate existing diabetes-related complications, as well as risk of adverse pregnancy outcomes, all of which inevitably increase anxiety. The frequency of hyperglycaemia and hypoglycaemia often increases during pregnancy, which causes concern for the health and physical well-being of the mother and unborn child. This review aimed to examine the experiences of women with T1DM focusing on the pregnancy and postnatal phases of their transition to motherhood. METHODS: The structured literature review comprised a comprehensive search strategy identifying primary studies published in English between 1990-2012. Standard literature databases were searched along with the contents of diabetes-specific journals. Reference lists of included studies were checked. Search terms included: 'diabetes', 'type 1', 'pregnancy', 'motherhood', 'transition', 'social support', 'quality of life' and 'psychological well-being'. RESULT: Of 112 abstracts returned, 62 articles were reviewed in full-text, and 16 met the inclusion criteria. There was a high level of diversity among these studies but three common key themes were identified. They related to physical (maternal and fetal) well-being, psychological well-being and social environment. The results were synthesized narratively. CONCLUSION: Women with type 1 diabetes experience a variety of psychosocial issues in their transition to motherhood: increased levels of anxiety, diabetes-related distress, guilt, a sense of disconnectedness from health professionals, and a focus on medicalisation of pregnancy rather than the positive transition to motherhood. A trusting relationship with health professionals, sharing experiences with other women with diabetes, active social support, shared decision and responsibilities for diabetes management assisted the women to make a positive transition. Health professionals can promote a positive transition to motherhood by proactively supporting women with T1DM in informed decision-making, by facilitating communication within the healthcare team and co-ordinating care for women with type 1 diabetes transitioning to motherhood

Interventions to improve teaching and learning in first year mathematics courses

In keeping with the national mandate of increasing graduates in the sciences in South Africa, a concerted effort in improving the first year experience becomes imperative. First year mathematics courses commonly provide the base knowledge necessary for progression in different degree programmes at university. Success in mathematics courses influences throughputs, retention and graduation rates of various degree programmes. Due to the highly complex and integrated nature of issues pertaining to improving teaching and learning in these courses, a multi-dimensional approach was conceptualized and implemented at the University of Pretoria. This paper reports on the development of a coherent framework, and the process and strategy for improving student success through a number of teaching and learning interventions in the first year mathematics courses, addressing the different dimensions of the framework. The process embarked upon resulted in a coherent, resource-focused approach with a replicable model for similar contexts.University of Pretoria.http://www.tandfonline.com/loi/tmes202016-08-30hb201