Never be afraid to question practice: the professional dilemma of a student midwife

As a third-year caseloading student midwife, I experienced a professional dilemma during an intrapartum placement whilst working on a busy obstetric unit: to use vaginal examination to confirm full dilatation (a medical approach) or advocate normality and a woman-centred approach.This article explores the three influential forces that contributed to the dilemma: the culture of obstetric units, the midwife-woman relationship, and the importance of assertive behaviours to achieve autonomy. Through reflection and use of Gibbs’ (1988) reflective cycle, I highlighted the need to develop my assertive skills, which also led me to make amendments to my own practice; this helped me transition from student to a newly qualified midwife

Chronic heart disease in pregnancy: exploring Marfan syndrome

Coronary heart disease is the biggest killer in the UK, causing more than a quarter of deaths in 2018 (British Heart Foundation, 2018). Congenital defects are the most common cause of heart disease in pregnancy (Wylie and Bryce, 2016). This article will discuss Marfan syndrome and the impact this has on pregnancy and childbirth. Current literature and research will be appraised and discussed to explore mode of delivery during the second stage of labour and calculate the most appropriate method of delivery. Additionally, this article will address how the midwife can support women with Marfan syndrome during the pregnancy booking, antenatal period and intrapartum period without labelling them, and discuss how this may be achieved in relation to the uncertainty reduction communication theory

Commercialisation of precision agriculture technologies in the macadamia industry

A prototype vision-based yield monitor has been developed for the macadamia industry. The system estimates yield for individual trees by detecting nuts and their harvested location. The technology was developed by the National Centre for Engineering in Agriculture, University of Southern Queensland for the purpose of reducing labour and costs in varietal assessment trials where yield for individual trees are required to be measured to indicate tree performance. The project was commissioned by Horticulture Australia Limited

Syntactic and Semantic Understanding of Conceptual Data Models

Conceptual data models are used for discovery and validation communication between analysts and users; as a communication tool between analysts and designers; as a basis for end-user developed applications; and as part of the systems documentation (e.g., Batra and Davis 1992; Juhn and Naumann 1985; Siau et al. 1997). A goal of creating a conceptual model is to develop a database schema to be used to implement a database that meets the information needs of intended users. To develop a suitable database schema, the designer must be able to use the conceptual data model as a communication tool to verify the assumptions made in its creation. Batra and Davis state that the conceptual model must be capable of providing a structure for the database along with the semantic constraints for communication with users. The conceptual data model also serves as a representation of the database after its completion: it is part of the systems documentation, and hence can be used for system evaluation by auditors or others. Conceptual data models include several components, each of which provides information content. Siau et al. examined the use of two components in entity-relationship data models: the surface semantics and the structural constraints (participation cardinality) of the relationships

Visual Attention Overload: Representation Effects on Cardinality Error Identification

Attention overload occurs when people are presented with so many different stimuli that they are unable to adequately direct their cognitive processing to all of the inputs. Visual attention overload is conceptually similar and occurs when people are given visual stimuli in a format that prevents them from effectively processing all of the stimuli. The current study examines whether visual attention overload results in differential performance with conceptual model representations for a task requiring identification of errors in relationship cardinalities. This study suggests that visual attention management is an important part of cognitive fit. Specifically, a representation that inhibits processing of information because of visual attention overload is not expected to have cognitive fit with a task that requires repeated use and scanning of the same objects that were previously inhibited. This study allows us to move beyond the “spatial representations should be used for spatial tasks” approach to instead attempt to identify the types of tasks that require repeated use of the representations and therefore are likely not to have cognitive fit with a diagram representation if the diagram is sufficiently complex

Use of Grounded Theory in Cardiovascular Research

While grounded theory is often cited in the qualitative literature as the methodology, there are few good examples of publications that follow the principles of grounded theory and result in an actual theory. The purpose of this paper is to demonstrate how the Corbin and Strauss (2015) method of grounded theory was used in a study looking at how patients with cardiovascular disease and diabetes develop health literacy skills that are used to manage their condition. The key principles of grounded theory include theoretical sampling, constant comparison, open, axial, and selective coding, the use of memoing, and theoretical saturation. Data collection in this study was in the form of semi-structured interviews of 16 patients with cardiovascular disease and diabetes, and 19 healthcare professionals that care for or educate these patients. Patients were recruited from a primary care medical practice, a cardiology medical practice, patient focused programs provided by the American Heart Association, and social media. Healthcare professionals were recruited from the medical practices, the American Heart Association, and social media. Each interview was recorded, transcribed, and coded. Insights from these interviews led to the development of the health literacy instructional mode, which explores the use of digital tools, instructional approaches, social support, and self-directed learning in the development of health literacy skills, and is an example of the use of grounded theory in cardiovascular research

Common Grasses of Nebraska: Rangeland Prairie Pasture (Including Grass-Like Plants)

Introduction 3 • Plant Groups 4 • Parts of a Grass Plant 5 • Inflorescence Characteristics 5 • Vegetative Characteristics 5 • Parts of a Grass-Like • Plant 5 • Fruit and Floral Characteristics 5 • Vegetative Characteristics 5 • Warm-Season • Perennial Grasses • Bermudagrass 14 • Blowoutgrass 15 • bluestems: • Big bluestem 16 • Little bluestem 18 • Sand bluestem 20 • Silver bluestem 21 • Yellow bluestem 22 • Buffalograss 24 • dropseeds: • Alkali sacaton 26 • Prairie dropseed 27 • Sand dropseed 29 • Tall dropseed 30 • Eastern gamagrass 32 • gramas: • Blue grama 33 • Hairy grama 35 • Sideoats grama 36 • Indiangrass 38 • Inland saltgrass 40 • Johnsongrass 41 • lovegrasses: • Purple lovegrass 43 • Sand lovegrass 44 • muhlys: • Marsh muhly 45 • Plains muhly 47 • Sandhill muhly 48 • Scratchgrass 49 • Phragmites 50 • Prairie cordgrass 52 • Prairie sandreed 54 • Purple threeawn 55 • Purpletop 56 • Sand paspalum 58 • Switchgrass 59 • Tumblegrass 61 • Windmillgrass 62 Warm-Season • Annual Grasses • Barnyardgrass 66 • Bearded sprangletop 67 • crabgrasses: • Hairy crabgrass 68 • Smooth crabgrass 69 • Fall panicum 70 • foxtails: • Green foxtail 72 • Hooked foxtail 73 • Yellow foxtail 74 • Goosegrass 76 • Poverty dropseed 77 • Purple sandgrass 78 • Sandbur 79 • Stinkgrass 81 • threeawns: • Forktip threeawn 82 • Prairie threeawn 83 • Witchgrass 84 Cool-Season • Perennial Grasses • bentgrasses: • Redtop bentgrass 88 • Spike bentgrass 89 • Winter bentgrass 90 • bluegrasses: • Bulbous bluegrass 91 • Canada bluegrass 92 • Kentucky bluegrass 94 • Mutton bluegrass 95 • Plains bluegrass 96 • Sandberg bluegrass 98 • Bluejoint reedgrass 99 • bromegrasses: • Meadow brome 101 • Smooth brome 102 • Creeping foxtail 103 • Fowl mannagrass 105 • Foxtail barley 106 • Green needlegrass 108 • Indian ricegrass 109 • Needleandthread 111 • Orchardgrass 112 • Perennial ryegrass 114 • Porcupinegrass 115 • Prairie junegrass 116 • Prairie wedgescale 117 • Quackgrass 119 • Reed canarygrass 120 • rosettegrasses: • Scribner rosettegrass 121 • Wilcox rosettegrass 123 • Squirreltail 124 • Tall fescue 125 • Timothy 127 • Weeping alkaligrass 129 • wheatgrasses: • Crested wheatgrass 130 • Intermediate wheatgrass 132 • Slender wheatgrass 133 • Tall wheatgrass 135 • Western wheatgrass 136 • wildryes: • Canada wildrye 138 • Russian wildrye 139 Cool-Season • Annual Grasses: • American sloughgrass 142 • Annual bluegrass 143 • Cheatgrass 144 • Japanese brome 145 • Little barley 146 • Northern wildrice 148 • Sixweeksgrass 149 • Grass-Like • Plants: • American bulrush 152 • Field horsetail 153 • Schweinitz flatsedge 154 • sedges: • Nebraska sedge 155 • Needleleaf sedge 156 • Sun sedge 157 • Threadleaf sedge 158 • Yellow nutsedge 160 • Glossary 161 • Ecological Sites 170 • Selected References 173 • Index 17

Resources-Events-Agents Design Theory: A Revolutionary Approach to Enterprise System Design

Enterprise systems typically include constructs such as ledgers and journals with debit and credit entries as central pillars of the systems’ architecture due in part to accountants and auditors who demand those constructs. At best, structuring systems with such constructs as base objects results in the storing the same data at multiple levels of aggregation, which creates inefficiencies in the database. At worst, basing systems on such constructs destroys details that are unnecessary for accounting but that may facilitate decision making by other enterprise functional areas. McCarthy (1982) proposed the resources-events-agents (REA) framework as an alternative structure for a shared data environment more than thirty years ago, and scholars have further developed it such that it is now a robust design theory. Despite this legacy, the broad IS community has not widely researched REA. In this paper, we discuss REA’s genesis and primary constructs, provide a history of REA research, discuss REA’s impact on practice, and speculate as to what the future may hold for REA-based enterprise systems. We invite IS researchers to consider integrating REA constructs with other theories and various emerging technologies to help advance the future of information systems and business research

Understanding Health Literacy Skills in Patients with Cardiovascular Disease and Diabetes

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched the learning preferences and needs of the patients. A social ecological framework was used, which underscored the importance of understanding health literacy from multiple sources. Semistructured interviews were conducted on 19 healthcare professionals and 16 patients. Emergent key themes included: (a) social support plays an important role as a learning opportunity; (b) many patients get their information from internet searches; (c) instructional strategies should be personalized, interactive, social, and relevant; and (d) patients are self-directed learners. Linking of these themes led to the development of the health literacy instructional model, which is a 3-step approach, including an emotional support, behavioral approach, and instructional strategy. Social support was the common element in all 3 phases and was perceived to be key to developing health literacy skills, resulting in the key implication for social change. Recommendations are to consider social support in the development of health literacy instructional strategies