Recovery after caesarean birth: a qualitative study of women's accounts in Victoria, Australia

<p>Abstract</p> <p>Background</p> <p>The caesarean section rate is increasing globally, especially in high income countries. The reasons for this continue to create wide debate. There is good epidemiological evidence on the maternal morbidity associated with caesarean section. Few studies have used women's personal accounts of their experiences of recovery after caesarean. The aim of this paper is to describe women's accounts of recovery after caesarean birth, from shortly after hospital discharge to between five months and seven years after surgery.</p> <p>Method</p> <p>Women who had at least one caesarean birth in a tertiary hospital in Victoria, Australia, participated in an interview study. Women were selected to ensure diversity in experiences (type of caesarean, recency), caesarean and vaginal birth, and maternal request caesarean section. Interviews were audiotaped and transcribed verbatim. A theoretical framework was developed (three Zones of clinical practice) and thematic analysis informed the findings.</p> <p>Results</p> <p>Thirty-two women were interviewed who between them had 68 births; seven women had experienced both caesarean and vaginal births. Three zones of clinical practice were identified in women's descriptions of the reasons for their first caesareans. Twelve women described how, at the time of their first caesarean section, the operation was performed for potentially life-saving reasons (Central Zone), 11 described situations of clinical uncertainty (Grey Zone), and nine stated they actively sought surgical intervention (Peripheral Zone).</p> <p>Thirty of the 32 women described difficulties following the postoperative advice they received prior to hospital discharge and their physical recovery after caesarean was hindered by a range of health issues, including pain and reduced mobility, abdominal wound problems, infection, vaginal bleeding and urinary incontinence. These problems were experienced across the three zones of clinical practice, regardless of the reasons women gave for their caesarean.</p> <p>Conclusion</p> <p>The women in this study reported a range of unanticipated and unwanted negative physical health outcomes following caesarean birth. This qualitative study adds to the existing epidemiological evidence of significant maternal morbidity after caesarean section and underlines the need for caesarean section to be reserved for circumstances where the benefit is known to outweigh the harms.</p

Virtual Realia: Maneuverable computer 3D models and their use in learning assembly skills.

Two experiments compared real and virtual models as aids for learning assembly skills. In Experiment 1, ten participants individually studied either a fully assembled model, or a computer-generated one, in exploded view, that could be spatially manipulated in any direction. Participants then assembled the object in front of a video camera. ANOVA indicated virtual model are studied significantly longer but yield faster assembly than a real model. Experiment 2 used the same treatments plus a fully assembled virtual mode, randomly assigned to 28 participants who studied the aid, assembled the model, and then repeated the task from memory 3 days later. ANOVA indicated no differences between the three groups in assembly speed or accuracy. However, participants studied the exploded virtual model significantly longer than the two intact views of the model suggesting the former may impose a greater cognitive load due to the additional visual information it provides

Concreteness and imagery effects in the written composition of definitions.

Concreteness and imagery effects have been found to be among the most powerful in explaining performance on a variety of language tasks. Concreteness and imagery effects involve the capacity of concrete language to evoke sensory images in the mind (e.g., juicy watermelon), whereas abstract language has relatively less capacity to do so (e.g., agriculturalproduce). The effects of concreteness and imagery on reading and text recall have been well-established (e.g., Goetz, Sadoski, Fatemi, &amp; Bush, 1994; Paivio, 1971, 1986; Paivio, Walsh, &amp; Bons, 1994; Sadoski, Goetz, &amp; Avila, 1995; Sadoski, Goetz, &amp; Fritz, 1993a, 1993b). Concrete words, phrases, sentences, and texts have been found to be more imageable, comprehensible, memorable, and interesting than abstract language units even when other relevant contextual variables are carefully controlled. These results can be consistently interpreted by dual coding theory (Paivio, 1971, 1986, 1991), which maintains that cognition involves the operation of two separate but interconnected systems, one for verbal representations and processes and one for nonverbal (imagery) representations and processes

Guest editor’s introduction: At the nexus of mentoring and technology.

With the ever-increasing role of technology as an innovative force in society, we have witnessed major changes in the types of education being developed and in how learning and instruction is conceptualised. Consider, for example, the dramatic rise in the number of Internet-based courses offered in higher education as well as the evolving role of the teacher as creator of learning environments. Accordingly, considering the possibilities and limitations of mentoring in this new and dynamic technological context is both timely and relevant. It is the nexus between mentorship and technology that is the subject of this first special issue of Mentoring &amp; Tutoring

Opportune encounters: Hosting extramural mentoring programmes for new scholars.

This article explores the new and important field of mentoring in higher education. It describes a pilot project that launched the mentoring of new scholars through an academic writing programme. In its inaugural year, this national programme attracted educators from the US, Canada, and the UK who are international members of a US-based conference. The analysis of the extramural programme uses the formative evaluations of the 48 participants Ðmentors (established scholars) and mentees (graduate students, recent graduates, and beginning faculty). The questionnaire data are organised into issues highlighting preliminary insights for programmatic development at professional venues. Salient elements of the Mentoring for Academic Writing (MAW) Programme are provided to encourage the development of other mentoring opportunities for new scholars. Benefits and limitations are included. An overview of the current mentoring climate that supports new models of human relationship is given. Discussion covers the relevant literature and recommendations for programmatic improvemen

National technology standards for K-12 schools: A case study of unresolved issues in public relations.

This article addresses an important need—the dissemination of information relating to technology as a public relations tool—and the associated exigency for administrator and teacher technology training. Specifically, we identify the increased expectations for the performance of school leaders and teachers, as well as unresolved issues in public relations emerging from national technology standards. Current models of educational reform, particularly the Technology Standards for School Administrators (TSSA) Collaborative, raise questions about the relationship between public relations and communications technology for schools. Within this context, a case scenario that features the site-based research of a concerned public relations practitioner is analyzed. Related discussions include assumptions of basic know-how; challenges and contexts of technology use, including embedded cultural codes; mechanistic attitudes toward technology; and, significantly, equity and access

When tactics collide: Counter effects between an adjunct map and prequestions.

Eighty-five undergraduates read a 1,399-word story using computer programs that differed in the types of learning aids provided: either prequestions only (PO) viewed prior to the reading, a related map that was first reviewed feature by feature (MR), prequestions plus an unreviewed map (PM), or prequestions with a reviewed map (PMR). During reading, subjects accessed the map as desired by depressing the mouse button, at which time the computer recorded how often they viewed the display and for how long. Analyses of scores on a 20-item constructed-response test on the story showed significantly higher recall by PO and PM groups compared to subjects receiving only a map. The MR group accessed the map significantly more often than did the PM group, while subjects given a reviewed map (MR and PMR groups) rated it significantly more useful for learning the story than did those who received both prequestions and a map that was not reviewed. All three groups receiving prequestions rated the text itself more useful than did the map-only group. These findings provide partial evidence that graphic and verbally based instructional tactics can, in certain circumstances, "collide" with one another when used concurrently. Because both adjunct displays and adjunct questions rely on mental rehearsal during initial processing, they potentially compete for the limited resources of working memory leading to, in some cases, attenuation of their benefits during learning

The effect of picture position on learning from an accompanying text.

This study examines whether the spatial configuration of two adjunct pictures influences processing of accompanying text as has been found in the case of other types of graphic displays. Forty-eight undergraduates studied a text along with drawings or verbal descriptors portraying the main characters of a story. These adjuncts were spatially arranged on the page with the senior character situated above the junior, or vice versa. Analysis of variance of performance on constructed-response questions showed no effect for configuration. However, significant differences in achievement were noted for questions derived from paraphrased parts of the story versus ones developed from verbatim rewordings of the text. Analysis of simple effects revealed these differences were only significant in cases where the story was studied in concert with an adjunct picture. Results are discussed in terms of residual processing demands brought about by switching from linguistic to imaginal codes. When adjunct pictures do not contribute to an understanding of the text, a net loss in processing may occur for the memory system

Epilogue: Unresolved questions about mentoring and technology.

As we embrace the concept of e-mentorship, we not only wonder whether face-to-face mentoring can be replaced by an electronic doppelganger (i.e. a phantom twin), but also encounter questions that deal with the fundamental nature of mentoring. What does it mean, for example, to have a ‘personal’ relationship with a mentor or role model? Conceivably, such questions may only have importance from the perspective of a naïve and overly sentimental view of mentorship. As e-mentoring supplants the ‘old fashioned’ way of mentoring, we may be in danger of idealising the latter and, as a result, missing opportunities offered by the former

Psychological norms for simple three-line graphic shapes.

There is a longstanding tradition in psychological research for norming lists of words that are used in experimental studies. The present study extends this practice to graphic imagery by obtaining norming data on 24 simple abstract graphic shapes composed of three straight-line segments. The attributes obtained in the norming procedure were the shapes' familiarity, describability, associability, availability, and potential for word association. Results from rating data indicate significantly different, yet reliable, responses by participants to the various shape configurations. Multidimensional scaling analysis of shape ratings identified two underlying dimensions of perceived differences: the continuity of a shape's linear direction and the consistency or regularity of its interior angles. By contrast, performance in generating word associations for figures appeared to be linguistically driven, with initial responses related to the similarity of shapes to letters of the alphabet. The norms and the computer program used to collect them can be downloaded from www.psychonomic.org/archive