Evaluating the ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’: A mixed method study in England

Background Caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable improvements in maternal or neonatal mortality or morbidity. The ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’ was a facilitative initiative developed to promote opportunities for normal birth and reduce Caesarean section rates in England. Objective To evaluate the ‘Focus on Normal Birth and Reducing Caesarean section Rates’ programme, by assessment of: impact on Caesarean section rates, use of service improvements tools and participants’ perceptions of factors that sustain or hinder work within participating maternity units. Design A mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews. Participants Twenty Hospital Trusts in England (selected from 68 who applied) took part in the ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’ initiative. In each hospital Trust, the head of midwifery, an obstetrician, the relevant lead for organisational development, a supervisor of midwives, or a clinical midwife and a service user representative were invited to participate in the independent evaluation. Methods Collection and analysis of mode of birth data from twenty participating hospital Trusts, web-based questionnaires administered to key individuals in all twenty Trusts and in-depth semi-structured telephone interviews conducted with key individuals in a sample of six Trusts. Results There was a marginal decline of 0.5% (25.9% from 26.4%) in mean total Caesarean section rate in the period 1 January 2009 to 31 January 2010 compared to the baseline period (1 July to 31 December 2008). Reduced total Caesarean section rates were achieved in eight trusts, all with higher rates at the beginning of the initiative. Features associated with lower Caesarean section rates included a shared philosophy prioritising normal birth, clear communication across disciplines and strong leadership at a range of levels, including executive support and clinical leaders within each discipline. Conclusions It is important that the philosophy and organisational context of care are examined to identify potential barriers and facilitative factors

Languages at key stage 4 2009-2011 : evaluation of the impact of Languages Review recommendations : baseline findings from the first year of the evaluation

• Heads of language departments consider good teaching and support to be central to encouraging language uptake at KS4, and constraints of the options system to be the main barrier. Many schools are reported to have received excellent support for languages in 2008/09 in terms of staffing, training and resources. • Some schools report a positive impact of the Languages Review recommendations but there is a low level of awareness of the Review in the majority of schools. • 19 per cent of schools set a benchmark for languages uptake in 2009/10 (at an average level of 64 per cent) but 62 per cent of schools had actual levels of uptake lower than 50 per cent. In schools where languages are optional (69 per cent of schools), 80 per cent had levels of uptake below 50 per cent

Missing out or singling out? Parents’ views on how health professionals should work with them now to get the best for their child in the future

Aim To investigate parents’ views about how health professionals should identify and work with families who may benefit from additional input to maximise their children’s future health and well-being. Methods A qualitative study was conducted. Eleven focus group interviews were carried out with 54 parents living in the north of England. Comparative analysis was carried out to highlight similarities and differences across key concepts. Results The idea of preventive services was welcomed by all parents. They strongly believed that everyone should have access to services aiming to enhance child well-being. Parents recognised that some families need additional support but were concerned that targeted services could result in missing out on some services. They were also concerned that if certain services were offered because they belonged to a group with an increased likelihood of poor child outcomes this could lead to feelings of being assessed, stereotyped and judged and that their abilities as parents were being questioned. Parents projected a belief in themselves as ‘good parents’ even in adverse circumstances. Targeted services could be acceptable if health professionals introduced them sensitively, for example, encouraging attendance at groups to provide support was considered to be helpful. Conclusions Targeted additional preventive services can be acceptable and welcome if health professionals introduce them sensitively, in the context of an existing relationship, providing parents are active participants

Lump Sum versus Annuity: Choices of Kentucky Farmers during the Tobacco Buyout Program

Our study uses the data collected during the implementation of the tobacco buyout program in Kentucky to evaluate how rural households, diverse in income, age, family structure, location, education level, and other characteristics, made a choice between annuities and a lump-sum payment. Subjects in our field experiment did not have to retire or change their employment, as did subjects in many field studies of the choice between annuities and lump-sum payments, which allowed us to evaluate the relationship between the option choice and a decision whether to exit the tobacco market. Our results suggest that while discounted utility theory gives acceptable predictions of the farmers’ behavior, other factors have to be taken into consideration. First, there are consistent biases that describe individual intertemporal behavior, such as availability bias or acquiescence bias. Second, there is a certain degree of heterogeneity in individual intertemporal preferences that correlates with their personal characteristics, such as education and production status. Third, our analysis revealed that the decision to exit the tobacco market positively correlated with the decision to take a lump-sum payment.annuity, family business system, intertemporal choice, lump sum, tobacco buyout, Agribusiness, Consumer/Household Economics, Institutional and Behavioral Economics, Marketing, G11, H31, J10,

The Eleventh Decade

https://ir.library.illinoisstate.edu/isuhistorybook/1002/thumbnail.jp

(The) relation of the educational activities of Martin Luther and Philip (Schwartzerd) Melanchthon ..

Typewritten sheets in cover. Thesis (M.A.)--Boston University Bibliography: p. 123-126 This item was digitized by the Internet Archive

A Collection of Solo French Chansons From the Early Fifteenth Century for Use in the College Level Voice Studio.

The first great flowering of polyphonic song occurred from the middle of the fourteenth century through the fifteenth century. A few of these songs are now occasionally included in public concerts. Because of the increasing interest in performance of early music of all types at colleges, universities, and by professional groups, it is important for students and teachers of singing to be exposed to this body of literature. The study of solo songs offers a convenient beginning. This study presents a small collection of French chansons from the early to the middle fifteenth century, each for solo voice with two accompanying contrapuntal lines. The composers represented are Gilles Binchois (ca. 1400-1460), Guillaume Dufay (ca. 1398-1474), John Dunstable (ca. 1390-1453), Richard Loqueville (d. 1418), and Gilet Velut (fl. 15th century). Two anonymous chansons from the Chansonnier El Escorial have also been included. Fifteen pieces have been evaluated for their pedagogical potential for today\u27s students of singing. Particular topics which have been addressed are range, melodic content and construction, length and shape of phrases, and rhythmic complexities. It has been found that the tessituras tend to emphasize the middle register, and that the phrases often are long with some coloratura, therefore encouraging the development of breath control and flexibility. Also, the melodies tend to move stepwise with few leaps, and the rhythms constantly alternate between groups of two and three beats. The literature, therefore, offers many possibilities for development of the basic musical skills, sightsinging and counting. The study includes a discussion of the differences between modern and fifteenth-century pronunciation of the French, and information regarding fifteenth-century performance practices, including the fitting of texts to music, the adding or deleting of accidentals, and the selecting the instrumental accompaniment. Each of the chansons in the collection is prefaced by a short biographical sketch of the composer, an indication of the form (e.g., rondeau or ballade), a suggestion as to the appropriate voice and instrumental accompaniment, a word-by-word translation presented in the appropriate fixed form (e.g., rondeau or ballade), and an International Phonetic Alphabet transcription of the early fifteenth-century French