Is maternity care in Scotland equitable? Results of a national maternity care survey

Objective High-quality maternity care is key to long-term improvements in population health. However, even within developed welfare systems, some mothers and babies experience poorer care and outcomes. This study aimed to explore whether women’s experiences of maternity care in Scotland differs by their physical or sociodemographic characteristics. Design Secondary analysis of the 2015 Scottish Maternity Care Experience Survey. The questionnaire was based on the Care Quality Commission English maternity survey. Setting National Health Service maternity care in Scotland. Participants The survey was distributed to 5025 women who gave birth in Scotland during February and March 2015 with 2036 respondents (41%). Main outcome measures The questionnaire explored aspects of care processes and interpersonal care experienced from the first antenatal contact (booking) to 6 weeks following the birth. The analysis investigated whether experiences were related to age, parity, deprivation, rurality, self-reported general health or presence of a health condition that limited daily activities. Analysis used mixed effect multilevel models incorporating logistic regression. Results There were associations between parity, age and deprivation with gestation at booking indicating that younger women, women from more deprived areas and multiparous women booked later. Women reporting generally poorer health were more likely to describe poorer care experiences in almost every domain including continuity, pain relief in labour, communication with staff, support and advice, involvement in decision making, confidence and trust and overall rating of care. Conclusions We found few differences in maternity care experience for women based on their physical or socioeconomic characteristics. Our findings indicate that maternity care in Scotland is generally equitable. However, the link between poorer general health after childbirth and poorer experience of maternity care is an important finding requiring further study

A Case Study Of The Student Academic Support System: State University

In 1985, the Florida Legislature mandated the development of a computer assisted academic advisement program for the State University System. This study of the Student Academic Support System (SASS) explored the administrator and advisor viewpoints, rather than traditional student perception assessments, in order to add to the understanding of computer assisted advising as it now stands in the State of Florida. The goal of this research was to determine the best practices of computer assisted advising throughout the State University System. Individuals who use or have responsibility for the advising system were identified in each institution in the State University System. An instrument was developed to identify the use of key components of the Student Academic Support System and interviews were scheduled. A review of the literature and results of this study found that there were many factors that influenced the success or failure of a computer assisted advising system. Factors such as funding, administrative sponsorship from the highest levels of the institution, institutional culture, advisor computer proficiency, and the existence of alternate computer advising technologies played significant roles in the development and implementation of the mandated state computer advising system. The qualitative interviews utilized in this case study highlighted the complexities of computer assisted advising. This research studied the perceptions and practices of administrators and advisors in the 11 State Universities in Florida. This research study documents the history of the development and implementation of computer assisted advising within the Florida State University System. As such, this research provides insight for administrators, technology professionals, and policy makers in the field of student advisement. Implications of this study, for the Florida State University System, show that strong administrative support and acceptance of the value of the system by advisors are necessary for successful implementation of a computer assisted advising system. Continued assessment, modification, and funding must be a priority for any institution that utilizes computer assisted advising systems. A properly implemented advising tool, such as the Student Academic Support System, results in a better informed student and a more effective sharing of information between students, advisors, and the university. Properly advised students will reach their educational goals in a timely and efficient fashion. The use of computer assisted advising was found to result in a satisfying academic experience for the advisor and to increase a student\u27s level of satisfaction with the advising encounter

Interdisciplinary enquiry into learning and teaching: Lessons from Geography

In this chapter we explore how research in the discipline of geography can help you to undertake productive enquiry into learning and teaching in higher education. We outline the characteristics that geographers in higher education possess and highlight how these relate to the broad and synthetic nature of research in the discipline. Rooted within its interdisciplinary imperative, educational enquiry in geography spans subject matter and approaches found across the spectrum of the humanities, and the social and natural sciences. We present four case studies of enquiry into teaching and learning carried out by geographers, selected to demonstrate analogies between disciplinary and educational enquiry across the research process. These examples highlight the range of questions that have been posed, the types of concepts in learning and teaching that geographers have engaged with, and the breadth of methodological approaches they have employed. We define the steps you might take if you wish to adopt new ways of researching your teaching and student learning. We finish by reflecting on some of the benefits of adopting a geography-specific approach to higher education enquiry

Republican Ideology and American Diplomats: The Roles of John Jay and James Monroe

Republican ideology is the basis of a case study of the diplomatic careers of John Jay and James Monroe. Both men were committed to a republican form of government but each perceived it differently. Likewise they viewed diplomacy and the role oi a diplomat differently. In establishing the republicanism oi both Jay and Monroe extensive use was made of their private and public correspondence. Through these letters it becomes apparent that Monroe\u27s republican commitment fed his incipient paranoid personality in that he constantly looked homeward for approval. On the other hand, John Jay\u27s elitist perspective did not lead him to expect approval of his actions, and he proved to be a more effective diplomat

Immersion as a lifeway: the cultural sustainment and humanization of Mandarin dual language immersion teachers

The U.S. is growing in its recognition of the value of multilingualism, and is rapidly expanding educational programs, such as dual language immersion (DLI), to that end (Singleton et al., 2018). However, the historical socio-political, regulatory, and cultural contexts have led to a current climate that may not demonstrate equivalent value of its multilingual teachers (Flores & Rosa, 2015). With a concerning teacher shortage that is exacerbated for teachers of culturally and linguistically diverse backgrounds (MacIntyre et al., 2019), it is critical to understand factors that impact the wellbeing and satisfaction of such teachers in the U.S. educational system. In particular, with the complexities of globalization (Schaeffer, 2009) and a growing anti-Asian backlash (Chen et al., 2020), this study is concerned with the possible impact on teachers in programs such as Mandarin DLI, coveted for its language as a resource (M. Heller, 2003), as there is great potential for their workplace experience to be driven by transactional exchanges, rather than the desired transformative interaction in such a commodified climate. Therefore, using a qualitative phenomenological approach, this study focuses on the professional lived experiences of Mandarin language teachers within the ecological system (Bronfenbrenner, 1977) of their uniquely dual language immersion environment. Using the lenses of humanization (Freire, 1970; Todres et al., 2009) and cultural sustainment (Paris, 2012; Paris & Alim, 2017), this study examines the connection between such interactions and the resulting value expressed by the teachers. Thirteen Mandarin dual language immersion teachers participated in semi- structured interviews that contributed to rich and thick descriptive findings. The teachers’ insight led to implications regarding the systemic features in schools that can create culturally sustaining lifeways, develop humanizing leadership, and cultivate school communities as places of love that can collectively support the wellbeing and retention of diverse teachers

Developing a home monitoring system for patients with chronic liver disease using a smartphone

Liver disease is a growing problem in the UK, and one of the major causes of working-age premature death. Patients with advanced liver disease are typically admitted to hospital on multiple occasions, where they are stabilised before discharge. At home, there is little or no monitoring of their condition available, making it difficult to time additional treatment. Here, a system for non-invasive assessment of serum bilirubin level is proposed, based on imaging the white of the eye (sclera) using a smartphone. Elevated bilirubin level manifests as jaundice, and is a key indicator of overall liver function. Smartphone imaging makes the system low cost, portable and non-contact. An ambient subtraction technique based on subtracting data from flash/ no-flash image pairs is leveraged to account for variations in ambient light. The subtracted signal to noise ratio (SSNR) metric has been developed to ensure good image quality. Values falling below the experimentally-determined threshold of 3.4 trigger a warning to re-capture. To produce device-independent results, mapping approaches based on image metadata and colour chart images were compared. It was found that introducing a one-time calibration step of imaging a colour chart for each device leads to the best compatibility of results from different phones. In a clinical study at the Royal Free Hospital, London, over 100 sets of patient scleral images were captured with two different smartphones and paired clinical information was recorded. A filtering algorithm was developed to tackle the high density of blood vessels and specular reflection observed in the images, yielding a 94% success rate. Strong cross-sectional and longitudinal correlations of scleral yellowness and serum bilirubin level were found of 0.89 and 0.72 respectively (both p<0.001). When the proposed processing was applied, results from the two phones were demonstrated to be compatible. These results demonstrate the strong potential for the system as a monitoring tool

Women’s Understanding of the Effects of Domestic Abuse: The Impact on Their Identity, Sense of Self and Resilience. A Grounded Theory Approach

Research on women who have experienced domestic abuse indicates that they feel marginalized; stigma, shame and fear about the response of services stop women from seeking the support they need. The current study aimed to explore the unique perspectives of women who have experienced domestic abuse in order to gain an understanding of their experiences, their perceived identity, sense of self and resilience. Interviews were conducted with eight women who had experienced domestic abuse and transcripts were analysed using grounded theory methodology. Findings indicated that domestic abuse had a significant impact on the women interviewed. In particular, the ongoing relationship the women had with their abusive partner, due to contact with the children, served to perpetuate their identity as an abused woman. The study also found, however, that the women were able to utilise resources that increased their resilience. They were striving for a normal life, prioritising their role as a mother and attempting to reconstruct their own identity through the assumption of new roles