Antenatal predictors and use of coping strategies in labour

Abstract

One aim of antenatal preparation is developing coping strategies for use (luring labour. However, the existing literature suggests that attendance at classes is not associated with lower pain or distress, possibly because receiving training cannot be assumed to be associated with subsequent practice.

This study aimed to assess whether attenders at classes actually used their taught strategies in their labours, whether use was associated with psychological benefits and whether antenatal measures could predict subsequent use. Concepts from the theories of planned behaviour and self efficacy were used to attempt to predict use of three types of coping strategy.

Use was high for breathing strategies but poor for relaxation and posture. Proportion of use of breathing and relaxation showed weak associations with lower fear. Whilst intentions did act as significant predictors for use of posture and relaxation only small proportions of the variance were accounted for and other antenatal measures showed little predictive capacity.

Reasons why women in labour may fail to take behavioural consequences from their antenatal beliefs are considered. Predicting health-related behaviours where maintenance rather than just initiation is involved may require greater consideration of intra-situational and emotional factors. Modifications of antenatal preparation to facilitate use of strategies are discussed.     

Exploring patient perspectives of prediabetes and diabetes severity: a qualitative study

Abstract

Objective: This qualitative study sought to identify and describe patients’ variant perceptions of disease severity after receiving a type 2 diabetes (T2DM) or prediabetes (preDM) diagnosis.

Design: Researchers interviewed 29 patients from two US medical centers to ascertain perceptions of severity. We used the constant comparative method from a grounded theory approach to identify themes from patients’ perspectives that inform their disease severity. This approach was used to help translate research to practice and ultimately identify intervention strategies informed by authentic experiences of preDM and T2DM patients.

Results: Perceptions of disease severity fell into two groups: high and low severity. Patients diagnosed with T2DM and preDM emerged in both groups and were comparative in terms of sample size, gender, and ethnic diversity. Several factors contributed to patients’ beliefs, including what they were told about the disease, observations from experiences within their own social network, and information from formal diabetes classes and their own research. The two perspectives diverged when patients described how their belief was informed by three thematic properties or personal factors: (i) fears; (ii) clinician communication; and (iii) social comparisons.

Conclusions: Beliefs about severity are influenced by patients’ fears, interactions with clinicians, and experiences within their social networks. These findings show that when interacting with patients with T2DM or preDM, clinicians should elicit patient perceptions of disease severity so they may then tailor the discussion to address these perceptions and help patients grasp the severity of these conditions.     

Perceived responsibility for disease onset affects HIV/AIDS Education

Abstract

Ninety-nine participants were assigned to one of three experimental conditions in which they viewed an AIDS education videotape that systematically manipulated whether or not the educator would be perceived as responsible for HIV infection. Participants were administered pre and post-video affect measures, and an HlV/AIDS knowledge test after watching the video. Participants who viewed the speaker who acquired HIV through a blood transfusion (perceived not responsible) and those who viewed the speaker who did not reveal mode of acquisition (control) performed significantly better on the knowledge test compared to those who viewed the speaker who acquired HIV through unprotected sexual inttrcourse (perceived responsible). In addition. male participants in the perceived responsible condition reported a significant increase in sensation-sceking after viewing the video. Finally, females experienced a significantly greater increase in anxiety as a result of seeing the video than did males. Implications of these tindings for the design and implmentation of AIDS education programs were discussed.     

Associations Between Participant Ratings of PREP for Strong Bonds and Marital Outcomes 1 Year Postintervention

After completing a relationship education program, collecting participant evaluations of the program is common practice. These are generally used as an index of “consumer satisfaction” with the program, with implications for feasibility and quality. Rarely have these ratings been used as predictors of changes in marital quality, although such feedback may be the only data providers collect or have immediate access to when considering the success of their efforts. To better understand the utility of such ratings to predict outcomes, we evaluated links between participant ratings and changes in self-reported marital satisfaction and communication scores 1 year later for a sample of 191 Army couples who had participated in a relationship education program delivered by Army chaplains (PREP for Strong Bonds). Overall ratings of general satisfaction with the program and the leader did not predict changes in marital outcomes 1 year later, whereas higher ratings of how much was learned, program helpfulness, increased similarity in outlook regarding Army life, and helpfulness of communication skills training predicted greater change in communication skills 1 year later. Higher ratings of items reflecting intent to invest more time in the relationship, and increased confidence in constructive communication and working as a team with the spouse predicted greater increases in both marital satisfaction and communication skills 1 year later. The constructs of intention and confidence (akin to perceived behavioral control) suggest that the Theory of Planned Behavior may be particularly useful when considering which Army couples will show ongoing benefit after relationship education.     

The ‘Matchbox School’ (1927–1932): Anna Freud and the idea of a ‘psychoanalytically informed education’∗

Of all the applications of psychoanalysis to various fields, perhaps none has been as important – or as fraught – as the application of psychoanalytic insights to education. This paper re-constructs some of the early debates around psychoanalysis and pedagogy that Anna Freud engaged with during the 1920s in Vienna, when the whole question of what education should be became a central issue for politicians, pedagogues and psychoanalysts alike. The paper focuses on the period leading up to the creation of the so-called ‘Matchbox School’, operating under Anna Freud's guidance between 1927 and 1932, and describes the influence of pioneers such as Seigfried Bernfeld and August Aichhorn. Compared to her more well-known work at the Hampstead War Nurseries during the Second World War, Anna Freud's involvement with this earlier educational experiment is relatively neglected. Yet one can argue that this short-lived project not only laid the foundation for much of Anna Freud's later work; it also had some far-reaching consequences, both for psychoanalysis and for the practice of progressive education.     

Rural Embedded Assistants for Community Health (REACH) Network: First-Person Accounts in a Community–University Partnership

Community research and action projects undertaken by community–university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community–university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community–university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider’s perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership’s efforts to improve the delivery infrastructure for rural healthcare.     

Education for Vocation in Public Life USA1

Abstract : The Lutheran sensibility is that life is a paradox, a dialectical tension, in the midst of which one must act and live. This sensibility informs an open and dialectical educational model for liberal arts education, which encourages a dynamic interaction of faith and learning. It supports a vocational understanding of public life that cultivates critical analysis while seeking to encourage citizenship for the common good.     

The effects of self-monitoring on the procedural integrity of a behavioral intervention for young children with developmental disabilities

The effects of self-monitoring on the procedural integrity of token economy implementation by 3 staff in a special education classroom were evaluated. The subsequent changes in academic readiness behaviors of 2 students with low-incidence disabilities were measured. Multiple baselines across staff and students showed that procedural integrity increased when staff used monitoring checklists, and students' academic readiness behavior also increased. Results are discussed with respect to the use of self-monitoring and the importance of procedural integrity in public school settings.     

Using the stimulus equivalence paradigm to teach course material in an undergraduate rehabilitation course

In 2 experiments, we examined whether the stimulus equivalence instructional paradigm could be used to teach relations among names, definitions, causes, and common treatments for disabilities using a selection-based intraverbal training format. Participants were pre- and posttested on vocal intraverbal relations and were trained using multiple-choice worksheets in which selection-based intraverbal relations were taught and feedback was delivered until mastery. Most participants in Experiment 1 showed the emergence of vocal intraverbal relations, but responding did not generalize to final written intraverbal tests. Participants in Experiment 2 showed the emergence of not only vocal intraverbal relations but also written intraverbal relations on final tests. Results suggest that the stimulus equivalence paradigm can be effectively implemented using a selection-based intraverbal training format, the protocol may be an effective means of emphasizing important concepts in a college course, and emergent skills may generalize to novel response topographies.