The answer is staffing: midwives' opinions of their profession

AimTo explore obstetric nurses and midwifery professionals’ experiences with the Perinatal Bereavement Care Training Programme (PBCTP) after implementation.DesignA qualitative descriptive design was used.MethodThis qualitative study was conducted at a tertiary level maternity hospital in China. The PBCTP was implemented at Women’s Hospital School of Medicine, Zhejiang University from March to May 2022. A total of 127 nurses and 44 midwives were invited to participate in the training. Obstetric nurses and midwives studied a 5-module training programme comprised of eight online theoretical courses and submitted a reflective journal after each session. Semi-structured interviews were conducted with 12 obstetric nurses and four midwives from May to July 2022 as a post-intervention evaluation. Thematic analysis was used in data analysis.FindingsA total of 16 participants in this study ranged in age from 23 to 40 years [mean age (SD), 30 (4) years]. Six main themes within participants’ experiences of PBCTP intervention were identified: participants’ aims of undertaking the training; personal growth and practice changes after training; the most valuable training content; suggestions for training improvement; directions for practice improvement; influencing factors of practice optimization.ConclusionNursing and midwifery professionals described the PBCTP as satisfying their learning and skills enhancement needs and supporting positive changes in their care providing for bereaved families. The optimized training programme should be widely applied in the future. More efforts from the hospitals, managers, obstetric nurses, and midwives are needed to jointly contribute to forming a uniform care pathway and promoting a supportive perinatal bereavement care practice.

Shaping the midwifery profession in Nepal – Uncovering actors' connections using a Complex Adaptive Systems framework

RPA (Raising of Participation Age) legislation re-positioned all youth in England to participate in post-16 education and training, the ultimate aim to develop ‘human capital’, i.e. skills, abilities and knowledge (Foucault 2008). However, how does RPA play out in practice with previously NEET and so-called disengaged youth engaged on a Level 1 prevocational course? Empirical research was conducted at a large general further education (FE) college in South East England, named The Site with seven tutors and twenty six students from the 2013-14 and 2014-15 cohorts. Adopting a case study approach, multiple methods of data collection were used, including classroom observations, semi-structured interviews, focus group discussions and document analysis. Key findings problematize education and highlighted complications for marginalised youth that participated in the study. Far from being a straightforward experience for former NEET and disadvantaged youth to gain knowledge and skills whilst at college, conversely, these Level 1 pre-vocational students faced multiple barriers that challenged student efforts to access essential provision in an attempt to improve on previous academic failure. Research findings revealed ‘warehousing’ appeared to be the main purpose of education for these particular students in this study. Distinctly different to stereotypical ideas, these particular students wanted to learn. In a profound way, empirical research highlighted how stringent academic conditions were powerfully used to demarcate access and predetermined which types of youth were permitted on higher levels of study programmes and apprenticeship. This study adopts a social justice framework and therefore advocated for numerous structural and pedagogical changes. Amongst others, the recommendation was made for an overhaul in government and organisational policies on GCSE provision. This study also calls for a sharpened political focus, inviting academic and government debate for a critical re-think and revamp of re-engagement provision - so it is fit for purpose for disadvantaged students.

RPA (Raising of Participation Age) legislation re-positioned all youth in England to participate in post-16 education and training, the ultimate aim to develop ‘human capital’, i.e. skills, abilities and knowledge (Foucault 2008). However, how does RPA play out in practice with previously NEET and so-called disengaged youth engaged on a Level 1 prevocational course? Empirical research was conducted at a large general further education (FE) college in South East England, named The Site with seven tutors and twenty six students from the 2013-14 and 2014-15 cohorts. Adopting a case study approach, multiple methods of data collection were used, including classroom observations, semi-structured interviews, focus group discussions and document analysis. Key findings problematize education and highlighted complications for marginalised youth that participated in the study. Far from being a straightforward experience for former NEET and disadvantaged youth to gain knowledge and skills whilst at college, conversely, these Level 1 pre-vocational students faced multiple barriers that challenged student efforts to access essential provision in an attempt to improve on previous academic failure. Research findings revealed ‘warehousing’ appeared to be the main purpose of education for these particular students in this study. Distinctly different to stereotypical ideas, these particular students wanted to learn. In a profound way, empirical research highlighted how stringent academic conditions were powerfully used to demarcate access and predetermined which types of youth were permitted on higher levels of study programmes and apprenticeship. This study adopts a social justice framework and therefore advocated for numerous structural and pedagogical changes. Amongst others, the recommendation was made for an overhaul in government and organisational policies on GCSE provision. This study also calls for a sharpened political focus, inviting academic and government debate for a critical re-think and revamp of re-engagement provision - so it is fit for purpose for disadvantaged students.

Exploring the Unmet Needs of Parents of Adolescent Girls with Heavy Menstrual Bleeding and Dysmenorrhea: A Qualitative Study.

BackgroundThe midwifery profession is crucial for a functioning health system aiming at improved maternal and child health outcomes. Complex Adaptive Systems (CAS) can be used as a tool to understand actors’ interactions in the system around midwifery profession for improved maternal and child health. The purpose of this study is to explore how actors connect to promote the Bangladesh’s midwifery profession.MethodsAn explorative study based on the framework of CAS was performed. Data were collected through semi-structured interviews with 16 key persons representing nine different organisations promoting the establishment of the midwifery profession. Qualitative analysis was used.ResultsFindings show that the actors were intertwined and driving towards a common goal; to save lives through education and deployment of 3000 midwives. The unique knowledge contributions of everyone involved were giving the system strength and power to perform. Collaboration was seen as more could be achieved compared to what an individual organisation could do. Significant results of this were that two midwifery curricula and faculty development had been produced. Although collaboration was mostly seen as something positive to move the system forward, the approach to reach the set goal varied with different interests, priorities and concerns, both on individual organisational level as well as at system level. Frequent struggles of individual philosophies versus organisational mandates were seen as competing interests for advancing the national priorities. It would appear that newcomers with innovative ideas were denied access on the same terms as other actors.ConclusionsThis study illustrates that CAS thinking can be used as a metaphor to understand how to adapt more emergent ways of working instead of the traditional planned approaches to change and develop in order to deal better with a more complex world. Through examining how actors connect for establishing a midwifery profession, offers insights of shared interests towards stepping up efforts for a competent midwifery profession in Bangladesh and elsewhere. Good relationships, where everyone’s expertise and innovations, are used to the full, are crucial for establishing a strong midwifery profession and thus improved maternal and child health.

Teacher educators are a diverse and essential part of the university workforce particularly in post-1992 universities in England. The majority of teacher educators have enjoyed successful careers as teachers and senior leaders in schools. However, their transition from school to university is fraught with difficulties. Inadequate induction to academia, particularly to academic research, coupled with their lack of experience of conducting research, renders them vulnerable within the performative culture of universities (Ellis, McNicholl, Blake, & McNally, 2014). The research landscape within higher education in England is competitive between and within universities. Research is a key element of teacher education (e.g., Burn & Mutton, 2013) and so it is vital that teacher educators engage with and become research active to advance knowledge of all aspects of education. However, new teacher educators are insufficiently supported to start their research journeys within higher education, leaving them on the margins of academe. This chapter reveals the findings of in-depth qualitative semi-structured interviews conducted in one university in North-West England illustrating the dilemma of teacher educators in higher education. The participants in the study explicate the ways in which their presence could be legitimated, for example, through the support of a mentor to lift their status to become research active academics and gain recognition and legitimation in academe.

The period 2010-19, which is the focus of this research saw several key policy developments in the skills and education arena which were to have a considerable impact on the higher education sector in England. These included an expansion of the apprenticeship programme to include higher (level 4 +), and then degree apprenticeships, a new employer-led method for designing the content and assessment and a major shift in the way the whole programme was funded. This research set out to identify the drivers, tensions and opportunities presented by government policy on higher/degree apprenticeships and how this affected universities in England. This was prompted by the increasing number of universities that decided to register and deliver apprenticeships – something that would have been unheard of at the start of 2010. As of 31st December 2018, 97 English universities had registered to deliver apprenticeships. The approach taken in this work was a qualitative study that used thematic analysis of relevant policy documentation triangulated with semi-structured interviews with policy informants (individuals holding a role related to policy production) and participants working in higher education responsible for delivering the policy. The themes that were identified related to policy intention and implementation, policy levers, programme design, learning, teaching and assessment and finally perceptions and attitudes. These themes were analysed drawing upon policy implementation theoretical frameworks including top-down and bottom-up implementation (Sabatier, 1986, Trowler, 2014a), policy networks and principal-agent theory (Gunn, 2015), change management (Fullan, 2003) and Saunders’ policy implementation staircase (Saunders and Reynolds, 1987, Saunders and Sin, 2014). The research found that tensions existed around the increasing role of neoliberalism, the purpose of HE in the 21st century, academic identity and resistance and cultural and systemic clashes. Opportunities and benefits identified included market opportunities for higher education, pedagogic and curriculum innovations and improved civic engagement and business partnerships.

Purpose – In the face of diverse national and international threats, the purpose of this paper is to explore the transformational leadership challenges in emergency services systems in Canada. These adaptive complex systems respond to critical mass emergencies, disasters and catastrophes. Design/methodology/approach – This qualitative research study uses grounded theory to examine the phenomenology of emergency services leadership from systems perspective. Using the theoretical Wu-Shi-Ren (WSR)-Li systems paradigm, this key informant study of 103 emergency leaders from 81 organizations focusses on the systemic challenges that transformational leaders face in emergency services systems. The response rate was 83.5 percent using a semi-structured and open-ended questionnaire. Findings – This key informant study underscores the competencies for transformational leadership and identifies 12 key leadership challenges in the context of the future evolution of emergency services systems. From the use of a grounded theory methodology, the new theory of transcendental transformational emergency leadership is posited. Research limitations/implications – Qualitative studies such as this key informant study underscores the relevance of the WSR-Li systems paradigm and grounded theory approach in discerning leadership challenges that are specific if not unique to emergency services systems. Practical implications – This study underscores the theoretical and pragmatic implications of the transformational leadership challenges for leadership paradigms, innovation and inter-sectorial collaborative networks and possible future emergency services research. Social implications – This study stresses the importance of addressing leadership challenges of emergency services systems as instrumental in ultimately saving lives, minimizing injuries and assuring complete health and social recovery from the scourges of emergency events nationally and internationally. Originality/value – Qualitative studies of the perspectives of strategic emergency leadership of systemic emergency services systems has not hitherto been done in Canada nor internationally. This key informant study underscores the relevance of the WSR-Li systems paradigm and grounded theory approach in discerning transformational leadership challenges that are specific if not unique to emergency services systems. Moreover, from the use of a grounded theory approach, a new theory of transcendental transformational emergency leadership emerged.

Who is sensitising whom? A participatory interview guide development as an awareness tool within a health care research project

Authors of previous research at a public university in New England, where the current study takes place, showed that approximately one-third of undergraduate students have experienced some aspect of food insecurity. More recent investigators at this university revealed that students who were members of a sport team were 4 times more likely to be food insecure than their peers who were not on a sport team. The estimated prevalence of student-athlete food insecurity from other previous research studies ranged from 14% to 32%. To understand the contributing factors to food insecurity among collegiate athletes. Qualitative study. A public university in New England. Data are presented for 10 collegiate athletes who experienced some level of food insecurity according to the United States Department of Agriculture Six-Item Short Form. Data were collected using a brief demographic questionnaire and semistructured interviews. Contributing factors were a lack of time, special dietary needs, limited campus dining options, and limited access to transportation or kitchens. Coping strategies were managing time and resources, buying cheaper foods, and skipping meals. Food insecurity negatively affected students' athletic performance. The athletes struggled to balance their athletic and academic schedules and obtain a diet that allowed them to meet their performance goals. Additional and innovative programming is needed to support food-insecure student-athletes.

Unmet Needs and Experiences of Adolescent Girls with Heavy Menstrual Bleeding and Dysmenorrhea: A Qualitative Study.

To gain insight in the onset and meaning of transgressive behaviour in care relationships with nurses, from the perspective of patients. Aggression and transgressive behaviour in health care have been a focus of research over the last decades. Most studies describe staff experiences on patient aggression. Patient' perspectives on aggression and transgressive behaviour in interactions with nurses are rarely sought. Qualitative interview study. Twenty patients were purposefully sampled from six wards of two general hospitals. Semi-structured interviews were carried out in 2011. Data were analysed using the constant comparative method influenced by the grounded theory approach. On elaborating on what constitutes experiences of transgressive behaviour, patients employ a framework of suppositions towards hospital care and nurse-patient relationships. This framework leads to implicit ideas on how competent professional caregivers will be and on how relationships with nurses will be characterized as normal human interactions. When these anticipated ideas are not met, patients feel obliged to address this discrepancy by adjusting their expectations or behaviour. Patients become more vigilant with regard to care given by nurses; search for own solutions; make excuses for nurses or reprioritize their expectations. Because of this adjustment, perceptions of transgressive behaviour are reinforced, mitigated or put into perspective. Patients adjust their behaviour based on what they experience in care relationships with nurses or the hospital care. It is crucial that patients feel free to discuss their assumptions or untoward needs and nurses learn to understand and reflect on those experiences.

To date, the increasing number of research on international students in higher institutions in the United Kingdom has generally focused on the experiences of mainly the undergraduates coming from various countries. Research that explores the experiences of international postgraduates has recently concentrated on Chinese students as they comprise a high percentage of international students’ population in England. This paper, in contrast, draws on the experiences of a group of mature Malaysian postgraduates in a university in the south-west England and focuses on their learning experiences. The qualitative feasibility study of 16 Malaysian postgraduates suggests that their learning challenges are exclusively to them being mature students such as challenges in managing time and roles, international students in terms of language barriers and racial discrimination and postgraduates, such as meeting the expectations of their supervisors and other parties and meeting the demands of research work and ethics. This leads to suggestions on the types of support that mature Malaysian postgraduates studying abroad would need to help with the completion of their PhDs.

Purpose: This study has explored the knowledge acquisition and sharing processes operative in the football industry of Sialkot, Pakistan. This study has focused on how these firms could adopt new means of technologically advanced football processes. Knowledge acquisition, dissemination, and conversion have remained unexplored in the football production processes.
 Study design: The qualitative research methodology was used, and the grounded theory approach was applied. Using semi-structured interviews, data were collected from 15 informants, including CEOs, managers, and owners. Purposive sampling was used to select the informants. This was a cross-sectional study with an inductive approach. Gioia (2013) methodology was used to analyze the data in grounded theory.
 Findings: Data structure developed from the interviews produced three aggregate dimensions, namely strategic position, knowledge acquisition & strategic fit, and knowledge sharing. Data analysis reveals that football producing firms have invented state of the art technology and upgraded their operations according to the changing production requirements. These firms have earned a competitive advantage based on their dynamic capabilities, research & development, innovation and rich history of football production.