Low Professional Status Research Articles

Comparative study of the clinical parameters of pregnancy and childbirth in teenagers and women of the optimal reproductive age

Objective. Pregnancy in teenagers is still frequent, while notions about the level of it’s safety and risk of specific obstetrical complications is controversial. Materials and methods. On the basis of interview and medical charts analysis in 500 minors (13 to 18 years) and 1500 women of the optimal reproductive age (20 to 25 years) for the years 2011-2014, social status, main clinical parameters of pregnancy and labor were examined. Results. The average age of young pregnant women was 17,2 ± 0,89 years. Among pregnant teens the students of schools and specialized secondary schools (57.8 %) were dominated, while majority of 20-25-year-olds (66.9 %) were employed. In adolescents, sexual debut was on average two years earlier than in the control group of women. Primigravida were 94.4 % of adolescents and 74.4 % of women aged 20-25. Among most common complications of pregnancy were anemia, threatened abortion, fetal hypoxia, gestational hypertension and preeclampsia. The risk of complications was slightly greater in young women. In 92.2 % of adolescents and 94.4 % of controls, pregnancy was finished with term delivery. The average duration of labor was similar in both groups. The rate of caesarean section was 13 % in minors and 17.6 % in 20-25 years-old women. Conclusions. Pregnancy in adolescents is usually unplanned and occurs in early onset of sexual relations, “socio-adjective position” and low professional status. Among minors precipitate delivery and preterm birth were more common as well as greater percentage of low birth weight newborns in comparison with 20-25 year old women.

Nursing students’ views on rural nursing practice in China: A questionnaire survey

Objective: The purpose of this study was to investigate final year nursing students’ views on rural nursing practice in China. There are fewer nurses in rural areas compared to urban areas in China. Little is known about how current nursing students view rural nursing practice, and what influences their intentions to work rurally in their career. Methods: A questionnaire survey was designed. Data were collected in one area in Eastern China between December 2011 and March 2012. A self-completion questionnaire was hand distributed to final year nursing students in six nursing schools and collected by the researcher with a response rate of 89% (n = 445). Results: Nursing students in China had some unique perceptions on rural nursing practice. Respondents viewed nursing posts in rural areas as having lower incomes, lower professional status and fewer opportunities for learning skills. They also associated rural nursing with a light workload, less stress and few night shifts. In contrast to the wider literature, Chinese nursing students did not consider that rural nursing posts could foster autonomy in practice or offer the opportunities to broaden their skills. Conclusions: The perceived lower financial rewards, fewer opportunities for skills development and the low professional status of rural nurses make recruitment of a skilled nursing workforce to rural areas a major challenge in China. Policies, such as reforming the rural nursing delivery system, providing financial incentives and supporting for professional development, should be considered.

A Case-Control Study of Obstetric Fistula Risk Factors in the Democratic Republic of the Congo

Background: Pregnant women in the Democratic Republic of Congo (DRC) are at increased risk for developing obstetric fistulas (OFs) as a result of obstructed labor, in conditions similar to many other African countries. No case-control study of biological and social risk factors for OF has been reported from the DRC. This study aimed to identify factors that would aid in prevention and early identification of women who are at risk of developing OF. Methods: Participants were enrolled in a case-control study at four obstetric clinics in the central DRC. Cases of OF were evaluated as they presented, then a control participant was enrolled among women presenting subsequently to the same clinic, seeking to match parity at the time of the fistula and tribe of the case. A questionnaire was administered to elicit physical, obstetric, demographic, socioeconomic, religion, geographic, and delivery attributes of the participants. Case-control comparisons sought to identify independent risk factors for OF in the total case-control pairs and in subgroups of the participants. Logistic regression was utilized to identify independent risk factors for OF in the total case-control study group and in selected subgroups of the participants, and linear regression was utilized to estimate the variation explained between case and control outcomes from the variables independently significant in the logistic regression models. Results: A total of 177 case-control pairs were enrolled. Among all pairs, shorter height of the case (odds ratio = 1.06, 95% Confidence Limits 1.02 - 1.12); more kilometers travelled to the delivery site (1.02, 1.01 - 1.02); her village, not town, residence (OR = 5.52, 2.72 - 11.2), and her lower professional status (2.95, 1.53 - 5.72) were statistically independent factors associated with OF development. When applied in linear regression comparison of the pairs, these variables yielded an r2 = 0.48, imputing 48% of the difference in delivery outcome between the pairs was explained by these variables. Among the 38 pairs who were primigravida, the independent variables were more kilometers travelled to the delivery site (1.02, 1.00 - 1.05), village, not town, residence (50.0, 10.2 - 248.7), and facility intended for lower patient acuity (3.7 s, 1.01 - 13.6, r2 = 0.66) patients who were matched on parity and tribe, the significant risk factors were professional status (OR = 0.29), greater distance travelled to the clinic (OR = 1.02, 1.01 - 1.02), village, not town, residence (5.52, 2.72 - 11.2), and mother’s lower professional status (2.95, 1.53 - 5.72) when the OF occurred. Conclusions: Our study showed biological and social factors associated with the development of OF. Shorter height was the only biological risk factor found to be statistically significant in the study population. Other factors were related to limited resources and limited access to medical care.

Coping with Recession in the Ski Industry: A Suppliers’ and Consumers’ Perspective

The current study explores the impact of the recession on the ski industry based on interviews with suppliers in two ski resorts (n=10) as well as ski travel agencies (n=8). Subsequently, Flemish ski tourists (n=252) were surveyed about changes in their behavior towards ski vacations from 2008 to 2011, taking into account their socio-cultural background as well their level of ski/snowboard participation. Both studies reveal a decline in ski tourism during the years under investigation. The impact of the recession varies according to the type of sports provider. The impact of the recession on ski vacations is more prevalent for some groups in society (e.g., households with no children, more financial constraints, lower professional status, younger people), regardless if one is a highly motivated and/or experienced skier. This paper contributes to socio-economic theory related to the ski tourism industry and assists suppliers to identify strategies to overcome hurdles during a recession.

From medium to pedagogy: ‘fun and colourful’ lessons as a model for trainee teachers in further education colleges – questioning the postmodernist constructivist approach to classroom practice

As a result of the ‘fragmented and largely isolated traditions of pedagogy’ in the vastly diverse further education (FE) sector, initial teacher training (ITT) courses have been difficult to design and implement. Nevertheless, the historical requirement for FE teachers to possess a teaching qualification – although now removed – has raised their historically low professional status, from unqualified instructor or trainer, to qualified teacher. No sooner are we celebrating this initiative, when a new problem arises, a problem that threatens to undermine the value of both FE teaching qualifications and ITT provision at FE colleges: a postmodernist constructivist approach that is rapidly replacing a tradition of direct instructional guidance in the ITT classroom. Under this increasingly popular scheme, trainee FE teachers are encouraged to explore and discover educational concepts for themselves, by way of discussion groups, collaborative research, and an assortment of interactive and student-led tasks that emphasise learner enjoyment, interest and motivation. This is being applied across ITT courses at a number of FE colleges, regardless of the subject and level taught by trainee teachers. It is increasingly being described as ‘modelling’ for the trainee’s own lessons with his or her learners. Nevertheless, research shows that this postmodernist constructivist approach is not a pedagogy and that it does not automatically lead to higher student achievement. The article concludes with an appeal to balance postmodernist constructivist approaches to education with didactic instruction, in the belief that such a balance will not compromise learners’ skills and expertise in their future employment.

Lessons for regulating informal markets and implications for quality assurance – the case of migrant care workers in Austria

ABSTRACTThe rising number of private care arrangements in which live-in migrant care workers are engaged as a functional equivalent to family care calls for special attention by policy makers and formal long-term care providers on their implications for quality assurance and professional standards in the long-term care sector. Austria is one of the first countries in Europe where tangible legal measures have been taken to regulate this area under the heading of ‘24-hour care’, typically provided by middle-aged women. Reform measures went beyond policing and control mechanisms, including also incentives and tangible subsidies for all stakeholders. This paper contributes to a better understanding of their impact on the transition from informal to formal economy, focusing on quality assurance and working conditions. Based on empirical data and findings from semi-structured interviews with relevant stakeholders, a framework for the analysis of ‘illegal markets', based on Beckert and Wehinger's theory, is used to discuss potential implications in terms of valuation, competition and co-operation for policy in Austria, and to draw lessons for other countries. Results indicate that even after efforts to ‘legalise’ migrant care, the sector remains a ‘grey’ area within modern labour market legislation and quality management. This is due to the very nature of personal care, low professional status associated with care work and the reluctance of political stakeholders to regulate private household activities.

Gender segregation as a benefit - a qualitative study from Pakistan.

To explore the possibility of exploiting gender segregation as a benefit for registered female nurses. Nursing is a highly gendered profession in Pakistan with 95% of nurses comprising females who suffer from low professional status, negative identity and unfavourable work environments. A qualitative research design was used to interview 12 nurses in management positions through purposive sampling. Face-to-face in-depth interviews were conducted to explore the views of female nurses on the benefits, if any, of gender segregation in the nursing profession. Content analysis identified three major categories of benefits of gender segregation for female nurses including: (1) demand for female nurses compared with demand for males, (2) resilience of female nurses in the face of difficult work environments and (3) comfort and safety of female co-workers in a male-dominated setting. Realising the benefits of gender segregation could mobilise nurse teamwork and union efforts in order to improve nurse identity, professional status and work environments. The present study highlights the nurse manager role in advancing knowledge of gender segregation benefits, team-building for gender solidarity, control of nurse supply, union mobilization and raising community awareness for women's health development.

The teaching of social sciences in health: between practice and theory

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

Challenges of social workers' involvement in the recovery of the 5.12WenchuanEarthquake inChina

This article explores the challenges of social workers' involvement in recovery work of the 5.12WenchuanEarthquake (12May 2008). Six social workers working in three social work stations inSichuan,China, were asked to report the challenges they faced in working with disaster survivors. Findings reveal that the social workers faced many challenges. These include lack of government support, low professional status of social work, rapid changes in the social environment in disaster‐affected areas, lack of supervision, lack of cooperation and coordination among social service agencies, and lack of experience and knowledge in working with disaster survivors. The practical, educational and policy implications of the findings are addressed.

George Braine: Nonnative Speaker English Teachers: Research, Pedagogy, and Professional Growth.

Today we live in a very interesting world. The English language, spoken approximately by two billion people in varying degrees of proficiencies (Graddol 2006), is now considered to be ‘the world's first truly global language’ (Crystal 2004: 4) and believed to have ‘touched the lives of so many people, in so many cultures and continents, in so many functional roles, and with so much prestige’ (Kachru 1990: 5). What makes this picture even more interesting is that it is acknowledged that non-native English speakers (NNSs) are estimated to outnumber their native speaker (NS) counterparts by three to one (Crystal 2003). Therefore, there is a growing realization that the ownership of English is shared by all its speakers, regardless of their ‘nativeness’ (Widdowson 1994). English language teachers, particularly non-native English-speaking teachers (NNESTs) comprising 80% of the world's English teacher labour force (Canagarajah 2005), have a unique role in the global triumph of English. Nevertheless, they are frequently perceived and treated at a lower professional status as compared with native English-speaking teachers (NESTs), which leads to unprofessional favouritism in many settings (Medgyes 2001) and unfair employment discrimination (Selvi 2010). Problematizing the politically and ideologically driven concept of ‘native speaker’ (Davies 1991), and demystifying the prevalent assumption that ‘the ideal teacher of English is a NS’ [a phenomenon (Phillipson 1992) calls the ‘NS fallacy’] paved the way to a reconceptualization of pedagogical and professional legitimacy in the NS/NNS dichotomy. These efforts have been institutionalized by the promotion of anti-discriminatory practices such as issuing position statements (TESOL 1992; 2006) and the establishment of the Non-native English-speaking Teachers Caucus within TESOL, Inc. and thereby planted the seeds for the emergence of a viable area of research: the NNEST movement. This legitimate area of research has exponentially grown in the last two decades and expanded in both depth and width and has resulted in several edited volumes (Braine 1999; Kamhi-Stein 2004; Llurda 2005; Mahboob 2010), nearly 200 scholarly journal and newsletter articles, tens of MA theses and PhD dissertations. In this picture, George Braine's latest contribution to the NNEST movement, Nonnative Speaker English Teachers: Research, Pedagogy, and Professional Growth, requires attention for two reasons. First, in a single-authored volume, it presents a coherent and accessible reading about the developmental trajectory and future directions of the movement. Secondly, it was written by one of the forefathers and highly acclaimed leaders of the NNEST movement, George Braine, who himself is a prolific researcher and dedicated NNEST, and the founder of the NNEST Caucus within TESOL, Inc.

Perception of budgetary control: a study of differences across managers in Swedish public primary healthcare related to professional background and sex

The composition of managers in Swedish public primary care centres has changed since the mid-1990s, favouring nurses and female managers. In parallel, health-care professionals have become more involved in the management structure and many have experienced an increased demand for cost containment. There is limited empirical evidence about how managers with different professional backgrounds perceive tight budgetary control. To examine whether perceptions of tight budgetary control across managers in Swedish public primary care are related to personal characteristics such as professional background and sex. A questionnaire measuring perception of tight budgetary control was administered to all (636) identified managers in Swedish public primary care centres (response rate was 59%). Differences between groups were analysed through logistic regression and factor analysis. Nurses and other non-physicians perceived the budgetary control to be tighter than did physicians and female physicians perceived the budgetary control to be tighter than did male physicians. Results suggest that nurses were more committed to the budgetary control system and county council objectives than physicians. The impact of these differences are uncertain, however, nurses' capacity to influence primary care services may be more limited compared with physicians because of their lower professional status.

Läraren som konkurrensmedel - Kunskapskälla, ,stödperson eller icke-person

The purpose of the article is to show empirically how upper-secondary schools describe, understand and present teachers in their external communication. The ambition is to demonstrate to what extent and how teachers’ competencies are stressed by local school management in a competitive setting. Swedish upper-secondary schools’ Internet communication to external audiences is content analyzed. Private and public schools are compared. The study finds that teachers’ qualities and competencies are rarely communicated. Other aspects are emphasized. When teachers are mentioned, it is usually as a depersonalized category whose function is stressed, for example the role of the teacher in the pedagogical concept or idea that the school adopts. In practice, no differences between private and public schools are found. The findings of the study can be understood in the context of the ongoing discussion on teachers’ status. By being “non-existent” in the external communication, the image of the teachers as a group with low professional status is sustained.

Other people's children: Single women and residential childcare in mid-20th century England

This article compares the conditions of service for unmarried women working as house mothers in institutions run by a local authority and a voluntary association (the National Children's Homes) in mid-20th-century England. It explores the different organizational structures within which these women were employed and examines tensions relating to class, gender, occupational and marital status and emotional labour. It concludes that there were conflicts between the high value that was attached to these women's perceived role as nurturers for Britain's citizens of the future and their relatively low professional and economic status. In the case of the local authority, who believed married couples were most suitable for this kind of work, tensions were exacerbated by the women's marital status. Women working in this field often made a high level of personal investment and this was recognized in the National Children Homes, which offered workers a professional training, pay structure and retirement provision. However in both the case histories the hard physical and emotional labour performed by these women and the organizational structures within which their work was located put them under considerable strain, making it difficult for them always to offer the continuity of care the children needed.

‘I think it's a good idea, I just don't know how to do it’: The struggle for PE reform in China

Among the many changes occurring across Chinese society in the early phase of Y2K is the construction and implementation of a new physical education (PE) curriculum. Not unlike recent changes in Australia, New Zealand and the UK, this process has seen a heightening of the emphasis on health. Presented within a wider framework for making the school curriculum more relevant, PE is more closely aligned with China's emerging population health concerns around lifestyle practices of its youth. Foremost here are burgeoning social anxieties about decreased levels of physical activity, poor dietary practices, risk-taking tendencies, and a general shift in focus from ideology to skills. This paper reports on a study undertaken to explore the perceptions of Chinese PE teachers and their engagement with the new PE & Health curriculum. The data reveals a number of structural, personal and cultural factors that work against PE teachers taking up the opportunities presented in the new curriculum. Prominent here are; low professional status, lack of resources, lack of training and the grip of deeply rooted cultural values.

Intimate partner violence against women in rural Vietnam - different socio-demographic factors are associated with different forms of violence: Need for new intervention guidelines?

BackgroundThis population-based study investigated the different forms, magnitude and risk factors of men's violence against women in intimate relationships in a rural part of northern Vietnam and whether a difference in risk factors were at hand for the different forms of violence. Vietnam has undergone a rapid transition in the last 20 years, moving towards a more equal situation for men and women however, Confucian doctrine is still strong and little is known about men's violence against women within the Vietnamese family.MethodsThis is a cross-sectional population-based study that used a questionnaire developed by the World Health Organisation for investigating women's health and violence against women in different settings. Face-to face structured interviewing was performed and 883 married women, aged 17 to 60 participated. Bi- and multivariate analyses was used for risk factor assessment.ResultsThe lifetime prevalence of physical violence was 30.9 percent and past year prevalence was 8.3 per cent, while the corresponding figures for physical and sexual violence combined was 32.7 and 9.2 percent. The lifetime prevalence was highest for psychological abuse (27.9 percent) as a single entity. In most cases the violence was of a severe nature and exercised as repeated acts over time. Woman's low educational level, husband's low education, low household income and the husband having more than one wife/partner were risk factors for lifetime and past year physical/sexual violence. The pattern of factors associated with psychological abuse alone was however different. Husband's low professional status and women's intermediate level of education appeared as risk factors.ConclusionMen's violence against women in intimate relationships is commonly occurring in rural Vietnam. There is an obvious need of preventive and treatment activities. Our findings point at that pure psychological abuse is different from physical/sexual violence in terms of differing characteristics of the perpetrators and it might be that also different strategies are needed to reduce and prevent this violence.

Troubles de l’adaptation : étude clinique d’une population hospitalière tunisienne

The objectives of this study were to determine the frequency of adjustment disorders in psychiatric hospital and to establish the clinical and evolutional profiles of these disorders. A descriptive and retrospective study with approximately 115 patients hospitalized a first time in a psychiatric setting of the university hospital of Monastir in Tunisia for adjustment disorders according to the DSM-IV. The frequency of adjustment disorders in a psychiatric hospital was estimated at 11,8 %. The majority of patients were young (65,3 % between 16 and 20), female (60,9 %), of low professional and socio-economical status, and without any psychiatric history (59,1 %). The acute appearance of adjustment disorders caused by psychosocial stress factors which were usually various (60 %), recent (61,7 %) and with a high severity (69,6 %). The suicide attempts were frequent (53 %) representing the first reason for hospitalization. An evolution was favourable in 75,7 % of cases after a short hospitalization (about 8,2 days). Finally, the authors insist on the short hospitalization in order to provide evaluation, observation and treatment setting for these disorders.

Job-related stress among nursing personnel in Greek dialysis units.

The purpose of this study was to describe specific work-related factors that contribute to increased levels of stress experienced by nursing personnel, and to compare their impact on nurses and assistant nurses who work in Dialysis Units (DU) to those who work in Peritoneal Dialysis Units (PDU) in Greece. The sample of the study consisted of 682 members of nursing personnel working in DU and in PDU in Greek Hospitals. The collection of data was done by means of a questionnaire. The latter included questions about the motivation of nursing personnel for having chosen to work in these units along with questions about the stress factors related to the patients and their care, the role of the nurse in the unit, and the working conditions. According to the results of the study, the percentage of nursing personnel working in DU or PDU by their own choice was 71% and 8.3% respectively, whereas the rest of the staff were placed there irrespective of their preferences, by the Administrators. Among nursing personnel who had chosen to work in DU, the reported motives that contributed to their decision were the absence of a night shift (27.8%), and working in a closed unit. The main motive that incited nursing personnel to work in PDU was the acquisition and the application of specialized knowledge. The percentage of nursing personnel working in DU that expected high levels of job satisfaction was 77%, whereas the corresponding percentage for nursing personnel working in PDU was 65%. However, only 44% and 37% of the nursing personnel working in DU and PDU reported high levels of job satisfaction. The most important stressors related: i) To the patient: were the risk of contamination (79% DU, 84% PDU) and the death of a patient (77% DU, 80% PDU). 2) To the role of nursing personnel in the unit: were increased responsibilities (65% DU, 37% PDU), low involvement of the nursing personnel in decision making (58% DU, 54% PDU), and low professional status of nursing personnel. 3) To the working conditions: were the shortage of nursing personnel (74% DU, 99% PDU), limited material (74% DU, 57% PDU), the closed environment (75% DU, 64% PDU) and the daily work routine (78% DU, 61% PDU). In conclusion, we can say that working in DU and PDU provokes increased stress in nursing personnel, even though the implicated stress factors differ between these units.

Is mental health work psychologically hazardous for staff? A critical review of the literature

Recent studies have highlighted the poor mental health of healthcare workers. This paper hypothesises that mental health staff in particular, face risks to their mental health. The relevant literature is reviewed to investigate this, and explores whether patient contact or other work factors may predict poor staff mental health. The review reveals that despite methodological flaws in the existing research, there is sufficient evidence to conclude that mental health work may be psychologically hazardous for staff. Contributing factors are likely to include intensive contact with severely ill patients, low professional status, organisational change and task characteristics such as inadequate feedback, uncertainty about role and low support. Future research should aim to clarify mechanisms by which psychiatric work may affect staff. A more detailed understanding could allow jobs to be designed in such a way that risks to staff mental health are minimised. the theoretical

Impairment and work disability due to whiplash injury following traffic collisions. An analysis of insurance material from the Swedish Road Traffic Injury Commission.

A study was set up to determine the trends in medical impairment and work disability ratings for persons affected by whiplash associated disorders (WAD) and other injuries secondary to road traffic collisions, and into the influence of age, gender, professional status, and final medical impairment rating on final work disability. A cross-sectional study was carried out of insurance files of 2,523 subjects in 1989 and 3,223 subjects in 1994 judged to have a permanent medical impairment of 10% or more and work disability due to road traffic injury. Files were obtained from the Swedish Road Traffic Injury Commission. The main outcome measures were the crude frequency and age-specific, standardized percentage of traffic injuries with a medical impairment of 10% or more for the years 1989 and 1994. Final work disability status was analysed with respect to age, gender, type of injury, degree of medical impairment, and professional status. The proportion of medical impairment due to WAD was found to have increased from 16% in 1989 to 28% in 1994, but the proportion of work disability was found to have remained the same. Age over 40 years, low professional status, and having a medical impairment judgement of 15% or more were independently associated with reduced or full work disability.

Com o olhar nos professores: Desafios para o enfrentamento das realidades escolares

A escola tem sido crescentemente focalizada, não só no Brasil, mas em outros países, constituindo importante fonte para a compreensão das realidades vividas e sofridas pela grande maioria das populações mais privilegiadas econômica, social e culturalmente. A bibliografia produzida pelos autores de tais estudos denuncia, de maneira contundente, a baixa qualidade educacional em vários países, expressa por problemas como indisciplina na sala de aula, precárias condições para o trabalho educativo, despreparo dos professores para realizar adequadamente seu trabalho, baixo status profissional e baixa remuneração, agravados no Brasil pelos alarmantes índices de evasão e repetência. Com o olhar nos professores, como comprometimento político e preocupação de pesquisa, desde o ano de 1984, nossos estudos permitem dizer que esse quadro de problemas não constitui um insucesso generalizado, mas representa, sobretudo, desafios a enfrentar.