Maternity care experiences of Asia ethnic minorities in rural Tasmania, Australia : a mixed methods study

When migrating to Australia Asian women bring with them birthing cultural beliefs and practices, many of which are different from the Australian medical and cultural understanding of reproduction. Such cultural differences may result in conflicts between clients and health care providers especially when the migrants have a poor knowledge of English. The research investigates the maternity care experiences of Asian migrants in Tasmania. The barriers that Asian migrants face in accessing maternity care services and the factors that affect their views towards maternity care were also explored. A mix of quantitative and qualitative methods was employed. Ten women from different ethnic minorities were invited to semi-structured interviews. The qualitative data were analysed using grounded theory. Findings from the interviews were utilized to design a survey questionnaire. Of the 150 survey questionnaires posted, 121 questionnaires were returned. Descriptive statistics and Chi-square tests of independence were used to analyse the quantitative data. Asian migrants followed some traditional practices such as having good rest and eating hot food during the postpartum month. However, they tended to adapt or disregard traditional practices that were no longer applicable in the new environment including the practices of not washing or having a shower. Support is vital for women recovering after childbirth to prevent postnatal depression. Two main barriers migrant women face in accessing health care are language and cultural barriers. Country of origin, partner’s ethnicity, religion and length of stay in Australia are factors that shape the migrants’ views and attitudes towards and experience of maternity care. Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers are recommended to improve available maternal care services. The factors that affect migrants’ view on maternity care should be taken into account when providing maternity care for Asian migrant women.

Retention mechanism divergence of a mixed mode stationary phase for high performance liquid chromatography

Mixed mode stationary phases utilize secondary retention mechanisms to add a dimensionality to the surface of high performance liquid chromatography (HPLC) adsorbents. This approach was used by several authors to improve the separation performance of single dimension separations. We explored the magnitude of these secondary interactions by performing an off-line two-dimensional (2D)-HPLC separation with a Scherzo SM-C18 column of a β-lactoglobulin tryptic digest with a mobile phase pH of 7 in the first dimension and 2 in the second. Mechanism divergence was determined using the peak capacity and a geometric approach to factor analysis, to measure the correlation. This separation was repeated with a C18 stationary phase as a control. It was found that the C18 column had a correlation coefficient of 0.784, smaller than the mixed mode column, 0.884. This indicated that the retention mechanisms of the C18 column were more divergent under these two pH environments than the mixed mode column. However, the SM-C18 still provided alternative selectivity of the peptides to that of the C18 and could be considered as a good alternative for further 2D-HPLC separations.

Factors to drive clinical practice improvement in a Malaysian intensive care unit : assessment of organisational readiness using a mixed method approach

This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identified as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.

Latent patient profile modelling and applications with mixed-variate restricted Boltzmann machine

Efficient management of chronic diseases is critical in modern health care. We consider diabetes mellitus, and our ongoing goal is to examine how machine learning can deliver information for clinical efficiency. The challenge is to aggregate highly heterogeneous sources including demographics, diagnoses, pathologies and treatments, and extract similar groups so that care plans can be designed. To this end, we extend our recent model, the mixed-variate restricted Boltzmann machine (MV.RBM), as it seamlessly integrates multiple data types for each patient aggregated over time and outputs a homogeneous representation called "latent profile" that can be used for patient clustering, visualisation, disease correlation analysis and prediction. We demonstrate that the method outperforms all baselines on these tasks - the primary characteristics of patients in the same groups are able to be identified and the good result can be achieved for the diagnosis codes prediction.

Constitutionalism, good faith and the doctrine of specific performance: rights, duties and equitable discretion

This article will explore the European roots of the doctrine of specific performance and the influence of transformative constitutionalism on these in recent times. The question whether specific performance is available as of right (as in the civil law), or only subject to judicial discretion (as in the common law), will be investigated. The demonstrated impact of constitutional rights on contract law in the mixed system of South Africa will be contrasted with developments in English and Australian contract law, where the common-law rules are more deeply entrenched and the potential scope for human rights-based development of these is arguably smaller, though still important. The article will argue, using comparative rules on specific performance as an example, that the concept of a duty of good faith or contractual fairness is likely to play a greater role in future in all three of the countries under consideration, reducing the common/civil/mixed legal systems divide.

A mixed mode low profile solar tunnel dryer for canarium indicum nuts

Canarium indicum nuts are dried and consumed widely across the Pacific Region. Traditional methods of drying offer little process control resulting in highly variable product quality and loss. A more reliable and effective drying technology is required but the technology must suit local conditions. This paper describes a low profile solar tunnel dryer designed for batch drying of small quantities of the nuts. Prototypes have been tested. Experimental results indicate that drying temperatures are within the range to achieve good kernel quality and that the desired final moisture content for safe storage could be achieved after 30 hours of exposure.

Tumor talk and child-well being: perceptions of 'good' and 'bad' news among parents of children with advanced cancer

CONTEXT: Little is known about how parents of children with advanced cancer classify news they receive about their child's medical condition.

OBJECTIVE: To develop concepts of "good news" and "bad news" in discussions of advanced childhood cancer from parent perspectives.

METHODS: Parents of children with advanced cancer cared for at three children's hospitals were asked to share details of conversations in the preceding 3 months that contained "good news" or "bad news" related to their child's medical condition. We used mixed methods to evaluate parent responses to both open-ended and fixed response items.

RESULTS: Of 104 enrolled parents, 86 (83%) completed the survey. Six (7%) parents reported discussing neither good nor bad news, 18 (21%) reported only bad news, 15 (17%) reported only good news, and 46 (54%) reported both good and bad news (1 missing response). Seventy-six parents (88%) answered free response items. Descriptions of both good and bad news discussions consisted predominantly of "tumor talk" or cancer control. Additional treatment options featured prominently, particularly in discussions of bad news (42%). Child well-being, an important good news theme, encompassed treatment tolerance, symptom reduction, and quality of life.

CONCLUSION: A majority of parents of children with advanced cancer report discussing both good and bad news in the preceding 3 months. While news related primarily to cancer control, parents also describe good news discussions related to their child's well-being. Understanding how parents of children with advanced cancer classify and describe the news they receive may enhance efforts to promote family-centered communication.