Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

The men behind the market: Merchants, the Atlantic slave trade, and the shaping of South Carolina plantation society, 1700–1756

The purpose of this dissertation is to examine the role played by merchants in the shaping of South Carolina plantation society in its early stages of development. In 1700 South Carolina was on the fringes of the British Empire. By mid-century the colony had become an integral part of the British Atlantic system. This dissertation addresses merchants' activity in the shaping of plantation society through their involvement in the Atlantic slave trade. Records of the British and South Carolina governments, and petitions from merchants on both sides of the Atlantic have been extremely valuable in understanding the complex and rapidly changing political affiliations of merchants on both sides of the Atlantic. These sources are valuable to this study since they illustrate the merchants' strategy of utilizing government policies to acquire the absolute best terms of trade. Records such as wills and inventories yielded valuable information on merchants' economic portfolios and provided valuable insight into their personal lives. The data shows that the integration of Colonial South Carolina into the global economy can be attributed to its merchant class, who actively sought out business opportunities in the global economy while working within the framework of British mercantilism.

The response to an ESL population boom in the Beaufort County, South Carolina school system: A case study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers.^ Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers' recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. ^ The findings from the teachers' interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes.^ Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County's ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County's schools. Finally, recommendations for further research are provided.^

The Response to an ESL Population Boom in the Beaufort County, South Carolina School System: A Case Study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers. Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers’ recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. The findings from the teachers’ interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes. Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County’s ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County’s schools. Finally, recommendations for further research are provided.