Objective: The Australian health workforce is experiencing workforce shortages like many other countries. Managing retention is one important element of workforce planning. Determining the drivers of retention in midwifery can assist workforce planning. The objective of this study was to determine the factors that contribute to the retention of midwives, that is, why do midwives stay?Design: A descriptive design was undertaken in two phases. Phase One used focus groups to adapt a questionnaire used in the 'Why Midwives Stay 'study in England for the Australian context. Phase Two used the questionnaire to collect qualitative and quantitative data.
Setting:One area health service in New South Wales, Australia.Participants: 392 midwives employed in the area health service either full-time, part-time or on a casual basis were invited to participate and 209 (53%) responded.
Findings:The majority of respondents were women aged 23-69 years (mean age 42 years). Just over half had received their midwifery qualification through the hospital-based system which was usual prior to 1994 reflecting the age of the cohort. The top three reasons for staying in midwifery were 'I enjoy my job', 'I am proud to be a midwife' and 'I get job satisfaction'. Job satisfaction was received when midwives felt that they made a difference to women, had positive interactions with women in their care and saw women happy. The motivation to keep going was achieved through having a positive outlook; having job satisfaction; and, having work colleagues with a sense of belonging.
Implications for practice:The findings have implications for the organisation of care, models of care, and management systems. Health services and departments of health need to consider these issues especially in an environment of workforce shortages. Addressing the way care is arranged and how staff are supported may lead to higher retention rates, thus reducing costs.
SummaryThe outcome of adult respiratory distress syndrome complicating cardiopulmonary bypass has changed little in recent years. A retrospective, case-controlled study was designed to assess the incidence of the adult respiratory distress syndrome in these circumstances and the extent to which it could be linked with pre and peri-operative predictive factors. Eleven patients who developed the syndrome out of 840 who underwent cardiopulmonary bypass over a 9 month period were compared with 53 controls matched for sex, operation and surgeon. The incidence of adult respiratory distress syndrome and its mortality were 1.3% and 53% respectively. Signifcant predictors were a high intra and postoperative intervention score, the total volume of blood pumped during bypass ( > 300 I ) and age ( > 60 years). These risk factors should alert the clinician to the possibility of severe postoperative pulmonary complications.
Precarious manhood beliefs portray manhood, relative to womanhood, as a social status that is hard to earn, easy to lose, and proven via public action. Here, we present cross-cultural data on a brief measure of precarious manhood beliefs (the Precarious Manhood Beliefs scale [PMB]) that covaries meaningfully with other cross-culturally validated gender ideologies and with country-level indices of gender equality and human development. Using data from university samples in 62 countries across 13 world regions ( N = 33,417), we demonstrate: (1) the psychometric isomorphism of the PMB (i.e., its comparability in meaning and statistical properties across the individual and country levels); (2) the PMB’s distinctness from, and associations with, ambivalent sexism and ambivalence toward men; and (3) associations of the PMB with nation-level gender equality and human development. Findings are discussed in terms of their statistical and theoretical implications for understanding widely-held beliefs about the precariousness of the male gender role.
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Elucidating dissolution kinetics and mechanisms at carbonate mineral-water interfaces is essential to many environmental and geochemical processes, including geologic CO(2) sequestration in deep aquifers. In the present work, effects of background electrolytes on dolomite (CaMg(CO(3))(2)) reactivity were investigated by measuring step dissolution rates using in situ hydrothermal atomic force microscopy (HAFM) at 90 °C. Cleaved surfaces of dolomite were exposed to sodium chloride and tetramethylammonium chloride (TMACl) aqueous solutions with ionic strengths (I) ranging from 0 to 0.77 m at pH 4 and pH 9. HAFM results demonstrated that dolomite step retreat rates increased with increasing solution ionic strength and decreasing pH. Comparison of [481] and [441] steps revealed that the anisotropy of [481] and [441] step speeds became significant as solution ionic strength increased, with NaCl exerting more pronounced effects than TMACl for the same I. To interpret the different trends observed for NaCl and TMACl, a dissolution mechanism involving orientation-dependent ion adsorption and consequent edge free energy changes is proposed.
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