Partner- and partnership-related risk factors for preterm birth among low-income women in Lima,Peru

A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy. Yet, with the notable exception of intimate partner violence, there has been little previous research addressing the associations between partner- or partnership-related factors and birth outcomes. This analysis tested the hypothesis that risk factors related specifically to partner or partnership characteristics increased the risk for preterm birth. Between 2003 and 2005, a total of 580 preterm cases (20–36 weeks gestational age at delivery) and 633 term controls (≥37 weeks) were selected from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a confidential, structured interview and provided biological specimens within 48 h after delivery. Multivariable logistic regression was used to assess associations between partner and partnership characteristics and preterm birth. After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (aOR = 1.91, 95% CI 1.22–2.99), ever having had anal sex (aOR = 1.40, 95% CI 1.07–1.84), having a current partner with a history of visiting prostitutes (aOR = 1.69, 95% CI 1.22–2.33), and perceiving one's current partner as a “womanizer” (aOR = 1.34, 95% CI 1.02–1.77) were significantly associated with an elevated risk of preterm birth when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with preterm birth risk (per additional partner risk factor: aOR = 1.31, 95% CI 1.16–1.49). These results highlight the importance of considering a broader set of risk factors for preterm birth, specifically those related to a woman's partner and partnership characteristics. Further research could clarify the specific mechanisms through which these partner and partnership characteristics may increase the risk of preterm birth.     

The parent-physician relationship in pediatric asthma care

OBJECTIVE: To examine the feasibility of using a behavioral coding system, the Five Minute Speech Sample (FMSS), to estimate the prevalence of relationship difficulties between parents and physicians in a pediatric asthma care setting. METHOD: The FMSS was administered to 20 parents of children with severe, chronic asthma and to the physicians they worked with during a brief day program admission. RESULTS: Rates of relationship difficulties between parents and physicians ranged from 15% to 40%, comparable to those previously identified in patient-therapist relationships in psychiatric populations. CONCLUSIONS: Although further information is needed about validity and reliability, the FMSS appears to provide clinically relevant information about the parent-physician relationship in the context of pediatric chronic illness.     

Joint commissioning across the primary health care–social care boundary: can it work?

General ideas about joint working have been commonplace in the UK for several decades and those more specifically about joint commissioning have been popular since the quasi-market reforms of the early 1990s. The Labour Government is now placing a heavy premium upon 'partnership working' and expects this to breathe new life into joint commissioning initiatives; especially those involving social care and primary health care. However, despite the relatively lengthy experience of joint commissioning, we still know very little about how it works in practice. This article reviews joint commissioning as a policy concept, describes some recent research findings and pulls out messages for policy and practice. It concludes that although effective joint commissioning is attainable, there can be no 'quick fix' at local level.     

PROSPER Community–University Partnership Model for Public Education Systems: Capacity-Building for Evidence-Based,Competence-Building Prevention

This paper presents a model to guide capacity-building in state public education systems for delivery of evidence-based family and youth interventions-interventions that are designed to bolster youth competencies, learning, and positive development overall. Central to this effort is a linking capacity agents framework that builds upon longstanding state public education infrastructures, and a partnership model called PROSPER or PROmoting School-community-university Partnerships to Enhance Resilience. The paper presents an overview of the evolving partnership model and summarizes positive results of its implementation over a 12-year period in an ongoing project.     

Interprofessional Education and Practice Guide No. 2: Developing and implementing a center for interprofessional education

Abstract

The complexity of implementing interprofessional education and practice (IPEP) strategies that extend across the learning continuum requires that institutions create a structure to support effective and organized coordination among interested administrators, faculty and staff. The University of Virginia Center for Academic Strategic Partnerships for Interprofessional Research and Education (UVA Center for ASPIRE) was formally established in 2013 following five years of dramatic growth in interprofessional education at the School of Nursing, School of Medicine and the UVA Health System. This guide briefly describes the steps that led to the creation of the Center and the key lessons learned that can guide other institutions toward establishing their own IPE centers.