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19 results

  • Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study

  • Louise M. Howard, Kylee Trevillion, Laura Potts, Margaret Heslin, Andrew Pickles, Sarah Byford, Lauren E. Carson, Clare Dolman, Stacey Jennings, Sonia Johnson, Ian Jones, Rebecca McDonald, Susan Pawlby, Claire Powell, Gertrude Seneviratne, Rebekah Shallcross, Nicky Stanley, Angelika Wieck, Kathryn M. Abel
  • Journal:
    The British Journal of Psychiatry / Volume 221 / Issue 4 / October 2022
    Published online by Cambridge University Press:
    04 May 2022, pp. 628-636
    Print publication:
    October 2022
    • Article
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  • Background

    Psychiatric mother and baby units (MBUs) are recommended for severe perinatal mental illness, but effectiveness compared with other forms of acute care remains unknown.

    Aims

    We hypothesised that women admitted to MBUs would be less likely to be readmitted to acute care in the 12 months following discharge, compared with women admitted to non-MBU acute care (generic psychiatric wards or crisis resolution teams (CRTs)).

    Method

    Quasi-experimental cohort study of women accessing acute psychiatric care up to 1 year postpartum in 42 healthcare organisations across England and Wales. Primary outcome was readmission within 12 months post-discharge. Propensity scores were used to account for systematic differences between MBU and non-MBU participants. Secondary outcomes included assessment of cost-effectiveness, experience of services, unmet needs, perceived bonding, observed mother–infant interaction quality and safeguarding outcome.

    Results

    Of 279 women, 108 (39%) received MBU care, 62 (22%) generic ward care and 109 (39%) CRT care only. The MBU group (n = 105) had similar readmission rates to the non-MBU group (n = 158) (aOR = 0.95, 95% CI 0.86–1.04, P = 0.29; an absolute difference of −5%, 95% CI −14 to 4%). Service satisfaction was significantly higher among women accessing MBUs compared with non-MBUs; no significant differences were observed for any other secondary outcomes.

    Conclusions

    We found no significant differences in rates of readmission, but MBU advantage might have been masked by residual confounders; readmission will also depend on quality of care after discharge and type of illness. Future studies should attempt to identify the effective ingredients of specialist perinatal in-patient and community care to improve outcomes.

  • 1 - Introduction

  • Edited by Matthew J. Burdelski, Kathryn M. Howard
  • Book:
    Language Socialization in Classrooms
    Published online:
    10 February 2020
    Print publication:
    13 February 2020, pp 1-26

  • Summary

    This chapter details how language socialization (LS) research has contributed to our understanding oflearning in classrooms. It describes the methodological and theoretical frameworks that underlie LS theory. It outlines five areas of LS and describes how they relate to classroom discourse: (1) indexicality, (2) practices, (3) ideologies, (4) power, authority, and agency, and (5) participation frameworks. It argues that the LS paradigm provides a unique and specific set of affordances for exploring the social and linguistic development of relative novices and theirlearning in classrooms involving teachers and peers. It asserts that LS theory and research contribute rich and socially situated understandings of children’s and other novices’ social worlds, their linguistic and social development, the interactions and learning modes that foster this development, and the broader fields of discourse, histories, and communities within which classrooms are situated. The chapter includes an overview of each section and its goals, explaining how each contribution instantiates the LS framework in ways that deepen our understanding of learning and development within classrooms.

Language Socialization in Classrooms
  • Culture, Interaction, and Language Development
  • Edited by Matthew J. Burdelski, Kathryn M. Howard
  • Published online:
    10 February 2020
    Print publication:
    13 February 2020
  • Classrooms are dynamic spaces of teaching and learning, where language and culture are intertwined in remarkable ways. The theory of language socialization explores how sociocultural practices in classrooms help to shape language learning and development. This collection is the first of its kind to bring together research on this fascinating concept. It presents ten case studies, based on linguistic and ethnographic research conducted in classrooms located within communities in North America, Europe and India, spanning learners from preschool, to primary and secondary school, to university. Following an introduction that discusses the theory and core concepts of language socialization, the volume is divided into three central themes: socializing values, dispositions, and stances; socializing identities; and language socialization and ideology. Both new and more experienced researchers will appreciate its new insights into how language socialization is carried out across the globe.

  • Breaking in and spinning out: Repetition and decalibration in Thai children’s play genres

  • KATHRYN M. HOWARD
  • Journal:
    Language in Society / Volume 38 / Issue 3 / June 2009
    Published online by Cambridge University Press:
    01 June 2009, pp. 339-363
    Print publication:
    June 2009

  • Children’s humorous play is a cultural activity with its own particular aesthetic – an aesthetic in which highly creative, incongruent, and unexpected speech and action are valorized, appreciated, and rewarded. Drawing on Bauman’s concept of calibration, the adjustments by which speakers align their intertextual utterances to new contexts and purposes, this paper argues that an aesthetic of decalibration is at work in children’s metalinguistic and metapragmatic language play. Children capitalize upon linguistic and pragmatic ambiguity to breach expectations, drawing on complex linguistic, contextual and pragmatic knowledge to create maximally humorous language play performances. Through close analysis of videotaped interactions from a larger ethnographic, discourse analytic study of northern Thai children’s everyday lives, this article examines how younger children are socialized into these practices of language play through peripheral participation in multi-age play groups, showing that the repetitive poetic structure and predictability of the play genres constitute jumping-off and breaking-in points for language play. (Calibration, repetition, children’s language, play, language socialization, Thai, humor)1