Midwifery management of second-degree perineal tears in New Zealand: A cross-sectional survey of practice

Background

Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.

NATURAL HEALTH DISCOURSES AND THE THERAPEUTIC PRODUCTION OF CONSUMER RESISTANCE

Social critics of the natural health movement charge that it indoctrinates consumers in a therapeutic consumerist ideology. This "dominated consumer" thesis ignores that socially situated individuals must negotiate a plethora of institutionally specific power structures aiming to classify and govern their identities. Accordingly, resistance toward specific institutional constructions of identity can be produced through marketplace ideologies. I explore this understudied ideological effect by analyzing the narratives of women who are using natural health alternatives to resist their ascribed medico-administrative identities. Natural health's therapeutic ideology enables these women to contest the degenerative implications of their medical diagnoses and, conversely, to reconstruct their chronic illnesses as an opportunity for discovering their inner regenerative potential and expanding their spiritual horizons. This analysis has implications for prior studies suggesting that resistance toward the technocratic and bureaucratic aspects of conventional medicine exemplifies a Foucauldian "care of the self." I argue that a postmodern adaptation of Foucauldian theory is needed to address the complex interrelationships among the care of the self, medical consumerism, and the therapeutic ideology of the natural health marketplace.     

Marginal and association regression models for longitudinal binary data with drop‐outs: A likelihood‐based approach

Longitudinal data often contain missing observations, and it is in general difficult to justify particular missing data mechanisms, whether random or not, that may be hard to distinguish. The authors describe a likelihood‐based approach to estimating both the mean response and association parameters for longitudinal binary data with drop‐outs. They specify marginal and dependence structures as regression models which link the responses to the covariates. They illustrate their approach using a data set from the Waterloo Smoking Prevention Project They also report the results of simulation studies carried out to assess the performance of their technique under various circumstances.     

Higher education outcomes, graduate employment and university performance indicators

Summary.  Official employment-related performance indicators in UK higher education are based on the population of students responding to the 'First destination supplement' (FDS). This generates potentially biased performance indicators as this population of students is not necessarily representative of the full population of leavers from each institution. University leavers who do not obtain qualifications and those who do not respond to the FDS are not included within the official analysis. We compare an employment-related performance indicator based on those students who responded to the FDS with alternative approaches which address the potential non-random nature of this subgroup of university leavers.     

Tasmania Together? A disability critique of a social plan

The 'Tasmania Together' social futures plan for Tasmania is critically examined. Authored by a Tasmanian Government appointed Community Leaders Group, on behalf of the people of Tasmania, the plan is supposed to deliver a better Tasmanian society by 2020, based upon community consultation. Rather than a step-forward in democracy, the process serves to remove the democratic rights of people, especially those who are disadvantaged. A critique from a disability perspective is offered, which suggests that this social plan constitutes a form of institutionalised disablism.     

Valuation of childhood risk reduction: the importance of age, risk preferences, and perspective.

This article explores two problems analysts face in determining how to estimate values for children's health and safety risk reductions. The first addresses the question: Do willingness‐to‐pay estimates for health risk changes differ across children and adults and, if so, how? To answer this question, the article first examines the potential effects of age and risk preferences on willingness to pay. A summary of the literature reporting empirical evidence of differences between willingness to pay for adult health and safety risk reductions and willingness to pay for health and safety risk reductions in children is also provided. The second dimension of the problem is a more fundamental issue: Whose perspective is relevant when valuing children's health effects—society's, children's, adults‐as‐children, or parents'? Each perspective is considered, followed ultimately by the conclusion that adopting a parental perspective through an intrahousehold allocation model seems closest to meeting the needs of the estimation problem at hand. A policy example in which the choice of perspective affects the outcome of a regulatory benefit‐cost analysis rounds out the article and emphasizes the importance of perspective.