Nausea and vomiting in pregnancy: Blooming or bloomin’ awful? A review of the literature

BackgroundNausea and vomiting in pregnancy (NVP) is a normal, commonly experienced affliction of early pregnancy. Despite this, its impact on women's lives is not necessarily minimal. For some women, the implications of NVP are substantial with multi-faceted effects, hindering their ability to maintain usual life activities, and particularly their ability to work. In an effort to understand the effect of NVP, several researchers have developed NVP measurement tools, which enable an understanding of NVP's effect on quality of life (QOL).ProblemThis paper seeks to provide a review of the literature to explore the impact of NVP on women's quality of life, particularly their ability to maintain social and professional commitments.MethodMedline, CINAHL, PsychINFO, Ebsco, Science Direct, Health Source, Academic Search Premiere, Cochrane databases were extensively searched using Boolean operators with various combinations of relevant terms: nausea, vomiting, pregnancy, emesis, quality of life, QOL, NVPQOL, PUQE, SF-12, SF-36 and limited to those published from 1999 onwards. Papers were scrutinised to include those discussing the impact of normal NVP on women's lives, particularly their QOL with careful exclusion of those addressing hyperemesis gravidarum (HG).FindingsNVP has a significant effect on women's QOL and therefore their ability to maintain day-to-day activities as well as work capacity. This has implications for the woman, her partner, her family and her employers.ConclusionIt is important that all maternity care workers consider the impact of NVP on the woman's QOL and that care is given not to minimise this experience. Further research is warranted which considers ways in which women can best manage this experience in relation to social and professional commitments. Given the authors were able to identify only one Australian study in this area, published in 2000 and utilising non-NVP specific QOL measurement tools, there exists scope for additional local studies using NVP-specific QOL tools to determine the impact of QOL for Australian women and therefore Australian society.     

Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature

ObjectiveTo undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.MethodOvid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) ‘making sense of evidence’ tools.FindingsAsian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries.ConclusionCurrent research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.     

What are the facilitators,inhibitors, and implications of birth positioning? A review of the literature

BackgroundFrom the historical literature it is apparent that birthing in an upright position was once common practice while today it appears that the majority of women within Western cultures give birth in a semi-recumbent position.AimTo undertake a review of the literature reporting the impact of birth positions on maternal and perinatal wellbeing, and the factors that facilitate or inhibit women adopting various birth positions throughout the first and second stages of labour.MethodsA search strategy was designed to identify the relevant literature, and the following databases were searched: CINAHL, CIAP, the Cochrane Database of Systematic Reviews, Medline, Biomed Central, OVID and Google Scholar. The search was limited to the last 15 years as current literature was sought. Over 40 papers were identified as relevant and included in this literature review.ResultsThe literature reports both the physical and psychological benefits for women when they are able to adopt physiological positions in labour, and birth in an upright position of their choice. Women who utilise upright positions during labour, have a shorter duration of the first and second stage of labour, experience less intervention, and report less severe pain and increased satisfaction with their childbirth experience than women in a semi recumbent or supine/lithotomy position. Increased blood loss during third stage is the only disadvantage identified but this may be due to increased perineal oedema associated with upright positions. There is a lack of research into factors and/or practices within the current health system that facilitate or inhibit women to adopt various positions during labour and birth. Upright birth positioning appears to occur more often within certain models of care, and birth settings, compared to others. The preferences for positions, and the philosophies of health professionals, are also reported to impact upon the position that women adopt during birth.ConclusionUnderstanding the facilitators and inhibitors of physiological birth positioning, the impact of birth settings and how midwives and women perceive physiological birth positions, and how beliefs are translated into practice needs to be researched.     

Does antenatal education affect labour and birth? A structured review of the literature

ObjectiveTo undertake a structured review of the literature to determine the effect of antenatal education on labour and birth, particularly normal birth.MethodOvid Medline, CINAHL, Cochrane and Web of Knowledge databases were searched to identify research articles published in English from 2000 to 2012, using specified search terms in a variety of combinations. All articles included in this structured review were assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).FindingsThe labour and birthing effects on women attending antenatal education may include less false labour admissions, more partner involvement, less anxiety but more labour interventions.ConclusionThis literature review has identified that antenatal education may have some positive effects on women's labour and birth including less false labour admissions, less anxiety and more partner involvement. There may also be some negative effects. Several studies found increased labour and birth interventions such as induction of labour and epidural use. There is contradictory evidence on the effect of antenatal education on mode of birth. More research is required to explore the impact of antenatal education on women's birthing outcomes.     

Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature

BackgroundYoung pregnant women who continue a pregnancy are primarily from a socioeconomically deprived background. The risk factors associated with low socio-economic status may independently affect perinatal and neonatal morbidity to a greater extent than the young age of the woman. Young pregnant women are frequently sceptical about health care providers who they can perceive to be judgemental. This may lead to late booking for pregnancy care, attending few appointments, or not attending the health service for any antenatal care.QuestionDoes the way maternity care is provided affect maternal and neonatal outcomes for young women?MethodA systematic search of the major health databases.ResultsNine research articles met the eligibility criteria: one randomised controlled trial, three prospective cohort studies, two comparative studies with concurrent controls, two comparative studies with historical controls, and one case series.DiscussionProviding young women with a non-standard model of maternity care has some beneficial and no known detrimental effects on childbirth outcomes. While there is a dearth of evidence on the effectiveness of a Midwifery Group Practice model of care for young women, there is strong evidence to suggest that a Group Antenatal Care model increases antenatal visit attendance and breastfeeding initiation, and decreases the risk of preterm birth. There is research to indicate that a Young Women's Clinic model may also increase antenatal visit attendance and decrease the incidence of preterm birth.ConclusionMore well-designed and resourced midwifery models of care for young women should be implemented and rigorously researched.     

How do health professionals support pregnant and young mothers in the community? A selective review of the research literature

BackgroundThe cultural phenomenon of “teenage pregnancy and motherhood” has been socially constructed and (mis)represented in social and health care discourses for several decades. Despite a growing body of qualitative research that presents an alternative and positive view of young motherhood, there remains a significant gap between pregnant and young women's experience of young motherhood and current global health and social policy that directs service delivery and practice.AimThis paper aims to heighten awareness of how a negative social construction of young motherhood influences global health and social policy that directs current community health models of practice and care for young mothers in the community.DiscussionThere is clear evidence on the vital role social support plays in young women's experience of pregnancy and motherhood, particularly in forming a positive motherhood identity. This discussion paper calls us to start open and honest dialogue on how we may begin to re-vision the ‘deficit view’ of young motherhood in order to address this contradiction between research evidence, policy discourse and current practice and service provision. Qualitative research that privileges young women's voices by considering the multidimensional experiences of young motherhood is an important step towards moving away from universally prescribed interventions to a non-standard approach that fosters relational and responsive relationships with young mothers that includes addressing the immediate needs of young mothers at the particular time.     

Personal networks and the incomes of men and women in the United States: Do personal networks provide higher returns for men or women?

Despite the many studies focusing on the relationship between social networks and labor market outcomes, few have examined differences in returns to personal networks by gender. Informed by the Social Resources Theory, this study tests whether various types of employment job search networks provide greater returns for males or females. Of the few studies examining gender differences, some find that the benefits of social networks are specific to males; others maintain that they also extend to females, and others argue that the benefits are greater for females than males. There are several limitations of the studies focusing on gender and social networks within the labor market. Such studies have not employed nationally representative datasets. They also neglect important distinctions between various types of personal networks. In this study, these limitations are rectified. A nationally representative dataset, the 2002 General Social Survey, is employed to address how personal networks operate for men and women within the US labor market. Additionally, various types of personal networks are employed to enable a more nuanced approach than previous research. The study provides evidence that social networks provide higher returns to women than men, as women receive returns from their networks while men do not.     

A simple method for projecting or estimating α and β: An extension of the Brass Relational Gompertz Fertility Model

This paper proposes a simple method that analytically links the parameters and , which are not demographically interpretableand measurable in the Brass Relational Gompertz Fertility Model, with demographic measures of median age and interquartile range. We also extend the Brass model that deals only with age-specific fertility to age-parity-specific fertility, first marriage, divorce, remarriage, and leaving the parental home. The method has been successfully tested by fittings to 180 reliable observed demographic schedules in various countries and periods, and to nearly 10,000simulated schedules with various combinations of possible values (including the extremes) of and . Our proposed method that uses median age and interquartile range instead of and as input is useful in the population and family household projections. It releases the traditionalunrealistic assumption in population projections that the curve of the fertility schedule moves to the right or left in a parallel way. Instead, using our proposed method, one can assume that the demographic events would be delayed or advanced, while the curve becomes more spread or more concentrated, or, more specifically, assume that young people delay the events more than the older persons do, or vice versa. Our proposed method is also useful to formulate assumptions on future demographic trends for purposes of policy analysisand planning. It can be used to indirectly estimate demographic schedules when the detailed age-specific data are not currently available, which is useful for developing countries and sub-region studies in developed countries. A crucial point for a successful application of the method is that the standard schedule chosen can capture the general pattern of the demographic process in the population under study.     

Is it Pleasure or Health from Leisure that We Benefit from Most? An Analysis of Well-Being Alternatives and Implications for Policy

International policy now constantly advocates a need for populations to engage in more physical activity to promote health and to reduce society’s health care costs. Such policy has developed guidelines on recommended levels and intensity of physical activity and implicitly equates health with well-being. It is assumed that individual, and hence social welfare will be enhanced if the activity guidelines are met. This paper challenges that claim and raises questions for public policy priorities. Using an instrumental variable analysis to value the well-being from active leisure, it is shown that the well-being experienced from active leisure that is not of a recommended intensity to generate health benefits, perhaps due to its social, recreational or fun purpose, has a higher value of well-being than active leisure that does meet the guidelines. This suggests rethinking the motivation and foundation of existing policy and perhaps a realignment of priorities towards activity that has a greater contribution to social welfare through its intrinsic fun and possibly social interaction.     

Is Leave for Fathers Pronatalist? A Mixed-Methods Study of the Impact of Fathers’ Uptake of Parental Leave on Couples’ Childbearing Intentions in South Korea

Population Research and Policy Review - While many countries with low birth rates have implemented policies incentivizing fathers to take parental leave with the anticipation that it will...     

The Extent of Economic Vulnerability in the Canadian Labour Market and Federal Jurisdiction: Is There a Role for Labour Standards?

This paper characterizes vulnerable workers in Canada and the federal jurisdiction, based upon characteristics such as employment status, demographic characteristics, and job characteristics, and identifies areas in which labour standards may have a role. Based on this analysis, the paper evaluates the potential for labour standards to address economic vulnerability, focusing on labour standards policies aimed at wages and benefits, hours, and employment arrangements. In addition, the analysis considers the extent to which labour standards are likely to reach vulnerable workers. The results suggest several potential roles for labour standards and highlights policy implications.

Is Chinese National Health Insurance Effective in the Face of Severe Illness? A Perspective from Health Service Utilization and Economic Burden

Over the past decade, health insurance coverage has expanded dramatically in China. Health insurance benefits, however, remain shallow or ambiguous. This study examines the effect of Chinese national health insurance policy on health service utilization and economic burden in urban settings using the Urban Resident Basic Medical Insurance Household Survey. We employ the Heckman selection model to correct for selection bias among hospital inpatients, and find that compared to individuals without health insurance, those with health insurance are more likely to be admitted to the hospital when their physicians recommended them to enter the hospital as inpatients. Health insurance is also associated with about 45.6 % decrease in out-of-pocket inpatient expenditures. Individuals with urban employee basic medical insurance see the largest decrease in economic burden, followed by individuals with urban resident basic medical Insurance, and those with new rural cooperative medical insurance.     

Is the ADB’s Conjecture on Upward Trend in Poverty for China Right? An Analysis of Income and Multidimensional Poverty in China

Social Indicators Research - The measurement of well-being of people is very difficult because it is characterized by a multiplicity of aspects or dimensions. Principal Components Analysis (PCA) is...     

A room of one’s own or room enough for two? Access to housing and new household formation in Sweden, 1968–1992

Familistic and individualistic theories both provide explanations for recent declines in family household formation. Securing access to housing plays a key role in new household formation for both these theories. Familistic theories hypothesize a positive relationship between access to housing and new family household formation. Individualistic theories hypothesize a positive relationship between access to housing and nonfamily household formation. Here I test these hypotheses in Sweden by modeling leaving home for family and nonfamily household formation using the Swedish Family Survey and supplemental housing data. I find significant support for the familistic notion that greater access to housing increases the likelihood of family household formation. I fail to find support for the individualistic theory.

Is the Lack of Specific Lesbian,Gay, Bisexual,Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons’ health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (r_s = 0.5052, p < .01). Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.