Advocacy Beyond Identity: A Dutch Gay/Lesbian Organization’s Embrace of a Public Policy Strategy

ABSTRACT

The gay/lesbian social movement has primarily been understood as an identity movement. This article contributes to expanding understandings of the gay/lesbian movement by following the advocacy of the Dutch Association for the Integration of Homosexuality COC (COC) as a case of a gay/lesbian movement organization’s expansion of its action repertoire to include public policy goals. On the basis of archival and interview data, this article identifies several factors that enabled the COC to see the Dutch government as a potential public policy partner. Previous legal successes and facilitation by the institutionalized wing of the women’s movement, coupled with a constitutional change, resulted in the COC’s development of a policy strategy. By tracing the history of the COC’s strategic interactions, this article demonstrates that, while an identity strategy was constant throughout the COC’s advocacy, the organization could combine an identity strategy with strategies of legal change, cultural change, and public policy.     

Welcoming Diversity? Symbolic Boundaries and the Politics of Normativity in Kansas City’s LGBTQ Communities

ABSTRACT

Using document analysis and ethnographic field work, this article examines the debate within the LGBTQ community of Kansas City over the decision to hold its Pride festival in the Power and Light District (P&L), a renewed downtown area with a controversial dress code. Despite the developers’ and city’s goals of creating a cosmopolitan urban space that welcomed diverse populations, the P&L acquired a reputation as an anti-Black, anti-queer space due to its dress code and redevelopment history. I argue that the debate surrounding this controversy reveals limits to notions of diversity and diverging approaches to sexual politics within the LGBTQ community that are normally obscured by political actors within the movement but that work to create symbolic boundaries that exclude “non-respectable” members of the LGBTQ population. Recovering queer perspectives allows us to imagine a more capacious definition of diversity and inclusion, both within the LGBTQ movement and in urban space.     

Transnational Mobilties in Snowboarding Culture: Travel,Tourism and Lifestyle Migration

Abstract

Drawing upon global ethnographic methods conducted in six countries over seven years, this paper offers the first in-depth examination of the transnational flows and corporeal mobilities in the contemporary physical culture of snowboarding. Focusing on the travel and migration experiences of various groups of snowboarders (that is, tourists, professional athletes and lifestyle sport migrants), and engaging recent work by human geographers, as well as Pierre Bourdieu’s key concepts of field, capital and habitus, this paper reveals fresh insights into the lived transnationalism and global migration of contemporary youth facilitated by the ‘action’, ‘alternative’ or ‘extreme’ sports economy.     

Narrating Instability: Political detouring in Jerusalem

Abstract

This paper contributes to the ethnography of guided tours in politically contested spaces by interrogating their use for political advocacy by Palestinian guides in the Old City of Jerusalem. It advances the guided tour genre as a potentially transformative encounter for tourists, while offering reflection on its possibilities and limitations for solidarity. Analyzing the narrative framework of the tour vis-à-vis the cityscape shows that guides strategically employ both discourse and movement to convince tourists of the injustice of the Israeli occupation through a practice called political detouring. It reveals how guides manipulate the tour genre’s dynamic nature by spontaneously altering its trajectories to expose the corresponding instability of Palestinian lives in Jerusalem.     

A global review of the inferred meaning of woman centred care within midwifery professional standards

BackgroundAs an integral and guiding approach, woman centred care is well-grounded as the cornerstone of midwifery training and practice. A previous global review established that the concept, even though acknowledged as pivotal, has limited attention within the professional standards documents that underpin the discipline [1]. Whilst not detracting from the overall importance of woman centred care, it is further suggested that a broader meaning is generally being implied.ObjectiveWhether other related inferences and meanings of the actual term ‘woman centred care’ are also being utilised, has not yet been established. Therefore, this review of professional documents sought to investigate the occurrence of further depictions of the concept.MethodsWith an implied and inferred meaning of ‘woman centred care’ as the focus, a review and synthesis of narrative from a global sample of midwifery professional standards was conducted. The principles of meta-ethnography were utilised to develop a qualitative approach. Rather than the actual words ‘woman centred care’ further phrases implying or inferring the concept were sought. ‘A priori’ phrases were developed and narrative and examples were synthesised for each.FindingsStandards and governance documents were located from within Australia, the United Kingdom and New Zealand and a further 139 nations. Overall, the seven phrases, each considered as an inference to woman centred care, were all substantiated. As a proportion of all documents, these were collated with the outcomes being a woman’s right to choice (89%), being culturally sensitive (80.5%), a woman’s voice and right to be heard (78%), the woman as an individual (68%), universal human rights (40%), being holistic (39%) and being self-determined (17.5%).ConclusionThe outcomes of this review demonstrate that woman centred care may be a multidimensional concept. There were occurrences of all seven phrases across a broad scope of global professional midwifery documents, and each can be shown through its meaning to contribute something to an understanding of woman centred care. The creation of a universal meaning is recommended.     

We Find Our Way About: Everyday Media Use and ‘Inhabitant Knowledge’

Abstract

In this article, the author proposes that media uses in everyday living can helpfully be understood as practices of wayfaring. Whereas meaningful relations between media and their audiences or users have typically been conceptualised as matters of representation and interpretation, he focuses on matters of movement and dwelling or of orientation and habitation, opening up the possibility of a non-representational approach for media studies. His starting point is a passing remark in Scannell’s phenomenology of radio and television, and a discussion of that remark leads him to a sympathetic yet critical engagement with Ingold’s work on wayfaring and inhabitant knowledge. Along the way, consideration is given to Tuan’s notes on paths and place-making, and to Merleau-Ponty’s writing on incarnate subjectivity and the acquisition of habit.     

Wanting to be ‘with woman’, not with machine: Midwives’ experiences of caring for women being continuously monitored in labour

ProblemSome continuous electronic fetal monitoring (CEFM) devices restrict women’s bodily autonomy by limiting their mobility in labour and birth.BackgroundLittle is known about how midwives perceive the impact of CEFM technologies on their practice.AimThis paper explores the way different fetal monitoring technologies influence the work of midwives.MethodsWireless and beltless ‘non-invasive fetal electrocardiogram’ (NIFECG) was trialled on 110 labouring women in an Australian maternity hospital. A focus group pertaining to midwives’ experiences of using CTG was conducted prior to the trial. After the trial, midwives were asked about their experiences of using NIFECG. All data were analysed using thematic analysis.FindingsMidwives felt that wired CTG creates barriers to physiological processes. Whilst wireless CTG enables greater freedom of movement for women, it requires constant ‘fiddling’ from midwives, drawing their attention away from the woman. Midwives felt the NIFECG better enabled them to be ‘with woman’.DiscussionMidwives play a pivotal role in mediating the influence of CEFM on women’s experiences in labour. Exploring the way in which different forms of CEFM impact on midwives’ practice may assist us to better understand how to prioritise the woman in order to facilitate safe and satisfying birth experiences.ConclusionThe presence of CEFM technology in the birth space impacts midwives’ ways of working and their capacity to be woman-centred. Current CTG technology may impede midwives’ capacity to be ‘with woman’. Compared to the CTG, the NIFECG has the potential to enable midwives to provide more woman-centred care for those experiencing complex pregnancies.     

Mobile Ideas: Tracking a Concept through Time and Space

Abstract

John Urry’s defining work on mobilities calls for research into the movement of people, ideas and information. This article identifies that as things stand the work of the ‘mobilities turn’ has tended to concentrate almost exclusively on the movement of people and information and has given far less attention to the mobility of ideas. In order to address this absence this article focuses upon one idea in particular, the Spime neologism, and attempts to understand its movement, the systems that enable it and the implications it creates. This article demonstrates the potential offered by the contemporary mediascape for tracking, tracing and visualising the mobility of ideas.     

The influence and meaning of the birth environment for nulliparous women at a hospital-based labour ward in Sweden: An ethnographic study

BackgroundLabour and birth are sensitive physiological processes substantially influenced by environmental and psychosocial factors.AimTo explore the influence and meaning of the birth environment for nulliparous women giving birth in either one of two differently designed birthing rooms at a hospital-based labour ward.MethodsFive months of ethnographic fieldwork was conducted at a labour ward in Sweden, consisting of participant observations of 16 nulliparous women giving birth in either a ‘Regular’ birthing room (n = 8) or a specially designed, ‘New room’ (n = 8). Data included field notes, informal interviews, reflective notes, and individual interviews with eight women after birth. The data was analysed through an ethnographic iterative hermeneutic analysis process.FindingsThe analysis identified the birth environment as consisting of the physical space, the human interaction within it, and the institutional context. The analytic concept; Birth Manual was conceived as an instrument for managing labour in accordance with institutional authority. Significant to the interpretation of the influence and meaning of the birth environment were two abstract rooms: an Institutional room, where birth was approached as a critical event, designating birthing women as passive; and a Personal room, where birth was approached as a physiological event in which women’s agency was facilitated.ConclusionInstitutional authority permeated the atmosphere within the birth environment, irrespective of the design of the room. A power imbalance between institutional demands and birthing women’s needs was identified, emphasising the vital role the birth philosophy plays in creating safe birth environments that increase women’s sense of agency.     

Understanding the Bear Movement in Gay Male Culture

Abstract

The bear movement emerged in the gay male culture of the 1980s, but little research on this group has been conducted. The purpose of this qualitative study was to examine the meanings and functions of bear identity. Six bear-identified men participated in intensive interviews investigating this question. Results suggest that men who identify as bears consciously adopt a masculine aesthetic that signifies values of self-acceptance and maturity. The participants described the acceptance of diverse body shapes and ages within the bear community as leading to positive self-esteem and body image. Results are discussed in relation to clinical and advocacy work. They broaden the awareness of the diversity of cultures that exist within the gay community.     

Midwives’ experiences of using the Mindfetalness method when talking with pregnant women about fetal movements

BackgroundInformation given to pregnant women about fetal movements is important in maternity care and decreased fetal movements is associated with fetal growth restriction and stillbirth. The fetal movement pattern is different for every fetus and women perceive different types of movements. Mindfetalness is a self-assessment method for a woman to use to become familiar with her unborn baby’s fetal movement pattern.AimWe aimed to explore midwives’ perceptions about informing pregnant women about fetal movements and their experiences of working with Mindfetalness in their daily work.MethodsA web-questionnaire was distributed to midwives who participated in a randomized controlled trial evaluating Mindfetalness, a method for the observation of fetal movements. In total, 67 maternity clinics in Stockholm, Sweden, were randomized to Mindfetalness or routine care. Of the 144 midwives working in maternity clinics randomized to Mindfetalness, 80% answered the questionnaire.FindingsThe midwives thought that the leaflet about Mindfetalness was supportive in their work when informing women about fetal movements and the majority wanted to continue to distribute the leaflet when the trial ended. The midwives also expressed that the study increased their own knowledge about fetal movements. Women embraced the information about Mindfetalness positively and appreciated the written material. The midwives thought that talking about fetal movements in maternity care is an important but challenging task.ConclusionMindfetalness is a useful tool to use in maternity clinics when informing pregnant women about fetal movements. The written information was appreciated by both pregnant women and midwives.     

Mobilities in Finland’s Information Society Strategies from 1995 to 2010

Abstract

The article explores Finland’s national information society strategies and uses the Finnish case as an example to identify the limitation of the so-called ‘methodological nationalism’ and to explicate the advantages of the mobility paradigm. The research material consists of the Finnish national strategies published between 1995 and 2010. The article identifies two trends from the studied strategies; a further intermingling of physical movement of objects and virtual mobility, and a tendency to reduce corporeal mobility. The study also shows that most mobility-related challenges require international cooperation and multinational solutions, although state-centred thinking was prevalent in the studied strategies. In addition, it provides evidence that the various modes of mobility operate differently in micro and macro level analyses and that the mobilities paradigm could be enriched by studying policies of mobility.     

The clinical performance and cost-effectiveness of two psychosocial assessment models in maternity care: The Perinatal Integrated Psychosocial Assessment study

ProblemAlthough perinatal universal depression and psychosocial assessment is recommended in Australia, its clinical performance and cost-effectiveness remain uncertain.AimTo compare the performance and cost-effectiveness of two models of psychosocial assessment: Usual-Care and Perinatal Integrated Psychosocial Assessment (PIPA).MethodsWomen attending their first antenatal visit were prospectively recruited to this cohort study. Endorsement of significant depressive symptoms or psychosocial risk generated an ‘at-risk’ flag identifying those needing referral to the Triage Committee. Based on its detailed algorithm, a higher threshold of risk was required to trigger the ‘at-risk’ flag for PIPA than for Usual-Care. Each model’s performance was evaluated using the midwife’s agreement with the ‘at-risk’ flag as the reference standard. Cost-effectiveness was limited to the identification of True Positive and False Positive cases. Staffing costs associated with administering each screening model were quantified using a bottom-up time-in-motion approach.FindingsBoth models performed well at identifying ‘at-risk’ women (sensitivity: Usual-Care 0.82 versus PIPA 0.78). However, the PIPA model was more effective at eliminating False Positives and correctly identifying ‘at-risk’ women (Positive Predictive Value: PIPA 0.69 versus Usual Care 0.41). PIPA was associated with small incremental savings for both True Positives detected and False Positives averted.DiscussionOverall PIPA performed better than Usual-Care as a psychosocial screening model and was a cost-saving and relatively effective approach for detecting True Positives and averting False Positives. These initial findings warrant evaluation of longer-term costs and outcomes of women identified by the models as ‘at-risk’ and ‘not at-risk’ of perinatal psychosocial morbidity.     

Choreographing Resistances: Spatial–Kinaesthetic Intelligence and Bodily Knowledge as Political Tools in Activist Work

Abstract

Bodies have been used as a political tool in activism, but many scholars have ignored activists’ highly sophisticated and intelligent ways of using their moving bodies. This paper focuses on analysing three choreographies of resistance: the group crawling performance for striking nurses in Helsinki in 2007, the protest by Greenpeace at a nuclear construction site in 2007 and a protest in the 1989 Chinese student movement. The purpose is to shed light on how resisting choreographies can generate interactions and relations between agents keeping these interactions dynamic by the motivations and affections of these agents. I will apply Edmund Husserl’s and Edith Stein’s phenomenological method of analysing movement and their notion of kinaesthesia. One of the keywords here is ‘the kinaesthetic field’ that offers a new perspective to account for resisting choreography and its dynamics in socially, politically and emotionally complex environments. Drawing on Howard Gardner’s notion of kinaesthetic intelligence, I suggest that the core element of kinaesthetic intelligence is not only control of one’s bodily motion but also capabilities for working with kinaesthetic fields. The paper argues that the activists can operate gestures, the vulnerability of the body and timing by drawing various agents into their choreography. When activists are able to express their political ideas as concrete gestures, postures or kinaesthetic relations, it also supports their capabilities of articulating their moral intuitions. Even when witnesses disagree with protesters’ positions, protests frequently force them to reconsider their own.     

Ecological analysis of adolescent birth rates in Brazil: Association with Human Development Index

BackgroundAdolescent pregnancy is a multidimensional public health problem. It is known that every year in Brazil approximately 1.1 million adolescents become pregnant and around 20% of all newborns are born to teenage mothers.AimThis ecological study describes the spatio-temporal patterns of the percentages of live births to adolescent mothers between the years of 2010 and 2016 in Brazil and their associations with human development indexes in the meso-regions where they reside.MethodsPercentages of live births to adolescent mothers are the ratio between the number of live births to women aged 10–19 years old and total number of live births in each Brazilian meso-regions during the study period. A spatio-temporal Bayesian model was used to associate the percentages of live births to adolescent mothers with the human development index of each meso-region. Moran’s index was used to measure the spatial autocorrelation between the meso-regions at an aggregate level, whereas the local indicator of spatial auto-correlation measured local correlation.FindingsPercentages of live births to adolescent mothers for the whole country were 19.3% in 2010 and 17.5% in 2016. There is a heterogeneous spatial distribution pattern for these percentages, being the highest percentages in the North region (24.8% in 2016) and the lowest percentages in the Southeast region of the country (14.3% in 2016). The Bayesian model showed that meso-regions with lower human development index values have higher percentages of live births to adolescent mothers.ConclusionOur findings suggest that adolescent pregnancy is deeply associated with environmental characteristics.     

Predictors of postpartum depression service use: A theory-informed,integrative systematic review

ProblemPostpartum depression affects many women globally, yet rates of treatment use are low. A comprehensive view of factors associated with treatment use, from women’s and providers’ perspectives, based on a theoretical model is lacking.BackgroundSeveral studies examined various factors associated with postpartum depression service use; however, each study focused on a small number of factors.AimThis study describes a systematic literature review based on the Behavioral Model of Health Service Use. The purpose of this article is to review and synthesize the available literature regarding factors associated with women’s mental health service use for postpartum depression from women’s and healthcare providers’ perspectives, and provide a comprehensive integrative view of the subject.MethodsThree electronic databases were searched, and 35 studies published up to 2018 in English language journals met inclusion criteria for review. Factors associated with postpartum depression service use were classified according to the Behavioral Model of Health Service Use’s constructs.FindingsService use for postpartum depression is a function of a woman’s predisposition to use mental health services; individual, familial, and communal factors which enable or pose barriers to use of mental health services; and the woman’s perceived or evaluated need for treatment. In addition, societal determinants impact the woman’s decision to seek help directly or through impacting the health and mental health care service system’s resources and organization.ConclusionThis review illustrates key factors for researchers and practitioners to consider when treating postpartum women and developing interventions to enhance postpartum depression treatment use.     

‘The shops were only made for people who could walk’: impairment,barriers and autonomy in the mobility of adults with Cerebral Palsy in urban England

ABSTRACT

Based on research carried out with a group of adults with Cerebral Palsy in Birmingham, UK, we consider the complex inter-relationship between the accessibility of the urban environment for those with impaired gross motor skills, and the ability of these people to lead full and independent lives. Drawing on a framework that considers mobility as movement, meaning-making and political, we demonstrate the reality of differentiated mobility. For those with bodies that function outside the presumed operating parameters of the model subjects of urban design, mobility may be possible, but is often uncomfortable and even dangerous, with significant associated effects for impaired people’s autonomy. Our study details social and structural, or design, barriers to people’s mobility, demonstrating the inter-connection between individuals’ behaviour and urban design in a manner that questions a clear distinction between the two. We draw upon the notions of emotional work and a commoning approach to mobility in suggesting that further investment in urban accessibility is squarely an issue of social justice.     

Meeting in the Global Workplace: Air Travel,Telepresence and the Body

Abstract

In the highly connected and globalised corporate workplace, face-to-face communication is persisting and expanding, despite significant advances and investments in telecommunication. Drawing on interviews with 34 employees from an Australian company trying to reduce air travel associated with business meetings, this paper reveals how telepresence facilitates distinctly different practices of meeting and collaborating to those enabled by face-to-face encounters. The analysis draws attention to the essential role of the body in the practices of virtual and in-person business meetings. During in-person meetings the body’s physical presence conveys meanings of respect and value, provides sensorial competency and gestures, and enables physical mobility as it carries people between and within different material environments. The paper concludes by identifying some possibilities for telepresence meetings to replicate and replace in-person meetings as a normal and effective way of collaborating in the global workplace.     

Midwifery-led care in South Australia: Looking back to move forward

BackgroundFrom the 1980s to the turn of the century, Australia saw an evolution of midwifery-led models of care, in part due to legislative reform and federal funding, but largely owing to the efforts of strong midwifery leaders and consumers who rallied for the implementation of alternative models of care. Through persistence and extensive collaboration, the first South Australian birth centres were established.AimTo better understand the evolution of midwifery-led care in South Australia and identify the drivers and impediments to inform the upscaling of midwifery models into the future.MethodsSemi-structured interviews were conducted with ten midwifery leaders and/or those instrumental in setting up birth centres and midwifery-led care in South Australia. Data was analysed using thematic analysis.FindingsThree overarching themes and several sub-themes were identified, these included: ‘Midwifery suffragettes’ which explored ‘activism’, ‘adversity’ and ‘advocacy’; ‘Building bridges’ captured the importance of ‘gathering midwives’, a ‘movement of women’ and ‘champions and influencers’; and ‘Recognising midwifery’ identified the strong ‘sense of identity’ needed to outface ‘ignorance and opposition’ and the importance of ‘role reformation’.ConclusionThese midwifery leaders provide insight into an era of change in the history of midwifery in South Australia and contribute valuable learnings. In order to move forward, midwives must continue to embrace the political nature of midwifery, enact authentic, transformational leadership and engage women across all levels of influence. It is critical that midwives pursue equity in professional recognition, work collaboratively to provide quality, woman-centred maternity care and expand midwifery continuity of care models.     

The maternity experiences of women seeking asylum in high-income countries: a meta-ethnography

ProblemThe maternity care experiences and perinatal outcomes of women seeking asylum in high-income countries (HICs) are poorer than the general population of pregnant women in that HIC. There is a paucity of literature on the maternity experiences of women seeking asylum in HICs.BackgroundThere is an increasing number of women seeking asylum in HICs due to escalating violence and human rights abuses. Asylum-seeking women are a distinct group whom are likely to have different needs to refugees or migrants as a result of their undocumented status.AimThis literature review aimed to explore the emotional, physical and health information needs of women seeking asylum in the perinatal period in HICs, to provide insights to better address their maternity needs.MethodA meta-ethnography described by Noblit and Hare, was applied to analyse the studies, to reflect the voices of women seeking asylum, hosted in HICs in their perinatal period.FindingsEight studies were included in the review. The overarching theme was ‘just having to survive.’ Four sub-themes were revealed which highlighted the vulnerability of asylum-seeking women. They included: ‘I was never sure if I had understood’, ‘feeling ignored and alone’, ‘ongoing dislocation and recurrent relocation’ and ‘knowing there’s someone who cares for you’.DiscussionImproved maternity care for women seeking asylum requires culturally appropriate respectful maternity care and supportive strategies such as consistent access to language services.ConclusionIt is recommended that future research is targeted to explore the maternity experience of women seeking asylum in HICs, such as Australia.