Complementary and alternative medicine: Interaction and communication between midwives and women

BackgroundMany pregnant women use complementary and alternative medicine. Although midwives are often supportive, how they communicate with women about the safe use of these therapies has received limited research attention.AimThe aim of this study was to explore how midwives interact with women regarding use of complementary and alternative medicine during pregnancy.MethodsWe utilised grounded theory methodology to collect and analyse data. Twenty-five midwives who worked in metropolitan hospitals situated in Melbourne, Australia, participated in the study. Data were collected from semi structured interviews and non-participant observations, over an 18-month period.FindingsHow midwives communicate about complementary and alternative medicine is closely associated with the meaning they construct around the woman's role in decisionmaking. Most aim to work in a manner consistent with the midwifery partnership model and share the responsibility for decisions regarding complementary and alternative medicine. However, although various therapies were commonly discussed, usually the pregnant woman initiated the dialogue. A number of contextual conditions such as the biomedical discourse, lack of knowledge, language barriers and workplace constraints, limited communication in some situations.ConclusionMidwives often interact with women interested in using CAM. Most value the woman's autonomy and aim to work in partnership. However, various contextual conditions restrain overt CAM communication in clinical practice.     

"Mummies and babies" and friends and lovers in Lesotho

This paper examines an institutionalized friendship among adolescent girls and young women in southern Africa. Lesotho's economy is based on migrant male labor which leaves the women dependent on male earnings or subsistence from the land, and also creates unstable marital relations. Young girls in the modern schools develop close relationships, called "mummy-baby," with slightly older girls. Sexual intimacy is an important aspect of these relationships. Mummy-baby relationships not only provide emotional support prior to marriage, but also a network of support for married and unmarried women in new towns or schools, either replacing or accompanying heterosexual bonds.     

Understanding and Using Mediators and Moderators

Mediation and moderation are two theories for refining and understanding a causal relationship. Empirical investigation of mediators and moderators requires an integrated research design rather than the data analyses driven approach often seen in the literature. This paper described the conceptual foundation, research design, data analysis, as well as inferences involved in a mediation and/or moderation investigation in both experimental and non-experimental (i.e., correlational) contexts. The essential distinctions between the investigation of mediators and moderators were summarized and juxtaposed in an example of a causal relationship between test difficulty and test anxiety. In addition, the more elaborate models, moderated mediation and mediated moderation, the use of structural equation models, and the problems with model misspecification were discussed conceptually.

The relationships between population and economy, and between population and education]

The relationship between population and economy is regarded seriously by China and other countries. This problem can be analyzed and studied under 2 aspects: 1) the influence of economic development on changes in population, and 2) the influence of population increases on economic development. Under the 1st aspect, improved living conditions, hygiene, and health care generally result in lowered mortality rates. Improved economic conditions in China also increased the birthrate and at the same time increased birth control among the people; the increased birthrate was due to more marriages after liberation. In economically advanced countries, due to high expenses in raising children, people tend to limit family sizes to 2 children/family. Under the 2nd aspect, population increases place strains on the food supply and nutritional requirements, especially when increases are too rapid. They also demand more educational resources and influence quality of education. As there are currently 210 million students in China, the quality of education suffers, particularly at the college level, since most of Chinese manpower, physical and financial resources are spent on primary and secondary education. In terms of housing, transportation, health care, and natural resources, they are all intimately related to and influenced by increases in population. Consequently, the living standard would be difficult to raise if population increases are too rapid. Since 1971, population increases have been incorporated into 5-yearly and later yearly national economic plans in China. The large Chinese population is a major obstacle in raising the Chinese economic level, hence a well-planned population control program is essential.     

Mortality in New Zealand and England and Wales

This paper compares age-specific mortality rates in England and Wales with those of New Zealand. Differences in rates are greatest at the younger age groups, and are particularly high for infants under 1 year and children between 1 and 5 years. The age-specific mortality rates for females under 25 years and for males under 35 years are analysed by causes of death in order to discover where the main differences between the two countries occur, and for infant mortality in England and Wales a further analysis has been made by social class. The greatest room for improvement in England and Wales mortality rates, as compared with New Zealand rates, is at ages under 5 years, and in infant mortality in particular the greatest differences between England and Wales and New Zealand rates by causes of death are for those causes usually associated with environmental influences.     

第五届亚太生殖健康大会

为推动开罗国际人口与发展大会《行动纲领》及“千年发展目标”在亚太区域如期实现,2009年10月18-20日,由中国国家人口计生委、中国计划生育协会、中国人口学会、国际计划生育联合会、联合国人口基金、人口与发展南南合作伙伴组织等共同举办的第五届亚太生殖健康大会在北京召开。     

Gender and Intergenerational Co-residence in Egypt and Tunisia

This paper compares the levels and determinants of intergenerational co-residence among older women and men in Egypt and Tunisia. Women in both settings have higher odds than do men of living in child-headed households, largely because women more often are widowed and have fewer economic resources. In Tunisia, women have higher odds than do men of living in child-headed households partly because of their poorer health. In Egypt, the odds of living in parent- and child-headed intergenerational households for unmarried compared to married older adults are higher for women than men. Disparate needs and marital histories likely contribute to the different living arrangements of older women and men in these settings.     

Family Instability and College Enrollment and Completion

This research uses data from waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health, N = 9,631) to consider whether and how family instability in early or later childhood affects college enrollment and completion of a Bachelor’s degree by age 24. Explanatory factors include maternal selection into unstable unions, household resources available in adolescence, and adolescents’ academic achievement, behavior, and attitudes in high school. The association of later family instability with college enrollment and completion is largely explained by household resources in adolescence. The association of early family instability with college enrollment is partially explained by each set of factors, and its association with college completion, given enrollment, is explained by pre-existing maternal characteristics. The results demonstrate that early family instability has enduring consequences for eventual status attainment and that the mechanisms that connect family instability to educational outcomes vary by the timing of family structure change.     

Mother-Child Relations and Adolescent Sexual Attitudes and Behavior

We hypothesize that children who are close to their parents are more likely to have attitudes and behavior that are consistent with their parents' values than children who are not close to their parents. Using data from a probability sample of 888 mother-child pairs of white women in the Detroit metropolitan area, we tested this hypothesis, using both mother's and child's attitudes toward premarital sexual intercourse and the child's report of whether he or she had engaged in premarital sexual intercourse. Unlike most previous work in this area, which has posited a direct association between the closeness of the mother-child relation and the child's attitudes and behavior, we found that the quality of the relation interacted with the mother's attitudes in its effects on the child's attitudes and behavior. Children with close relations with their mothers were more likely to hold attitudes and behave in a manner consistent with their mothers' own attitudes than children with more distant relations.     

Populations and infectious diseases: Dynamics and evolution

The host-parasite or host-pathogen system was analyzed from dynamical and evolutionary viewpoints using simple mathematical models incorporating vertical transmission, immunity and its loss. We first analyzed a model without density regulation of host population. In the analysis on dynamics, the condition for the pathogen to work as a density regulating factor was obtained. In the analysis on evolution, criteria for the evolution of host and pathogen were proposed. These criteria implies that the evolution of hosts should result in an increase in infected host density, whereas the evolution of pathogens a decrease in susceptible host density. The direction of evolution at some parameters of host and that of pathogen were examined when the parameters were independently and freely changeable. Among the parameters, only reduction in additional mortality due to infection was the evolutionary trend common to both host and pathogen. In all the other parameters examined, trend of evolution predicted in host is reversed in pathogen. We then analyzed whether the obtained criteria still hold in models with density regulation of hosts. Using randomly generated parameter sets, we obtained the result that the criteria should hold very likely though they do not always hold. We discussed evolution of virulence when there is a constraint between the traits.     

积极老龄化与中国：观点与问题透视

人口老龄化问题日益严重,如何应对其带来的挑战受到国际社会的普遍关注,而积极老龄化的提出则为人们打开了一个新的视角。文章将在回顾积极老龄化国际发展历程的背景下,在理清我国老龄化政策实践与变迁脉络的基础上,从政治、经济、文化等视角分别对我国的年龄化问题进行描述与阐释,展现我国老龄化的现实图景,并以问题为导向,探寻我国的积极老龄化之路。     

Altruistic and contractual remittances between male and female migrants and households in rural Thailand

Past research has questioned the extent to which remittances are altruistic behaviors versus payments in a contractual relationship between households and migrants. This article explores altruistic and contractual patterns of remittances using a gendered approach. On the basis of results with various levels of significance in regression models, male and female migrants from Nang Rong, Thailand, behave both altruistically and contractually. However, women and migrants from poorer households behave more altruistically, while men and migrants from richer households behave more contractually. These results point to the need for further research and theory development to explain heterogeneities in migrants' behavior.     

Spirituality and spiritual care in and around childbirth

BackgroundEmerging evidence points to childbirth as a spiritually felt meaningful occasion. Although growing literature and development of guidelines charge the midwife to provide spiritual care felt spiritual experiences are not addressed. There is need to revisit contemporary approaches to spiritual care in midwifery lest something of significance becomes lost in policy rhetoric.AimThe aim of this discussion paper is to bring to the surface what is meant by spiritual care and spiritual experiences, to increase awareness about spirituality in childbirth and midwifery and move beyond the constraints of structured defined protocols.MethodsThe authors’ own studies and other's research that focuses on the complex contextual experiences of childbirth related to spirituality are discussed in relation to the growing interest in spiritual care assessments and guidelines.FindingsThere is a growing presence in the literature about how spirituality is a concern to the wellbeing of human beings. Although spirituality remains on the peripheral of current discourse about childbirth. Spiritual care guidelines are now being developed. However spiritual care guidelines do not appear to acknowledge the lived-experience of childbirth as spiritually meaningful.ConclusionIntroduction of spiritual care guidelines into midwifery practice do not address the spiritual meaningful significance of childbirth. If childbirth spirituality is relegated to a spiritual care tick box culture this would be a travesty. The depth of spirituality that inheres uniquely in the experience of childbirth would remain silenced and hidden. Spiritual experiences are felt and beckon sensitive and tactful practice beyond words and formulaic questions.     

Beliefs and values and the sterilization decision

A decision-making framework based on the models of personal decision making developed by psychologists and economists and a methodology based on axiomatic conjoint measurement are used to explore individuals' beliefs and values regarding contraceptive sterilization. Particular emphasis is given to demonstrating a. that there exist individual differences in beliefs and values, b. that there exist differences in beliefs and values between persons who choose sterilization—either tubal ligation or vasectomy—and persons who choose non-sterilization contraceptive methods when no more children are wanted, and c. that the effect of beliefs and values on the sterilization decision is an interactive one. The methodology used is compared to that typically used in studying fertility- and health-related behaviors.This research was supported by grants HD-10802 and HD-14403 from the National Institute of Child Health and Human Development. The technical assistance of Doreen Victor and the editorial suggestions of Sarah Gaskill, Alice Healy, and two anonymous reviewers are greatly appreciated. This paper is Publication No. 253 of the Center for Research on Judgment and Policy, University of Colorado, Boulder, CO 80309-0344. Requests for reprints should be sent to the Publications Librarian at the Center.     

Injecting and Rejecting,Framing and Failing

This paper seeks to examine how female subjectivities are privileged by Canadian human papillomavirus (HPV) vaccination discourse and, in turn, how homosexual male subjectivities are displaced. Employing a Critical Discourse Analysis approach, I analyze selected HPV vaccination (HPVV) promotional materials, and depict the discursive strategies which privilege and exclude gendered subjectivities. My critical analysis is influenced by feminist linguistic works that seek to uncover the discursive constructions around sexuality, gender and identity, and the discursive strategies used to communicate ideas about sexual health risks and responsible citizenship. In addition, I adopt feminist theories of knowledge and power to rethink the discursive representations of some bodies and subjectivities as normal, and Others as unintelligible within HPVV discourse in today's neoliberal time.     

A brief report on hope in peace and war,and in good times and bad

The Hope Index is presented as a measure sensitive to significant cultural changes. In this set of case studies, hope was measured in 1988, the weekend of the Gulf ground invasion in 1991, and in the recession of 1992. Hope for peace increased the weekend of the invasion of Iraq during the Gulf War in comparison to hope measured in 1988. Hope for peace increased in college students, in their mothers, and in their fathers. Hope for increased national productivity increased during the 1992 recession, as well as during the Gulf invasion, but only for mothers and fathers. The increased hope and expectation of peace and increased hope and expectations for productivity are discussed in terms of a need theory of hope, the availability heuristic, and in terms of coping strategies.     

Fertility and economic and social development in Turkey: a cross-sectional and time series study

Abstract The paper explores the impact of modernization on the fertility levels in Turkey, which started deliberate efforts at economic, social, and political transformation in the early 1920s. It is a disaggregative study using 'province' as the unit of observation. A relatively consistent series of data on population and various economic and social variables was available with quinquennial censuses starting with the 1940 Census. The technique of reverse projection is used to estimate provincial crude birth rates. Since 1955 there has been a consistent decline in the fertility level. A chain-relationship model is estimated using both cross-sectional and panel data. A major finding of the study is that in Turkey, continuing modernization and the concomitant spread of female education will result in a continuing decline in the fertility rate. This negative influence, stable and substantial over time, is largely due to factors other than the usual association between education and opportunity cost of female employment, such as changing attitudes and tastes. Also with the spread of economic and social development influencing the society's norm for average age at marriage and the proportion of women married, the marital rate, though not so significant as education, imparts a direct depressing effect on the aggregate period fertility rate at any given time.     

Gay and lesbian youth, emergent identities, and cultural scenes at home and abroad

This introduction opens up the field of studies of gay and lesbian adolescents, both with regard to past and present studies in the research literature, and by allusion to the new studies collected in this issue. Historical and crosscultural elements of the context of the "coming out" process are discussed. Four preconceptions of gay youth are critically examined, regarding their heterosexuality, inversion, stigma, and heterogeneity. The anthropological construct of life crisis "rites of passage" is utilized as a heuristic framework for deconstructing attitudes regarding change and constancy in homosexual adolescents. Aspects of age, sex, class, and related variables related to the form and content of the coming out process are then examined in the United States and other societies. Finally, the social problems of gay youth, AIDS and its impact in particular, are briefly considered. The author concludes with a plea for new and urgent research.     

Stability and change in levels and structure of subjective well-being: USA 1972 and 1988

It has long been recognized that more needs to be known about the dynamic behavior of measures of subjective well-being. As the Social Indicators Movement matures, it becomes possible to explore issues of stability and change in measures of perceived life quality. To contribute to this research need, this paper reports results of administering similar measures of subjective well-being to several representative samples of the adult American population assessed 16 years apart — in 1972 and in 1988. Results show that in the United States, which has experienced reasonably continuous economic prosperity and no major social disruptions during these 16 years, thestructure of the subjective well-being measures (i.e. how they relate to one another and how concern-level measures predict global-level measures) has remained remarkably constant. This is in accord with expectation and enhances confidence in the validity and usefulness of the measures. Changes were found in thelevels of some of the measures: For the total population, feelings about life-as-a-whole, oneself, and one's own health became notably more positive; evaluations of own income and the national government also gained; but assessments of one's own family life, social relationships, community, and job remained fairly stable. Some of these gross changes were general throughout the population, but others occurred only for certain age, racial, or socioeconomic groups. Younger cohorts and people with higher educations and incomes showed more gains in subjective well-being than other groups.     

吉林省人口和计划生育宣传教育调研——以96条标语口号分析为例

标语口号不仅可以宣传人口和计划生育的理念和措施,而且也是一个城市、一个地区文明程度的标志。在对长春市、辽源市人口与计生标语口号抽样调查基础上,对吉林省人口与计生标语口号现状进行评估。吉林省的人口与计生标语口号语言规范,内容科学合理,从正面鼓励、倡导入手,态度鲜明,含义明确,体现出了以人为本的思想,确保了标语口号被社会公众所认可接受,产生积极正面的社会影响。针对存在的问题提出对策:了解受众需求,宣传内容要与时俱进,不断创新,针对不同群体开展体现人文关怀特点的标语口号宣传;充分利用各类传播媒介,特别是新兴媒介,探索宣传新形式,实现人口与计生标语口号宣传的广覆盖;从塑造城市形象,提升城市整体文明层次的角度,对城市的公益广告牌统筹规划,将人口与计生标语口号纳入公益广告宣传的重要内容之一。