The multistate stable population model with immigration

This paper outlines the discrete‐time and continuous‐time formulations of the stable population model with immigration, showing their commonality. It then illustrates how the model can be extended to include multiple interacting populations, and goes on to consider a multistate version of reproductive value that further illuminates the evolutionary dynamics of an “open”; model of multistate population growth and redistribution. Attention is restricted to results arising from a fertility regime that is below replacement level.     

Population growth with variable family size

The Sharpe‐Lotka continuous time deterministic model of population growth is developed to take account of some possible forms of mother‐daughter fertility association, characterised here by a bivariable measure, A. This leads to a linear double integral equation for which, subject to certain conditions, a finite time solution can be found by Laplace transform methods and thus also model specific results relating the intergenerational fertility effect to the long term population growth rate and magnitude are established. The quantitative implications of the theory are illustrated by a consideration of a general bilinear form of A and in this context numerical results illustrating the finite time growth and also the long term distribution of fertility levels in the stable female population are obtained. In particular, it is shown that different fertility specific subpopulations can coexist indefinitely.     

A Markov Chain for calculating the durability of marriage

The usual Markov model of marriage permits informative experiments on the effect of alterations in the transition rules. It can tell, for example, what difference it would make to the durability of marriage if there was no divorce and the other transitions were as observed. This is in addition to the capacity of the usual model to find the effect of small changes in the transition rates.

Canadian data for 1970–1982 permit comparisons over time, and show among other things not only that married men live longer than single, but that the difference is increasing; the increase in the “marriage bonus”; over time also appears for women.     

Developing a best practice model of refugee maternity care

BackgroundAbout one third of refugee and humanitarian entrants to Australia are women age 12–44 years. Pregnant women from refugee backgrounds may have been exposed to a range of medical and psychosocial issues that can impact maternal, fetal and neonatal health.Research questionWhat are the key elements that characterise a best practice model of maternity care for women from refugee backgrounds? This paper outlines the findings of a project which aimed at developing such a model at a major maternity hospital in Brisbane, Australia.Participants and methodsThis multifaceted project included a literature review, consultations with key stakeholders, a chart audit of hospital use by African-born women in 2006 that included their obstetric outcomes, a survey of 23 African-born women who gave birth at the hospital in 2007–08, and a survey of 168 hospital staff members.ResultsThe maternity chart audit identified complex medical and social histories among the women, including anaemia, female circumcision, hepatitis B, thrombocytopenia, and barriers to access antenatal care. The rates of caesarean sections and obstetric complications increased over time. Women and hospital staff surveys indicated the need for adequate interpreting services, education programs for women regarding antenatal and postnatal care, and professional development for health care staff to enhance cultural responsiveness.Discussion and conclusionsThe findings point towards the need for a model of refugee maternity care that comprises continuity of carer, quality interpreter services, educational strategies for both women and healthcare professionals, and the provision of psychosocial support to women from refugee backgrounds.     

A stochastic version of the malthusian trap model: Consequences for the empirical relationship between economic growth and population growth in LDC's

A stochastic version of the Malthusian trap model relating the growth rate of income per capita to the population growth rate of a given country is described. This model is applied to the a priori evaluation of the cross‐sectional correlation between these two growth rates under two additional assumptions: i) the relations in the model at national levels include country‐specific and time‐invariant random components, and ii) these growth rates are measured with a certain degree of temporal aggregation. It is shown that these two assumptions can explain near‐zero correlations between the two growth rates even if there exist a strongly negative effect of population growth on economic growth. However it is not clear whether these assumptions fully explain such insignificant correlations. Indeed, the implementation of the model is complicated by the structural shifts which are likely to occur in the equations over the course of the demographic transition.     

Developing and testing a mobile application for breastfeeding support: The Milky Way application

BackgroundSupporting women to continue breastfeeding is a global challenge. The Milky Way Program is an effective face to face intervention to increase breastfeeding rates up to six months postpartum. The sustainability and access to the Milky Way Program could be enhanced by transforming it into a mobile application allowing women to access relevant information from their own place at a convenient time.AimTo explore the process of transforming the Milky Way Program into an acceptable and usable mobile health application.MethodStakeholders including multidisciplinary researchers and end-users designed the application based on the Milky Way Program by using Persuasive System Design principles. A mixed-method approach was used in the development and evaluation process. Seven women were recruited through convenience sampling to pilot test the application. The women’s feedback was collected through an online survey six weeks after birth and individual interviews at four months postpartum.FindingsWomen in the pilot study reported that the breastfeeding application was well designed, easy to use, interactive, reassuring and evidence-based with credible sources of information.ConclusionThe Persuasive System Design model combined with end-user engagement can feasibly inform the development of an acceptable and usable mobile health application for breastfeeding based on a proven clinical intervention. Further rigorous testing is required to evaluate the effectiveness of the application on breastfeeding initiation and duration.     

A Critical and Intersectional Model of LGBTQ Microaggressions: Toward a More Comprehensive Understanding

ABSTRACT

This article summarizes a proposed critical and intersectional model of LGBTQ microaggressions that can be used by scholars and practitioners from multiple disciplines. Drawing on critical and intersectional paradigms and decades of research from multiple fields, we constructed a model that acknowledges the breadth, depth, scope, and complexity of LGBTQ microaggressions. This proposed model includes the following elements: hegemonic influences, intersectional complexities, perpetration, interpersonal and environmental contexts, and responses.     

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.     

A behavioral two‐sex marriage model

In this paper we propose a particular marriage model, i.e., a model for the number of marriages for each age combination as a function of the vectors of the number of single men and women in each age group. The model is based on Dagsvik (2000) where it is demonstrated that a general type of matching behavior imply, under specific assumptions about the distribution of the preferences of the women and men, a convenient expression for the corresponding marriage model.

Data from the Norwegian Population Register for nine years are applied to estimate the model. We subsequently test the hypothesis that, apart from a random “noise”; component, the age‐specific parameters of the model change over time according to a common trend. We find that the hypothesis is not rejected by our data.     

The need for improved emotional support: A pilot online survey of Australian women’s access to healthcare services and support at the time of miscarriage

ProblemWomen need improved emotional support from healthcare professionals following miscarriage.BackgroundSignificant psychological morbidity can result following miscarriage and may be exacerbated by poor support experiences. Women frequently report high levels of dissatisfaction with healthcare support at this time.AimThis study was developed to pilot a survey aimed at exploring women’s access to healthcare services and support at the time of miscarriage.MethodsWomen over 18 years, residing in Australia, who had experienced a miscarriage in the past two years completed a 29-item online survey.FindingsA total of 399 women completed the survey. Two key findings arose: 1) More than half of women (59%) were not offered any information about miscarriage or pregnancy loss support organisations or referral/access to counselling services at the time of miscarriage, despite almost all reporting they would have liked various forms of support from items listed 2) More than half (57%) did not receive follow up care, or emotional support at this time, beyond being asked how they were coping emotionally. Other findings showed 3) Women accessed various healthcare services at the time of miscarriage and 4) Women often saw a general practitioner at the time of miscarriage despite having a private obstetrician.ConclusionThere is clear mismatch between the support women want at the time of miscarriage and the care they receive from healthcare professionals. Despite considerable structural barriers, it seems likely there is scope within healthcare professionals’ usual practice for improved support care through simple measures such as increased acknowledgement, information provision and referral to existing support services.     

Persistent age distributions for an age‐structured two‐sex population model*

In this paper we formulate an age‐structured two‐sex population model which takes into account a monogamous marriage rule and the duration of marriage. We are mainly concerned with the existence of exponential solutions with a persistent age distribution. First we provide a semigroup method to deal with the time‐evolution problem of our two‐sex population model. Next, by constructing a fixed point mapping, we prove the existence of exponential solutions under homogeneity conditions.     

The impact of outpatient priming for induction of labour on midwives’ work demand,work autonomy and satisfaction

BackgroundInduction of labour often begins with the application of a priming agent to soften the cervix, generally requiring women to stay in hospital overnight (inpatient priming). An alternative is outpatient priming by a midwife, where women are allowed to go home following priming. This approach has the potential to impact, either positively or negatively, on the midwives involved.QuestionTo what extent did the introduction of outpatient priming influence midwives’ work demands, work autonomy, stress and job satisfaction.MethodsA before–after study (with two separate cross-sectional samples) was conducted alongside a randomized controlled trial of outpatient versus inpatient priming, conducted at two metropolitan teaching hospitals in Australia. Midwives completed a questionnaire before the introduction of outpatient priming and again approximately two years later.Findings208 midwives participated (response rates-time 1:81% (87/108); time 2:78% (121/156)). A mixed model analysis test of pre-post intervention differences found no changes in work demand, work autonomy and satisfaction. At time 2, over 80% of midwives reported that the introduction of the practice had reduced or made no difference to their work stress and workload, and 93% reported that outpatient priming had increased or had no impact on their job satisfaction. Furthermore, 97% of respondents were of the opinion that the option of outpatient priming should continue to be offered.ConclusionResults suggest that outpatient priming for induction of labour is viable from a midwifery practice perspective, although more research is needed.     

Drivers of job satisfaction in midwifery—A work design approach

BackgroundIdentifying common factors that influence job satisfaction for midwives working in diverse work settings is challenging. Applying a work design model developed in organisational behaviour to the midwifery context may help identify key antecedents of midwives job satisfaction.AimTo investigate three job characteristics – decision-making autonomy, empowerment, and professional recognition as antecedents of job satisfaction in New Zealand (NZ) midwives.MethodsLatent multiple regressions were performed on data from Lead Maternity Carer (LMC) midwives n = 327, employed midwives n = 255, and midwives working in ‘mixed-roles’ n = 123.FindingsWe found that professional recognition is positively linked to job satisfaction for midwives in all three work settings. At the same time, decision-making autonomy and empowerment were shown to influence job satisfaction for midwives working as LMCs only.DiscussionOur main finding suggests that the esteem generated from being acknowledged as an expert and valuable contributor by maternity health colleagues is satisfying across all work contexts. Professional recognition encompasses the social dimension of midwifery work and influences midwives job satisfaction. Decision-making autonomy and empowerment are task and relational job characteristics that may not be similarly experienced by all midwives to noticeably influence job satisfaction.ConclusionGiven that job satisfaction contributes to recruitment, retention, and sustainability, our findings show that drivers of job satisfaction differ by midwifery work context. We present evidence to support tailored efforts to bolster midwives job satisfaction, especially where resources are limited.     

Aboriginal women in rural Australia; a small study of infant feeding behaviour

BackgroundAboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities.ObjectiveTo explore the factors impacting upon infant feeding choices in a rural Aboriginal Community.MethodsSemi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results.ResultsThree key themes were identified. These were “I’m doing the best thing for…” which encompasses the motivations underpinning infant feeding decisions; “this is what I know…” which explores individual and community knowledge regarding infant feeding; and “a safe place to feed” identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today.DiscussionAboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study.ConclusionsEfforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can do.