Cross-sectional survey of antenatal education attendance among nulliparous pregnant women in Sydney,Australia

BackgroundAntenatal education aims to provide expectant parents with strategies for dealing with pregnancy, childbirth and parenthood and may have the potential to reduce obstetric intervention and fear of childbirth. We aimed to investigate antenatal education attendance, reasons for and barriers to attending, and techniques taught and used to manage labour.MethodsAntenatal and postnatal surveys were conducted among nulliparous women with a singleton pregnancy at two maternity hospitals in Sydney, Australia in 2018. Classes were classified into psychoprophylaxis, birth and parenting, other, or no classes. Reasons for and barriers to attendance, demographic characteristics, and techniques taught and used in labour were compared by class type, using Pearson’s Chi Squared tests of independence.Findings724 women were surveyed antenatally. The main reasons for attending classes were to better manage the birth (86 %), feel more secure in baby care (71 %) and as a parent (60 %); although this differed by class type. Reasons for not attending classes included being too busy (33 %) and cost (27 %). Epidural, breathing techniques, massage and nitrous oxide were the most common techniques taught. Women who attended psychoprophylaxis classes used a wider range of pain relief techniques in labour. Women found antenatal classes useful preparation for birth (94 %) and parenting (74 %). Women surveyed postnatally wanted more information on baby care/sleeping and breastfeeding.ConclusionThe majority of women found antenatal education useful and utilised techniques taught. Education providers should ensure breastfeeding and infant care information is provided, and barriers to attendance such as times and cost should be addressed.     

Not addressing the root cause: An analysis of submissions made to the South Australian Government on a Proposal to Protect Midwifery Practice

BackgroundReports of unregulated birth workers attending birth at home, with no registered midwife in attendance (freebirth), have become more frequent in Australia in recent years. A Coronial Inquiry (2012) into the deaths of three babies born at home in South Australia resulted in a call for legislation to restrict the practice of midwifery to registered midwives. A Proposal to Protect Midwifery Practice in South Australia was issued as a consultation paper in January 2013.AimTo report the views of those making a submission to the Proposal to Protect Midwifery Practice in South Australia.MethodsThirty submissions to the South Australian Government were downloaded, read and thematically analysed.FindingsTwenty-five (81%) submissions supported the legislation, 5 (16%) opposed it and 2 (6%) were neither for nor against. Support for the proposed legislation was strong, however the underlying root causes that have led to the rise of UBWs attending homebirth in Australia were not addressed. Recommendations called for all stakeholders to work with women to develop a better framework of care that respected and met their needs and choices whilst safeguarding maternal and neonatal health.ConclusionsThe Proposal to Protect Midwifery Practice may promote greater protection of midwifery practice however, Private Indemnity Insurance (PII), collaborative agreements and power struggles associated with the medical domination of childbirth continue to marginalise homebirth and prevent women from accessing the care they want and need. These unresolved issues represent the root causes for UBWs attending homebirth; hence the proposal is only a partial solution.     

Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study

BackgroundIn Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain women from attending these services have not yet been sufficiently explored. Using qualitative methods, we aimed to explore the factors that delay maternal health service utilization in eastern Ethiopia.MethodA total of 13 audio-recorded focus group discussions were conducted comprising 88 participants. We conducted separate group discussions with reproductive aged women, mothers-in-law, traditional birth attendants, husbands, and Health Extension Workers to capture their knowledge, practices, feelings, thoughts and attitudes towards maternal health service utilization. The recorded sessions were transcribed into the local language and then translated into English for analysis.ResultThe study identified a number of factors that may delay maternal health service utilization. Factors were grouped using the Three Delays model as a framework. Low level of awareness regarding need, poor involvement of husband, perceived absence of health problems, social power, community misperceptions and cultural restrictions, negative attitudes towards male midwives, acceptance of traditional birth attendants and poor social networking were Delay One factors. Lack of physical accessibility and high transportation costs were categorised as Delay Two factors for skilled birth care attendance. Perceived or experienced poor quality of care were categorised as Delay Three factors for both skilled birth and postnatal care utilization.ConclusionDespite the ongoing government measures to improve maternal health service utilization in Ethiopia, numerous factors continue to contribute to delays in service use, which in turn contribute to high maternal mortality.     

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.     

Religious involvement and U.S. adult mortality

We use recently released, nationally representative data from the National Health Interview Survey-Multiple Cause of Death linked file to model the association of religious attendance and sociodemographic, health, and behavioral correlates with overall and cause-specific mortality. Religious attendance is associated with U.S. adult mortality in a graded fashion: People who never attend exhibit 1.87 times the risk of death in the follow-up period compared with people who attend more than once a week. This translates into a seven-year difference in life expectancy at age 20 between those who never attend and those who attend more than once a week. Health selectivity is responsible for a portion of the religious attendance effect: People who do not attend church or religious services are also more likely to be unhealthy and, consequently, to die. However, religious attendance also works through increased social ties and behavioral factors to decrease the risks of death. And although the magnitude of the association between religious attendance and mortality varies by cause of death, the direction of the association is consistent across causes.     

Measuring inequality with asset indicators

This paper examines whether, in the absence of information on household income or consumption, data on household infrastructure, building materials, and ownership of certain durable assets can be used to measure inequality in living standards. Principal components analysis is used to obtain a relative measure of inequality, and a bootstrap prediction method is provided for use when auxiliary surveys are available. Mexican data is used to show that the inequality methods provided do provide reasonable proxies for inequalities in living standards. An application finds that after controlling for household income and demographics, school attendance of boys in Mexico is negatively related to state-level inequality.     

Leisure before and after parenthood

The leisure time of 117 wives and husbands was studied to determine the effect of parenthood on this time allocation. Data from both a weekday and a weekend day, both before and after the birth of the first child were analyzed. Ordinary least squares regression was used to analyze the time use model which controlled for weekend/weekday, and looked at the effects of personal characteristics such as wife's education and employment status, husband's wage rate, and number of years married as well as parental status. The time of the wife and the husband and the ratio of the wife's to husband's time were negatively related to parental status. Each personal characteristic was negatively related to the wife/husband ratio of leisure time and unrelated to husband's leisure.     

Parental Divorce and Children’s Schooling in Rural Malawi

A growing body of literature has examined the impact of different types of family structures on children’s schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children’s schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children’s schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children’s schooling.     

University Students’ Sense of Belonging to the Home Town: The Role of Residential Mobility

In the study of young people’s relationships with residential contexts, it is important to consider the role of developmental tasks (e.g. identity construction, academic and professional choices, etc.) in influencing Place Identity and Sense of Community. Residential mobility may represent an adaptive strategy for modifying some aspects of one’s identity and a contributing factor to the development of autonomy from the family. Limited attention has been devoted to the study of the ways young people deal with their attachments to old and new places within this process. This study involved 203 university students, attending a large university in the North of Portugal. The aim was to investigate Place Identity (PI) and Sense of Community (SoC) related to the home town, and differences according to residential condition (native vs. temporary resident) and year of attendance (I vs. IV). Among students who moved, the role of motives (forced vs. voluntary) and of residential choices after graduation on PI and SoC were assessed. Results indicated that, among students who moved for academic reasons, SoC and PI related to the home town were lower and decreased from the first to the fourth year. SoC was higher among students who experienced the relocation as a forced choice. Students who anticipated to return to their home town after graduation had higher SoC and PI.     

Examining the Influence of the Wine Festival Experience on Tourists’ Quality of Life

Hosting events and festivals is the best way of providing the wine tourism experience. Wine festivals offer a wide range of experiences that are different from day-to-day living, offer a lifestyle package and are an indicator of lifestyle tourism experience. Tourists travel to wine festivals for wine and other leisure-related experiences, including opportunities for social and/or cultural experiences, interactivity and personal development. Therefore, wine festivals should provide an experience that can influence the quality of life (QoL) of the attending tourist. QoL is influenced by various life domains, which include social, leisure and recreational, intellectual, culinary, and travel life. By its nature, a wine festival is able to influence life domains, thereby decreasing or increasing the level of satisfaction with QoL, according to the level of satisfactory experience. The purpose of this article is to examine the influence of the wine festival experience on the QoL of attending tourists. The structural relationship between the wine festival experience on tourists’ QoL is shown in a structural equation model (SEM), which is based on the notion that the QoL of attending tourists will be influenced by their level of satisfaction in various life domains. A self-administrated questionnaire was distributed during the Wacky Wine Festival in Robertson South Africa. The data from 329 (N) eligible questionnaires was cleaned, captured and analysed using SPSS. Furthermore, Amos was used to test the structural model providing statistical support. From the study’s findings, managerial recommendations were made with the aim of maximising attending wine tourists’ QoL. The research contributes to the literature related to QoL.     

Irish University Students’ Support for the Human Rights of Lesbian Women and Gay Men

Irish university students attending a second year social psychology module (N = 353) were randomly allocated either a gay or lesbian version of a 25-item scale measuring support for the human rights of sexual minorities. Results indicated that, in comparison to female participants, males evidenced significantly lower levels of support. Further, this difference remained irrespective of whether the target was a gay man or a lesbian woman. Exploratory analyses also revealed that participants' support for the human rights of sexual minorities was inversely associated with their levels of political conservatism and religiousness (as determined by self-identification and church attendance measures), and was positively associated with having “out” gay and lesbian friends. Limitations of this study and avenues for further inquiry are articulated.     

Causal Effects of Single-Sex Schools on College Entrance Exams and College Attendance: Random Assignment in Seoul High Schools

Despite the voluminous literature on the potentials of single-sex schools, there is no consensus on the effects of single-sex schools because of student selection of school types. We exploit a unique feature of schooling in Seoul—the random assignment of students into single-sex versus coeducational high schools—to assess causal effects of single-sex schools on college entrance exam scores and college attendance. Our validation of the random assignment shows comparable socioeconomic backgrounds and prior academic achievement of students attending single-sex schools and coeducational schools, which increases the credibility of our causal estimates of single-sex school effects. The three-level hierarchical model shows that attending all-boys schools or all-girls schools, rather than coeducational schools, is significantly associated with higher average scores on Korean and English test scores. Applying the school district fixed-effects models, we find that single-sex schools produce a higher percentage of graduates who attended four-year colleges and a lower percentage of graduates who attended two-year junior colleges than do coeducational schools. The positive effects of single-sex schools remain substantial, even after we take into account various school-level variables, such as teacher quality, the student-teacher ratio, the proportion of students receiving lunch support, and whether the schools are public or private.     

Marital fertility and religion in Spain, 1985 and 1999

Since the transition to democracy in Spain in 1975, both total fertility and rates of church attendance of Catholics have dropped dramatically. In this study the 1985 and 1999 Spanish Fertility Surveys were used to investigate whether the significance of religion for fertility behaviour -- current family size and the spacing of births -- changed between the survey dates. In the 1985 survey, family size was similar for those Catholics who actively participated in religious activities and those who, though nominally Catholic, were not active participants. By 1999, the family size of the latter was lower and comparable to the family size of those without religious affiliation. These findings accord with the declines in both church attendance and fertility in Spain. The small groups of Protestants and Muslims had the highest fertility. Women in inter-faith unions had relatively low fertility.     

Family configuration and adolescent sexual attitudes and behavior

Several measures of family configuration, derived from the number, age, and sex of siblings and the number of parents, were related to adolescent sexual attitudes and behavior in a sample of 836 high school-aged teenagers from two Western states. Zero-order correlations showed that sexual intercourseexperience was less common among adolescents who lived with both parents and also among those who had younger siblings. Similarly, the zero-order correlations showed least permissiveattitudes among adolescents who had more siblings, especially younger siblings, and among those who lived with both parents. Controlling for adolescents' age, sex, race, religion, church attendance, and parents' educational attainment, however, essentially eliminated the relationships between family configuration variables and sexual attitudes and behavior. Only parents' marital structure, reflecting whether adolescents lived with both original parents or not, continued to be weakly related to adolescents' sexual attitudes and behvior.     

宗教参与对我国高龄老人死亡风险的影响分析

根据中国高龄老人健康长寿跟踪调查数据(1998～2005年),利用Cox比例风险模型考察宗教参与对高龄老人死亡风险的影响机制,深入分析人口学特征、肌体健康、心理健康、健康行为及社会经济支持这五类因素在宗教参与和死亡风险关系中的交互作用,以此对西方文献中相关的4种理论模型进行实证检验。结果表明,宗教参与对死亡风险存在一定程度的影响,但是控制其他因素则会削弱这种影响,其中肌体健康因素所代表的"替代性机制"能够将两者关系的显著作用完全消除。     

Religious attendance and mortality: Implications for the black-white mortality crossover

This study investigates the relationships among religious attendance, mortality, and the black-white mortality crossover. We build on prior research by examining the link between attendance and mortality while testing whether religious involvement captures an important source of population heterogeneity that contributes to a crossover Using data from the Established Populations for Epidemiologic Studies of the Elderly, we find a strong negative association between attendance and mortality. Our results also show evidence of a racial crossover in mortality rates for both men and women. When religious attendance is modeled in terms of differential frailty, clear gender differences emerge. For women, the effect of attendance is race- and age-dependent, modifying the age at crossover by 10 years. For men, however; the effect of attendance is not related to race and does not alter the crossover pattern. When other health risks are modeled in terms of differential frailty, wefind neither race nor age-related effects. Overall, the results highlight the importance of considering religious attendance when examining racial and gender differences in age-specific mortality rates.     

The effectiveness of remedial courses in Italy: a fuzzy regression discontinuity design

Skills are important for many social and economic outcomes. Whereas interventions during childhood are considered crucial to increase the skills of disadvantaged individuals, in this paper, we try to understand whether interventions which take place later in life can also be effective. With this aim, we evaluate the effects on student achievement of a number of remedial courses provided by an Italian university. We use a fuzzy regression discontinuity design to identify the causal effect of remedial courses relying on the fact that students were assigned to the treatment if their performance in a placement test was below a certain cutoff point. We deal with partial compliance by using the assignment rule as an instrumental variable for the effective attendance to remedial courses. From our analysis, it emerges that students attending the remedial courses whose results were just below the cutoff point acquire a higher number of credits than students whose results were just above the cutoff. We also find that remedial courses reduce the probability of dropping out from an academic career.     

Fertility and income,consumption aspirations,and child quality standards

Data from a 1975 national survey of the American population were used to investigate the relationships between childbearing and aspirations for consumption goods, child quality standards, and income. The data were consistent with the hypothesis that preferences for child quality are negatively related to fertility. Aspirations for consumer goods which are related to the home were not found to be negatively related to childbearing while aspirations for nonhome goods were negatively related to fertility as hypothesized. Several indicators of income and subjective economic well-being were examined, and the overall pattern of results was not supportive of the hypothesized effect of income on fertility.     

The effects of quality of working life (QWL) on employee behavioral responses

Quality of work life (QWL) was conceptualized in terms of need satisfaction stemming from an interaction of workers' needs (survival, social, ego, and self-actualization needs) and those organizational resources relevant for meeting them. It was hypothesized that need satisfaction (or QWL) is positively related to organizational identification, job satisfaction, job involvement, job effort, job performance; and negatively related to personal alienation. A survey study was conducted based on a sample of 219 service deliverers to the elderly in a large midwestern city. The results were consistent with the hypotheses. Managerial implications were also discussed.     

Determinants of Health and the Quality of Life in the Bella Coola Valley

The aim of this investigation is to obtain some baseline self-reported data on the health status and overall quality of life of all residents of the Bella Coola Valley of British Columbia aged 17 years or older, and to measure the impact of a set of designated health determinants on their health and quality of life. In the period from August to November 2001, a variety of procedures were used to ensure that all eligible residents of the Valley received a copy of our questionnaire, and 687 useable questionnaires were obtained for our working dataset. Health status was measured by SF-36 and the U.S. Centers for Disease Control healthy days items. Thirty-one items were used to measure the Provincial Health Officer’s designated determinants of health in four clusters, namely, biological, social and economic, health behaviours and health services determinants. Quality of life was measured by satisfaction levels in 13 specific domains of life (e.g., family, financial security), four global items (e.g., happiness, life satisfaction) and one global Subjective Well-Being Index. Besides obtaining baseline figures on all our measures for the Valley, we made some comparisons among our figures and those from other areas, e.g., Prince George, BC. Most of the measures indicated that the health status and quality of life of Bella Coola Valley residents were lower than those of Prince George residents. For the sample as a whole, SF-36 scores on the eight dimensions ran from 82.3 (physical functioning) to 50.0 (social functioning), with a mean of 62.7. Residents in the Valley averaged 6.5 days in the past 30 in which their health was physically not good, 5.5 days when it was mentally not good and 4.1 days when their health limited their usual daily activities. Eleven percent of respondents described their general health as “excellent” and another 27% said it was “very good”. On a 7-point scale from 1=very dissatisfied to 7=very satisfied, respondents had average life satisfaction and satisfaction with the overall quality of life scores of 5.5. For specific domains of life, the lowest mean level of satisfaction was reported for federal and provincial government officials (3.3) and the highest was reported for living partners and personal safety around home (5.8). Regarding bivariate relations, each of the eight dimensions of SF-36 was significantly correlated with a single item measure of general health, and five of the eight were significantly correlated with the number of good health days. Happiness and the Subjective Well-Being Index were positively but moderately correlated with six of the eight dimensions, and life satisfaction was positively correlated with five. Age was negatively related to general health, but positively related to life satisfaction. Not being of aboriginal descent was positively related to all of the four global health indicators and to the Subjective Well-Being Index. Education was positively related to the four global health measures but not to the three global quality of life measures. The Social Support and Good Family Indexes were positively related to all seven global measures. There was a positive correlation between six of the seven global measures and the frequency with which respondents participated in activities sponsored by voluntary organizations. Frequency of smoking was negatively associated with every global dependent variable except the Physical Health Index. Frequency of skipping meals was negatively associated and average hours of sleep per night was positively associated with all seven global measures. Turning to multivariate relationships, the four clusters of health determinants explained from 12% (SF-36 Mental Health Index) to 24% (general health) of the variance in the dependent global health variables, and from 20% (happiness) to 26% (Subjective Well-Being Index) of the variance in the dependent global quality of life variables. Adding domain satisfaction scores to the total set of predictors allowed us to explain from 20% (SF-36 Mental health Index) to 29% (general health) of the variance in the dependent global health variables, and from 39% (happiness) to 62% (life satisfaction) in the dependent global quality of life variables. By including measures of social support and good family relationships in our set of health determinants, we practically guaranteed that the latter would be relatively strongly predictive of global quality of life.