The role of need for contraception in the evaluation of interventions to improve access to family-planning methods

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on met need (i.e., contraceptive use by women who need contraception) but not on contraceptive use (i.e., contraceptive use by women who may or may not need contraception). Met need captures the woman's success in overcoming barriers to access to family planning, whereas contraceptive use confounds this construct with risk of pregnancy and fertility desires. Exceptions to this rule are identified.     

Veiled midwifery in the baby factory — A grounded theory study

Background

Midwives’ professional role has been changing drastically over time, from handling births in home settings to being part of a team in labour wards in hospitals. This demands a greater effort of interprofessional collaboration in childbirth care.

Self reported fear of childbirth and its association with women's birth experience and mode of delivery: A longitudinal population-based study

ObjectiveTo explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery.DesignA longitudinal population-based study.PopulationPregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden.MethodDifferences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used.ResultsFOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5–10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2–5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1–20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4–11.7), emergency caesarean section (RR 2.4, CI 1.2–4.5) and primiparity (RR 1.9, CI 1.2–3.1).ConclusionFOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required.     

Puerto Rican injection drug users: Prevention implications in Massachusetts and Puerto Rico

This study examines whether place of residence is a factor associated with reporting a positive HIV/AIDS, Hepatitis C (HCV), or Sexually Transmitted Disease (STD) status in a sample of 400 injection drug users (IDUs) residing on the Island of Puerto Rico (N=139) and in western Massachusetts (N=261). Logistic regression models revealed that IDUs residing in western Massachusetts were 66% less likely to be HIV positive compared to IDUs residing in Puerto Rico (p<.000) while IDUs residing in western Massachusetts were about 67% less likely to have a positive STD status than those residing in Puerto Rico (p<.000). Place of residence was not significantly associated with HCV status. Results indicate the need to develop prevention programs tailored to the unique socio-cultural context of Puerto Rican IDUs residing on the Island of Puerto Rico whose circumstances differ from those in the mainland US. To reduce drug use, HIV/AIDS, HCV, and STDs among Puerto Ricans in both locales, the Capacity Enhancement Model is proposed in order to develop more effective prevention programs.     

How Do the Professional Lives of Family Therapists Affect their Private Relationships: A Qualitative Study

This article is based on a qualitative research project about how the professional lives of family therapists affect their private relationships. The overarching research question was: How does your professional work as a family therapist affect your private relationships? To answer this question, semi‐structured qualitative interviews were conducted with four therapists from two different Family Counseling Services. Through the use of interpretative phenomenological analysis, three main findings were identified: (1) family therapists’ knowledge and values are a basis for interpersonal encounters; (2) participants describe resonance in relation to clients’ stories; and (3) therapists can be challenged in managing confidential knowledge particularly where they belong to the same communities as clients. The study also explores societal expectations and discourses that accompany the role of therapist, which can affect therapists’ freedom of movement in their private lives. These issues are discussed in relation to family therapy theory and relevant research.     

“I’ve changed my mind; I don’t want to go home”

Abstract

This article considers the motif of porosity and its opposite, impenetrability, in relation to the home or places where we feel at home. It discusses ambiguities in how the physical boundaries of the home—but also of the perceived human subject—are portrayed in the technology-pervaded world of the dystopian science fiction narrative Total Recall. Tracing the story from the 1966 novel by Philip K. Dick, through the 1990 film to the recent remake (2012), allows for a consideration of the changes in our understanding of how the boundaries between the home and its other are culturally conceived and what happens when the integrity of these boundaries are put into question. Despite their differences, we argue that all three narratives use the built structures of walls and the imagery of the container as a way of portraying the basic conflict of an outer world that tries to take possession of the protagonist’s inner life. Tracing narrative shifts, we suggest, can become a vehicle for understanding the ongoing negotiation of boundaries of the “self,” the human body, the home and even the city, and the implications these cultural negotiations have across the period from 1966 to 2012.     

Comfort aspects important for the performance and safety of kitesurfing

Equipment used in sports is of great importance, especially when the equipment is in direct contact with the athlete or is important for safety. In the sport kitesurfing environmental factors and the equipment design are crucial for the comfort and safety. The participants' choice and opinion of equipment can show which factors are considered most important for the performance and to reduce risk for injury. This study has evaluated self-reported information from the participants about what equipment they use, comfort of the equipment and if the equipment has contributed to any injuries. The methods used were questionnaires (n=206) and interviews (n=17), which in combination allows to assess the problem both quantitatively and qualitatively. The results showed that supported leading edge kites are most frequently used, with a waist harness and foot straps to attach the feet. The choice of kite type was mainly based on the discipline of riding for the respondent. Some issues concerning comfort of riding and injury risk the respondents did relate to the design of harness and foot straps. The information from this study can be used for development strategies for industry manufacturers and for further studies in the area of equipment design and biomechanics.