A qualitative inquiry into women’s experiences of severe maternal morbidity

Severe acute maternal morbidity (SMM) is a near-death experience during pregnancy, childbirth or termination of a pregnancy. Nine women recruited from hospital intensive care or high dependency units following the birth of their baby participated in two qualitative interviews about their SMM experience. The interpretative phenomenological analysis led to the identification of three superordinate themes related to participants: moving from a state of normal pregnancy to being severely unwell, being in critical care and returning to normal. Participants’ transition to a SMM event occurred quickly and was frightening, with participants expressing concerns about their husbands/partners’ trauma. Participants’ time in hospital was particularly hard for those separated from their baby, with this eased by staff kindness and family support. After discharge participants continued to seek explanations for their SMM. Implications include more formal support for mothering when women are in maternal critical care, and support for husbands/partners following a SMM event.     

Reflective Practice: An Exercise in Exploring Inner Dialogue and Vertical Polyphony

The dialogical notion of vertical polyphony, referring to multiple internal voices, is explored in relation to clinicians’ professional and personal selves. We describe an experiential training exercise developed to enhance clinicians’ awareness and understanding of their inner dialogue, and create space to practice what Schön terms ‘reflecting‐in‐action’ and ‘knowing‐in‐action.’ The exercise involves stages of personal reflection, discussion in groups of two or three, and shared learning by the group. A number of variations of the exercise are described. The invited commentaries following the article provide a sense of participants’ reactions to the exercises. Readers are invited to adapt the exercise to suit their own setting and to enhance reflective practice.     

Children's awareness of which peers like them and which peers dislike them

The present research examined children's awareness of the specific same-sex peers who like or dislike them. Awareness was evaluated in relation to children's peer sociometric status. All children in grades one through six provided same-sex peer sociometric nominations and same-sex peer sociometric ratings to determine their sociometric status. In addition, each child indicated the nominations and ratings they believed they received from same-sex peers. Children's sociometric status was associated with their awareness of liking and disliking from peers. Rejected status children were the least accurate in their judgments of who like them and popular status children were the least accurate in their judgments of who disliked them. These findings support and extend prior research documenting that rejected status children a) demonstrate a lack of awareness of their social competence, yet b) report more loneliness than children in other status groups.     

An Evolutionary Perspective on Human Fertility

This paper illustrates evolutionary approaches to population issues. Life history theory is a general theoretical framework that incorporates environmental influences, contextual influences, and heritable variation. In general, physically or psychologically stressful environments delay maturation and the onset of reproductive competence. Perceptions of scarcity also result in lower fertility by delaying reproduction or having fewer children—a phenomenon viewed as an adaptation to ancestral environments. The desire for upward social mobility is viewed as an evolved motive disposition affecting fertility decisions. The opportunity for upward social mobility typically results in delaying reproduction and lowering fertility in the interest of increasing investment in children. Variation in life history strategies is also influenced by genetic variation, but genetic variation interacts with cultural shifts in the social control of sexual behavior. Finally, i discuss the effects of between-group competition for resources on population issues. Immigration policy and group differences in fertility influence political power within and between societies, often with explosive results. Demographic expansion has often been an instrument of ethnic competition and is an important source of conflict in the contemporary world.     

Editorial: Introduction to Special Issue, “Perspectives on Fertility and Population Size”

Population and Environment -     

Equity market response to union decertification petitions and elections

The effect of union decertification elections on the valuation of corporations is examined using a standard event study methodology. Cumulative abnormal daily common stock returns for 203 NYSE and AMEX listed firms are estimated for the day on which a petition for a decertification election is filed and for the day on which the National Labor Relations Board (NLRB) certifies the decertification election outcome. The results are consistent with the hypothesis that successful union decertifications increase firm valuation and unsuccessful ones reduce firm valuation. The primary carrier of valuation information is the date the NLRB confirms the decertification election results. The petition file date yields little, if any, information about the firm’s capitalization. The authors thank the directors of the regional NLRB offices and the editor of this journal for their assistance. The usual caveats concerning errors and omissions apply. Correspondence should be directed to William L. Huth.     

Is There a Place for Biopsychosocial Formulation in a Systemic Practice?

There is a long history of literature concerning integrative practice and how a systemic practice can fit with other models of therapy Much of this literature has focused on establishing a space for systemic therapy within the dominant medical paradigm, and exploring how the medical model can be enhanced by systemic ideas. The outcome has been better practice, especially in child and adolescent mental health. Interestingly, however, there has been less discussion of the converse: the family therapy literature has rarely considered whether or not systemic practice itself can be enhanced by ideas from the dominant medical model. This article proposes that a biopsychosocial formulation can enhance systemic practice by: (I) holding clinicians accountable for their thinking; (2) facilitating a rigour and attention to detail that may prove useful when therapy falters; (3) opening up other possibilities for intervention; and (4) providing a way to engage with the dominant medical paradigm and support clients in negotiating their way through this system. Potential problems nevertheless arise when integrating a biopsychosocial formulation into a systemic framework. This article identifies these problems and presents ideas for how they can be managed in practice.