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.     

Dot Plots

Dot plots represent individual observations in a batch of data with symbols, usually circular dots. They have been used for more than 100 years to depict distributions in detail. Hand-drawn examples show their authors' efforts to arrange symbols so that they are as near as possible to their proper locations on a scale without overlapping enough to obscure each other. Recent computer programs that attempt to reproduce these historical plots have unfortunately resorted to simple histogram binning instead of using methods that follow the rules for the hand-drawn examples. This article introduces an algorithm that more accurately represents the dot plots cited in the literature.     

Safety culture

'Developing a positive health and safety culture is important if high standards of health and safety are to be achieved and maintained. There is a limit to the health and safety performance an organization can achieve without addressing the contribution which human factors have to play in eliminating occupational accidents and ill health' (David Eves, Deputy Director UK Health and Safety Executive; HSE 1997).     

An Empirical Evaluation of Conflict in the Franchise System

This paper articulates the theoretical rationale for conflict in franchising, operationalizes conflict through the measurement of franchisee satisfaction and labels empirically supported stratified satisfaction levels. Two propositions are advanced in relation to the drivers of conflict in franchise systems. The first proposition is underpinned by relational exchange theory, which postulates that franchisee–franchisor goal congruence is important to the fulfilment of the alliance efficiencies which motivate inter-organizational forms. Cooperation, communication, coordination and commitment, as perceived by the franchisees, are used in the context of a survey instrument to operationalize goal congruence.
The second proposition involves franchisor-provided services. Transaction-cost analysis suggests that long-term contractual relationships must be flexibly interpreted and governed if the relationship is to be maintained over a series of transactions. We propose that the transactional intersection of the franchise system is in franchisor-provided services. The perceived importance and subsequent adequacy of delivery of these services established a tolerance zone within which transactions support and/or enhance the relationship between the franchisor and the franchisee.
The empirical objectives of the study are accomplished utilizing a questionnaire sent to nine franchise systems, to which 621 franchisees responded. Three clear clusters of franchisee conflict emerged in near equal proportions. The propositions are supported and illustrated empirically and in CHAID tree diagram form.     

Older Women's Perceptions of Elder Maltreatment and Ethical Dilemmas in Adult Protective Services: A Cross-Cultural,Exploratory Study

In this study, older African American, Latina, and Caucasian women from varying socioeconomic backgrounds participated in eight focus groups that examined their perceptions of elder maltreatment and three ethical dilemmas within adult protective service work: mandatory reporting, involuntary protective services, and criminalization of elder maltreatment. Participants espoused a broad and inclusive view of elder maltreatment. In responding to illustrative case scenarios, participants strongly favored protection over freedom by supporting mandatory reporting and involuntary protective services. Criminalization of elder maltreatment also was supported. This article presents results of each scenario and broad themes across the study, with attention paid to areas of consistency and difference across ethnicity and socioeconomic categories.     

Three Types of Memory for Childhood Sexual Abuse: Relationships to Characteristics of Abuse and Psychological Symptoms∗

ABSTRACT

Data from a clinical sample (N?=?88) reporting childhood sexual abuse was compared by types of memory, abuse characteristics, and psychological symptoms. Three types of memory were identified from a questionnaire (“Always” n?=?27 [31%], “Recovered” n?=?41 [46%], and “Both” n?=?20 [23%]). When compared with narrative reports from a subset (n?=?30) of the sample, the lines between “Always,” “Recovered,” and “Both” types of memory were ambiguous. Consistency across reports, however, was 83%. Memories classified as either “Recovered” or “Both” were associated with earlier age-at-onset and more severe psychological symptoms compared to those who “Always” remembered CSA. No significant differences were found between the “Both” and “Recovered” groups.