Sense of belonging in secondary schools: a survey of LGB and heterosexual students in Flanders

This study focuses on differences in sense of belonging between lesbian, gay, and bisexual (LGB) and heterosexual students. Data from 1,745 secondary school students were collected with an online survey. Step-wise multiple regression analyses was used to investigate the relationship between sexual orientation and sense of school belonging. The results show that sexual orientation has an impact on sense of belonging for girls, but not for boys. Perceived discrimination and LGB friendliness of the school appeared to be important indicators of sense of belonging for all the respondents, irrespective of their sexual orientation.     

Gender dysphoric/gender variant (GD/GV) children and adolescents: summarizing what we know and what we have yet to learn

The optimal approach to treating minors with gender dysphoria/gender variance (GD/GV) is much more controversial than treating these phenomena in adults. This is because children have limited capacity to participate in decision making regarding their own treatment, and even adolescents have no legal ability to provide informed consent. Minors must, therefore, depend on parents or other caregivers to make treatment decisions on their behalf, including those that will influence the course of their lives in the long term. Presently, the highest level of evidence available for selecting among the various approaches to treatment is best characterized as "expert opinion." Yet, opinions vary widely among experts and are influenced by theoretical orientation and assumptions and beliefs regarding the origins of gender identity, as well as its perceived malleability at particular stages of development. This article outlines some of the more salient points raised by the clinicians who treat GD/GV and their discussants. This article summarizes what the editors believe is known and what has yet to be learned about minors with GD/GV, their families, their treatment, and their surrounding cultures.     

Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature

ObjectiveTo undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.MethodOvid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) ‘making sense of evidence’ tools.FindingsAsian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries.ConclusionCurrent research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.     

Home birth and the National Australian Maternity Services Review: too hot to handle?

Background

In February 2009 the Improving Maternity Services in Australia – The Report of the Maternity Services Review (MSR) was released, with the personal stories of women making up 407 of the more than 900 submissions received. A significant proportion (53%) of the women were said to have had personal experience with homebirth. Little information is provided on what was said about homebirth in these submissions and the decision by the MSR not to include homebirth in the funding and insurance reforms being proposed is at odds with the apparent demand for this option of care.

Method

Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Aging website. All 832 submissions were downloaded, coded and then entered into NVivo. Content analysis was used to analyse the data that related to homebirth.

Findings

450 of the submissions were from consumers of maternity services (54%). Four hundred and seventy (60%) of the submissions mentioned homebirth. Overall there were 715 references to home birth in the submissions. The submissions mentioning homebirth most commonly discussed the ‘Benefits’ and ‘Barriers’ in accessing this option of care. Benefits to the baby, mother and family were described, along with the benefits obtained from having a midwife at the birth, receiving continuity of care and having a good birth experience. Barriers were described as not having access to a midwife, no funding, no insurance and lack of clinical privileging for midwives.

Conclusion

Many positive recommendations have come from the MSR, however the decision to exclude homebirth from these reforms is perplexing considering the large number of submissions describing the benefits of and barriers to homebirth in Australia. A concerning number of submissions discuss having had or having considered an unattended birth at home due to these barriers. Overall there is the belief that not enabling access to funded, insured homebirth in Australia is a violation of human rights. It appears that homebirth was considered by the MSR as ‘too hot to handle’ and by dismissing it as a minority issue the government sought to avoided dealing with homebirth as a ‘sensitive and controversial issue.’     

Sexual attraction status and adolescent suicide proneness: the roles of hopelessness, depression, and social support

This study explored the relationship between sexual attraction status (same-sex, both-sex, and opposite-sex) and suicidal behavior in a diverse sample of adolescents (N = 1,533 youth). Adolescents with attractions to both sexes reported greater suicide proneness, recent and lifetime suicidal ideation, and past suicide attempts than those with exclusively opposite-sex attractions; individuals reporting same-sex attractions generally demonstrated moderate elevations on these variables. As hypothesized, both hopelessness and depression mediated the relationship between sexual attraction status and suicide proneness. Social support moderated the mediating effect of depression but not hopelessness in the sexual attraction status-suicide proneness link. Targeting the distress that can be associated with experiencing same-sex or both-sex attractions may enhance suicide prevention efforts, particularly in U.S. youth with reduced social support.     

Student degree program and attitudes toward gays and lesbians in the military: is there a connection?

Individuals routinely experience discrimination based on sexual orientation. Since the implementation of Don't Ask, Don't Tell in 1994, over 13,000 military personnel have been discharged from the U.S. military on the basis of sexual orientation. As helping professionals, social workers will often provide services to returning gay and lesbian veterans. Therefore, social work programs must ensure that students develop positive attitudes toward and understanding of the needs presented by this population. Little is known about whether a specific degree program can be a predictor of student attitude toward gay and lesbian individuals in the military. Eighty-nine graduate students completed the Attitudes Toward Homosexuals in the Military (ATHM) scale, and scores were compared between two graduate degree programs: Social Work and Business Administration. A statistically significant relationship was found between degree program and ATHM scores. Implications for policy, practice and research related to gay and lesbian veterans are discussed.     

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.     

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.     

In the slammer: the myth of the prison in American gay pornographic video

The purpose of this paper is to discuss the significance of the prison scenario and its various permutations in the texts of American commercial pornographic video. The paper will identify the prison as a highly eroticised all male environment, an arena where the active/passive dichotomy of gay pornography is staged and re-staged. The significances of the prison are multiple. The prison draws on a gay mythology of homosexual desire that has its origins in sources as diverse as the literature of the Marquis de Sade and Jean Genet and the erotic illustrations of Tom of Finland and Etienne. Prison scenarios take many shapes in gay pornography such as the American penitentiary, the military brig, and the fantasised dungeon of the leatherman. I see these scenarios as performing an important function within gay porn by offering idealised spaces for the acts of pornography: voyeurism, narcissistic display and active/ passive role-play.     

The relative importance of ethnicity and religion in predicting attitudes towards gays and lesbians

Using data from a sample of college students from several campuses throughout the United States, this research examines whether ethnic differences (African Americans versus European Americans) in attitudes toward gays and lesbians are a function of religious attendance. Multiple regressions were run separately for attitudes towards lesbians and attitudes toward gay men. When predicting attitudes toward lesbians, ethnic differences were present in the absence of religious attitudes; however, when religious attitudes were entered into the model, ethnic differences disappeared. In predicting attitudes toward gay men, ethnic differences were never present, while religious attitudes were always statistically significant. We conclude that differences in attitudes toward homosexuals in general, and gay men specifically, are not necessarily a function of ethnicity but possibly of religious attendance and the effect of the "Black church." We end with a discussion of the link between ethnicity, religion, HIV/AIDS, and heterosexism in the African American community.