Activism among older women in Quebec, Canada: changing the world after age 65

The aim of this article is to examine senior women's involvement experience in Quebec, Canada. Study results are based on a qualitative methodology, and shed light on family history and continuity in the involvement trajectory, diversity in terms of group type and involvement practices, and gender differences in involvement. The meaning that older women attribute to their involvement is also addressed, including attitudes toward feminism. The discussion highlights the extent to which older women's involvement has been marked by their life trajectories, above and beyond their age. In sum, their involvement in the private and public spheres is quite impressive.     

Time to listen: strategies to improve hospital-based postnatal care

BACKGROUND: In Australia and internationally, women report high levels of dissatisfaction with hospital-based postnatal care. AIM: To design and implement strategies to improve hospital-based postnatal care at a Sydney metropolitan hospital. METHOD: This was an Action Research study. In Phase One, midwives considered the literature and participated in group discussions and interviews to determine their perceptions of postnatal care and the factors that facilitate or hinder the provision of quality care. In Phase Two, midwives participated in 12 working group meetings to design strategies to improve care. RESULTS: Several important principles of postnatal care were described, including building a relationship with women, meeting their individual needs, being flexible in approach and providing continuity of care. 'Listening to women', 'being there,' and 'normalising experiences and expectations' were believed to be critical to achieving these principles. A key strategy 'One to One Time' was designed to provide women with an uninterrupted period of time each day with a midwife who was available to listen to their needs and concerns and discuss issues related to their health and that of their baby. CONCLUSION: Midwives designed and implemented strategies that they believed would improve in-hospital postnatal care.     

Desperately seeking social approval: Adam Smith, Thorstein Veblen and the moral limits of capitalist culture

Adam Smith and Thorstein Veblen shared much in matters of economic ontology. Both dismissed the very notion of an autonomous economic self and instead investigated the processes through which self and other are mutually constituted under changing cultural traditions of individual aspiration. Their strikingly similar critiques of status-oriented consumption and concern for the moral basis of the market economy are established in this manner. However, the political implications of their analyses point in different directions, with Veblen being the more radical. The Smithian individual can always use spectatorial insights to assert through genuinely praiseworthy behaviour personal moral distance from social norms of status-oriented consumption. The Veblenian individual, by contrast, has no such capacity for elevating abstract moral principles above socially-situated conduct, as mind and environment co-evolve in line with changing material circumstances of life. For Veblen, the rise of status-oriented consumption itself acted as a form of moral self-education that more deeply entrenched the social norms of ownership out of which it arose, thus the impossibility of an autonomous economic self was matched by the impossibility of an autonomous moral self. To his way of thinking, moral degradation in conspicuous consumption was irredeemably inscribed into the whole cultural structure of capitalism.     

Expert panel reviews of research centers: the site visit process

Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research centers. We review the processes of two site visit examples using an expert panel review: (1) a process to evaluate four university research centers and (2) a process to review a federally sponsored research center. A set of 14 categories describing the expert panel review process was obtained through content analysis and participant observation. Most categories were addressed differently through the two processes highlighting the need for more research about the most effective processes to use within different contexts. Decisions about how to structure site visits appear to depend on the research context, practical considerations, the level at which the review is being conducted and the intended impact of the report. Future research pertaining to the selection of site visitors, the autonomy of the visitors in data collection and report writing, and the amount and type of information provided would be particularly valuable.     

Process evaluation of an environmental walking and healthy eating pilot in small rural worksites

Small Steps are Easier Together (SS) was a pilot environmental intervention in small rural worksites in Upstate New York in collaboration with Extension educators. Worksite leaders teamed with co-workers to select and implement environmental changes to increase walking steps over individual baseline and to choose healthy eating options over 10 weeks. Participants were 226 primarily white, women employees in 5 sites. A mixed methods process evaluation, conducted to identify determinants of intervention effectiveness and to explain differences in outcomes across worksites, included surveys, self-reports of walking and eating, interviews, focus groups, and an intervention log. The evaluation assessed reach, characteristics of recruited participants, dose delivered, dose received, and context and compared sites on walking and eating outcomes. Emergent elements of participant-reported dose received included: active leadership, visible environmental changes, critical mass of participants, public display of accomplishments, accountability to co-workers, and group decision making. Participants at sites with high reach and dose were significantly more likely than sites with low reach and dose to achieve intervention goals. Although this small pilot needs replication, these findings describe how these evaluation methods can be applied and analyzed in an environmental intervention and provide information on trends in the data.     

Correlates of perceived effectiveness of the Safe Schools/Healthy Students Initiative

A three-level growth-curve model was applied to estimate perceived impact growth trajectories, using multi-year data from project and school surveys on outcome and program implementation collected from 59 sites and approximately 1165 participating schools in the Safe Schools and Healthy Students Initiative. Primary interest is to determine whether and how project-level and school-level correlates affect schools’ perceptions of the Initiative's effectiveness over time when the effects of the pre-grant environmental conditions, grant operations, and near-term outcomes are considered. Coordination and service integration, comprehensive programs and activities for early childhood development, and change in school involvement were found to be significant predictors of school-perceived overall impact when the effect of poverty was considered. Partnership functioning, perceived importance of school resources, and school involvement were found to be significant predictors of school-perceived impact on substance use prevention when the effect of poverty was considered.     

Risk Factors for Homelessness Among Lesbian, Gay, and Bisexual Youths: A Developmental Milestone Approach

Lesbian, gay, and bisexual (LGB) youths are over-represented in the homeless population. To examine why some LGB youths become homeless, this report compares homeless and non-homeless LGB youths. Of the 156 LGB youths, 48% reported ever being homeless (i.e., running away or being evicted from home). Results indicate that sexual orientation awareness and the initiation of sexual behavior occurred earlier in homeless than in non-homeless LGB youths and predated the first homeless episode. Substance use was more frequent and first occurred at an earlier age in homeless as compared to non-homeless LGB youths; however, substance use occurred subsequent to first homelessness. Childhood sexual abuse was associated with homelessness; and, early sexual orientation development was related to homelessness among youths without a history of sexual abuse. Findings suggest that interventions should help youths cope with their unfolding sexual orientation and work to prevent or address the consequences of sexual abuse.     

Predicting engagement in a transition to parenthood program for couples

Fostering participant engagement is a challenging but essential component of effective prevention programs. To better understand which factors influence engagement, this study examines several predictors of couple engagement in Family Foundations (FF), a preventive intervention for first-time parents shown to enhance parent mental health, couple relations, parenting quality, and child adjustment through age 3 years. FF consists of a series of classes delivered through childbirth education departments at local hospitals. Baseline data on socio-demographics, parent mental health, and couple relationship quality were examined as predictors of participants’ level of engagement in FF (n = 89 couples, 178 individuals). Sociodemographic variables such as parent gender, socioeconomic status, and age predicted program engagement to a limited extent. However, findings indicated that marital status was the best predictor of engagement. Discussion focuses on how findings can inform the development of practices that promote engagement, such as the use of targeted outreach efforts for individuals most at risk of disengagement.     

Changing attitudes about self-injury prevention management: lessons learned

In the behavioral health environment, nurses often use continuous staff monitoring and, at times, physical restraints, to manage the severity of patients' self-injury. Both options put staff in control, are the most restrictive in nature, and can be financially draining on the hospital's budget. This can result in negative reactions by both patients and staff. It is important to develop a program that will empower patients to control their behavior and allow staff to be aware of their perceptions and attitudes toward patients who self-injure. This article describes the leadership initiative that drove the development, training, and implementation of a self-injury prevention project and the lessons learned by staff.