Fathers' birth experience in relation to midwifery care

The aim was to identify the proportion of fathers having a positive experience of a normal birth and to explore factors related to midwifery care that were associated with a positive experience.

Background

Research has mainly focused on the father's supportive role during childbirth rather than his personal experiences of birth.

Methods

595 new fathers living in a northern part of Sweden, whose partner had a normal birth, were included in the study. Data was collected by questionnaires. Odds Ratios with 95% confidence interval and logistic regression analysis were used.

Results

The majority of fathers (82%) reported a positive birth experience. The strongest factors associated with a positive birth experience were midwife support (OR 4.0; 95 CI 2.0–8.1), the midwife's ongoing presence in the delivery room (OR 2.0; 1.1–3.9), and information about the progress of labour (OR 3.1; 1.6–5.8).

Conclusion

Most fathers had a positive birth experience. Midwifery support, the midwife's presence and sufficient information about the progress of labour are important aspects in a father's positive birth experience. The role of the midwife during birth is important to the father, and his individual needs should be considered in order to enhance a positive birth experience.     

Does More Schooling Reduce Hospitalization and Delay Mortality? New Evidence Based on Danish Twins

Schooling generally is positively associated with better health-related outcomes—for example, less hospitalization and later mortality—but these associations do not measure whether schooling causes better health-related outcomes. Schooling may in part be a proxy for unobserved endowments—including family background and genetics—that both are correlated with schooling and have direct causal effects on these outcomes. This study addresses the schooling-health-gradient issue with twins methodology, using rich data from the Danish Twin Registry linked to population-based registries to minimize random and systematic measurement error biases. We find strong, significantly negative associations between schooling and hospitalization and mortality, but generally no causal effects of schooling.     

Adaptation of a community-based participatory research model to gain community input on identifying indicators of successful parenting

Parenting models are generally based on families in stable homes, rather than in transitional situations such as in foster care, homeless shelters, and other temporary, at-risk residences. Consequently, these models do not recognize the unique challenges of families in transition. This study explored the domains of the Circumplex Model and examined its fit for transitional families using tenets from community-based participatory research. Findings suggest that in addition to the Circumplex Model's components, caregivers with children living in transition believe that managing the scrutiny of external authority systems and countering the negative influences of poverty and racism are two indicators that contribute to parenting success. Obtaining consumer-informed views of parenting not only is an important contributor to standards of practice, but also a promising avenue for future research.     

Making the journey into the networked enterprise, Part 2

In the May issue of Physician Executive, the authors described the difficulties other industries have had with vertical integration and why so many corporations have abandoned it for other organizational structures. In this second part of the series, they explore the ways health care organizations can make the shift into integrated delivery systems, avoiding the trap of the hierarchical, vertically integrated monolithic structures that will become the dinosaurs of the future.     

Learning how to learn: the key to CQI

All CQI/TQM efforts share a common purpose: to learn something that can correct past mistakes and/or to create better futures. Because learning is a dynamic circular process, the information about a problem or an opportunity will be limited unless four perceptions of the truth--each valid, and each incomplete--are accepted. These four types of learning styles or ways of perceiving are: abstract conceptualizers, active experimenters, concrete experiencers, and reflective observers. Unless all the stages of the learning process have been fully completed, unless all the strokes work in harmony, we cannot be confident that a CQI effort has added its full value. A CQI team's interpersonal process, the tools by which individually limited truths are forged into a consensual holistic truth, must ensure that the group's effort goes "around in circles."     

美国的司法制度与司法现状

目前,美国司法界最大的问题是法院的案件太多,联邦法院和五十个州法院通过法律解决的案件大约每年有600万件。总的来说,州法院是处理民事纠纷、刑事和非人力伤害之类的案件,而联邦法院主要则处理危害联邦宪法和联邦规定的案件。在这600万件案子中,有95%的案件由法官在当事人双方之间不经过审判就可得以解决。美国不仅法院案件多,而且     

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.     

Attitudes towards globalization and cosmopolitanism: cultural diversity, personal consumption and the national economy

One of the widely accepted consequences of globalization is the development of individual outlooks, behaviours and feelings that transcend local and national boundaries. This has encouraged a re-assessment of important assumptions about the nature of community, personal attachment and belonging in the face of unprecedented opportunities for culture, identities and politics to shape, and be shaped by, global events and processes. Recently, the upsurge of interest in the concept of cosmopolitanism has provided a promising new framework for understanding the nexus between cosmopolitan dispositions and global interconnectedness across cultural, political and economic realms. Using data from a representative social survey of Australians this paper investigates the negotiation of belonging under the conditions of globalization. The data tap into attitudes and behaviours associated with a broad gamut of cosmopolitan traits in the domains of culture, consumption, human rights, citizenship, and international governance. They show how cosmopolitan outlooks are shaped by social structural factors, and how forms of identification with humanity and the globe are fractured by boundaries of self and others, threats and opportunities, and the value of things global and local.     

Multi-couple reflecting team: preliminary report

The aim of therapeutic help in marital crisis is to break the vicious circle of mutual hurtful accusations. The method that the authors present below involves a group of couples working within a closed cycle of meetings. In the course of successive group meetings, the various couples act as reflecting teams (RTs) for each other. This achieves two objectives: the couple recounting their crisis receives nonthreatening feedback, which helps them to implement positive changes and break out of the self-perpetuating destructive interaction. In addition, the couples acting as the RT learn nonjudgmental, nontheorizing and affirmative communication.