Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care

BackgroundAlthough midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters.ObjectiveThe objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care.Research designThe qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters.FindingsSocially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional.ConclusionThis research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong; midwives. These findings suggest that midwives need to better communicate a valuing of the woman's participation in decision-making processes and to work with women so they do have a sense of belonging within the maternity care environment. Midwives need to ensure that socially disadvantaged women do feel safe about having a voice regarding their choices and find ways to give them a sense of control within their maternity care encounters.     

The NIP graph of a social welfare function

We consider the fraction of pairs of m distinct alternatives on which a social welfare function f may be nondictatorially independent and Pareto when the domain of f satisfies the free k-tuple property. When k = 4 we improve the existing upper bound to . When there are at least 26 alternatives and we obtain an original upper bound, . To obtain these results we define and analyze the graph formed from the nondictatorial independent and Pareto pairs and combine the results of this analysis with known results from extremal graph theory. The authors extend special thanks to the two reviewers and the editor for their comments.     

The practice of principles: an examination of CED groups in Vancouver, BC

The community economic development (CED) framework has its rootsat the margins of society but has gained a broader interest.This paper examines some key principles associated with theCED framework. Interviews with practitioners within three CEDorganizations in Vancouver resulted in themes that link CEDas a strategy for sustaining a broader vision of the organizations.CED ventures provide opportunities that enhance the connectionfor marginalized peoples to participate in local community organizations.Yet, there are challenges around delivering services withinan alternative framework operationalized within a market-basedparadigm. Nevertheless, CED initiatives can have far reachingimpacts beyond the individual and the organization. Indeed,CED is about networks of communities within communities.     

Political Elites and the Culture of Social Movements

While sociologists have paid a great deal of attention to how political elites matter for the emergence and development of social movements, they have focused less explicitly on how political elites matter for the culture of social movements. This essay reviews work that directly and indirectly addresses this relationship, showing how political elites matter for various aspects of movement culture, like collective identity and framing. It also reviews literature that suggests how movement culture comes to impact political elites. The essay concludes by drawing from very recent scholarship to argue that to best understand political elites and the culture of social movements, we need to think about culture and structure as intertwined and to understand how relations matters in the construction of meaning.     

Do peer effects mediate the association between family socio‐economic status and educational achievement?

Differences in levels of academic achievement according to socio‐economic status (SES), and parental education in particular, have been a persistent feature of Australian education systems. Young people with highly educated parents are more likely than their peers with low‐educated parents to attain high levels of achievement at school. Students with low levels of achievement are less likely than their high achieving peers to complete Year 12 and are more likely to experience negative post‐school outcomes. The SES of the neighbourhood, and in particular, the school attended, has also been found to have an effect on levels of both academic achievement and attainment. For this paper, we conduct analyses of National Assessment Program – Literacy and Numeracy test scores for four cohorts of secondary school students attending government schools in the Australian Capital Territory to examine the associations between parental education, school attended and levels of educational achievement. Our findings show that students with university‐educated parents achieve at much higher levels than their peers with low‐educated parents and that attending a school with a higher proportion of students from educationally disadvantaged families has a negative effect on educational achievement.     

Less than human: a qualitative study into the experience of parents involved in the child protection system

This paper reports on the findings from a qualitative study into the experiences of parents who were involved in the English child protection system in 2013. Seventeen in‐depth interviews were conducted involving 19 parents and/or partners, and a framework approach was used to analyse the data. There were positive experiences of individual social workers and some positive experiences of the child protection system. However, the overwhelming theme of the parents' experiences was that the system was uncaring, inflexible and for some harmful to both themselves and their children. Despite being included in the child protection process, parents felt they were not afforded the same rights as a participant, as a decision‐maker or as a partner in seeking to improve the situation. The threat of consequences silenced parents who felt unable to speak out or challenge the things they disagreed with or coerced others into signing agreements they did not agree to. Such experiences related to a sense that they were being treated as ‘less than human’. These findings are considered within the context of recent reforms within the English child protection system.     

Shifting STEM Stereotypes? Considering the Role of Peer and Teacher Gender

This study builds on research on the power of counter‐stereotypical cues, as well as intergroup contact theory, to consider whether interactions with a female teacher and female peers in a high school engineering classroom decrease male students' gender/science, technology, engineering, and math stereotypical beliefs and whether this varies according to the initial strength of their stereotypical views. Analyses reveal that among male students who initially reject stereotypes of male superiority, more female peers in the classroom leads to a further decrease in their stereotypical views by the end of the year. In contrast, boys who held strong stereotypical beliefs became less stereotypical by the end of the course when they had a female teacher. Implications for future research and current educational reforms are discussed.     

Perspectives on Filial Responsibility Among Uprooted Families From South Lebanon

This study focuses on filial responsibilities among uprooted families. Views of 20 mothers and 20 adolescents and young adults from southern Lebanon residing in Israel were compared to identify the roles that adolescent children assume and the perceived effects of these roles. Eight domains of filial responsibilities were agreed upon: language broker, cultural broker, financial supporter and breadwinner, surrogate parent and sibling caretaker, emotional supporter of parents, mediator of family conflicts, heritage transmitter, and role model. The roles had simultaneous positive effects and negative effects. The discussion illustrates the importance of cultural context of country of origin and the host culture. Moreover, it suggests implications of the findings for research and practice.     

Stress,strain, coping and social support for affected family members attending the National Problem Gambling Clinic,London

Aims were: to compare burden experienced by affected family members (AFMs) attending a problem gambling treatment clinic in London, England with that of AFMs affected by substance problems; to examine socio-demographic correlates of AFM burden; to evaluate change following an intervention designed for AFMs; and to test the assumption of the stress-strain-coping-support (SSCS) model that change in AFM coping is important. AFMs (N = 215) completed a gambling version of the short questionnaire for family members affected by addiction (SQFM-AA) which assesses stressful impact, symptoms of ill health, ways of coping, social support and overall burden. All received a 5-Step Method workbook, based on the SSCS model. The SQFM-AA was repeated three to six months later (n = 96). T-test analyses showed that baseline burden and related variables were comparable to those of family members affected by substance problems, were greater for wives and those living in the same household as the gambling relative, and were significantly reduced at follow-up. Regression modelling indicated the importance, for AFMs’ health, of reduced levels of engaged-emotional coping. Family members affected by gambling, some subgroups especially, experience high levels of burden. They can benefit from a model-based intervention, and coping change may be an important process.