Women's acceptance of the diaphragm: the role of relationship factors

The vaginal diaphragm is a candidate for a female-controlled method of reducing risk of HIV/STI acquisition. We examined the association between relationship and partner factors and three measures of diaphragm acceptability: current use, consistency of use, and satisfaction with use. We conducted a telephone survey with 448 female members of a managed care organization, aged 18-49, who currently used contraception (including 140 diaphragm users, 187 pill users, and 121 male condom users). Use of a specific contraceptive was significantly associated with relationship length, condom-use negotiation self-efficacy, importance of covert use, perceived motivation of partner to prevent HIV/STIs, and perceived satisfaction of partner with current method. In addition, among diaphragm users, communication about HIV/STIs and perceived partner motivation to use a diaphragm were related to consistent use. These results suggest that acceptability of contraceptive methods among women is influenced by their perceptions of their male partner and relationship factors.     

Premarital cohabitation and marital disruption among white,black, and Mexican American women

We use data from the 1995 National Survey of Family Growth (N = 4,547) to investigate racial and ethnic differences in risk factors for marital disruption, with a particular emphasis on premarital cohabitation. We find that the nature and strength of the estimated effects of several risk factors for disruption differ across groups. In particular, premarital cohabitation is positively associated with subsequent marital disruption among non‐Hispanic White women but not among non‐Hispanic Black or Mexican American women. Little of the observed gaps between groups in levels of disruption, however, appears to be attributable to differences in premarital cohabitation. In addition to improving our understanding of marital disruption, this research contributes to a growing literature emphasizing heterogeneity across groups in the meaning and function of cohabitation.     

The link between unemployment and crime rate fluctuations: An analysis at the county, state, and national levels

Cantor and Land (1985) developed a theoretical model that proposed two pathways through which economic activity - as indexed by the aggregate unemployment rate - could affect the rate of criminal activity. The first is by increasing levels of criminal motivation within the population as deteriorating economic conditions affect social strain and social control; the second is by influencing the availability and vulnerability of criminal targets and thus the number of criminal opportunities. Although much empirical research has applied this theoretical model, few analyses have done so at disaggregated units of analysis. We present the most comprehensive analysis to date by empirically evaluating this model with data on 400 of the largest US counties - and examine the effects of aggregation on results as these county data are combined to the state and national levels - for the years 1978-2005. For seven Index crimes at each of the three levels of analysis, and with or without controls for structural covariates at each level, the directional effects hypothesized by Cantor and Land are found for 78 out of 84 estimated relationships. Even after taking into account the lack of statistical independence of these estimates by drawing on recently developed statistical theory, this is a very unlikely outcome. In accordance with expectations based on theory and prior research, (a) some of these relationships are weak and not statistically significant, and (b) the strongest and most consistent patterns of relationships for both the crime opportunity and crime motivation effects are found for three property crimes: burglary, larceny, and motor vehicle theft. Suggestions for further research on this topic are given.     

Conducting research with children: the limits of confidentiality and child protection protocols

This paper addresses the issue of child protection protocols within research conducted with children. Based partly on primary data this paper raises questions about the role of ethics committees in defining the limits of confidentiality in relation to child protection protocols within research, the perceptions of both children and parents about the meanings of confidentiality and notions of ‘harm’, and the role of the researcher in relation to legal and professional guidance about the protection of vulnerable people in society. We explore the concept of confidentiality within a research setting from a child protection perspective. In doing so we examine the legal and moral obligations of researchers to report child protection concerns, how children themselves perceive ‘harm’, and the need for much clearer guidance to researchers, as well as child participants and parents, about the limitations of confidentiality.     

Women's sexual experience during the menstrual cycle: identification of the sexual phase by noninvasive measurement of luteinizing hormone

Imprecise measures of ovulation obscure the relationship between women's sexuality and the menstrual cycle, as does studying women with different contraceptive goals in different social contexts. Here we present a novel noninvasive method to precisely pinpoint the preovulatory surge of Luteinizing Hormone (LH), demarcating hormonally distinct cycle phases with greater than 95% reliability. Women were more sexually active on days prior to and including the preovulatory (LH) surge. This pattern was evident only when women initiated sexual activity and not when their partners did, indicating an increase in women's sexual motivation rather than attractiveness. A second study replicated the 6-day increase in sexual activity beginning 3 days before the LH surge, accompanied by stronger sexual desire and more sexual fantasies. We propose the term 'sexual phase' of the cycle, since follicular phase is over inclusive and ovulatory phase is not sufficient. These findings are striking because the women were avoiding pregnancy and were kept blind to the hypotheses, preventing expectation bias. The sexual phase was more robust in women with regular sexual partners, although the increase in sexual desire was just as great in nonpartnered women, who also reported feeling less lonely at this time. We use these results to evaluate potential neuroendocrine mechanisms underlying women's sexual motivation and activity.     

THE REVIEW OF THE COMPULSORY DETENTION OF THE MENTALLY ILL: WHO SHOULD DECIDE?

The Mental Health Act 1986 (Victoria) established the Mental Health Review Board to periodically review the detention of involuntary patients in State mental institutions. The purported rationale for the inclusion of two non-medical personnel on the Board is that compulsory detention decisions should not be made by doctors alone and should include social and legal considerations. It is argued that the effectiveness of non-medical members is restricted by the dominance of medical discourse within Board hearings, the lack of availability of community-based care and treatment facilities and a failure to identify the relevance of non-medical issues to the decision-making process.     

Obfuscating Child Sexual Abuse I: The Identification of Social Problems

Despite the increase in public knowledge about the existence of child sexual abuse, caused by public inquiries, media attention and the significant number of publications on the subject, the problem of child sexual abuse has failed to be systematically addressed as a policy problem. It appears that neither the public nor the government has been convinced that child sexual abuse is a serious problem which is common, persistent and widespread across the dimensions of race, ability and social class. This paper examines the factors which enable child sexual abuse to be obfuscated, that is, obscured and hidden. © 1997 by John Wiley & Sons, Ltd.     

Reliability of reasons for early termination of breastfeeding: application of a bivariate probability model with sample selection to data from surveys in Malaysia in 1976-77 and 1988-89

Although extensively collected, data on people's reasons for their behaviour provided retrospectively have been met with some scepticism on the grounds that they may be subject to biases and errors that jeopardize their usefulness. This study investigates, for a sample of 1,327 births, the reliability with which women in Peninsular Malaysia recalled, at intervals 12 years apart, reasons for not initiating or for stopping breastfeeding less than 3 months after a birth. Overall, we find low to moderate reliability of recall. Levels of reliability are relatively high for some reasons (the child died and no or insufficient milk) but low for some others (child ill, breastfeeding inconvenient). Results from selection models show that reliability does not vary with the length of time since the child's birth but is inversely related to socio-economic status (proxied by education and employment). Social status, social norms, and health-related factors appear to be significant influences on women's consistency of reporting.     

Children's disaster knowledge,risk perceptions,and preparedness: A cross-country comparison in Nepal and Turkey

While children are one of the groups at risk in disasters, they can also take an active part in disaster management, provided that the opportunity is given. This research examined the effect of disaster experience, disaster education, country, and city socioeconomic status on children's perceived risk and preparedness with a survey of 1335 children between 11 and 14 years old, in Nepal and Turkey. The survey used questionnaires and the pictorial representation of illness and self measure (PRISM) tool. Results showed that (1) children's risk perceptions were in line with their country-specific objective risks; (2) there were differences between the countries in relation to perception of risk for all the hazards except wildfire; (3) socioeconomic status had a statistically significant effect on children's perceptions of risk and preparedness for earthquakes, wildfires, that is, children who live in wealthier places had higher perceived risk and preparedness; (4) children in both countries showed similar trends in their knowledge of the correct protective actions to take in the event of a hazard occurrence. However, there is still room to enhance children's knowledge, in terms of safety behaviors, as the children selected many incorrect protective actions. There are important implications in terms of child-centered disaster management which hopefully will make life safer and help to create more resilience to disaster in society as a whole.     

Empirical Comparison Between Capability and Two Health-Related Quality of Life Measures

The Investigating Choice Experiments Capability Measure (ICECAP) is a new preference-based measure of the extent to which a person is able to achieve attributes or capabilities related to the quality of life. Conceptually, it differs from health-related quality of life (HRQoL) as the focus is upon the ability or capacity to achieve as distinct from the current experience of the attributes. The objective of this study was to explore the empirical relationships between capability as assessed by the ICECAP for Adults (ICECAP-A) and HRQoL as assessed by the Assessment of Quality of Life (AQoL)-8D and the five-level EuroQol Five Dimensions questionnaire (EQ-5D). To compare these measures, the study employed self-reported survey data from the healthy public and from seven disease areas in five countries. Results indicate that, despite their conceptual origins, the ICECAP-A is strongly associated with the AQoL-8D and that the clear distinction between capabilities and HRQoL found in other studies is attributable to the use of the EQ-5D in the comparison and the weaker association between the EQ-5D and ICECAP-A. The suggestion that ICECAP-A should be included in evaluation studies along with a HRQoL instrument is more persuasive when the instrument is the EQ-5D. The case for its inclusion with other HRQoL instruments requires further research and evaluation.