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61.
62.

Background

Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.

Aim

The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.

Methods

An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.

Findings

Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.

Conclusions

Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education.  相似文献   
63.
Entrepreneurism is widely regarded as being one way in which women can sidestep the sexism of male‐dominated institutionalized work environments and enter into a world in which men and women operate on a level playing field. Yet, in a corpus of stories of female entrepreneurs’ experiences, we noted that being ignored by men was a constant theme. Taking a social constructionist and narrative approach to identity, we analyse the gendered identity work that female entrepreneurs do in these stories and we seek to explicate the process through which female entrepreneurs do not evaluate being ignored by men as sexism‐in‐action. Using positioning theory as an analytical tool, we analyse these stories at three different levels: the here‐and‐now interaction between interviewer and storyteller; the there‐and‐then identity work of the characters in the storyworld; and the wider societal Discourses that the storytellers enact, and which are enacted by such identity work. Findings indicate that despite making gendered difference, inferiority and lack of agency relevant, the stories are not evaluated as sexism‐in‐action because the female entrepreneurs enact a postfeminist and neoliberal Discourse of freedom, autonomy and choice, rather than a feminist Discourse of discrimination and sexism.  相似文献   
64.
The influence of relational identification (RI) on leadership processes and the effects of social identity leadership on followers' responses to stress have received scant theoretical and research attention. The present research advances theoretical understanding by testing the assertion that high RI with the leader drives follower mobilization of effort and psychophysiological responses to stress. Two experimental scenario studies (Study 1 and Study 2) support the hypothesis that being led by an individual with whom followers perceive high RI increases follower intentional mobilization. Study 2 additionally showed that high (vs. low) RI increases follower resource appraisals and cognitive task performance. A laboratory experiment (Study 3) assessing cardiovascular (CV) reactivity showed that, compared to neutral (i.e., non-affiliated) leadership, being led by an individual with whom participants felt low RI elicited a maladaptive (i.e., threat) response to a pressurized task. In addition, relative to the low RI and neutral conditions, high RI with the leader did not engender greater challenge or threat reactivity. In conclusion, advancing social identity leadership and challenge and threat theory, findings suggest that leaders should be mindful of the deleterious effects (i.e., reduced mobilization and greater threat state) of low RI to optimize follower mobilization of effort and psychophysiological responses to stress.  相似文献   
65.
Childbearing behavior in East Asian countries has changed rapidly during the past half century from an average of five to seven children per family, to replacement-level fertility, and subsequently to unprecedentedly low levels, the lowest in the world. This article analyzes fertility trends in Hong Kong, Japan, singapore, south Korea, and Taiwan using cohort fertility data and methods, then examines social and economic causes of the childbearing trends, and surveys policies pursued to reverse the fertility trends. Postponement of childbearing started in the 1970s with continuously fewer delayed births being "recuperated," which resulted in ultra-low fertility. A rapid expansion of education and employment among women in a patriarchal environment has generated a stark dilemma for women who would like to combine childbearing with a career. Policy responses have been slow, with a more serious attempt to address issues in recent years. Thus far public and private institutions are not devoting sufficient attention to generating broad social change supportive of parenting.  相似文献   
66.
Research examining parental reports of children's living arrangements has often relied on information about legally ordered custody agreements following divorce. This analysis used data from matched pairs of parents (N = 1,156) in the Fragile Families and Child Wellbeing Study who live apart to compare mother and father reports of their child's residence 5 years after a nonmarital birth. The authors found that over one third of unmarried parents disagreed about who their child lived with and that conflicting reports were much more likely when fathers spent nights with the mother (an indicator of part‐time cohabitation) and had overnights with the child on their own. The results further suggest that discrepancies in unmarried parents' reports were more closely associated with the complexity and ambiguity of their living situations than with the quality of their relationships with each other. Implications for measuring children's living arrangements in families formed outside of marriage are discussed.  相似文献   
67.
“Hookups” are sexual encounters between partners who are not in a romantic relationship and do not expect commitment. We examined the associations between sexual hookup behavior and depression, sexual victimization (SV), and sexually transmitted infections (STIs) among first-year college women. In this longitudinal study, 483 women completed 13 monthly surveys assessing oral and vaginal sex with hookup and romantic partners, depression, SV, and self-reported STIs. Participants also provided biological specimens that were tested for STIs. During the study, 50% of participants reported hookup sex and 62% reported romantic sex. Covariates included previous levels of the outcome, alcohol use, impulsivity, sensation seeking, and romantic sex. Autoregressive cross-lagged models showed that, controlling for covariates, hookup behavior during college was correlated with depression, Bs = .21, ps < .05, and SV, Bs = .19, ps < .05. In addition, precollege hookup behavior predicted SV early in college, B = .62, p < .05. Hookup sex, OR 1.32, p < .05, and romantic sex, OR 1.19, p < .05, were associated with STIs. Overall, sexual hookup behavior among college women was positively correlated with experiencing depression, SV, and STIs, but the nature of these associations remains unclear, and hooking up did not predict future depression.  相似文献   
68.
Alcohol and marijuana use are thought to increase sexual risk taking, but event-level studies conflict in their findings and often depend on reports from a limited number of people or on a limited number of sexual events per person. With event-level data from 1,856 sexual intercourse events provided by 297 college women (M age = 18 years; 71% White), we used multilevel modeling to examine associations between alcohol and marijuana use and condom use as well as interactions involving sexual partner type and alcohol-sexual risk expectancies. Controlling for alternative contraception use, partner type, regular levels of substance use, impulsivity and sensation seeking, and demographics, women were no more or less likely to use condoms during events involving drinking or heavy episodic drinking than during those without drinking. However, for drinking events, there was a negative association between number of drinks consumed and condom use; in addition, women with stronger alcohol-sexual risk expectancies were marginally less likely to use condoms when drinking. Although there was no main effect of marijuana use on condom use, these data suggest marijuana use with established romantic partners may increase risk of unprotected sex. Intervention efforts should target expectancies and emphasize the dose-response relationship of drinks to condom use.  相似文献   
69.
The role of subsequent school contexts in the long-term effects of early childhood interventions has received increasing attention, but has been understudied in the literature. Using data from the Chicago School Readiness Project (CSRP), a cluster-randomized controlled trial conducted in Head Start programs, we investigate whether the intervention had differential effects on academic and behavioral outcomes in kindergarten if children attended high- or low-performing schools subsequent to the preschool intervention year. To address the issue of selection bias, we adopt an innovative method, principal score matching, and control for a set of child, mother, and classroom covariates. We find that exposure to the CSRP intervention in the Head Start year had significant effects on academic and behavioral outcomes in kindergarten for children who subsequently attended high-performing schools, but no significant effects on children attending low-performing schools. Policy implications of the findings are discussed.  相似文献   
70.
This paper considers how shifts within the social sciences towards conceptualising spatiality in relational terms have unfolded in rural studies in particular ways over the past decade or so. A period in which networks, connections, flows and mobility have all established themselves as compelling conceptual frames for research, the rural has increasingly been recast in relational terms as a multi-authored and multi-faceted space, constituted through local-global interconnections and their place specific, sometimes contested, manifestations. In this way, the multiple meanings of the rural continues to be a focus of critical concern, as are the implications ‘of’ and ‘in’ rural spaces for some of the major issues currently being faced by governments and citizens around the world; including climate change and food security. Apprehending the complexity of the rural in these terms, we argue, requires not only thinking space relationally, but at the same time being epistemologically relational or theoretically pluralist. That is, recognising the co-constituent production of rural space through material and discursive phenomenon, processes and practices, and thus the value of existing theoretical resources (social constructionism, political and economic materialism) in relation with the critical and rigorous appraisal of ‘new’ concepts and ideas to better comprehend rural space in its multidimensional complexity and particularity. To this end, we identify Cindi Katz's notion of ‘countertopography’ as a promising conceptual and methodological addition to the rural scholar's toolkit insofar as it attends to a politics of location and differentation in relation to global processes. We conclude our discussion by sketching out possible objects of countertopographical analysis for understanding ongoing processes of change in rural space(s).  相似文献   
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