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91.

Problem

Clinical practice guidelines indicate that over 80% of women with a previous caesarean should be offered a planned vaginal birth after caesarean (VBAC), however only one third of eligible women choose to plan a VBAC. To support informed choices for birth after caesarean, it is necessary to understand the factors that influence women’s decision-making.

Aim

The goal of this study was to explore attitudes towards and experiences with decision-making for mode of delivery after caesarean from the perspectives of Canadian women.

Methods

In-depth, semi-structured interviews were conducted with 23 women eligible for VBAC in three rural and two urban communities in British Columbia, Canada, during summer 2015. Constructivist grounded theory informed iterative data collection and analysis.

Findings

Women’s decision-making experiences were a process of “seeking control in the midst of uncertainty.” Women formed early preferences for mode of delivery after their primary caesareans and engaged in careful deliberation during their inter-pregnancy interval, consisting of: reflecting on their birth, clarifying their values, becoming informed, considering the feasibility of options, deliberating with the care team, and making an actual choice. Women struggled to make trade-offs between having a healthy baby and social attributes of delivery, such as uninterrupted bonding with their newborn.

Conclusions

Women begin decision-making for birth after caesarean earlier than previously reported and their choices are influenced by personal experience and psychosocial concerns. Future interventions to support choice of mode of delivery should begin early after the primary caesarean, to reflect when women begin to form preferences.  相似文献   
92.
Consumers are put in the driver seat on the road to a sustainable development. Following a consumer-centric approach, this paper explores the dimensionality and the antecedents of responsible consumption from a psychological perspective. Concerning the dimensionality, the study proposes that responsible consumption should comprise a societal as well as an individual dimension. The data (N = 339) supported this two-dimensional approach, differentiating between societal responsibilities of consumers (doing good) and consumers’ responsibilities for their personal well-being (doing well). Moreover, the results indicate that both consumer awareness and sustainability-focused value orientation have a direct positive influence on responsible consumer behavior. In addition, the hypothesized mediating role of consumer awareness is confirmed, with mediations for societal or personal responsible consumer behavior by the respective consumer awareness dimension. Consequently, it is crucial for organizations to flank their sustainable offers with appropriate communication activities in order to motivate consumers to engage in more responsible consumption.  相似文献   
93.
This study examined linear and curvilinear longitudinal associations between peer status (i.e., likeability and popularity) and socioevaluative concern, a socio-cognitive feature characterized by attunement to judgment from peers. A sample of 716 adolescents (Mage = 16.01, SD = 1.25; 54% female; 46.5% White; 69.5% reduced-price lunch) was assessed twice annually. Likeability and popularity were assessed with peer nominations at Time 1. Measures of general (rejection sensitivity, peer importance) and online (digital status seeking, online status importance) socioevaluative concern were obtained at Times 1 and 2. High and low levels of likeability were longitudinally associated with increased peer importance, while high and low levels of popularity were associated with increased digital status seeking, and decreased online status importance for girls.  相似文献   
94.
The spaces and ethics of organic food   总被引:2,自引:0,他引:2  
Initial assessments of the potential for organic food systems have offered an optimistic interpretation of the progressive political and ethical characteristics involved. This positive gloss has prompted a stream of critique emphasising the need to explore the ambiguities and disconnections inherent therein. In this paper, we consider the case of Riverford Organic Vegetables,1 arguably the largest supplier of organic vegetables in the UK, and suggest that existing debates assume too much about the “goods” and “rights” of organic food and leave important questions about the spaces and ethics of organic food. We argue that, in the case of Riverford, the space of organic food production and distribution is neither the small, local, counter-cultural farm nor the large, transnational, corporate firm. Rather, simultaneously, the spaces of organic food production and distribution are the national network, the regional distribution system and the local farm. In addition, in the case of Riverford, the ethics of organic food exhibit few grand designs (of environmental sustainability, for example). Rather, the ethics of organic food are best characterised as: ordinary, since they relate to concerns about taste, value for money, care within the family and so on; diverse, since multiple practices steer the production and distribution of organic food; and graspable, in that both vegetables and box have material and symbolic presence for consumers.  相似文献   
95.
96.
In this article we reflect on the complexity and the contested nature of the roles of multi‐disciplinary teams working with children. This is an increasingly important issue in the current UK child welfare policy environment. The article uses the theories of Etienne Wenger to understand data gathered from five multi‐disciplinary teams working with children. We explore key issues relating to location; information sharing; models of understanding; and professional identities. We hope to demonstrate that the teams addressed tensions creatively through their engagement with diversity while at the same time developing common team values. We argue that effective strategies for making multi‐disciplinary teams work will combine inter‐agency issues with internal team‐specific aspects. Copyright © 2007 John Wiley & Sons, Ltd.  相似文献   
97.
98.
In prior writings, we have explored alternative means of justifying claims in evaluation practice. After a brief review of these previous investigations, we provide an analysis employing Toulmin's (1958) jurisprudence metaphor in the assessment of evaluative arguments. Applications and implications for evaluation practice are discussed.  相似文献   
99.
This article reviews developments in children's services since 1997 and considers their effect on children in need by examining government statistics, recent additions to the evidence‐base, and data from two studies conducted by the authors. It shows that there has been extensive service development, mainly beyond the Department of Health, and considerable effort to improve assessment and administrative data. The limits to what can be demonstrably achieved by children's services, particularly in a short period, are acknowledged, and it is argued that the approach of providing predominantly low level interventions to large groups may need re‐thinking if significant and lasting changes to children's development are to be secured. Copyright © 2003 John Wiley & Sons, Ltd.  相似文献   
100.
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