The influence of the birthplace and models of care on midwifery practice for the management of women in labour

This paper will examine how the settings in which midwives practice (the birthplace) and models of care affect midwives’ decision making during the management of labour. One-hundred-and-four independent, team and hospital based midwives and 100 low obstetric risk nulliparous women to whom labour care was provided were surveyed. These midwives and women resided in the Auckland metropolitan area of New Zealand. The majority of midwives who participated worked in models of care which provided women with continuity of carer and care, however, this was not found to influence the way the midwives provided labour care. Instead, practice was found to be relatively homogenous regardless of whether the midwives worked in independent, team, or hospital-based practice. The birthplace setting in which the labour care took place did influence midwifery practice. The majority of midwives provided labour care in large obstetric hospitals and identified practices dominated by the medical model of care. Practice was described as being influenced by intervention and the need for technology, however, this did not prevent the majority of women from perceiving they were actively involved in the decision making process and that they worked in partnership with their midwives. Closer examination of the midwives’ decision making processes whilst providing the labour care revealed that the midwives’ individual decisions were influenced by the needs of the women rather than the hospital protocols. What became evident was that the midwives in this study had adopted a humanistic approach to care whereby technology was used alongside relationship-centred care.     

The emerging role of Financial Counsellors in supporting Older Persons in financial hardship and with management of Consumer‐directed Care packages within Australia

The role of financial counsellors as providers of information, support and advocacy for those in financial difficulty is a well established mechanism in the mainstream welfare landscape in Australia. In general, the role of financial counsellors is in helping people alleviate or resolve their financial difficulties through improvement of their financial literacy. It is recognised as an important component of policy responses to assist low‐income households and individuals in financial stress. The use of financial counsellors for older persons (i.e., those aged 65+ years), however, appears to be underutilised. Financial hardship and abuse of older persons within our community are becoming key issues as the population of Australia “ages”. Existing evidence also suggests that service providers alone do not have adequate skills to address these issues. This paper firstly examines the development of financial counselling in Australia. It then examines the newly emerging role of financial counselling in supporting older persons in addressing barriers to financial literacy and then in navigating the complex landscape of aged care service provision. The current financialisation, marketisation and complexities of consumer‐directed care are identified as key contextual factors. The paper will then discuss an evaluation study of the provision of financial counselling to the older person population designed to support financial hardship and navigation of the complex aged care services system. The findings of the paper are based on an evaluation of the Financial Consumer Rights Council (FCRC), Victoria: Dignity and Debt Financial Difficulty and Getting Older initiative. This pilot initiative included older persons from both community‐based and aged care residential facilities in one regional area of Victoria. The initiative, conducted over 2016, was designed to assess the effectiveness of one‐on‐one financial counselling sessions with older persons that provided consumer advocacy and information about support services and entitlements (including hardship protections) associated with ageing. The evaluation found that the provision of financial counselling to the older person population could be a key mechanism in improving overall financial literacy, avoiding periods of financial hardship and in maintaining financial well‐being, quality of life and positive ageing. Findings also demonstrated a need for an expanded outreach financial counselling model to better service older persons in more isolated living environments and/or with mobility impairments living in the community, and the potential to situate offices of financial counsellors within medical centres (a space often visited by the ageing population), to co‐situate financial health check‐ups as an overall element of health and well‐being. As such, financial counselling was viewed as well placed to support older persons in improvement of financial literacy and in supporting navigation of the increasingly complex marketised and consumer‐directed care (CDC) landscape of aged care service provision in Australia.     

Intergenerational Relations between English Students,Graduates Living at Home,and their Parents

Debate about intergenerational relations has become more prominent since the financial crisis of 2007–09, focusing particularly on the difficulties faced by young adults trying to enter the labour and housing markets, whilst often bearing high levels of debt incurred as students. This article reviews the nature of the ‘intergenerational contract’ at both the micro level of the family, and at the macro level between individuals and the state. We then present qualitative, empirical data on the relationship between parents and: (1) their student children; and (2) their graduate children who have returned home. We focus primarily on the financial support provided by parents to the two groups. We explore why support is given, and the nature of similarities and differences in terms of what is given. We find that virtually all parents who were able to support their young adult children financially did so, but to different degrees and with different amounts of tension and anxiety. We suggest that the increased importance of the intergenerational contract at the micro level is likely to contribute to intra‐ rather than intergenerational inequalities.     

Workplace discrimination and missing limbs: the national EEOC ADA research project

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with missing limbs is documented. Researchers compare and contrast the key dimensions of workplace discrimination involving Americans with missing limbs and persons with back and other non-paralytic orthopedic impairments. Specifically, the researchers examine demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom complaints are filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the legal outcome or resolution of these complaints. Findings indicate that persons with missing limbs were more likely to encounter discrimination if they were male, under 20 or over 65 years of age, and White or Native American. They were also more likely to encounter more frequent discrimination when they worked for employers in the Southern United States, those with 200 or fewer employers, or whose industry designation involved manufacturing, construction, or transportation. Finally, the nature of job discrimination experienced by Americans with missing limbs is more likely to involve hiring, promotion, or job training than other issues. Implications for policy and advocacy are addressed.     

Philosophical speculations on systems design

Belief in the value of the scientific method as a means of implementing improvement in social systems (here called “systems design”—SD) raises important philosophical questions concerning, inter alia, the meaning of “scientific method”, of “improvement”, and of social reality. One underlying problem is that of the “self reflecting paradox”; e.g. the content and validity of the scientific method can only be discovered by the application of the scientific method. Similarly, SD has its own “social reality” through which it perceives that of its client. “Improvement” is bound up with ethics but ethics does not admit the limitation of obligation to one sub-system, therefore improvement requires the recognition of sub-system linkages. Paradoxically, again, the “improver” is himself part of the total system and bears its impress. Implementation (of improvement) meets the paradox that SD on SD is needed to judge the worth of the SD proposal. The pragmatic escape from the paradox identifies SD with a heuristic role in social progress but presupposes the possibility of progress. “Implementation” secures the possibility of such progress. The second major problem is that SD requires a social reality in which individuals have visible goals; but the “inner world” of individual goals is unknown and cannot be tracked from observable responses. In any case, Kant's moral precept requires that individuals be valued as ends rather than means. Much of SD uses them as means. Though SD is and must be practised, such philosophical speculation raises SD's self knowledge and points the neat paradox of its technical precision won at the price of its fundamental woolliness.     

Public perceptions of the ideal number of children for contemporary families

Demographic and family dynamics have been influenced by the recent downturn in average family size. This research examines perceptions of the ideal size for contemporary families and beliefs regarding factors which have contributed to families' decisions to have fewer children. Findings reveal that the two child family is the overwhelming standard chosen by respondents, and that this preference holds for virtually all demographic categories. Three of five reasons offered for smaller families today (expense of children, wives working and better birth control) were viewed as important by over 85% of those sampled.A previous version of this paper was presented at the annual meetings of the Southern Demographic Group, Austin, Texas, October, 1985. Support for computer analyses was provided by the Office of Computer and Information Services, University of Maryland Baltimore County.     

The North Korean famine and its demographic impact

The North Korean famine began in 1995 and its ill effects, while peaking in the late 1990s,undoubtedly linger. Recent conjectures on excess deaths caused by the famine range widely from about 200,000 to 3 million or more. This article assesses the demographic impact of the famine with greater rigor than has previously been attempted and describes the unique setting in which the famine occurred. The analysis begins with a pair of population projections based on mortality statistics from two sources. Given their contradictory implications, the analysis turns to less direct evidence of famine‐related mortality. That evidence includes China's demographic experience during the Great Leap Forward and recent measurements of child malnutrition in North Korea. Crosscountry comparisons translate this malnutrition into corresponding levels of infant mortality. The article concludes that famine‐related deaths in North Korea from 1995 to 2000 most likely numbered between 600,000 and 1 million.     

Animals and anomalies: an analysis of the UK veterinary profession and the relative lack of state reform

The sociology of professions literature would predict that the contemporary state would not allow groups to continue unregulated or unreformed. However, this is indeed the case with the UK veterinary profession, with legislation dating back to 1966. Using an interdisciplinary analysis of published literature and reports, this paper assesses whether wider social, political and ethical dynamics can better explain this intriguing anomaly. We conclude with critical implications for the sociology of the professions. Furthermore, we argue that continuing to ignore the veterinary profession, and animals more generally, in sociological research will result in an impoverished and partial understanding of contemporary healthcare and occupations.