Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature

BackgroundYoung pregnant women who continue a pregnancy are primarily from a socioeconomically deprived background. The risk factors associated with low socio-economic status may independently affect perinatal and neonatal morbidity to a greater extent than the young age of the woman. Young pregnant women are frequently sceptical about health care providers who they can perceive to be judgemental. This may lead to late booking for pregnancy care, attending few appointments, or not attending the health service for any antenatal care.QuestionDoes the way maternity care is provided affect maternal and neonatal outcomes for young women?MethodA systematic search of the major health databases.ResultsNine research articles met the eligibility criteria: one randomised controlled trial, three prospective cohort studies, two comparative studies with concurrent controls, two comparative studies with historical controls, and one case series.DiscussionProviding young women with a non-standard model of maternity care has some beneficial and no known detrimental effects on childbirth outcomes. While there is a dearth of evidence on the effectiveness of a Midwifery Group Practice model of care for young women, there is strong evidence to suggest that a Group Antenatal Care model increases antenatal visit attendance and breastfeeding initiation, and decreases the risk of preterm birth. There is research to indicate that a Young Women's Clinic model may also increase antenatal visit attendance and decrease the incidence of preterm birth.ConclusionMore well-designed and resourced midwifery models of care for young women should be implemented and rigorously researched.     

Unpacking Court Divorce Decrees,Children’s Outcomes,and Three Unconfounded Determinants: An Evidence-Based Look

This article examines evidence on 3 determinants of the outcomes of children of divorce that are shaped but neither confound or are confounded by court decrees for custody and parenting time: father contact or involvement, high interparental conflict, and domestic violence. This evidence is brought to bear in an analysis that contrasts predictions based on the rationales for sole maternal versus joint custody and explores implications for judicial decision making. It is found that the best-interests-of-the-child standard better serves children in contested cases when this evidence is taken into account. A call is made for rebuttable presumptions for joint custody and commensurate parenting time except when parent-perpetrated violence or other patterns of abusive behavior are substantiated. Steps for judicial reform are proposed.     

An Exploratory Analysis of Executive Functioning for Female Sexual Offenders: A Comparison of Characteristics Across Offense Typologies

This study examined the association between female sexual offending behavioral patterns, as delineated by Sandler and Freeman's (2007 Sandler, J. C. and Freeman, N. J. 2007. Typology of female sex offenders: A test of Vandiver and Kercher. Sex Abuse, 19: 73–89. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) typologies, and executive functioning. The sample included all referrals for sexual offender assessments within a women's maximum/medium security prison between January 2009 and October 2009. Each subject was administered the Stroop (Golden & Freshwater, 2002 Golden, C. J. and Freshwater, S. M. 2002. The Stroop color and word test: A manual for clinical and experimental uses, Wood Dale, IL: Stoelting Company.  [Google Scholar]) and Trail Making Test (Reitan, 2004 Reitan, R. M. 2004. “Validity of the trail making test as an indicator of organic brain damage”. In Neuropsychological assessment, 4th, Edited by: Lezak, M. D., Howison, D. B. and Loring, D. W. 371–374. New York: Oxford University Press.  [Google Scholar]) and were assigned to a typological category. Nonparametric analyses were conducted to determine if there was an association between typology and performance on neuropsychological tests. Results yielded no significant associations between test scores and typological category. Subjects displayed average capacities for a subset of executive functions, suggesting that the mechanisms for sexually offending behavior in females may differ from males.     

Using natural language processing technology for qualitative data analysis

Social researchers often apply qualitative research methods to study groups and their communications artifacts. The use of computer-mediated communications has dramatically increased the volume of text available, but coding such text requires considerable manual effort. We discuss how systems that process text in human languages (i.e. natural language processing [NLP]) might partially automate content analysis by extracting theoretical evidence. We present a case study of the use of NLP for qualitative analysis in which the NLP rules showed good performance on a number of codes. With the current level of performance, use of an NLP system could reduce the amount of text to be examined by a human coder by an order of magnitude or more, potentially increasing the speed of coding by a comparable degree. The paper is significant as it is one of the first to demonstrate the use of high-level NLP techniques for qualitative data analysis.     

Social Status and Attitudes toward Organizational Control of Genetic Data

Abstract

Advances in genetics testing technologies have lead to concerns over the use of genetic testing in non-medical, organizational settings. Genetic testing, which is becoming an increasingly common practice in organizations to screen employees and applicants for employment and insurance for genetic anomalies, has been demonstrated to be consistent with organizational goals such as profitablity and efficiency. This paper examines the characteristics of those who support organizational genetic screening. Data from a randomly selected sample of adults reveal that three indicators of socio-economic status — income, education and supervising others — were negatively associated with support for the non-medical use of genetic data. These findings suggest that working class individuals are more likely to conform to organizational policies requiring genetic testing of employees and clients. The study argues that managerial decisions based on genetic data may have the most impact on individuals with the fewest socio-economic resources.     

Mothers of Children With Physical Disabilities: Influence of Family Processes on Mothers' Depressive Symptomatology

This study examines how family processes, or specific behaviors and relationships within the family, influence the risk of depression in mothers of children with disabilities. Specifically, the collective influence of children's maladaptive behavior problems, father involvement, and coparental conflict on the risk of depression among 60 married mothers of children with physical disabilities is examined. Based on data from the National Survey of Families and Households, findings showed that these mothers perceived the child's behavioral problems as less influential when they were more satisfied with the father's parenting. Furthermore, coparental conflict appeared to mediate the influence of the child's behavior and her satisfaction with the father's involvement on the mother's risk of depression.     

Perceptions of Parental Intimate Relationships and Their Affects on the Experience of Romantic Relationship Development Among African American Emerging Adults

The quality of romantic relationships that parents maintain has an impact on their children. Emerging adult children base their relationships on similar values and/or opposing beliefs of their parental romantic relationships. This phenomenological study aimed to identify how African American emerging adults experience their parental romantic relationships and how they find meaning in the romantic relationships of their parents. Results suggest that African American emerging adults develop both positive and negative perceptions about romantic relationships from their parents’ relationships, which affect the way these adults perceive, develop, and maintain their own romantic unions. African American emerging adults also find meaning in their parental couple relationships as they share similar experiences in their relationship quality, mate choice, and/or personal or mate characteristics and personality traits as their parents.     

Health-Related Stereotype Threat Predicts Health Services Delays Among Blacks

To our knowledge, no published research has developed an individual difference measure of health-related stereotype threat (HRST). We adapted existing measures of academic stereotype threat to the health domain on a sample of black college students (N = 280). The resulting health-related stereotype threat scale-24 (HRST-24) was assessed for internal consistency, construct and incremental validity, and whether it explains variance in self-reported delays among four preventive health behaviors—blood pressure and cholesterol assays, physical exams, and routine checkups. After adjusting for several control variables, the HRST-24’s (full scale α = 0.96) perceived black health inferiority (18 items; α = 0.96) and perceived physician racial bias (6 items; α = 0.85) subscales explained unique variance in delays among two of the four behaviors including a blood cholesterol check (p < .01) and routine checkup—albeit at marginal levels (p = .063) in the case of the latter. Overall, these data provide preliminary evidence of construct and incremental validity for the HRST-24 among blacks. Recommendations for administering the scale are provided and future directions for HRST research are discussed.