Power of the First Hour

Abstract

In 2012, the NGO Save the Children launched its No Child Born to Die campaign with the tagline, “Breastfeeding Saves Lives.” The press release explains that in the first hours and days after a baby is born, their mother produces colostrum, a substance known to improve immunity, which must be delivered to infants in the first sixty minutes of life; this is referred to as “the power of the first hour.” Invoking a sense of urgency and a crisis of infant mortality, which breastfeeding is positioned to resolve, the campaign cites staggering medical statistics of infant deaths in the campaign targets of Africa, Asia and Latin America, and also Northern Indigenous and Inuit reserves in Canada. More than misrepresenting racialized women in the developed world as uneducated on infant health, childcare and child rearing and as lacking agency and empowerment, the campaign mobilizes the erroneous conflation of medical science, morality, capitalism and public health – a linkage typically mobilized by the development industry to the detriment of globally marginalized women. In order to understand how this conflation is mobilized to manufacture crisis at the expense of examining the root causes of infant mortality globally, we collect theories of crisis temporalities to develop a “feminist politics of crisis.”     

Individual Differences in Women's Salivary Testosterone and Estradiol Following Sexual Activity in a Nonlaboratory Setting

Objectives: The current study evaluated women's salivary testosterone and estradiol levels before and after exposure to sexual stimuli in a U.S. sex club. Methods: Behavioral data and salivary samples were collected from 19 women during semistructured interviews. Results: Findings demonstrate substantial individual differences in the magnitude and direction of women's hormonal changes following sexual activity. Conclusions: In an age of individualized medicine, these findings highlight the need to better understand factors shaping variation in physiological responses to sexual activity. Findings contribute to a relatively small and contradictory literature on women's hormonal responses to sexual stimuli.     

What Difference Does Difference Make? The Persistence of Inequalities in Healthcare Delivery

Scholars across many disciplines have amassed a mountain of research documenting how social differences along lines of race, class, gender, and sexuality shape how those who need medical attention are cared for in the US healthcare system. Here, we aim to succinctly review a selection of studies that have considered the many ways both patients' and healthcare providers' social identities can impact care delivery. After establishing how these differences influence patient–provider interactions and patient diagnosis, treatment, and outcomes, we argue that a critical sociological perspective can help us to better understand why these inequities persist despite decades of research calling attention to them. Specifically, we suggest that research guided by symbolic interactionist and intersectional frameworks can generate more comprehensive analyses of inequality in healthcare delivery and help researchers delve deeper into the complex interactional processes undergirding disparities in care provision. We conclude by highlighting recent work that illustrates the value of this approach.     

“He's Doing Fine”: Hope Work and Emotional Threat Management Among Families of Seriously Ill Children

In this study, I examine how people in emotionally fraught circumstances strategically structure social interactions in order to protect fragile emotional states. Data come from interviews and observations with 18 families of children being treated for life‐threatening conditions at an elite university research hospital. I show how families worked to ward off emotional threats to their ability to maintain hope that their children would recover by preempting and restructuring social interactions with friends and family members and pruning social networks. These efforts allowed families to minimize reciprocal obligations and avoid encountering pessimistic reflected appraisals that might trigger “emotional shortcuts” leading to states of fear and anxiety. Similar efforts to reconstruct social interactions and social networks may be common among those working to maintain fragile emotional states in a variety of challenging circumstances.     

Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.     

‘I’m not really sure but I hope it’s better’: early thoughts of parents and carers in a regional trial site for the Australian National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) is one of the most significant initiatives in Australian social policy history. Its complexity has been compounded by a fast-paced introduction and ongoing refinement throughout the initial trial phase. Parents and carers of very young disabled children face particular challenges accessing and navigating NDIS systems. This article presents findings from a mixed-method pilot study examining the perspectives of parents and carers of disabled children in one NDIS trial site – the Hunter Region of New South Wales. The research highlights a number of policy assumptions potentially impacting on NDIS take up for young disabled children and their families in regional contexts. Based on research findings a number of policy suggestions and improvements for disabled children and their families entering the NDIS and other individualised funding schemes are outlined.     

Urbanicity Moderates Associations between Family Income and Adolescent Academic Achievement

Research has shown that family income's relations to early childhood achievement is stronger in large inner cities and weaker in less urbanized areas. Research has not yet considered whether links between family income and achievement in adolescence differ across the urban to rural landscape. Using nationally representative data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (N ≈ 9,350), this study examines differences in family income's links with eighth‐grade achievement across large urban, small urban, suburban, and rural communities. The point at which income‐achievement links plateau occurs later in the income distribution in less urbanized areas. The magnitude of the association between family income and reading and science skills also differs across the urban‐rural continuum, such that family income has stronger relations to reading and science achievement in urban cities and weaker links in suburban and rural communities.     

Exploring youths' perceptions of the hidden practice of youth work in increasing social capital with young people considered NEET in Scotland

This small-scale research explores the generation of social capital in young people growing up in one urban area and one rural area in Scotland via community-led youth work projects that aim to re-engage young people categorised as NEET (Not in Employment Education or Training). By looking at their varied and complex biographies, it considers young people's experiences and perceptions of their communities and their transitions from education to the workplace. Using social capital as a theoretical lens, we examined the impact that youth work can have not just on these important transitions but also upon the young people themselves. By visiting two different sites of engagement we were able to explore whether the type of initiative (media or sports) or place (urban or rural) had an impact on the generation of capital for young people. The youth work practice in both areas acted as a glue between the young people and their communities, creating opportunities where the two could be bound together and relationships created. This occurred in both sites regardless of the area or type of initiative and confirmed in this study that youth work acts as a site of capital building.     

THE NEW EPISTEMOLOGY AND THE MILAN APPROACH: FEMINIST AND SOCIOPOLITICAL CONSDDERATIONS*

While the new epistemology and related models of therapy are claimed to have radical social implications, the Milan approach is in ill repute amongst feminists who see it as conservative in relation to women's issues. This paper explores the sociopolitical implications of the new epistemology and the Milan approach, concluding that, while second order cybernetics has greater potential to incorporate a radical social analysis, it has, nevertheless, failed to do so. The application of second order cybernetics in family therapy appears to be constrained by the sociopolitical conservatism of its proponents.