Setting and maintaining standards in menopause care: audit of current practice in a specialist clinic

Standards are an important way of demonstrating quality of care in any given setting. The British Menopause Society (BMS) has produced guidelines as to what should be recorded at the initial menopause consultation. A retrospective audit of case-notes of women attending Poole Menopause Centre was undertaken using these criteria as audit standards. Although areas of good practice were highlighted, the published criteria were met for only five of the 23 standards. An action plan to improve the documentation to achieve these standards has been formulated.     

Employee absence,age and tenure: A study of nonlinear effects and trivariate models

Multiple regression techniques were used to explore the nature of the relationships between age, tenure and absence in 2417 British local government workers drawn from three work groups. The data were collected from organizational records and included measures of both non-certified absence and medically certified absence. Linear and curvilinear associations among age, tenure and absence were examined. The possible moderating or mediating role of tenure in the relationship between age and absence was subsequently analysed. The data revealed linear relationships between age and absence that were negative for non-certified absence and positive for certified absence. In contrast, curvilinear relationships were found between tenure and absence that were U-shaped for noncertified absence and inverse U-shaped for certified absence. Tenure was found to moderate but not to mediate the relationship between age and absence. The implications of the results are discussed in the context of the changing age and career paths of the workforce, and of methodological issues in absence research.     

Policing the Borderlands: White- and Black-American Newspaper Perceptions of Multiracial Heritage and the Idea of Race, 1996–2006

By employing a new policy of "check all that apply," the Census Bureau accommodated a mushrooming multiracial lobby demanding that its members be allowed a right to self-identification. With its implied shifting meaning of race, newspapers portrayed the reaction to this change as a firestorm of debate along racial fault lines, highlighted by Black-American inferences that this was a perilous decision. Using textual analysis, I examine from 1996 to 2006 how five Black-American and three White-American newspapers characterized multiracial people. White-American papers framed the discussion in two ways: (a) multiracial people epitomize a new era in which race has lost its bite, and (b) Black America stands in the way of their gaining their civil rights. There were also two frames for the Black-American papers: (a) The lobby advocates individual identity and is undergirded by denial or distancing from Blackness, and (b) that focus undermines Black America's future by playing into the misguided notion that race is socially insignificant.     

Four Decades of Trends in Attitudes Toward Family Issues in the United States: The 1960s Through the 1990s

This article examines trends in family attitudes and values across the last 4 decades of the 20th century, with particular emphasis on the past 2 decades. The article focuses on attitudes toward a wide range of family issues, including the roles of men and women, marriage, divorce, childlessness, premarital sex, extramarital sex, unmarried cohabitation, and unmarried childbearing. More generally, the article considers trends in 3 broad contemporary values: freedom; equality; and commitment to family, marriage, and children. Five data sets are used for the article: Monitoring the Future, General Social Survey, International Social Science Project, Intergenerational Panel Study of Parents and Children, and the National Survey of Families and Households. These 5 data sets reveal substantial and persistent long‐term trends toward the endorsement of gender equality in families, which may have plateaued at very high levels in recent years. There have also been important and continuing long‐term trends toward individual autonomy and tolerance toward a diversity of personal and family behaviors as reflected in increased acceptance of divorce, premarital sex, unmarried cohabitation, remaining single, and choosing to be childless. At the same time, marriage and family life remain important in the cultural ethos, with large and relatively stable fractions of young people believing that marriage and family life are important and planning marriage and the bearing and rearing of children.     

Inside co‐production: Stakeholder meaning and situated practice

Co‐production has risen to the fore of contemporary policymaking, with the intention of placing citizens at the heart of public service design and production. Although this may lead to more democratic and legitimate decision‐making, achieving “meaningful” co‐production can be difficult. In this qualitative study, we examine what constitutes meaningful co‐production, in particular asking whether there is a disconnect between the elite policy narrative that legitimizes co‐production and stakeholder experiences of this approach. Our research adopts a decentred approach to examine the different ways that actors understand and participate in co‐production, both as a methodology and as an interactive social practice. We conclude that a lack of synergy between local narratives may undermine the potential success of co‐production.     

Evaluating Potential Distribution of High‐Risk Aquatic Invasive Species in the Water Garden and Aquarium Trade at a Global Scale Based on Current Established Populations

Aquatic non‐native invasive species are commonly traded in the worldwide water garden and aquarium markets, and some of these species pose major threats to the economy, the environment, and human health. Understanding the potential suitable habitat for these species at a global scale and at regional scales can inform risk assessments and predict future potential establishment. Typically, global habitat suitability models are fit for freshwater species with only climate variables, which provides little information about suitable terrestrial conditions for aquatic species. Remotely sensed data including topography and land cover data have the potential to improve our understanding of suitable habitat for aquatic species. In this study, we fit species distribution models using five different model algorithms for three non‐native aquatic invasive species with bioclimatic, topographic, and remotely sensed covariates to evaluate potential suitable habitat beyond simple climate matches. The species examined included a frog (Xenopus laevis), toad (Bombina orientalis), and snail (Pomacea spp.). Using a unique modeling approach for each species including background point selection based on known established populations resulted in robust ensemble habitat suitability models. All models for all species had test area under the receiver operating characteristic curve values greater than 0.70 and percent correctly classified values greater than 0.65. Importantly, we employed multivariate environmental similarity surface maps to evaluate potential extrapolation beyond observed conditions when applying models globally. These global models provide necessary forecasts of where these aquatic invasive species have the potential for establishment outside their native range, a key component in risk analyses.     

Chronic pain,pain severity and analgesia use in Australian women of reproductive age

Background

The increasing prevalence and adverse outcomes associated with opioid analgesia use in women of reproductive age have become a significant public health issue internationally, with use during pregnancy potentially affecting maternal and infant health outcomes.

Age of onset of epilepsy: its effects on coping strategies

Research into the use of coping strategies to reduce emotional distress from negative life events has identified specific subscales within the more general concepts of problem-focused and emotionfocused coping. This study presents a preliminary assessment of the ultilization of coping strategies during stressful incidents among people with epilepsy, and the differences which may arise as a result of the age of onset of the disorder. Twenty early-onset and 20 late-onset patients were asked to complete a questionnaire using subscales from the «Ways of Coping» scale (Aldwin and Revenson 1987) and from the «COPE» scale (Carver et al 1989). Data were also obtained from two groups of 20 subjects without epilepsy, matched for age and sex with the patient groups (a total of 80 subjects included in the study). Results indicated that subjects with epilepsy attempted to minimize problems more than non-epileptic subjects. Adult onset of the disorder appeared to increase the use of negotiation, acceptance and self-blame. Thus, there appear to be some significant differences in the types of coping strategy employed in stressful situations, with the late-onset group tending to utilize strategies that may be considered maladaptive, perhaps in an initial adjustment to the disorder.