Preconceiving Life: Response to Gentile’s “Troubling Temporalities”

When behavior is reported that objectively places the patient and others at risk and subjectively exposes the therapist to a vivid range of private experience, the challenge in maintaining a clinical stance is complicated to say the least. This complication is intensified to the degree that the clinician's aim involves understanding rather than discipline and control. To specify details of that challenge, I discuss two patients whose unsafe sexual practice confronted me. In these clinical situations, I found it useful to be mindful that bareback sex contains a range of meanings, including the search for a quality of relating that can enliven an inner deadness. Thinking this, I found it necessary to be alert to wishes for creativity as well as destructiveness. Attending to such paradoxes also required me to come up with a new way of working with countertransference: to render it an imaginary theatrical performance.     

An interpretive review of women's experiences of gestational diabetes mellitus: Proposing a framework to enhance midwifery assessment

BackgroundGestational diabetes mellitus (GDM) affects almost 5% of pregnancies in Australia, and within 15 years, 25% of affected women will go on to develop Type 2 Diabetes Mellitus (T2DM). The adoption of preventive health behaviours may be influenced by women's experiences of GDM.QuestionThis review sought to understand women's beliefs, values, perceptions and experiences following diagnosis of GDM.MethodsPeer reviewed and professional journals were searched for primary research, published between January 1991 and December 2011 that explored the beliefs, values, perceptions and experiences of peripartum or postpartum women with a diagnosis or history of GDM.FindingsNineteen studies met the inclusion criteria and the majority of these studies were qualitative (n = 15). Each study was reviewed and synthesis revealed three emergent themes and core concepts related to each theme: Responses (initial reaction to GDM diagnosis, negative thoughts following diagnosis, struggle to manage GDM, feelings of ‘loss of control’, changes to identity and adapting to change), Focus of Concern (concern for baby's health, mother's concern for her own health, perceived seriousness of GDM, perceived fear of T2DM) and Influencing Factors (cultural roles and beliefs, social stigmas, social support, professional support, adequate and appropriate information, social roles and barriers to self-care).ConclusionThe experiences of women with GDM are unique and personal however this review highlights common experiences evident in the existing research. The proposed framework may be used by midwives in clinical assessment and care of women diagnosed with GDM.     

A Foucauldian journey into the islands of the deaf and blind

This autoethnographic study integrates Foucault's genealogical approach to explore disability, notably deafness and blindness, from historical, social, and personal perspectives. Disability as a modern institution is defined through nuances of language and silence so that power constructs are hidden and continue to evolve through social collusion. Multiple modern circumlocutions intensify the sense of dislocation, emphasising the difference it attempts to conceal, which makes disability a ripe field for ethnographic work. The two men studied, Blind Brewster and Deaf Brewster, led creative working lives that found a small place in history. Both were sustained by a deep piety. The language used to hide disability in the contemporary world is more destructive than protective, in comparison with the blunt labelling of the deaf and blind two hundred years ago when it was a point of distinction, not discrimination.     

Effects of the physical accessibility of maternal health services on their use in rural Haiti

An analysis of data from the 2000 Demographic and Health Survey shows that little use is made of antenatal and delivery-care services in rural Haiti. After adjusting for individual-level factors, poor road conditions significantly reduce the likelihood of timely receipt of antenatal care and of four or more antenatal care visits, while the availability of a health centre within 5 kilometres significantly increases the odds of each outcome. The odds of being attended at delivery by trained medical personnel and of institutional delivery are significantly reduced by mountainous terrain and distance from the nearest hospital, and are increased if a health worker providing antenatal care is present in the neighbourhood. Neighbourhood poverty reduces the likelihood of safe delivery care. The findings suggest that improving the use made of maternal healthcare services would require, among other things, improvement of the availability of services and road conditions, and the reduction of poverty.     

Midlife Women Online: Evaluation of an Internet-Based Program to Prevent Unintended Pregnancy & STIs

Background: Midlife women are an underserved population in the areas of unintended pregnancy and STI prevention yet remain at risk for both health conditions. Methods: A randomized controlled trial of an Internet-based multimedia program to reduce risk of unintended pregnancy and STIs among midlife women was conducted with 164 women ages 40–55 years of age. Results: Women in the treatment condition compared to the control condition reported significant gains in attitudes, self-efficacy, and behavioral intentions at posttest. Conclusion: Interventions specifically targeted to midlife women can impact constructs known to reduce risk. Implications for future research and intervention development are presented.     

More Nuanced Universal Services for New Parents: Avoiding Assumptions of Homogeneity

Abstract

Universal services focus on prevention and providing the support to parents that will help them meet the challenges of parenthood and deal with problems before they become entrenched. Many countries now have good universal services available for new families, and significant advances have been made in recent years to recognize the importance of the early years in the optimal development of the child. This article is based on a qualitative study of transition to parenthood. The study explored the experience of 25 first-time mothers in socioeconomically diverse circumstances in New Zealand. Eleven partners of these women also participated. Mothers were interviewed three times, first in late pregnancy, then 3 and 12?months after giving birth. Partners were interviewed once, mid-way through the baby’s first year. The article focuses on how participants experienced service support. It illustrates some of the diverse needs of new parents, and explains ways in which prevention services might become more responsive to parents’ expressed needs. The authors offer a case for stronger interplay between universal services and informal systems of support, and the development of a new generation of universal services that act as enablers of natural support hubs for new families within their own communities.     

Identifying Themes Regarding the Benefits and Limitations of Caregiver Support Group Conversations

Support groups continue to be one of the most needed and desired forms of help for family caregivers to persons with dementia. Though the effects of caregiver support group participation have been examined, the benefits and limitations of the dynamics of support group conversations have been neglected. This study focuses on the perceived consequences of group dynamics. Three themes—balance, sameness, and individuality—emerged through analysis of open-ended interviews with support group members following observations of their meetings. The consequences of these themes are illustrated with a case study and the implications of these themes for practitioners are discussed.     

Where I Belong: Identification Processes of Young Volunteers in Super-Diverse Cities

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - In the context of super-diverse cities, scholars and policy makers are increasingly interested in the potential of...     

Dynamic capacity adjustments with reactive customers

In this paper we develop a behavioural model in which customers come and go based on their perception of waiting time (relative to other facilities) while managers gradually adjust the capacity of the facility based on their perception of demand. We explicitly account for the difference in access to information between existing and potential customers, which implies that the perception of potential customers lags the perception of current customers. We investigate the outcome of the interaction between these simultaneous dynamic decision processes, and in particular the impact of the lags created by the perception formation process and the time to implement desired changes in capacity. These multiple delays may result in customers and service provider being out of step: customers walk away just as the service provider manages to bring extra capacity online.