Qualitative insights into women's personal experiences of perinatal depression and anxiety

Background and aimSymptoms of perinatal depression and anxiety are usually described and understood from a nosological perspective. This research sought to gain insight into women's lived experience of postnatal depression and anxiety, the factors that contribute to these symptoms and the context in which they develop.MethodFace to face and telephone interviews were conducted with 28 women from metropolitan and rural areas across Australia, who had experienced postnatal depression and/or anxiety within the last five years. Analysis was conducted from a grounded theory perspective.FindingsParticular symptoms of anxiety and depression develop in the context of the numerous changes inherent to the transition to motherhood and contribute to a common experience of frustration and loss. Symptoms were also associated with feelings of dissatisfaction with the pregnancy and motherhood experience.ConclusionsThe findings provide useful insights into women's experiences of mental health symptoms during the perinatal period, how these symptoms present and the factors involved in their development and maintenance. The need to consider women's perspectives to develop resources and health promotions strategies, as well as within the context of relationships with health professionals is highlighted. The study emphasizes the need for greater, more accurate information surrounding perinatal depression and the need to increase the profile and awareness of anxiety disorders.     

Simple subcontracting rules for make-to-order shops with limited subcontractor capacity: an assessment by simulation

Companies that produce a high variety of customised products often suffer from large fluctuations in demand. Subcontracting can be an important means of overcoming resulting capacity shortages during high demand periods. A set of effective subcontracting rules, for determining which jobs to subcontract and which to produce internally, has recently been presented in the literature for this type of company. But evaluations of these rules have assumed subcontractor capacity is infinite. This study examines the impact of limited subcontractor capacity on the performance of the three best-performing subcontracting rules for make-to-order companies using a simulation model of an assembly job shop. Limiting subcontractor capacity inhibits the ability of a subcontracting rule to protect the internal shop from surges in demand, which negatively affects performance. However, significant performance differences between the rules evaluated are maintained, which underlines the importance of choosing the right subcontracting rule. Further analysis reveals that a limit on the work that can be subcontracted leads to less work being subcontracted more often, which requires adequate response by management. Meanwhile, the assumption of infinite capacity results in sporadically subcontracting a large amount of work. The results have important implications for future research and practice.     

Turnaround: from breakdown to breakthrough with Open Space Technology

This interpretive case study sought to fully understand and describe the turnaround experience from an organizational breakdown to breakthrough with the use of Open Space Technology. The turnaround occurred in a Roman Catholic parish. Participant interviews were used to collect the data. These qualitative portrayals provided insights and implications around the effectiveness and impact of Open Space. Four important themes emerged: the experience of breakdown, the deep longing for a breakthrough, the transformation of crisis into a turnaround and the effectiveness of Open Space Technology. This case study provides perspectives on how to effect transformation for an organization in crisis with the least effort and maximum impact within a short time span. It contains insights and implications for leaders and consultants to do the same.     

Cancer Dose-Response Modeling of Epidemiological Data on Worker Exposures to Aldrin and Dieldrin

The paper applies classical statistical principles to yield new tools for risk assessment and makes new use of epidemiological data for human risk assessment. An extensive clinical and epidemiological study of workers engaged in the manufacturing and formulation of aldrin and dieldrin provides occupational hygiene and biological monitoring data on individual exposures over the years of employment and provides unusually accurate measures of individual lifetime average daily doses. In the cancer dose-response modeling, each worker is treated as a separate experimental unit with his own unique dose. Maximum likelihood estimates of added cancer risk are calculated for multistage, multistage-Weibull, and proportional hazards models. Distributional characterizations of added cancer risk are based on bootstrap and relative likelihood techniques. The cancer mortality data on these male workers suggest that low-dose exposures to aldrin and dieldrin do not significantly increase human cancer risk and may even decrease the human hazard rate for all types of cancer combined at low doses (e.g., 1 g/kg/day). The apparent hormetic effect in the best fitting dose-response models for this data set is statistically significant. The decrease in cancer risk at low doses of aldrin and dieldrin is in sharp contrast to the U.S. Environmental Protection Agency's upper bound on cancer potency based on mouse liver tumors. The EPA's upper bound implies that lifetime average daily doses of 0.0000625 and 0.00625 g/kg body weight/day would correspond to increased cancer risks of 0.000001 and 0.0001, respectively. However, the best estimate from the Pernis epidemiological data is that there is no increase in cancer risk in these workers at these doses or even at doses as large as 2 g/kg/day.     

Negotiating for more than a slice of the pie

Negotiation is an important way for physician executives to manage conflict and to accomplish new projects. Because of the rapidly changing nature of the health care environment, as well as conflicts and politics within their organizations, managers need to effectively negotiate with a wide range of other parties. Managers should consider the relative importance of both the substantive and relationship outcomes of any potential negotiation. These two factors may guide the executive's selection of initial negotiation strategies.     

The Duplic and Codic: the Importance of a Consistent Taxonomy of Verbal Behavior

The Analysis of Verbal Behavior - Behavior analysts operationally define relations among environmental stimuli and behavior both functionally and topographically, and an insistence on objectivity,...     

Change in Covert Social Movement Networks: The ‘Inner Circle’ of the Provisional Irish Republican Army

In this paper, we contribute to both the growing body of literature on social movement networks and the growing body of literature on change in networks by exploring patterns and mechanisms of change within the network of the ‘inner circle’ of the Provisional Irish Republican Army. Specifically, we focus upon the period between 1969 (when it formed) and 1988 (the last point for which we have been able to gather good data). Our primary aims are substantive. We want to know how this network changed over time. In addition, however, our analysis identifies changes which other analysts might look for in their networks and offers methodological suggestions for those who, like us, find that their networks do not meet the assumptions of mainstream approaches to modelling network dynamics. There is a further dimension to the paper, however. We are studying a covert social movement network. This is a special type of movement network whose organisation and dynamics are predicted to vary from other movement networks. Some have suggested that they are inclined to be relatively static because the need for trust within them is so great and the risk to whatever they hold secret so considerable when new ties are formed that their members tend only to recruit within the pool of their pre-existing ties and actively seek to minimise recruitment and the formation of new ties. One of the aims of our paper was to determine whether and to what extent this is so.     

Assessing Variations in Developmental Outcomes Among Teenage Offspring of Teen Mothers: Maternal Life Course Correlates

This study investigated potential heterogeneity in development among offspring (age 17) of teen mothers and maternal life course as correlates of variation. Using latent class analysis, subgroups of developmental outcomes were identified. Maternal standing in two life course realms (i.e., socioeconomic and domestic) was considered as a potential explanation for heterogeneity in offspring's development. Offspring reported on measures assessing their psychological, academic, and behavioral development. Teen mothers reported on measures of life course realms. Three subgroups of developmental outcomes were identified: on track (52%), at risk (37%), and troubled (11%). Findings suggest that economic hardship and number of pregnancies among teen mothers distinguish developmental patterns among teenage offspring, whereas teen mothers' educational attainment and marital status do not.