Conflicting contexts: Midwives’ interpretation of childbirth through photo elicitation

IntroductionThis study seeks to explore midwives’ perceptions about childbirth and in particular their beliefs about normality and risk. In the current climate of increasing interventions during labour, it is important to understand the thought processes that impact on midwifery care in order to examine whether these beliefs influence midwifery clinical decision-making.Method12 Midwives who worked in a variety of metropolitan hospitals in Sydney, Australia were interviewed about how they care for women during labour. The study utilised an inductive qualitative design using photo elicitation during the interview process.ResultsSix themes emerged from the data that clearly indicated midwives felt challenged by working in a system dominated by an obstetric model of care that undermined midwifery autonomy in maintaining normal birth. These themes were: desiring normal, scanning the environment, constructing the context, navigating the way, relinquishing desire and reflecting on reality. Most midwives felt they were unable to practice in the manner they were philosophically aligned to, that is, promoting normal birth, as the medical model restricted their practice.DiscussionThe polarised views of childbirth held by midwives and obstetricians do little to enhance normal birth outcomes. Midwives in this study expressed frustration that they were unable to practice midwifery in a way that reflected their belief in normal birth. This, they cite is a result of the oppressive obstetric model prevalent in maternity care facilities in Sydney and the over use of technological interventions during childbirth.     

Impact of having a high-risk pregnancy on future postpartum contraceptive method choice

BackgroundTo compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.Research questionDoes a high-risk pregnancy condition affect future postpartum contraceptive method choice?MethodWomen hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.FindingsA total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p < 0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p = 0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.ConclusionA high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.     

Sexual Behaviors,Sexual Health Practices,and Community Engagement Among Gay and Bisexually Identified Men Living in Rural Areas of the United States

Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men’s engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.     

Life Satisfaction as a Distinguishing Indicator of College Student Functioning: Further Validation of the Two-Continua Model of Mental Health

The two-continua model of mental health contends that both psychological distress and psychological well-being make related-yet-distinct contributions to our understanding of human health and its relations with other quality of life outcomes. Using self-reported somatization, depression, and anxiety symptoms as indicators of psychological distress and self-reported life satisfaction as an indicator of psychological well-being, the present study classified participants into one of four mental-health-status groups—mentally healthy, mentally unhealthy, symptomatic yet content, or asymptomatic yet discontent—and investigated between-group differences across three key indicators of college student functioning: academic achievement, interpersonal connectedness, and physical health. Findings provide further validation for the two-continua model of mental health among college students, showing that, when considered in conjunction with clinical symptoms, life satisfaction serves as a distinguishing indicator of college students functioning across academic, social, and physical health domains—as well as a strong predictor of the absence or presence of clinical symptoms and comorbidity. Implications for theory, practice, and future research are discussed.     

论品特威胁喜剧中的疾病情感隐喻

人本观基础上的后现代主义视野下的隐喻观可以看作是隐喻发展的第四阶段。隐喻表达在抽象情感的理解与表达中起着至关重要的作用。从疾病是情感的维度对品特威胁戏剧进行语言考察,可以看出剧中大量出现的疾病是情感的隐喻,盲、哑、疯、麻风病、风湿病、癫痫病等各种疾病映射了剧中人物内心的极度压抑,以及人物内心的不安、惊恐与危机感,折射出了存在主义的哲学思想。情感隐喻具有经验基础,是为戏剧主题服务的。     

企业业务流程重组理论思想的演进与发展

企业业务流程理论是先进的现代企业变革理论 ,在我国有着广阔的应用前景。深入研究企业业务流程重组理论的内涵、成因与发展及其国内外理论研究现状 ,并对该理论进行深入地分析 ,将有助于我国企业更好地应用业务流程重组理论 ,促成业务流程重组思想由理论到实践的转变 ,对于集中体现企业优势 ,培育企业核心竞争力具有现实意义。     

Discount rates and risky sexual behaviors among teenagers and young adults

This article examines the relationship between personal discount rates and sexual behaviors in a sample of teenagers and young adults. We find that higher discount rates (an indication of less willingness to forego current consumption for future consumption) are significantly associated with a range of sexual behaviors, including ever having sex, having sex before age 16 years, and past or current pregnancy. These associations are consistent with previous studies showing a link between discounting and other, non-sexual health behaviors. JEL Classification D80 · D90 · I10     

Household Composition,Family Migration,and Community Context: Migrant Remittances in Four Countries*

Objectives. We study migrant remittances among households surveyed in Mexico, the Dominican Republic, Nicaragua, and Costa Rica, testing expectations derived from the new economics of labor migration (NELM) and from the historic‐structural approach. Methods. We applied logistic regression analyses to survey data collected by the Mexican Migration Project and the Latin American Migration Project, focusing on the contrast between Mexico and the Dominican Republic. Results. In Mexico, remittances seem to be associated with the patriarchal traditional family, but in the Dominican Republic we verified the opposite. Receipt of remittances is positively associated with degree of development among Mexican households, but the association is negative in the Dominican Republic. In addition, Mexican remittances are negatively associated with the number of businesses in the local community. Conclusions. In Mexico, as predicted by NELM, the cohesive patriarchal family ensures the flow of remittances as part of a household strategy of risk diversification. Dominican remittances, however, seem to be mostly determined by lack of opportunities and household need.     

“碳关税”对中国经济的潜在影响

近年来,一些发达国家以应对气候变化为由,提出对进口的碳排放密集型产品征收特别的CO2排放关税,并将"碳贸易限制措施"扩大为"碳关税"壁垒。"碳关税"的开征必然对我国经济、出口贸易造成严重冲击。因此,我们应该积极主动参与相关国际规则的制定,优化出口贸易结构,加强低碳技术创新,实现向低碳经济的转型,以便充分地应对"碳关税"壁垒。