Couple childbearing plans and births in Sweden

We use data from a nationally representative sample of Swedish couples to estimate effects of partners’ childbearing plans on the rate of subsequent childbearing. Only 11% of the couples in this sample expressed plans in opposite directions (plan to have a child versus not to have a child), but 24% had differing levels of certainty about their plans. Of the couples in which both partners said they definitely planned to have another child, 44% had a child within two years. If neither partner planned to have another child, less than 2% of couples had a birth. The figure was 6% if the partners had opposing childbearing plans. Thus, both men and women exerted veto power over further childbearing. Disagreements were equally likely to be resolved in favor of the woman as of the man, and effects of partners’ plans on the birth hazard did not depend on the couple’s gender arrangements, family ideologies, or marital status. We discuss these results in the context of Sweden’s public support for gender equality and for childrearing, its pervasive contraceptive regime, and its high rates of cohabitation. We also argue for the collection of data from partners in future family and fertility surveys.     

How are nurses at risk?

The effectiveness of occupational health and safety management systems (OHSMS) can be understood through analysis of surveys such as the experiences of exposure to occupational hazards by Australian nursing occupations. How effectively OHSMS are implemented in the Australian health industry is unclear as few studies describe current hazard exposure patterns or the impact of OHSMS in the Australian health industry. This paper concludes from the analysis of an Exposure Survey of Australian nursing occupations that nursing occupations perceive themselves to be "at risk" of injury and/or management of OHS risk in work duties is affected by the patterns of hazard exposure, occupation group as well as employee attributes, perceptions, patterns and situations of work. The results highlight the top-rated hazards and imply that the perceptions of hazards in the workplace are different to actual risk experience (e.g. injury patterns). There is an unacceptable level of exposure to diverse hazards in Australian nursing occupations workplaces in regard to regulatory and performance obligations. Stronger strategies to achieve more effective risk treatment, integrate with hospital accreditation and quality programs are discussed to benefit system performance and the welfare of those in nursing occupations.     

Correspondence Between Gonadal Steroid Hormone Concentrations and Secondary Sexual Characteristics Assessed by Clinicians,Adolescents, and Parents

Adolescent sexual maturation is staged using Tanner criteria assessed by clinicians, parents, or adolescents. The physiology of sexual maturation is driven by gonadal hormones. We investigate Tanner stage progression as a function of increasing gonadal hormone concentration and compare performances of different raters. Fifty‐six boys (mean age, 12.7 ± 1.3 years) and 52 girls (mean age, 12.0 ± 1.6 years) were seen at baseline, 6 and 12 months. Estradiol and testosterone concentrations were determined from three morning serum samples and Tanner stage by three different raters (clinician, parent, and adolescent). Results confirm that Tanner criteria reflect gonadal hormone concentrations, and clinician rating provides optimal assessment. Detailed insight about the strengths and limitations of different raters is provided, augmenting the scientific understanding of pubertal development.     

Prediction of body fat in older adults by time spent in sedentary behavior

The purpose of the study was to determine the relationship between sedentary behavior (SB), physical activity (PA), and body fat (total, abdominal) or body size (body-mass index [BMI], waist circumference [WC]) in community-dwelling adults 50 yr old and over. This study included 232 ambulatory adults (50-87 yr, 37.4% ± 9.6% body fat [BF]). Average daily time spent in SB (<100 counts/min) and light (100-759 counts/min), lifestyle-moderate (760-1,951 counts/min), walking-moderate (1,952-5,724 cts/min), and vigorous-intensity (≥ 5,725 counts/min) PA were determined by accelerometer and corrected for wear time. BF was measured with dual-energy X-ray absorptiometry. SB was positively related to measures of BF. Measures of SB, PA, and gender accounted for 55.6% of the variance in total BF, 32.4% of the variance in abdominal fat, and 28.0% of the variance in WC. SB, PA, and age accounted for 27.1% of the variance in BMI. Time spent in SB should be considered when designing obesity interventions for adults 50 yr old and over.     

Mind‐Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind‐Related Comments Independently Predict Infant–Mother Attachment in a Socially Diverse Sample

In a socially diverse sample of 206 infant–mother pairs, we investigated predictors of infants’ attachment security at 15 months, with a particular emphasis on mothers’ tendency to comment appropriately or in a non‐attuned manner on their 8‐month‐olds’ internal states (so‐called mind‐mindedness). Multinomial logistic regression analyses showed that higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments distinguished secure‐group mothers from their counterparts in the insecure‐avoidant, insecure‐resistant, and insecure‐disorganized groups. Higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments also independently predicted dichotomous organized/disorganized attachment. General maternal sensitivity predicted neither attachment security nor organization, although sensitivity was found to relate to dichotomous secure/insecure attachment specifically in the context of low socioeconomic status. The findings highlight how appropriate and non‐attuned mind‐related comments make independent contributions to attachment and suggest that mind‐mindedness is best characterized as a multidimensional construct.     

Comparison of models for average bioequivalence in replicated crossover designs

Average bioequivalence (ABE) has been the regulatory standard for bioequivalence (BE) since the 1990s. BE studies are commonly two-period crossovers, but may also use replicated designs. The replicated crossover will provide greater power for the ABE assessment. FDA has recommended that ABE analysis of replicated crossovers use a model which includes terms for separate within- and between-subject components for each formulation and which allows for a subject x formulation interaction component. Our simulation study compares the performance of four alternative mixed effects models: the FDA model, a three variance component model proposed by Ekbohm and Melander (EM), a random intercepts and slopes model (RIS) proposed by Patterson and Jones, and a simple model that contains only two variance components. The simple model fails (when not 'true') to provide adequate coverage and it accepts the hypothesis of equivalence too often. FDA and EM models are frequently indistinguishable and often provide the best performance with respect to coverage and probability of concluding BE. The RIS model concludes equivalence too often when both the within- and between-subject variance components differ between formulations. The FDA analysis model is recommended because it provides the most detail regarding components of variability and has a slight advantage over the EM model in confidence interval length.     

Condom negotiation strategy use and effectiveness among college students

College students may engage in risky sexual behaviors, such as inconsistent condom use, which increase their risk of sexually transmitted infections. This study examined the association between six condom influence strategies (CIS) and reported condom use among a diverse group of college students. Differences in CIS and condom use were examined by gender, race or ethnicity, and relationship status (casual, monogamous, or no current relationship). The study also used a cluster analysis to investigate how the CIS were used relative to one another, and how patterns of CIS use were related to condom use. Results showed interesting differences in CIS use by gender, race or ethnicity, and relationship status. Four patterns of CIS usage emerged, and results suggested that using all CIS frequently and using more assertive CIS may be particularly important for increased condom use. Men reported more condom use than women overall, but results indicated that using CIS were especially vital for increasing condom use for women. Surprisingly, there were no differences in condom use found for race or ethnicity and relationship type. Programs aimed at increasing students' condom use could benefit from promoting and practicing CIS, and recognizing potential differences among demographic groups.     

The Cost of Instability: The Effects of Family,Work, and Welfare Change on Low‐Income Women’s Health Insurance Status

The number of uninsured Americans has risen substantially over the last decade. Despite the availability of Medicaid, low‐income women are at particularly elevated risk of having no or inadequate health insurance. How does continuity of work, family, and welfare affect low‐income women’s health insurance status? A multinomial logistic regression analysis of 1,662 low‐income women from the Welfare, Children, and Families: A Three‐City Study provides evidence of the consequences of life changes on access to health insurance from 1999–2005. The results show that compared to those with stable welfare, work, and family attachments, new full‐time employment actually increases low‐income women’s risk of being uninsured as does being underemployed, on welfare, or single for extended periods of time. These findings illustrate how health‐care reform must adequately address the complexity of low‐income women’s lives—including the ways labor market, state, and family factors interact to create barriers to health insurance—in order to improve access to care under the current U.S. health insurance model.