The journey from pain to power: A meta-ethnography on women’s experiences of vaginal birth after caesarean

Background

Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.

Gendered uncertainty and variation in physicians' decisions for coronary heart disease: the double-edged sword of "atypical symptoms"

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256 physicians who viewed 1 of 16 video vignettes with different patient-actors presenting the same symptoms of coronary heart disease. Physician participants completed a structured interview and provided a narrative about their decision-making processes. Quantitative analysis showed that diagnostic uncertainty reduces the likelihood that physicians will order tests and medications appropriate for an urgent cardiac condition in particular. Qualitative analysis revealed that a subset of physicians applied knowledge that women have "atypical symptoms" as a generalization, which engendered uncertainty for some. Findings are discussed in relation to social-psychological processes that underlie clinical decision making and the social framing of medical knowledge.     

Quality of College Life (QCL) of Students: Further Validation of a Measure of Well-being

This paper reports a study designed to further validate a measure of quality of college life (QCL) of university students (Sirgy, Grzeskowiak, Rahtz, Soc Indic Res 80(2), 343–360, 2007). Two studies were conducted: a replication study and an extension study. The replication study involved surveys of 10 different college campuses in different countries. The results of the replication study provided additional nomological (predictive) validation support of the measure based on a theoretical model mapping out the antecedents and consequences of satisfaction with college life. With respect to the extension study, the focus was to further test the nomological validity of the QCL measure by arguing and empirically demonstrating that the consequence of QCL is life satisfaction. The extension study involved a survey of three college campuses in different countries. The results were also supportive of the nomological validity of the QCL measure.     

Nursing-Home Resident Quality of Life: A Longitudinal Case Study Approach

Longitudinal quality-of-life (QOL) research incorporating multiple perspectives can add to knowledge about how nursing home residents experience QOL, but these methods are seldom used. This study employed interviews and participant observation to conduct multiple-perspective, longitudinal case studies of six residents. Close, reciprocal relationships with staff members, staff knowledge of residents, and autonomy were fundamental to QOL. Autonomy was experienced through choice and self-advocacy. Changes in QOL over time related to changes in resident health status, acclimation to the setting and family member availability. Study results may have implications for staffing and staff training.     

Household Income and Trajectories of Marital Satisfaction in Early Marriage

Are the marriages of lower income couples less satisfying than the marriages of more affluent couples? To address this question, we compared trajectories of marital satisfaction among couples with a wide range of household incomes. The marital satisfaction of 862 Black, White, and Latino newlywed spouses (N = 431 couples) was assessed five times, each 9 months apart, during the first 4 years of marriage. Lower income couples did not have less satisfying marriages on average, nor did their satisfaction decline more steeply on average. They did, however, experience (a) significantly greater fluctuations in marital satisfaction across assessments and (b) significantly more variability between husbands and wives. If efforts to support the marriages of low‐income couples are to address the unique characteristics of their marital development, these findings suggest that efforts to stabilize their marriages may be more effective than efforts to improve their satisfaction alone.     

Determinants of Subjective Quality of Life Among Rural Adolescents: A Developmental Perspective

This study examines youths' experiences of loneliness and community connectedness in relation to seven domains of subjective quality of life among pre-adolescents, early adolescents, and middle adolescents. Participants consisted of 464 youth, ranging in age from 11 to 17 years, from two rural towns. Youth reported on their subjective experiences of loneliness and their perceptions of their community environments (neighbourhood and school). Hierarchical regressions indicated the importance of loneliness in accounting for subjective quality of life for early adolescents, and less so for middle and pre-adolescents. Community factors significantly accounted for additional variance in pre-adolescents' reports of their quality of life, compared with early and middle adolescents' reports. Discussion highlights the importance of understanding the determinants of quality of life from an individual, community, and developmental perspective.     

Exact intervals and tests for mean of symmetrical population when one "sample" value possibly an outlier

The (continuous) data are n observations that are believed to be a random sample from a symmetrical population. Confidence intervals and significance tests for the population mean are desired. There is, however, the possibility that either the smallest observation or the largest observation is an outlier. That is, the population providing this observation differs from the symmetrical population providing the other n - 1 observations. If this occurs, intervals and tests are desired for the mean of the population providing the other n - 1 observations. Some investigation difficulties can be overcome if intervals and tests can be developed that are simultaneously usable for all of these three situations (a confidence coefficient, or significance level, has the same value for all three situations). Two kinds of intervals and tests with this property are developed. These results always involve both the next to smallest observations and should have at least moderately high efficiencies. Also, some extensions are considered, such as allowing each observation to be from a different population.     

Making visits better: the perspectives of parents,foster parents,and child welfare workers

Mothers of children recently placed in foster care, foster mothers, and child welfare workers participated in semistructured, clinical interviews focusing on the challenges of parent visitation with young children. Mothers described their feelings of grief, trauma, and rage about the forced separation from their children and stressed the importance of emotional expression and communication during visits. Child welfare workers described the complexities of supporting emotionally close parent-child interactions while monitoring and assessing parental behavior during visits. Foster mothers described the importance of preparing children for visits and the difficulties of supporting the children afterward. Implications of understanding mothers', foster mothers', and child welfare workers' perspectives on enhancing the quality of visits with young children are discussed.