Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature

BackgroundYoung pregnant women who continue a pregnancy are primarily from a socioeconomically deprived background. The risk factors associated with low socio-economic status may independently affect perinatal and neonatal morbidity to a greater extent than the young age of the woman. Young pregnant women are frequently sceptical about health care providers who they can perceive to be judgemental. This may lead to late booking for pregnancy care, attending few appointments, or not attending the health service for any antenatal care.QuestionDoes the way maternity care is provided affect maternal and neonatal outcomes for young women?MethodA systematic search of the major health databases.ResultsNine research articles met the eligibility criteria: one randomised controlled trial, three prospective cohort studies, two comparative studies with concurrent controls, two comparative studies with historical controls, and one case series.DiscussionProviding young women with a non-standard model of maternity care has some beneficial and no known detrimental effects on childbirth outcomes. While there is a dearth of evidence on the effectiveness of a Midwifery Group Practice model of care for young women, there is strong evidence to suggest that a Group Antenatal Care model increases antenatal visit attendance and breastfeeding initiation, and decreases the risk of preterm birth. There is research to indicate that a Young Women's Clinic model may also increase antenatal visit attendance and decrease the incidence of preterm birth.ConclusionMore well-designed and resourced midwifery models of care for young women should be implemented and rigorously researched.     

‘Making Pies’—A Way of Exploring Pupils’ Views on Curriculum Innovation

This article examines the use of focus groups (FGs) as a way of gathering pupils’ views on the implementation of new curricula. We provide illustrations of creative activities, which were especially designed for a case‐study research project exploring the views of 11‐year‐old pupils in English schools adopting an innovative approach to the Year 7 curriculum. We argue that combining FGs with creative methods encourages pupils to take an active role in interviews, enriches the quality of the data being collected and enhances the place of FGs as important tools in eliciting pupils’ voices for both research and curriculum planning purposes.     

Exposed Singularity

In his photographs of children in displaced persons’ camps, Salgado takes each subject seriously. His images dis‐place us through their dignity and presence. We are no longer spectators but engaged: each gaze demands a response and produces the self as exposed. Pictures of prisoners from Tuol Sleng in Cambodia take the same form: a single figure facing the camera. Here, however, we are caught in an additional and irresolvable aporia: we are faced with thousands to whom we cannot adequately respond. As Derrida argues, responsibility is only possible by sacrificing ethics: we can respond to one only by sacrificing whatever obliges us to respond to others. In the final set of images considered here, Daravuth’s positing of the indistinguishability of victim and perpetrator disturbs any easy response once more. A reading of Nancy alongside and against Derrida points to significant differences in emphasis between the two, and throws further light on the aporia of responsibility. The essay concludes that Nancy’s being singular plural is productive in emphasizing the need, politically, to focus not on how we might establish a bond between us, but rather on how it is that we seem separate at all. The photographs expose us to our inevitable engagement or being‐with.     

Toddlers Activate Lexical Semantic Knowledge in the Absence of Visual Referents: Evidence from Auditory Priming

Language learners rapidly acquire extensive semantic knowledge, but the development of this knowledge is difficult to study, in part because it is difficult to assess young children's lexical semantic representations. In our studies, we solved this problem by investigating lexical semantic knowledge in 24‐month‐olds using the Head‐turn Preference Procedure. In Experiment 1, looking times to a repeating spoken word stimulus (e.g., kitty‐kitty‐kitty) were shorter for trials preceded by a semantically related word (e.g., dog‐dog‐dog) than trials preceded by an unrelated word (e.g., juice‐juice‐juice). Experiment 2 yielded similar results using a method in which pairs of words were presented on the same trial. The studies provide evidence that young children activate of lexical semantic knowledge, and critically, that they do so in the absence of visual referents or sentence contexts. Auditory lexical priming is a promising technique for studying the development and structure of semantic knowledge in young children.     

Self-stigma coping and treatment-seeking in problem gambling

Stigma has been explored as a cause of reduced and delayed treatment-seeking for problem gambling, a population in which only 1 in 10 seek treatment. The present study examined the effect of perceived public stigma and self-stigma on affect and behavioural coping efforts. Path analysis was used to examine self-stigma in 155 individuals with gambling problems. The majority of participants met criteria for a gambling disorder (93.5%), were current gamblers (69%) and had never sought treatment (54.2%). The data fit the proposed path model well; self-stigma was associated with reduced self-esteem and increased shame. Shame predicted use of secrecy and withdrawal coping. Endorsement of negative stereotypes of ‘problem gamblers’ was associated with decreased treatment-seeking while greater self-stigma predicted increased treatment-seeking. Additional predictors of increased treatment-seeking included greater gambling problem severity, more positive attitudes towards treatment, male sex and higher income. Self-stigma increased rather than decreased treatment-seeking in this analysis. Efforts to increase treatment-seeking could target women, those with lower income and those with less severe gambling problems.     

Parents' Partnership Decision Making After Divorce or Widowhood: The Role of (Step)Children

Using data from the Netherlands Kinship Panel Surveys, this study investigated divorced and widowed parents' (N = 350) decision making about living arrangements after repartnering: Twenty‐eight percent lived apart together (LAT) and others lived together (remarried or cohabiting). The focus was on determinants of LAT: Women, older respondents, residents of larger cities, and parents of 2 or more children are more apt to LAT. On the basis of additional qualitative interviews with LAT respondents (n = 25), the reasons for LAT were investigated. Data showed that many children are involved in pure boundary work in an effort to guarantee the continuation of their family. Other (step)children use the sabotage or refusal types of boundary work, not accepting the new partner or excluding a parent from contact, especially with grandchildren. Many of these efforts are successful. To preserve the ties with their children, parents often adapt their decision making about the living arrangements with a new partner accordingly.     

A Rapid Review of Sexual Wellbeing Definitions and Measures: Should We Now Include Sexual Wellbeing Freedom?

An increasing number of studies refer to sexual wellbeing and/or seek to measure it, and the term appears across various policy documents, including sexual health frameworks in the UK. We conducted a rapid review to determine how sexual wellbeing has been defined, qualitatively explored and quantitatively measured. Eligible studies selected for inclusion from OVID Medline, PsychInfo, PubMed, Embase, CINAHL were: in English language, published after 2007, were peer-reviewed full articles, focused on sexual wellbeing (or proxies for, e.g. satisfaction, function), and quantitatively or qualitatively assessed sexual wellbeing. We included studies with participants aged 16–65. Given study heterogeneity, our synthesis and findings are reported using a narrative approach. We identified 162 papers, of which 10 offered a definition of sexual wellbeing. Drawing upon a socio-ecological model, we categorised the 59 dimensions we identified from studies under three main domains: cognitive-affect (31 dimensions); inter-personal (22 dimensions); and socio-cultural (6 dimensions). Only 11 papers were categorised under the socio-cultural domain, commonly focusing on gender inequalities or stigma. We discuss the importance of conceptualising sexual wellbeing as individually experienced but socially and structurally influenced, including assessing sexual wellbeing freedom: a person’s freedom to achieve sexual wellbeing, or their real opportunities and liberties.     

SYMBOLIC REALITY BITES: WOMEN AND RACIAL/ETHNIC MINORITIES IN MODERN FILM

Criticisms of mass media productions often include a discussion of how women and minorities are systematically excluded and/or relegated to minor roles, or roles that match traditional stereotypes. These types of portrayals are important factors in the social construction of reality among the general public, and therefore may perpetuate racism and sexism on a larger scale. Using a content analysis of fifty popular films in 1996 the present study explores the demographic composition of the leading actresses and actors. The goal is to gauge the strength of female and minority presence and to provide an assessment of character representations through an analysis of labor force participation, sex-roles of occupation, prestige of occupation, and gender. Findings indicate that although both women and minorities have made some advancement in their film portrayals, compared to earlier studies, they still are under-represented in leading roles in Hollywood, and their portrayals are often consistent with traditional stereotypes.