Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care

BackgroundAlthough midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters.ObjectiveThe objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care.Research designThe qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters.FindingsSocially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional.ConclusionThis research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong; midwives. These findings suggest that midwives need to better communicate a valuing of the woman's participation in decision-making processes and to work with women so they do have a sense of belonging within the maternity care environment. Midwives need to ensure that socially disadvantaged women do feel safe about having a voice regarding their choices and find ways to give them a sense of control within their maternity care encounters.     

Evaluation case histories as a parallel to legal case histories: Accumulating knowledge and experience in the evaluation profession

Legal case histories are a basic and essential part of the law. It is proposed that evaluation case histories would be valuable to the evaluation profession in that they would serve both to accumulate knowledge and experience and as examples of how to do evaluations. Part I of the paper is a discussion of the nature, place and use of case histories in law. The format of a reported case, the use of cases by attorneys and how case decisions are reported and categorized are also discussed. Part II of the paper tries to envision the nature and use of evaluation case histories as a parallel to legal case histories. Matters discussed include the possible function and use of evaluation case histories, the difference between an evaluation report and an evaluation case history, information an evaluation case history could contain, and how case histories might be reported and categorized.     

Wrapping and Unwrapping Emotions: Clinical Practice with East Asian Immigrant Elders

Using the cultural norm of the way gifts are wrapped, unwrapped, and exchanged as a metaphor for interpersonal connections, this paper presents the way therapists can establish therapeutic relationships with East Asian clients who do not express emotions openly. We first discuss the ways in which emotions are conceptualized, experienced, and expressed in East Asian cultures. We then present vignettes of our work with older Chinese and Japanese immigrant women to illustrate the importance of therapist authenticity and co-construction of the therapeutic relationship. Using the framework of relational/cultural theory, which posits that healing takes place in the context of mutually empathic growth-fostering relationships, we illustrate the importance of establishing mutuality between therapist and client as a form of cultural empathy.     

Gambling and Sport: Implicit Association and Explicit Intention Among Underage Youth

This study examined whether an implicit association existed between gambling and sport among underage youth in Australia, and whether this implicit association could shape their explicit intention to gamble. A sample of 14–17 year old Australian participants completed two phases of tasks, including an implicit association test based online experiment, and a post-experiment online survey. The results supported the existence of an implicit association between gambling and sport among the participants. This implicit association became stronger when they saw sport-relevant (vs. sport-irrelevant) gambling logos, or gambling-relevant (vs. gambling-irrelevant) sport names. In addition, this implicit association was positively related to the amount of sport viewing, but only among those participants who had more favorable gambling attitudes. Lastly, gambling attitudes and advertising knowledge, rather than the implicit association, turned out to be significant predictors of the explicit intention to gamble.     

Breaking Bad: Comparing Gambling Harms Among Gamblers and Affected Others

This article examines gambling harms from both gamblers and affected others’ perspectives. Participants (3076 gamblers and 2129 affected others) completed a retrospective survey that elicited information on harms they experienced from gambling across their lifetime. Their responses were analyzed through testing measurement invariance, estimating item-response theoretic parameters, calculating percentages, confidence intervals, and correlations, as well as regressions. The results indicated large commonalities in the experience of harms reported by gamblers and affected others. Further, gamblers appeared to ‘export’ about half of the harms they experienced to those around them. The findings also provided detailed profiles of evolving harms as problem gambling severity varies.     

Understanding Membership in a World of Global Migration: (How) Does Citizenship Matter?

This article synthesizes the literature on citizenship and immigration to evaluate the heft of citizenship and theorize why it matters. We examine why citizenship laws vary cross‐nationally and why some immigrants acquire citizenship while others do not. We consider how citizenship influences rights, identities, and participation and the mechanisms by which citizenship could influence lives. We consider frameworks, such as cultural and performative citizenship, that de‐center legal status and the nation‐state. Ultimately, we argue for a claims‐making approach to citizenship, one that is a relational process of recognition, includes actors outside the individual/state dyad, and focuses on claims to legitimate membership.     

Page turning solutions for musicians: a survey

Musicians have long been hampered by the challenge in turning sheet music while their hands are occupied playing an instrument. The sight of a human page turner assisting a pianist during a performance, for instance, is not uncommon. This need for a page turning solution is no less acute during practice sessions, which account for the vast majority of playing time. Despite widespread appreciation of the problem, there have been virtually no robust and affordable products to assist the musician. Recent progress in assistive technology and electronic reading devices offers promising solutions to this long-standing problem. The objective of this paper is to survey the technology landscape and assess the benefits and drawbacks of page turning solutions for musicians. A full range of mechanical and digital page turning products are reviewed.     

Estimation of Feral Pigeon (Columba livia) population size using a novel Superimposed Urban Strata (SUS) method

A reference method to estimate Feral Pigeon (C. livia) population size in urban areas is missing: results of different surveys are difficult to compare due to the wide heterogeneity of approaches. A combined technique, the Superimposed Urban Strata (SUS) method, especially designed to estimate pigeon population size in urban areas, is proposed. SUS implements methods based on stratified sampling layers: its reliability was tested with a pilot study in Padua (Italy). The survey area was split into two superimposed strata and a different survey technique was applied to each stratum. The first stratum consisted of twelve topographic sampling units, identified as critical ornithic-density loci. The second stratum was obtained by selecting 10 % of the survey area with systematic sampling. In the estimate of the population size, different detection probabilities were assigned to the two strata. The SUS method was first applied in 2007, when three-year growth projections for the C. livia population were calculated, with a density-dependent model. In 2010, the survey was repeated to countercheck previous data. Estimated C. livia population size was of 2340 ±93 units in 2007, whereas in 2010 it was of 3679 ±161 units. The 2010 estimated population size resulted in fair accordance with the three-year projections, showing less than a 4 % mismatch. SUS proved to be an adequate estimate method for urban areas: so far it has been tested only in an average Italian urban area, but it could be easily adapted to other cities by calibrating parameters linked to the peculiar urban background.