The Long‐Term Effects of Caregiving on Women's Health and Mortality

Caregivers experience numerous mental and physical health effects from the stress of providing care, but we know little about whether these problems persist in the long term and whether long‐term effects differ across caregiving contexts. Using the National Longitudinal Survey of Mature Women, we examined the relationship between caregiving and long‐term patterns of depressive symptoms, functional limitations, and mortality. We also explored the health effects of caregiving in‐home versus out‐of‐home and by caregiver/care‐recipient relationship. Analyses show that in‐home spousal and parental caregiving predict increased depressive symptoms and functional limitations in the long term but are unassociated with mortality, whereas caregiving outside the home is unassociated with later depression and functional limitations but predicts a lower risk of mortality. This study highlights the usefulness of approaching stressful experiences such as caregiving from the life course perspective, viewing them as processes that unfold over time within specific contexts that may carry delayed or cumulative consequences.     

Spillover in the Home: The Effects of Family Conflict on Parents' Behavior

Conflict with a spouse or child may generate spillover, defined as short‐term affective changes in parents that affect their behavior with other family members. In a diverse sample of 86 parents, this 56‐day diary study examined daily bidirectional spillover between conflict in the marital or parent–child dyad and parents' irritable, frictional behavior with their child or spouse, respectively. Tests of daily associations between conflict and parent behavior revealed robust spillover effects according to parent as well as spouse and child reports. Parents' daily negative mood and child externalizing behavior contributed to several but not all of these associations. Daily spillover findings were largely unaffected by parents' neuroticism, suggesting that parents' day‐to‐day fluctuations in negative mood, not average levels of negative affectivity, promoted spillover. Significant direct effects of conflict on parent behavior even when controlling for negative mood, however, implicate additional cognitive or social processes as contributors to conflict spillover in families.     

Sexuality in the Global South: 50 Years of Published Research in the Journal of Sex Research—Inclusions,Omissions, and Future Possibilities

Sexuality researchers from a range of disciplines have called for more global inclusiveness in sexualities research, particularly in the Global South (GS). We investigated the degree to which sexuality researchers have published work focused on the GS by conducting a content analysis of 50 years of research published in the Journal of Sex Research (JSR). We examined all research articles, brief research reports, and clinical notes published in JSR from 1965 to 2014 (N = 1,626). Overall, a small percentage of articles focused on the GS with no increase over time (4.8%; N = 78). Articles in the GS focused on Asia (37.2%), Latin America (28.2%), Sub-Saharan Africa (23.1%), the Middle East (6.4%), and a mix of GS regions (5.1%). Topics related to sexual and reproductive health were most prevalent (19.2%), followed by articles on sexual risk, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV) (17.9%), sexual norms, attitudes, and beliefs (16.7%), sex work (11.5%), cultural practices (10.3%), gay, lesbian, and bisexual issues (9.0%), intimate partner relationships (3.8%), and sexual violence (3.8%); the remaining categories (transgender and transsexual populations, sex research methods, sex testing, and women’s sexuality) were negligible. We conclude with recommendations for improving the quantity, quality, and scope of global sexuality research in JSR.     

Are There Still Alternatives? Relationships Between Alternative Media and Mainstream Media in a Converged Environment

Media scholars and non‐scholars alike have long sought to discern and describe the differences between alternative media and mainstream media — a task that became harder in the digital age, as online communications blurred boundaries. This essay examines how theorists and researchers have attempted to clarify the term ‘alternative media’ and to explain why this category remains relevant in a networked society. Academics largely reject the alternative–mainstream dichotomy and view these media on a continuum, featuring many hybrids and few pure instances. While differences between the two forms are less apparent in liberal democracies than in authoritarian regimes, alternative media persist in being less commercial, producing more critical content and being more committed to social change than their mainstream counterparts. In a converged context, the idea of ‘alternative media’ with a dialectical, interdependent relationship to the mainstream remains important to many producers, users and scholars.     

Caring for vulnerable populations: curricula in U.S. internal medicine residencies

The Accreditation Council for Graduate Medical Education (ACGME) encourages internal medicine training programs to include specific curricula devoted to health care issues of vulnerable populations. Our aim was to determine the prevalence of curricula involving selected vulnerable populations among U.S. Internal Medicine residencies. We conducted a survey of Program Directors of all US Internal Medicine Residencies assessing whether the program had a curriculum for six vulnerable populations (racial and ethnic minorities, non-English speaking patients, lesbians, gay men, victims of domestic violence and patients with substance abuse problems). Most residencies address substance abuse and victims of domestic violence, while there remains a lack of dedicated teaching on other vulnerable populations, including lesbians, gay men, racial and ethnic minorities and non-English speaking patients.     

Craving closeness: a grounded theory analysis of women's experiences of mothering in the Special Care Nursery

AIM: The aim of the study was to increase knowledge and understanding of how women begin their roles as mothers when their infant is in the neonatal nursery. BACKGROUND: Research is limited into how women experience mothering in contexts such as the neonatal nursery. Consequently many nurses and midwives remain inadequately informed of parents' experiences which we know may have long-term family outcomes. METHOD: This paper presents the overarching synthesis of a grounded theory analysis of data collected from 28 Australian women whose infants were in Special Care Nurseries. It draws together a number of previous publications that have described in detail the categories derived from the analysis that explain the actions, interactions and reactions women engage in as they seek to 'connect' with their infant. Data collection consisted of two in-depth interviews conducted with women, 333h of taped cot side recordings, field notes and interview data collected from 20 nursery staff, 19 of whom were midwives. FINDINGS: Six major categories were identified that, when combined, explained the intense emotional, cognitive and worry 'work' women undertook with both their infants and the nursery staff in an effort to learn how to mother in the nursery. Four explained how women worked to get to know and connect with their infants. The first three were labelled 'just existing', 'striving to be the baby's mother' and 'trying to establish competence'. The fourth, 'learning and playing the game', overlays the first three and represents the reality of having to undertake these already difficult and unexpected activities of mothering in the nursery. Two categories 'becoming connected' and 'struggling to mother' were identified as the consequences of women's actions and interactions. A significant finding of the study was the impact of the interactions between nurses and mothers' mothering. The nurse-mother relationship had the potential to significantly affect how women perceived their connection to the infant and their confidence in caring for their infant which occurred through a three way interaction. CONCLUSIONS: It becomes clear that the intense work women undertake as mothers in the nursery is focused on not only the infant, which might have been expected, but also the nursery staff. It is driven by their desire to develop or re-establish some sense of competence in the eyes of the nurse and to achieve control over the situation. Achieving physical closeness with the baby was a major strategy through which women not only learned about and gained intimate knowledge of their infant, but also demonstrated authority and ownership. It appears that reorientating the delivery of services from the infant to the mother-infant dyad would improve the care women and families receive during their nursery experience.     

Remembering gay/lesbian media characters: can Ellen and Will improve attitudes toward homosexuals?

The purpose of the current research was twofold. First, a pilot study was conducted in which participants were asked to recall any memorable gay or lesbian television or film character and complete a survey about their perceptions of the character. Results indicated that over two-thirds of heterosexual participants recalled either Ellen or Will, and evaluative ratings for these characters were generally positive. The second purpose of this research was to examine the priming effects of remembering portrayals of homosexual characters in the media. Therefore, an experiment was conducted to directly assess the effects of thinking about either a positive or negative homosexual character on general heterosexuals' attitudes toward gay men and lesbians. Results indicated that those recalling a positive portrayal later showed a more positive attitude toward gay men than those recalling a negative portrayal, and women had a more positive attitude overall than men toward gay men and lesbians. Such findings illustrate the importance of positive role models in entertainment media as potential primes of social attitudes.     

Providing perinatal loss care: satisfying and dissatisfying aspects for midwives

PURPOSE: There is limited midwifery research that focuses on midwives experiences and attitudes to providing care for women who experience the death of a baby. There is also limited research investigating care components, and evidence to inform the basis of clinical practice in Australia and internationally. This paper presents the qualitative findings of a small study that aimed to investigate midwives experience, confidence and satisfaction with providing care for women who experienced perinatal loss. PROCEDURE: Eighty-three Western Australian midwives responded to an open ended question asking them to describe the most and least satisfying aspects of their role when providing care to women who experienced a perinatal loss. Thematic analysis was used to analyse the data. FINDINGS: The analysis revealed that Australian midwives gained most satisfaction from providing skilled midwifery care that they considered made a difference to women. This was enabled when midwives were afforded the opportunity to provide continuity of midwifery carer to women throughout the labour, birth and early postnatal period. In terms of the least satisfying aspects of care, midwives identified that they struggled with the emotional commitment needed to provide perinatal loss care, as well as with how to communicate openly and share information with women. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Within the context of the study setting, midwifery care for women following perinatal loss reflects the care components espoused in the literature. There are, however, organisational issues within health care that require commitment to continuity of care and further education of practitioners to enhance outcomes for clients.     

Can’t We Just Live Together? New Evidence on the Effect of Relationship Status on Health

There has been a large empirical literature on the effect of marriage on health, but scant empirical evidence on the effect of cohabitation on health, although cohabitation is increasingly common. We contributed to this literature in three ways. First we explicitly modeled cohabitation distinct from marriage. Second, we included lagged health in our models to address the dynamic process of health and health-related selection into relationships. Extant literature has failed to control for lagged health risking omitted variable bias. Rather, it has controlled for general unobservable heterogeneity using fixed effects models that have relied on limited variation in relationship status over time to identify the effect of relationship status on health. Third, we employed a continuous health index that aids in estimation and inference of dynamic models. Using the Blundell and Bond dynamic panel data estimator and 18 years of the British Household Panel Survey of nearly 18,000 adults, we found that being in a relationship is good for health, but the benefits are not unique to marriage. Our finding that cohabitation is as beneficial as marriage for health was good news for health policy as changing social norms and economic instability have delayed or impaired family formation.     

Different preferences or different opportunities? Explaining race differentials in the academic achievement of friends

A popular explanation for race and ethnic disparities in academic achievement is that minorities are exposed to different peers and have different opportunities to make friends with high-achievers. Although we know that adolescents from different race and ethnic groups attend different schools and that they choose different friends, we do not know how these different opportunities affect the friends they make. This paper fills this gap by studying how the opportunities within adolescents’ schools affect race and ethnic differences in the academic characteristics of friends. Using data from the National Longitudinal Study of Adolescent Health and the conditional logit and opportunities framework, I account for adolescents’ different opportunities to make friends both within and across schools. Ignoring their different opportunities, Black and Latino adolescents’ nominated friends have significantly lower levels of achievement than white adolescents. After accounting for their different opportunities to make friends within and between schools, race and ethnic differences in the achievement characteristics of friends disappear. If Black and Latino adolescents’ opportunity structures were identical to white adolescents’, their probabilities of nominating high-achieving friends would not differ.