Using a Community Participatory Research Approach to Understand Satisfaction with Psychopharmacology Among Families of Children with Psychiatric Co-Morbidities

How do parents of children with psychiatric co-morbidities perceive their children’s use of psychiatric medications? To learn more, the Parent/Professional Advocacy League of Massachusetts (PAL), representing families of children with mental health needs, collaborated with researchers on a community-based participatory research (CBPR) study. A questionnaire assessed satisfaction with psychiatric medication as it pertained to children with psychiatric co-morbidities (n = 212). Satisfied parents were likely to employ alternative therapies and feel that prescribers had informed them about medication use and side effects. Results reinforce the need for prescribers to discuss psychopharmacology with families. CBPR improved study relevance and supported PAL’s advocacy efforts.     

Everyday health and identity management among older women with chronic health conditions

The majority of older women have at least one chronic health problem and coping with multiple conditions is common with advancing old age. In this longitudinal, qualitative study we explored the health perceptions of older women (N = 36) with multiple chronic conditions. Guided by a symbolic interactionist perspective, our research questions asked: (a) how do older women with chronic health conditions interpret their own health in their everyday lives and (b) how do they talk about their health with others. We found that women depended on their embodied self, or signs from the body, to interpret their everyday health. The women engage in identity management to make sense of limitations caused by their chronic health conditions. They regulated how much and with whom they were willing to share issues related to their everyday health. Findings suggest that everyday health is important in identity construction among older adults.     

The subjective dimension of social isolation: A qualitative investigation of older adults' experiences in small social support networks

In the aging literature, social isolation has been primarily defined in terms of reduced support network size and low frequency of social contacts. Having a small social support network is associated with social isolation and an increased risk of physical and emotional vulnerability. However, this conceptualization ignores the contributions of a host of other factors, including life experiences, family dynamics, and long-term patterns of socialization. This paper argues that alongside quantitative assessments of support systems, the application of a life course perspective is needed to understand small social networks as lived experience. We report on findings from 28 in-depth interviews with older adults identified as being at risk of social isolation on the basis of the self-reported size of their social networks. We discuss these participants' experiences in the context of significant life course transitions such as marriage and widowhood.     

Australian women's experiences of living with gestational diabetes

PurposeThe purpose of this study was to describe Australian women's reflections on the experience of having a pregnancy affected by GDM.MethodsParticipants were women aged ≥18 years, diagnosed with GDM ≤3 years previously and registered with the National Diabetes Services Scheme. Data was collected from a cross-sectional written postal survey which included the opportunity for women to document their experiences of living with GDM. Thematic framework analysis was undertaken to determine underlying themes.ResultsOf 4098 invited eligible women, 1372 consented to participate. Of these, 393 provided feedback on their experiences of living with GDM. Eight key themes emerged from the data (1) shock, fear and anxiety (8.9%), (2) uncertainty and scepticism (9.4%), (3) an opportunity to improve one's health (9.6%), (4) adapting to life with GDM (11.6%), (5) the need for support (17.2%), (6) better awareness (3.5%), (7) abandoned (14.9%), (8) staying healthy and preventing diabetes (13.7%). Women taking insulin were more likely to experience shock, fear or anxiety (p = 0.001) and there was a trend towards women who spoke another language also being more likely to report this experience (p = 0.061). Those diagnosed with GDM in a previous pregnancy (p = 0.034) and younger women (p = 0.054) were less likely to view the diagnosis as an opportunity to improve their health.ConclusionsThis study provides an insight into the experience of the pregnant woman diagnosed with GDM. It emphasises the importance of health professional support and provides insight into the challenges and opportunities for future diabetes risk reduction.     

Marriage and divorce in twentieth century American cohorts

Marital status life tables have provided a basis for describing the marriage, divorce, and mortality experience of U.S. cohorts born 1888-1950. In brief, marriage occurred earlier and became more universal from the earliest cohorts to those of the late 1930s. More recent cohorts show declines in the proportion ever marrying and increases in the mean age at marriage. Period data for 1980 and cumulative cohort data by age suggest the likelihood of a continuing retreat from first marriage. Divorce has been rising steadily, with the latest cohorts indicating that 46 percent of male marriages and 42 percent of female marriages will end in divorce. Period data for males in 1980 raise the possibility that levels of divorce may have reached a peak, but cumulative cohort data by age show no such pattern. The present results are consistent with the view that a fundamental change in the traditional concept of marriage is underway. Traditional marriage involved the husband providing the wife with economic support and protection in return for her companionship and maternal services. Strong social pressures urged men and women to marry, and made the coveted services married persons provided each other difficult to obtain elsewhere. Recent economic changes have undermined the social and economic forces that maintained the institution of marriage. The U.S. economy has grown to include a large service sector in its labor force, and that growth has produced a dramatic increase in female labor force opportunities (Oppenheimer, 1970). The resultant large scale participation of women in economic activity blurs the traditional division of labor by sex, and goes to the very heart of the traditional marriage "bargain." At the same time, economic changes have weakened family ties by encouraging lower fertility, stressing achieved as opposed to ascribed characteristics, and fostering geographical mobility (Goode, 1970). The "marital union" of the past may be giving way to the "marital partnership" of the future, which will accommodate informal as well as formal marriages, less dependence between spouses, greater egalitarianism, lower fertility, and higher levels of divorce.     

Indigenous (im)mobilities in the Anthropocene

ABSTRACT

This paper explores Indigenous (im)mobilities in the Anthropocene, and their relationship to Pacific Islands climate activism. In a context where Indigenous peoples and perspectives are poorly represented in global climate politics, it is important to understand how Pacific people represent their own interests and imagine their own futures as pressures to move due to climate change take hold. We examine political action outside of formal governance spaces and processes, in order to understand how Indigenous people are challenging state-centric approaches to climate change adaptation. We do so by studying the works of Pacific activists and artists who engage with climate change. We find that *banua – an expansive concept, inclusive of people and their place, attentive to both mobility and immobility, and distributed across the Pacific Islands region – is essential for the existential security of Pacific people and central to contemporary climate activism. We find that Pacific activists/artists are challenging the status quo by invoking *banua. In doing so, they are politicising (im)mobility. These mobilisations are coalescing into an Oceanic cosmopolitanism that confronts two mutually reinforcing features of contemporary global climate politics: the subordination of Indigenous peoples, perspectives and worldviews; and the marginalisation of (im)mobility concerns within the global climate agenda.     

Fertility in Kenya and Uganda: a comparative study of trends and determinants

Between 1980 and 2000 total fertility in Kenya fell by about 40 per cent, from some eight births per woman to around five. During the same period, fertility in Uganda declined by less than 10 per cent. An analysis of the proximate determinants shows that the difference was due primarily to greater contraceptive use in Kenya, though in Uganda there was also a reduction in pathological sterility. The Demographic and Health Surveys show that women in Kenya wanted fewer children than those in Uganda, but that in Uganda there was also a greater unmet need for contraception. We suggest that these differences may be attributed, in part at least, first, to the divergent paths of economic development followed by the two countries after Independence; and, second, to the Kenya Government's active promotion of family planning through the health services, which the Uganda Government did not promote until 1995.     

Naturalization of U.S. Immigrants: Highlights from Ten Countries

The saga of U.S. immigrant naturalization is merely sketched for about 25 million immigrants entered in three decades of renewed immigration. This study documents naturalization outcomes for immigrants from ten major countries of origin, using administrative records on immigrants and naturalizations. Following the 1978–1987 admission cohorts for the first decade or more of permanent residence, this study finds significant covariate effects on the timing of naturalization by origin, mode of entry, and immigrant visa class, net other influences of demographic and background characteristics. Immigrants from the Philippines, Vietnam, and China naturalized more quickly than immigrants from India, Korea, Cuba, Colombia, Jamaica, the Dominican Republic, and Mexico. Those who adjusted from statuses as nonimmigrants, refugees, or asylees became naturalized citizens more quickly. Those immigrants with employment sponsorship naturalized faster than family-sponsored immigrants. Spouses of citizens, spouses of permanent residents, spouses of siblings of citizens, and spouses of sons and daughters of citizens naturalized faster than some other immigrants. Gender was not significant in the multivariate analysis, but further research will more fully explore sex-specific variation in the timing of naturalization given likely variation in women's representation by origin and admission categories.     

Children's Economic Roles in the Maya Family Life Cycle: Cain,Caldwell, and Chayanov Revisited

This article examines the relationship between household demographic pressure and interage transfers for a group of Maya subsistence agriculturists in Yucatán, Mexico. The authors use data from a field study conducted in 1992–93 on individual time allocation, relative productivity by age and sex, and caloric costs of activities to estimate age schedules of average consumption and production. Using these, they investigate the net costs of children to their parents and find that children have a negative net asset value up to the time they leave home. The direction of net wealth flows in this group is downward, from older to younger, and in economic terms the internal rate of return to children is highly negative up to the time they leave home. Nonetheless, children play a critically important role in the family's economic life cycle. On average, girls offset 76 percent of their consumption costs before leaving home at age 19, and boys offset 82 percent before leaving home at 22. Without the contributions from children as a group, parents would have to double or triple their work effort during part of the family life cycle if they were to raise the same number of children. By the thirteenth year of the family life cycle, children as a group produce more than half of what they consume in every year, and after the twentieth year children produce more than 80 percent of what they as a group consume. The authors also find that the elderly in the sample, ages 50 to 65, produce more than they consume. Thus while children have a negative net asset value to parents, the timing of their children's economic contribution across the family life cycle plays a key role in underwriting the cost of large families.