The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study

BackgroundThe prevalence of overweight and obesity is increasing amongst women of child bearing age. The objective of this study was to investigate the views and attitudes of providers of antenatal care for women who have a body mass index (BMI) of 30 kg/m² and over.MethodsA qualitative study using focus groups was undertaken within the department of obstetrics and gynaecology at a large teaching hospital in south-eastern Australia. Three focus group discussions were held. One with hospital midwives (n = 10), one with continuity of care midwives (n = 18) and one with obstetricians (n = 5). Data were analysed using Interpretative Phenomenological Analysis (IPA).FindingsSix dominant themes emerged: (1) obesity puts the health of mothers, babies and health professionals at risk; (2) overweight and obesity has become the norm; (3) weighing women and advising about weight gain is out of fashion; (4) weight is a sensitive topic to discuss; (5) there are significant barriers to weight control in pregnancy; and (6) health professionals and women need to deal with maternal obesity. These themes are drawn together to form a model representing current health care issues for these women.ConclusionHealth professionals, who have a high BMI, can find it difficult to discuss obesity during antenatal visits with obese women. Specialist dietary interventions and evidence based guidelines for working with child-bearing women is seen as a public health priority by health care professionals.     

The Developmental Progression of Understanding of Mind during a Hiding Game

In this longitudinal study, 52 typically developing preschoolers engaged in a hiding game with their mothers when children were 42‐, 54‐, and 66‐months old. Children's understanding of mind, positive affect, and engagement with the task were rated, and mothers' utterances were coded for role and content. Analyses confirmed that some facets of children's understanding of mind developed sequentially; specifically, they expressed an understanding of knowledge access before an understanding of deception and false beliefs, and expressed an understanding of deception before an understanding of false beliefs. Children's understanding of mind increased across visits and positively correlated with false belief task performance. Results suggest that mothers may tailor the content of their utterances to the child's growing expertise, but the role of mothers' utterances did not change. Observing preschoolers engaged in a playful hiding game revealed that children's understanding of mind not only increased with age but also developed sequentially.     

“You're not getting married for the moon and the stars”: The uncertainties of older British widowers about the idea of new romantic relationships

Older widowers are more likely to remarry than older widowed women. However, relatively little is known about the attitudes of older widowers to new romantic relationships and remarriage or repartnering. In this study of 60 widowers, more than half spontaneously discussed their attitudes toward, and experiences of, these relationships. However, none of the widowers had remarried and of those who described themselves as repartnered only one was cohabiting. We examine these data in the light of Lopata's concept of ‘husband sanctification’ (1981). We identify four themes. First, some widowers do sanctify their late wives. Second, we argue that wife sanctification contributes to widowers' uncertainties about repartnering. Third, when widowers make decisions to repartner, wife sanctification does not appear to make an important contribution. Finally, there is evidence to suggest that wife sanctification influences how men refer to their new women friends. Thus, we conclude by arguing that wife sanctification influences widowers' decisions surrounding remarriage/repartnering.     

An algorithm for the evaluation of the incomplete gamma function and the first two partial derivatives with respect to the parameter

A simple to use, straight coded, Fortran 4 algorithm, is presented. This algorithm has the ability to:

1) evaluate the Incomplete Gamma function, Y(r,λx), for parameter values in the range 0 < r < 20.0 and upper limit of integration values in the range 0 75.0;

2) evaluate both the first and second partial derivatives of y with respect to the parameter

3) evaluate both the Euler Di and Trigamma functions, ψ(r) and if ψ′(r)for 0<rf.20.0.

In all cases the accuracy is nine or more significant figures. The user has several choices of data output format     

Parenting Stress and Perceived Family Functioning of Chinese Parents in Hong Kong: Implications for Social Work Practice

This article reports the results of a telephone survey (n = 1002) conducted in November 2008, which aimed to identify parenting stress and perceived family functioning of Chinese parents in Hong Kong; to explore the effects of the parents’ socio‐demographic characteristics (gender, family income, education and family structure) on the aforementioned stress and functioning variables; and to examine the interrelationship among these characteristics and the two variables in question. Results showed that the reported parenting stress was at average level, while the perceived family functioning was slightly below average. The results also indicated that the parenting stress of mothers, single parents, the low‐income and the less‐educated was higher than that of fathers, parents of nuclear and extended families, the high‐income and the better‐educated. Socio‐demographic characteristics except the parent’s gender had similar effects on perceived family functioning. Higher parenting stress was associated with lower family functioning, and explained a larger variance in the perceived family functioning than the socio‐demographic characteristics taken alone. The results of the study have provided empirical support regarding the interrelationships among the vulnerable groups in society, parenting stress and perceived family functioning. Implications of the study for social work practice are discussed.     

Healthcare-Related Financial Burden Among Families in the U.S.: The Role of Childhood Activity Limitations and Income

This study examined the impact of childhood activity limitations on family financial burden in the U.S. We used ten complete panels (1996–2006) of the Medical Expenditure Panel Survey (MEPS) to evaluate the burden of out-of-pocket healthcare expenditures for 17,857 families with children aged 0–17 years. Multivariate generalized linear models were used to examine the relationship between childhood activity limitation status and both absolute and relative financial burden. Families of children with limitations had higher absolute out-of-pocket healthcare expenditures than families of children without limitations ($594.36 higher; p < 0.05), and were 54% more likely to experience relative burden (p < 0.05). Substantial socioeconomic disparities in financial burden were observed. Policies are needed to enable these families to access appropriate and affordable healthcare services.     

Physical Activity and Physical Self‐Concept in Adolescence: A Comparison of Girls at the Extremes of the Biological Maturation Continuum

This study examined differences in physical activity and physical self‐concept between the least and most biologically mature female adolescents within chronological age and academic year groups. A total of 252 British female adolescents (M age = 12.9 years; SD = .7) in Years 7–9 completed self‐report measures to assess physical activity and physical self‐concept. Percentage of predicted adult (mature) stature served as the index of biological maturation. Univariate analyses of covariance, controlling for decimal age, revealed that the least mature girls generally held higher perceptions of physical self‐concept but were no more, or less, active than the most mature girls. A subsequent meta‐analysis suggested, however, that across age and year groups the least mature girls were more active than the most mature girls.     

One Still Face,Many Visions

Tronick, Cohn, and Muir and Lee have strengthened and extended our history of the still‐face procedure by reflecting on important theoretical and methodological issues in the current literature, and by looking to the future of how the still face can inform and guide further investigations. These commentaries provide a wonderful illustration of how the use of a shared, if not fully standardized, paradigm can continue to inspire ever more sharing of ideas.     

Sample Timing and Mathematical Considerations for Modeling Breath Elimination of Volatile Organic Compounds

Real-world exposure measurements are a necessary ingredient for subsequent detailed study of the risks from an environmental pollutant. For volatile organic compounds, researchers are applying exhaled breath analysis and the time dependence of concentrations as a noninvasive indicator of exposure, dose, and blood levels. To optimize the acquisition of such data, samples must be collected in a time frame suited to the needs of the mathematical model, within physical limitations of the equipment and subjects, and within logistical constraints. Additionally, one must consider the impact of measurement error on the eventual extraction of biologically and physiologically relevant parameters. Given a particular mathematical model for the elimination kinetics (in this case a very simple pharmacokinetic model based upon a multitenn exponential decay function that has been shown to fit real-world data extremely well), we investigated the effects on synthetic data caused by sample timing, random measurement error, and number of terms included in the model. This information generated a series of conditions for collecting samples and performing analyses dependent upon the eventual informational needs, and it provided an estimate of error associated with various choices and compromises. Though the work was geared specifically toward breath sampling, it is equally applicable to direct blood measurements in optimizing sampling strategy and improving the exposure assessment process.