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.     

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.     

Immigration,national identity and political trust in European democracies

This article argues that discrepancies between individual-level conceptualisations of national identity and official government approaches to national identity, as reflected in policies towards migrants, contribute to reduced levels of political trust in Europe. Public opinion data matched with contextual data measuring immigrant incorporation policies are used to investigate this proposition. The findings indicate that individuals who take a more exclusive approach to national identity but live in political systems that are comparatively more welcoming of immigrant incorporation into the national political system tend to be the least trusting of their political systems, and this is closely followed by those individuals who adopt a more inclusive form of identity but live in countries that are relatively less welcoming in their treatment of immigrants. Where individual identity and immigrant incorporation are both inclusive, trust tends to be relatively high.     

Beyond Orphanhood: Parental Nonresidence and Child Well‐being in Tanzania

This article used data from the Rufiji Health and Demographic Surveillance System in Tanzania to examine the influence of parental nonresidence on child survival and school entry. Using survival analysis methods, the article tested variations by parent and by cause, examining parental death, nonresidence because of parental relationship status, and migration. In general, maternal nonresidence was more consequential for child survival, whereas paternal nonresidence influences school entry. This is consistent with gendered parenting patterns in the setting. There was important variation by cause and by outcome, particularly for paternal nonresidence. Paternal nonresidence because of nonmarital birth was associated with increased risk of child death, whereas paternal migration was associated with improved survival. Paternal death and migration were associated with lower odds of school entry. This article moves beyond orphanhood to consider multiple causes of parental nonresidence simultaneously, demonstrating that parental nonresidence is not uniformly deleterious for children.