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271.

Background

Midwifery care has been linked to positive birth outcomes. Despite the broad racial disparities in maternal and infant outcomes in the United States (US), little is known about the role of minority women in either providing or receiving this type of care. A vibrant community of minority women, who self-identify as providing these services, exists online. In this exploratory study we ask how they describe their role; view their practice; and position themselves in the broader discussions of racial health disparities in the US.

Methods

Using an internet mediated qualitative design we analyse online narratives from self-described African-American nurse-midwives, lay midwives and birth assistants; we found 28 unique websites. We collected and analysed narrative material from each site. We used a thematic analysis approach to identify recurrent and emergent themes in relation to the study question.

Results

Narratives identified a strong link to the past, as providers viewed their practice in a historical perspective linking African roots, to the diaspora, and to current African-American struggles. Providers engaged both in direct clinical work, and in activist roles. Advocacy efforts sought to expand numbers of minority birth care workers and to extend the benefits of woman-centred birth care to underserved communities.

Conclusion

Results demonstrate the continued existence and important role of diverse types of African-American birth care providers in minority communities in the US. Recognition, support, and increasing the number of midwives of colour is important in tackling racial inequalities in health. Further research should explore minority access to woman-centred care.  相似文献   
272.
This paper aims at the application of an ergonomic maturity model (EMM), in order to assess the ergonomic sustainability outreach of ergonomic actions. This proposition was motivated by the widespread sensation that the development of the discipline, its educational devices and related practices depends on the attitude of ergonomics practitioners rather than environmental macroergonomic conditions. Maturity modeling in this paper is undertaken as a tool for ergonomic practitioners. Thus, its foundations were uprooted from diverse fields: Clinic Psychology, Quality Management and Project Management. The paper brings about a detailled explanation of this ergonomic maturity tool. The empirical part is fulfilled by the examination - using the EMM - of four emblematic cases excerpted from our research lab ergonomic portfolio.  相似文献   
273.
This article analyses the distributional effects of education spending across regions of Thailand, a country that purportedly seeks to reduce regional welfare disparities through decentralisation. It finds that public expenditure on education is neither progressive nor pro‐poor, although there are sizeable regional differences, driven by the pro‐rich distributional profiles of public tertiary education spending and public transfers to private education. Policy‐wise, these results suggest that the current decentralised allocation of educational spending is not consistent with an equity‐enhancing goal.  相似文献   
274.
In this paper, we propose a method to assess influence in skew-Birnbaum–Saunders regression models, which are an extension based on the skew-normal distribution of the usual Birnbaum–Saunders (BS) regression model. An interesting characteristic that the new regression model has is the capacity of predicting extreme percentiles, which is not possible with the BS model. In addition, since the observed likelihood function associated with the new regression model is more complex than that from the usual model, we facilitate the parameter estimation using a type-EM algorithm. Moreover, we employ influence diagnostic tools that considers this algorithm. Finally, a numerical illustration includes a brief simulation study and an analysis of real data in order to show the proposed methodology.  相似文献   
275.
Each of the many two-dimensional variations of the classical assignment problem has at least one counterpart in higher dimensions. This paper is a tutorial on these higher dimensional assignment models and their applications. It is a synthesis of a vast literature scattered throughout a great variety of journal articles and other miscellaneous sources. We have attempted to make the paper a complete bibliography with the emphasis on topics important to practitioners of decision sciences. These topics include original results by the authors, most notably, a polynomial solution approach for a class of multidimensional assignment problems which often arise in scheduling applications.  相似文献   
276.
In this article we argue that career counseling with adults is the exploration of personal identity and meaning, both of which are fundamental to an individual's survival, well-being, and family life-style.  相似文献   
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Current legal and professional guidelines related to master's-level training programs in marriage and family therapy are reviewed. The admission and program requirements of 50 California-based programs are then evaluated in light of these standards. The data indicate that the reality of these training programs often departs significantly from the ideals and suggested standards of the field. It is recommended that the various national and state organizations interested in promoting quality marriage and family training programs collaborate with program representatives to establish more explicit and rigorous expectations for master's-level training.  相似文献   
280.
Young people's participation, supported by the advent and the use of social media, seems to increase and become more definite, especially when it is linked to the local territory and its activities. In this respect, the connections the youths are able to create online go beyond the web, also developing social interactions with local communities. This article, starting from these premises, aims at investigating more deeply the debate about the civic use of the web by young people. The analysis focuses on 20 youth movements (cultural, social-collective, and environmental ones), with national/international relevance, mainly related to the web. Taking into account five main dimensions – internationalization, level of organization, participation, communication, and benefits for the social structure – the paper point outs different dynamics among the movements related to: (1) the use of the net, (2) the transfer from the online communication exchange to the local implementation of the civic actions, and (3) the involvement of the local public opinion. Moreover, the study reveals strong connections among participants, both in terms of bridging and bonding links so that the movements may be considered as a promising opportunity to strengthen civicness and foster social capital.  相似文献   
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