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Background

The proportion of babies born by caesarean section in Australia has almost doubled over the last 25 years. Factors known to contribute to caesarean such as higher maternal age, mothers being overweight or obese, or having had a previous caesarean do not completely account for the increased rate and it is clear that other influences exist.

Aim

To identify previously unsuspected risk factors associated with caesarean using nationally-representative data from the Longitudinal Study of Australian Children.

Methods

Data were from the birth cohort, a long-term prospective study of approximately 5000 children that includes richly-detailed data regarding maternal health and exposures during pregnancy. Logistic regression was used to examine the contribution of a wide range of pregnancy, birth and social factors to caesarean.

Findings

28% of 4862 mothers were delivered by caesarean. The final adjusted analyses revealed that use of diabetes medication (OR = 3.1, 95% CI = 1.7–5.5, p < 0.001) and maternal mental health problems during pregnancy (OR = 1.3, CI = 1.1–1.6, p = 0.003) were associated with increased odds of caesarean. Young maternal age (OR = 0.6, CI = 0.5–0.7, p < 0.001), having two or more children (OR = 0.7, CI = 0.6–0.9, p < 0.001), and fathers having an unskilled occupation (OR = 0.7, CI = 0.6–1.0, p = 0.036) were associated with reduced odds of caesarean.

Conclusion

Our findings raise the prospect that the effect of additional screening and support for maternal mental health on caesarean rate should be subject of prospective study.  相似文献   
84.
In the current study the authors drew on Waves I and III from Add Health to examine the closeness of parent–adolescent relationships in married mother–stepfather families (N = 1,934). They used latent class analysis to identify family constellations defined by adolescents' relationships with all of their parents: mothers, stepfathers, and biological nonresident fathers. In particular, the authors (a) identified the most common underlying patterns of adolescent–parent relationships in stepfamilies; (b) determined the background characteristics that predict membership in these groups; and (c) examined how adolescents in these groups fare with respect to depressive symptoms, delinquency, and substance use. The results indicate that adolescents' relationships can be represented with 4 latent classes. Adolescents in these classes differ on measures of adjustment, and many of these differences persist into the early adult years.  相似文献   
85.
This paper explores how feminist social movements are organized and re-generated across and through different media, both online and offline, using the example of zines. We critically examine the emergence and growth of an intersectional feminist zine community through a 6-year in-depth qualitative netnographic and ethnographic study. Theoretically, we build on work concerning feminist digital information and archival infrastructures, bringing it together with work on feminist digital activism. We make three key contributions: first to theorize zines and their communities as infrastructures, which cut across the social, digital, and material. Second in understanding the political potential of engagements in zine infrastructures in which the individual and collective are entangled, and third in revealing how the current generation of young feminists move across and work at the interfaces of formats to benefit from their synergistic, but also their agonistic, relations to form new affective solidarities.  相似文献   
86.
On the basis of a close reading of two early articles by Patrick Geddes, which form the basis of his later approach to sociology, it is argued that Geddes should be reclaimed by sociologists from the geographers and the town planners, as the founder of a distinctive environmental sociology in Britain at around the turn of the last century. Certain of Geddes’ arguments are seen to be comparable with those of Durkheim, in particular, and Marx to a somewhat lesser extent. Moreover, his work contains a distinctively sociological account of the ‘structuring’ of social (and environmental) reality via the creative agency of human beings actively working in a variety of environments. Geddes’ naïve optimism may make him as much Utopian as sociological, but does not invalidate his contribution to the development of a classical environmental sociology.  相似文献   
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The effect of maternal support on the development of counting and cardinality was examined by observing 18 mother-child dyads engaged in two procedurally similar , but conceptually different tasks in a longitudinal design consisting of three phases (32, 38 and 44 months). At 32 and 38 months of age in both the supported and a similar unsupported condition the children were more successful in the count task than in the give 'x' task, which requires knowledge of the relationship between counting and cardinality. Observations of mother-child interactions found that whilst maternal support for the count word sequence was similar in the two tasks the way mothers focused their child's attention on the objects in the set differed between the tasks. It is argued that social biases as well as cognitive ones constrain the development of cardinal understanding.  相似文献   
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Bibliography     
In this article, we explore how those taking part in an interview about sex and risk reflected on their participation and what, if any, impact it had on them. All 22 individuals who were interviewed in an initial study were invited to document their thoughts and feelings about the research process in a short follow-up exercise. The data relating to the 11 people who shared their reflections on the interview were subjected to a thematic analysis. The themes that emerged describe the value participants placed on honest and open interaction within neutral and non-judgmental environments. They also illustrate how being interviewed about prior behaviour can facilitate a sense-making process and might provide some degree of cathartic benefit. The findings help improve our understanding of how individuals reflect on their interview participation, which can in turn help to inform the development of ethically sensitive qualitative data collection.  相似文献   
90.
Frahm KA  Brown LM  Gibson M 《Omega》2011,64(2):143-155
The emphasis in disaster situations is on preserving life, and this goal is both appropriate and laudable. There is a risk, however, that the needs of people who are dying can become lost when there is a sudden surge of people needing acute intervention. There are significant ethical considerations inherent in society's prioritization of care needs across the acute, rehabilitative, and palliative spectrum in general, let alone in a disaster situation. These ethical conundrums are not the focus of this article. Rather, we anchor our discussion on the assumption that care needs are equally valid, and our purpose is to explore the issues that impact the provision of quality end-of-life care in nursing home settings for those who require this care when a disaster occurs. Nursing home residents, in particular, are at heightened risk for experiencing negative disaster-related outcomes due to compromised physical or mental health that requires skilled nursing care. Moreover, within the already vulnerable nursing home population are many people who are receiving palliative end-of-life services when a disaster strikes. Education and training in end-of-life services for nursing home staff, disaster emergency responders, and other lay people is vital to build capacity for adapting the delivery of these services in disaster situations in the interest of equity and human rights. Given the present lack of guidance in the literature as to what end-of-life care looks like when adapted to the context of disaster response, there is also a pressing need for research to inform this discussion. The purpose of this article is to draw attention to this topic and highlight some of the critical issues, gaps, and opportunities.  相似文献   
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