Risk Factors for Infant Mortality in Nineteenth-Century Sweden

This study examines risk factors for infant mortality using individual-level data from a sample of parishes in northern Sweden in the nineteenth century. Sweden is of particular interest because of its unusually regular pattern of infant mortality decline during the century. We follow a sample of women longitudinally through their successive pregnancies and observe the mortality experience of each child. Exploratory and multivariate logistic regression analyses reveal an important intra-familial dimension to infant mortality that appears from the early stages of a woman's reproductive career. In addition, multivariate analyses by birth-order group suggest that ignoring intra-familial correlations of infant mortality may result in incorrect inferences. Siblings' shared probabilities of dying as infants suggest that high-birth-order children were not necessarily disadvantaged in any systematic way.     

Considerations of family structure and gender composition: the lesbian and gay stepfamily

Lesbian and gay stepfamilies are unique family forms which must be investigated as such. This paper explores the similarities and dissimilarities between heterosexual stepfamilies and lesbian/gay stepfamilies, arguing that similarity of structure is impacted by gender composition. Utilizing face-to-face and telephone interviews with biological and stepparents in 23 lesbian and gay stepfamilies, the results show that while lesbian and gay stepfamilies share some challenges and strengths with heterosexual stepfamilies, they also evidence a unique and flexible adaptation to becoming a family. The paper is aimed at delineating future areas for lesbian and gay stepfamily research.     

The Influence of Acculturation on Breastfeeding Initiation and Duration for Mexican-Americans

This paper uses data from the Fragile Families and Child Wellbeing Study to test the hypotheses that (1) similar to other positive pre- and post-natal outcomes, Mexican immigrant mothers are more likely to breastfeed, and to breastfeed longer, than white or Mexican-American mothers; and (2) acculturation accounts for the ethnic/nativity differential in breastfeeding initiation and duration. The results support both hypotheses. Mexican immigrants to the U.S. are much more likely than whites to breastfeed, and to breastfeed longer. Mexican-American mothers, after controlling for background characteristics, have similar initiation and duration to whites. Using expanded acculturation measures developed for this paper, acculturation accounts for some of the difference between whites and Mexican immigrants in breastfeeding initiation, and much of the difference for breastfeeding duration. The results suggest that low levels of acculturation operate to protect Mexican immigrants from choosing to formula-feed, which gives their babies many health advantages, and may be associated with better health outcomes across the life course. The results also suggest that successive generations of Mexican immigrants may abandon breastfeeding, which is deleterious for their infants.     

What does empathy sound like in social work communication? A mixed‐methods study of empathy in child protection social work practice

It is widely accepted that empathy is important for social work practice, yet there are multiple dimensions of empathy and comparatively few studies of empathy as a component of social work skill. To date, published studies have been quantitative, and as a result, we know little about how social workers demonstrate empathy in practice or what skilled empathic practice in child and family social work might sound like. This study contributes to the development of understanding of empathy as a social work skill through a mixed‐methods analysis of 110 audio recordings of meetings in a child protection service between workers and parents, applying a coding framework for analysis. Findings indicate that workers who demonstrate higher levels of empathy skill use more open questions and reflections in their communication with parents. Further, they demonstrate curiosity about and make efforts to understand parents' often difficult experiences, including a focus on emotions. That the majority of workers were found not to demonstrate a high level of empathy skill presents concerns to be considered by the social work profession. A deeper understanding of empathy presents an opportunity for an increased focus in organizations to enable workers to demonstrate empathy towards families they work with.     

Legacy Volunteering: A Test of Two Theories of Intergenerational Transmission

Sociological theory suggests two reasons that volunteering runs in families. The first is that parents act as role models. The second is that parents who volunteer pass on the socioeconomic resources needed to do volunteer work. Panel data from two generations of women (N = 1,848) are analyzed to see how much influence family socioeconomic status and mother's volunteering have on daughter's volunteer careers. More highly educated women and women whose mothers volunteered donate more hours initially, but only family socioeconomic status increases volunteering over the life course.     

The shift from vertical to networked integration, Part 1

Lessons, dangers, and difficulties for health care integrators from the world of mergers, acquisitions, and alliances. The authors examine why there needs to be a shift from vertical integration, with its command and control hierarchical structure, to the more fluid and flexible networked enterprise in health care. By sharing the integration experiences of other industries, the authors make a compelling case for rethinking the integrated delivery system that so many have embraced and explain why the emergence of the extended health care enterprise will be the next stage in the progression. Making the journey into networked enterprises--how to start, what to do, and case studies from St. Vincent's, Cascade Healthcare Alliance, and Mullikin Medical Centers--will be presented in the second article in the June 1996 issue of Physician Executive.