Diversity in Midwifery Care: Working toward Social Justice

La pratique de la sage‐femme opérant dans la communauté a apporté avec elle, lorsque devenu une profession régie et financée par l’état vers la fin du vingtième siècle, les objectifs et aspirations de son mouvement social. Parmi ces objectifs, elles désiraient à faire attention à l’équité et la diversité sociale lors de la provision de soins pendant la naissance. Dans cet article, nous utilisons des interviews avec des sage‐femmes qui pratiquent en ce moment en Ontario, afin de nous concentrer sur les conceptualisations de la diversité des sage‐femmes. Nous explorons leurs efforts, dans le travail quotidien, visant à supporter et fortifier la diversité sociale des clientes et des sage‐femmes elles‐mêmes. Nous proposons que la transition de la pratique de la sage‐femme vers le système de soins santé gouvernemental ne signale pas l'abandon des projets et engagements de changement social. Les réponses à la diversité sociale en soins de santé varie des efforts à améliorer l'accès aux soins de santé jusqu'à l’étude du rôle de la justice sociale en reconnaissant les besoins des populations diverses. L'aspiration de ‘créer un monde meilleur’ continue à animer le travail des sage‐femmes nonobstant la réglementation de leur pratique. Cet article explore le patrimoine de pratique des sage‐femmes en tant que mouvement social et décrit les rapports entre la diversité, la justice sociale et la pratique actuelle des sage‐femmes. As midwifery moved from lay practice to a regulated health‐care profession in Ontario toward the end of the twentieth century, it brought with it many of its social movement goals and aspirations. Among these was the desire to attend to diversity and equity in the provision of birthing care. Drawing on interviews with currently practicing Ontario midwives, this paper focuses on midwives’ conceptualizations of diversity and explores their everyday work to support and strengthen diversity among those using and those providing midwifery care. We argue that midwifery's recent relocation within state structured health care means neither that the social change projects of midwifery are complete nor that midwifery has abandoned its movement‐based commitment to social change. Responses to social diversity in health care range from efforts to simply improve access to care to analyses of the role of social justice in recognizing the needs of diverse populations. The social justice aspiration to “create a better world” continues to animate the work of midwives postregulation. This paper explores the legacy of midwifery as a social movement, addressing the connections between diversity, social justice and midwifery care.     

Attenuating Initial Beliefs: Increasing the Acceptance of Anthropogenic Climate Change Information by Reflecting on Values

Anthropogenic climate change information tends to be interpreted against the backdrop of initial environmental beliefs, which can lead to some people being resistant toward the information. In this article (N = 88), we examined whether self‐affirmation via reflection on personally important values could attenuate the impact of initial beliefs on the acceptance of anthropogenic climate change evidence. Our findings showed that initial beliefs about the human impact on ecological stability influenced the acceptance of information only among nonaffirmed participants. Self‐affirmed participants who were initially resistant toward the information showed stronger beliefs in the existence of climate change risks and greater acknowledgment that individual efficacy has a role to play in reducing climate change risks than did their nonaffirmed counterparts.     

Associations of Marital Conflict With Emotional and Physiological Stress: Evidence for Different Patterns of Dysregulation

The goal of this study was to explore theoretically suggested but untested links between interparental conflict and stress physiology in late adolescence. A multi‐method study was conducted involving families (n = 42) who previously participated in the University California, Irvine site of the NICHD Study of Early Child Care and Youth Development; adolescents were 17½ years of age on average. Parent report and observer ratings of conflict, adolescent participation in a robust social‐evaluative stressor, and assessment of cortisol, cardiovascular, and emotional functioning were included. Marital conflict was associated with dampened physiological stress responses in adolescence but sensitized emotional responses, suggesting that conflict may be associated with problems integrating and coordinating emotional and physiological responses to stress.     

How Moroccan‐Dutch parents learn in communities of practice: Evaluating a bottom‐up parenting programme

Research shows that top‐down‐designed parenting programmes do not always meet the needs of postmigration parents. Bottom‐up programmes by migrant organizations hold a promise to fill this gap; however, research about these programmes and appropriate evaluation methodologies is scarce. Drawing upon Wenger's ( 2010 ) “communities of practice,” this paper explores an alternative perspective on parenting programme evaluation. Findings are presented from a study looking into social learning processes of postmigration parents who participated in a bottom‐up programme about raising teenagers in urban areas. Using an ethnographically inspired method combined with a preprogramme and postprogramme design, 115 Moroccan‐Dutch mothers and fathers from 15 programme groups participated. Results show that the programme provided a social learning space in which parents used themselves as resources to learn collectively about parenting. Moreover, parents consciously engaged in learning interactions across learning spaces stretched into their social networks. These analyses showed how parents' development of “learning citizenship” (Wenger, 2009 ) provides us with insight in collective learning dimensions present in a bottom‐up parenting programme, which is often not included in evaluation studies. Implications for practitioners as facilitators of parents' collective learning are presented.     

The Relation Between Therapeutic Alliance and Treatment Motivation in Residential Youth Care: A Cross-Lagged Panel Analysis

This study investigated the longitudinal relation between therapeutic alliance and treatment motivation in a sample of 174 adolescents receiving residential treatment in the Netherlands. Structural equation modeling with a cross-lagged panel design was used to examine the relation between therapeutic alliance and treatment motivation up to 9 months of treatment. Results revealed that autoregressive associations between initial therapeutic alliance and alliance at subsequent time points were significant, whereas for treatment motivation a significant association was found after 6 months, but not after 9 months. Results also showed that a higher level of therapeutic alliance after 3 months was predictive of a higher level of treatment motivation after 6 months. Furthermore, a higher level of therapeutic alliance after 6 months was predictive of a higher level of treatment motivation after 9 months. Implications for research and clinical practice are discussed.     

Beyond the Preschool Years: Children’s Perceptions About Starting Kindergarten

This article describes a research study that investigated three‐ and four‐year‐old Canadian preschool children’s perceptions about starting kindergarten. Findings from 33 focus‐group discussions suggest that children begin to formulate ideas about starting kindergarten prior to school entry. Children’s responses were grouped according to three themes, play versus academic activities and homework; getting bigger but still needing help; and rules. Overall, the responses highlighted their expectations regarding continuity and discontinuity between the two environments. These findings support the position that children should be given the opportunity to contribute to the planning of transition practices.     

Understanding Popularity and Relational Aggression in Adolescence: The Role of Social Dominance Orientation

This study investigated a potential moderator of the association between popularity and relational aggression: social dominance orientation (SDO), the degree to which an individual endorses the importance of social hierarchy. One hundred eighty‐five ninth graders completed a sociometric assessment of RA and popularity, and a self‐report SDO measure. SDO was positively associated with popularity for both boys and girls, and with RA for girls. Popularity and RA were positively correlated for both genders. Regression analyses showed that SDO moderated the association between popularity and RA for girls, but not for boys. Girls who were both popular and who were social dominance‐oriented were particularly high in peer‐nominated RA. SDO may provide a useful framework for understanding the role of popularity in adolescent peer groups.     

Infill asymptotics for adaptive kernel estimators of spatial intensity

We apply the Abramson principle to define adaptive kernel estimators for the intensity function of a spatial point process. We derive asymptotic expansions for the bias and variance under the regime that n independent copies of a simple point process in Euclidean space are superposed. The method is illustrated by means of a simple example and applied to tornado data.     

Forms of gambling,gambling involvement and problem gambling: evidence from a Swedish population survey

The purpose of this study was to explore the association between problem gambling (PG) and participation in different forms of gambling in order to elucidate relationships between PG, gambling involvement and gambling intensity. Using data from the first wave of the Swedish Longitudinal Gambling Study (Swelogs) (n = 4,991), the study tested four hypotheses, namely that (1) some forms of gambling are more closely associated with PG than other forms; (2) high gambling involvement is associated with PG; (3) gambling involvement is positively associated with the intensity of gambling; and (4) the relationship between gambling involvement and PG is influenced by the specific forms of gambling in which individuals participate. All four hypotheses were supported. More specifically, the study found that while many PGs regularly participate in multiple forms of gambling, half of PGs participate regularly in only one or two forms of gambling. The study concluded that some forms of gambling are more closely associated with problem gambling than other forms, and that gambling policy and regulation, as well as the development of responsible gambling initiatives, should focus on these forms.