Refusal of recommended maternity care: Time to make a pact with women?

Background

The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care.

Measuring the Immeasurables: Development and Initial Validation of the Self-Other Four Immeasurables (SOFI) Scale Based on Buddhist Teachings on Loving Kindness,Compassion, Joy,and Equanimity

Multiple measures exist that examine the attentional aspects of meditation practice, but measurement of the compassion component is relatively understudied. This paper describes the development and initial validation of a scale designed to measure application of the four immeasurable qualities at the heart of Buddhist teachings: loving kindness, compassion, joy and acceptance toward both self and others. Our analyses suggest four distinct subscales: positive qualities toward self, positive qualities toward others, negative qualities toward self and negative qualities toward others. Initial examination of reliability and validity showed high internal consistency for the subscales as well as strong concurrent, discriminant, and construct validity. We believe the Self-Other Four Immeasurables (SOFI) scale has broad utility for research on mindfulness, positive psychology, and social psychology.     

Evidence of a Housing Decision Chain in Rural Community Vitality*

Abstract The purpose of this research was to explore and explain the role housing plays in rural community vitality. Community vitality refers to economic strength and social well‐being. In spring 2002 we collected primary interview data from informants in 134 small rural communities in nine north‐central states and identified related secondary data from the U.S. census. We developed a structural‐equation‐path model, which supported a “housing decision chain” that influenced community vitality. Based on this research, local housing decisions do play an important role in community vitality. Strong local leaders use housing planning to secure funding to produce a change in the quantity of housing, which in turn positively influences community vitality. Housing inventory also mediated the effects of total population and percentage population change on community vitality, indicating that housing supply is a fundamental ingredient in community growth strategies. These findings support the conclusion that a combination of housing plans and strategies orchestrated by skilled, committed leadership strengthens rural communities. Heretofore the ling between housing and community vitality has not been investigated; evidence‐based data has been missing from the debate on viable rural community‐development strategies.     

Risk factors for preterm,low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia

Objective

To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women.

Working in partnership: user perceptions of intensive home visiting

The aim of this study was to explore the perceptions of vulnerable women about the value of intensive home visiting in pregnancy and the first year of life delivered by health visitors trained to work in partnership with families. Twenty in‐depth interviews were conducted with women who had completed the home visiting programme and agreed to be interviewed. The data were fully transcribed and analysed thematically. Despite initial concerns and negative preconceptions about health and social service professionals, participating women greatly valued the relationships that were established with their home visitors and identified a number of ways in which they had benefited. These included increased confidence, improved mental health, better parenting, improved relationships and changes in their attitudes toward professionals. These findings demonstrate the potential of intensive home visiting delivered in partnership with mothers in reaching and helping vulnerable and ‘hard‐to‐reach’ families. They highlight the importance of establishing a trusting relationship between helper and provider, and the need for home visitors to have the necessary skills and qualities to establish such relationships. Copyright © 2007 John Wiley & Sons, Ltd.     

Meeting Family Housing Needs: Experiences of Rural Women in the Midst of Welfare Reform

Though sometimes overlooked, the availability, affordability, and quality of housing in rural communities are a potential barrier to transitioning from welfare to work. In this investigation we examine housing issues confronting 17 rural women and their families who were recipients of welfare benefits in 1997. Respondents' housing accounts illustrate the significance of reliance on both government housing subsidies and informal subsidies supplied by friends, family, and more distant relatives. The study focuses on concerns women have in meeting their families shelter needs and the complexities involved in doing so. The findings of the research suggest that additional housing policy initiatives, as well as a targeted research agenda are needed, especially for families whose welfare benefits are nearing termination.