Midwives,Marginality, and Public Identity Work

Because midwifery in the United States is an occupation at the margins of medicine, midwives must frequently negotiate competing identity claims. This article examines the public identity work of a group of midwives by focusing on two important tools they use to accomplish this work: boundary negotiation and impression management. Drawing on data from in‐depth interviews with twenty‐six licensed, nurse, and empirical midwives in the state of Florida, this article illustrates the ways in which midwives frame their identities in relation to history and media representations and manage public identities through boundary negotiation and impression management. I argue that the marginality of this occupation lends itself to competing categories of identity that midwives must negotiate. These categories become salient when midwives confront historical and media representations of childbirth and midwifery as well as the perceptions of the general public, consumers, lawmakers, and medical professionals.     

Doing Disability: Disability Formations in the Search for Work*

Disability theorists have spent much time discussing how disability is defined. The theoretical roots for these debates reside in the medical, structural, and minority models of disability. The medical model views disability as equivalent to a functional impairment; the minority model sees a lack of equal rights as a primary impediment to social equality between able and disabled populations; and the structural model looks to environmental factors as the cause of disability. While debates over how to define disability are informative, there is currently an insufficient amount of empirical research looking at how people come to identify themselves as having a disability. Rather than focus on how disability is (or should be) defined, herein we look at how disability identities are constructed as people search for work. We show that people's interactions with employers and employment agencies have important influences on how disability identities are constructed. We borrow from the “doing gender” and “racial formations” paradigms to introduce an interactive approach to looking at how disability identities are constructed. We introduce the concept of disability formation to highlight how disability identities are continually negotiated through interactions with employment agencies and employers. Our findings are based on focus groups with 58 people who self‐identified as having a disability and were working or searching for work.     

The success of protest groups: Multivariate analyses

This paper reviews earlier research and presents new analytical findings regarding the outcomes of social movements. Using the resource mobilization/management approach, empirical propositions that seek to explain protest group success or failure are tested. Based upon data gathered from a sample of 53 US protest groups, the causal models explained the majority of the variance in degree of success between these groups. Our findings indicate that protest groups which threaten to replace or destroy established groups are usually unsuccessful, and those having many strong alliances tend to be more successful than groups fighting alone. The use of violence does not greatly aid the prediction of group outcome because of the unpredictable, ambivalent reaction to violence by established groups.     

Factitious Illness by Proxy: Understanding Underlying Psychological Processes and Motivations

Children are put at risk of emotional and physical harm when parents seek unnecessary medical care. Understanding why parents seek medical interventions that create risk for their children requires us to consider how past experiences, and the mental representations of these experiences influence current behaviour. Past experiences of danger affect how parents interpret ‘dangerous’ situations in the present and how they organise protection of their child. This article demonstrates how the notion of mental representations (that dispose parents to act in particular ways) can assist in engaging, assessing and treating parents who display factitious illness by proxy behaviour. When classified using the Dynamic‐Maturational Method, the Adult Attachment Interview (AAI) allows both assessment of implicit and explicit representations and also understanding of the developmental process through which parents have learnt to attribute meaning to information and to organise their behaviour. In this case study, psychosocial assessment of the family included an AAI with each parent. The use of this assessment tool both aided the therapy team in the process of case formulation and intervention planning, and had therapeutic value in and of itself. We argue that treatment is more likely to be effective if the parents and professionals have a shared understanding of the parents' intentions and the developmental process that led to unsafe behaviour, which requires change.     

An Examination of Listening Concepts in the Healthcare Context: Differences Among Nurses,Physicians, and Administrators

This study explores the perceived conceptualizations of listening in a healthcare context. The review of literature focusing on communication and listening in healthcare supports the belief that listening is an essential element in patient satisfaction. This study sought to determine which activities physicians, nurses and healthcare administrators perceive as similar or identical to listening. A survey of 203 health care professionals, using a web-based version of the Imhof-Janusik Listening Concepts Inventory (Imhof and Janusik, 2006 Imhof, M. and Janusik, L. A. 2006. Development and validation of the Imhof-Janusik listening concepts inventory to measure listening conceptualization differences between cultures. Journal of Intercultural Communication Research, 35(2): 79–98. [Taylor &; Francis Online] , [Google Scholar]) was completed. The results suggest the listening conceptualizations vary among physicians, nurses, and administrators with administrators exhibiting the most flexibility in their conceptualization of listening. It is concluded that these conceptualizations may play a critical role in the behaviors displayed by nurses, physicians and hospital administrators.     

Muslim Women's Challenges to Islamic Law The Case of Malaysia

The reform of Islam by women and especially the lessons this activism might contain for feminist praxis is a highly topical and important issue. This article outlines some of the lessons to be drawn from studying this area with a specific focus on the activism of some groups of Malaysian Muslim women aimed at the reform of Islam. Two different strategies for reform are explained and traced in their attempts to reform religious interpretation and the Islamic legal system, the Syar'iah. The aim of the article is to provoke dialogue over the relationship of Islam to women's rights, while highlighting the agency of Muslim women within an Islamic framework. Another aim is to contribute to the debate over what constitutes feminism and the need to subject the debate continuously to cross-cultural and international perspectives.     

Midwifery as established sect: an expanded application of the church–sect continuum

Based on church–sect theory, this paper asserts that midwifery is much like an established sect in relation to its church equivalent: Western medicine. We find that midwifery can endure in this form – as both protest movement and established institution – because of its ability to maintain its central oppositional values while being accepted as a legitimate, if marginalized, profession. Using interview data from 25 Florida midwives, we draw an analogy between the liminal status of midwifery and three of the most important characteristics of the established sect: limited institutionalization, acceptance and opposition, and a unique value set. This comparison sheds light on both church–sect theory and midwifery, which also leads us to suggest that similar analogies be used for analysis across other sub-fields in sociology.     

Sources of health insurance and characteristics of the uninsured. Analysis of the March 1992 Current Population Survey

Eighty-three percent of nonelderly Americans and 99 percent of elderly Americans (aged 65 and over) were covered by either public or private health insurance in 1991, according to EBRI tabulations of the March 1992 Current Population Survey (CPS). The March 1992 CPS is the most recent data available on the number and characteristics of uninsured Americans. In 1991, 16.6 percent of the nonelderly population--or 36.3 million people--were not covered by private health insurance and did not receive publicly financed health assistance. This number compares with 35.7 million in 1990 (16.6 percent), 34.4 million in 1989 (16.1 percent), and 33.6 million in 1988 (15.9 percent). The most important determinant of health insurance is employment. Nearly two-thirds (64 percent) of the nonelderly have employment-based coverage. Workers were much more likely to be covered by group health plans than nonworkers (71 percent versus 40 percent). Even though workers and members of their families were more likely to be covered by health insurance than nonworkers, 85 percent of the uninsured lived in families headed by workers in 1991, primarily because most people lived in families headed by workers. More than 60 percent of uninsured were in families headed by full-year workers with no unemployment. Nearly all persons who were covered by an employment based-plan received at least some contribution to that plan from their employer. The estimated average annual contribution among those receiving a contribution to employee or family plans was $2,129. Although many individuals in poor families are covered by public health plans, that coverage is far from universal. In 1991, only 52 percent of the nonelderly with income below the poverty line were covered by a public plan--49 percent by Medicaid. The number of children who were uninsured in 1991 was 9.5 million, or 14.7 percent of all children, compared with 9.8 million or 15.3 percent of all children in 1990. Twenty-three percent of children were covered by public health insurance, with 21 percent being covered by Medicaid. In 11 states and the District of Columbia, more than 20 percent of the population was uninsured in 1991. These states and their uninsured rates were the District of Columbia (30.3 percent), Texas (25.3 percent), New Mexico (24.5 percent), Louisiana (23.8 percent), Florida (23.5 percent), Mississippi (22.1 percent), Oklahoma (22.1 percent), Nevada (21.8 percent), California (21.7 percent),Arizona (21.1 percent), Alabama (20.6 percent), and Idaho (20.6 percent).