Vaginal births after caesarean: What does Google think about it?

AimVaginal birth after caesarean (VBAC) is a relatively safe alternative to repeat caesarean birth in the proper context. This important decision to undergo an elective caesarean versus VBAC is ultimately a decision of the mother. The purpose of our study was to assess the quality of online information in relation to VBAC collected using the most common search engine: Google.MethodsThe 10 most common hit sites for the keywords “VBAC” and “Vaginal birth after caesarean” were evaluated using the search engine Google. The quality of websites was rated based on the Silberg scale for accountability, the modified Abbott's criteria for presentation and the SMOG index for readability. The content of each website was compared to the Society of Obstetricians and Gynecologists of Canada (SOGC) guidelines for VBAC.Findings13 out of 20 identified websites met the adequate criteria for accountability, with 85% of the websites indicating authorship. 11 websites were deemed aesthetically agreeable. The target audience, assessed by the readability score, was notably above the non-medical population with an average SMOG index score of 14.75. Only half of the websites contained recommendations, as detailed by the SOGC guidelines.ConclusionAlmost all sites target a higher academic level, making it beyond the comprehension of the general population. Woman friendly web-assessment tools should be provided to enable pregnant women to take an active role in their decision making.     

Decision‐making under uncertainty in child protection: Creating a just and learning culture

The argument is made for having a positive error culture in child protection to improve decision‐making and risk management. This requires organizations to accept that mistakes are likely and to treat them as opportunities for learning and improving. In contrast, in many organizations, a punitive reaction to errors leads to workers hiding them and developing a defensive approach to their practice with children and families. The safety management literature has shown how human error is generally not simply due to a “bad apple” but made more or less likely by the work context that helps or hinders good performance. Improving safety requires learning about the weaknesses in the organization that contribute to poor performance. To create a learning culture, people need to feel that when they talk about mistakes or weak practice, there will be a constructive response from their organization. One aspect of reducing the blame culture is to develop a shared understanding of how practice will be judged and how those appraising practice will avoid the hindsight bias. To facilitate a positive error culture, a set of risk principles are presented that offer a set of criteria by which practice should be appraised.     

Maternal and paternal reactions to child sadness predict children's psychosocial outcomes: A family‐centered approach

Parents' reactions to children's emotions shape their psychosocial outcomes. Extant research on emotion socialization primarily uses variable‐centered approaches. This study explores family patterns of maternal and paternal responses to children's sadness in relation to psychosocial outcomes in middle childhood. Fifty‐one families with 8‐ to 12‐year‐old children participated. Mothers and fathers reported their reactions to children's sadness and children's social competence and psychological adjustment. Cluster analyses revealed three family patterns: Supportive (high supportive and low non‐supportive reactions from both parents), Not Supportive (low supportive reactions from both parents), and Father Dominant (high paternal supportive and non‐supportive reactions, low maternal supportive and non‐supportive reactions). Supportive families had children with higher social competence and more internalizing symptoms whereas Father Dominant families had children with lower social competence and fewer internalizing symptoms. Not Supportive families had children with average social competence and fewer internalizing symptoms. Findings are discussed in relation to the “divergence model” which proposes that a diverse range of parental responses to children's sadness, rather than a uniformly supportive approach, may facilitate children's psychosocial adjustment.     

Journey towards independent living: a grounded theory investigation of leaving the care of Girls & Boys Town,South Africa

The journey out of care and towards independent living is a challenge for many care-leavers. There has been little research into the social processes involved in this care-leaving journey. This paper presents the results of a grounded theory investigation into the care-leaving journeys of nine young men who had, several years previously, been in the care of Girls & Boys Town in South Africa. Working from a resilience perspective, with an ecological emphasis, four central social processes emerged that together explain the care-leaving experiences of the participants. These processes are striving for authentic belonging; networking people for goal attainment; contextualised responsiveness and building hopeful and tenacious self-confidence. These four processes are located within contextual boundaries and at the social environmental interface. The paper presents these processes in detail, drawing on selected narratives of the participants and integrated with additional theory. It is hoped that this paper may contribute to theory building concerning care-leaving processes and enhance youth care practices for youth in care and leaving care.     

Parental Divorce and Interpersonal Trust in Adult Offspring

It has been proposed that recent increases in parental divorce have inhibited the development of trust among offspring. This proposition is tested by examining whether parental divorce is associated with offspring trust in parents, intimate partners, and others. Data come from the Marital Instability Over the Life Course Study. Results reveal that although parental divorce is negatively associated with trust, these effects largely disappear once the quality of the past parent‐teen relationship is taken into account. The one exception is trust in fathers where children of divorce remain at higher risk of mistrust. Trust in parents, intimates, and others is strongly linked to positive parent‐teen relationships regardless of parental divorce. Contemporary relationship experiences also influence trusting intimates and others.     

Comprehensive neighbourhood mapping: developing a powerful tool for child protection

This paper proposes ‘comprehensive neighbourhood mapping’ as a schema for gathering and interpreting information within a given geographical area which is informed by imaginative thinking about the safety of children and young people from sexual crime. It would build upon current forms of profiling by local authorities, health authorities and central Government. CNM would actively involve local people, in partnership with agencies, in ‘mapping’ danger points and support points. Eight components are discussed, including environmental issues, locations of sex offenders, sites where teenagers meet and share information, supportive individuals and organizations. Some issues for pilot projects are discussed, including the need to set up planning and implementation groups and to integrate CNM into wider child protection and community safety strategies. CNM is grounded in an ecological perspective which sees partnership approaches as essential and believes an overarching view of neighbourhood needs, based on detailed local information and understanding of how different forms of harm interconnect, is crucial in developing child protection strategies. At times of acute official anxiety about community ‘lynch‐mob’ reactions to known paedophiles, CNM aims to build communities which instead are informed and thoughtful about child protection. Copyright © 2002 John Wiley & Sons, Ltd.     

Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia

This report evaluates the extent of perceived and enacted HIV/AIDS-related stigma in a rural setting in Zambia. Stigmatisation is abundant, ranging from subtle actions to the most extreme degradation, rejection and abandonment. Women with HIV and pregnant women assumed to be HIV positive are repeatedly subjected to extensive forms of stigma, particularly once they become sick or if their child dies. Despite increasing access to prevention of mother to child transmission initiatives, including anti-retroviral drugs, the perceived disincentives of HIV testing, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status. Unless efforts to reduce stigma are, as one peer educator put it, “written in large letters in any HIV/AIDS campaign rather than small”, stigma will remain a major barrier to curbing the HIV/AIDS pandemic.     

Child Characteristics,Parenting Stress,and Parental Involvement: Fathers Versus Mothers

This study examined variations in the relationships among child characteristics, parenting stress, and parental involvement. Participants were 100 two‐parent families with preschool‐aged children. Self‐report and interview data were collected to measure parental involvement, as well as perceptions of child temperament and parental stress. Analyses revealed significant, yet somewhat different, associations between child temperament and parental stress for mothers and fathers. More significant associations were found between perceptions of child temperament and involvement for fathers than for mothers. The associations between child temperament and parental stress and involvement differed on the basis of child and parent gender. Results are discussed in terms of future research on father involvement, as well as programs designed to encourage fathers to assume more active parental roles.