Safe,Healthy Birth: What Every Pregnant Woman Needs to Know

In spite of technology and medical science''s ability to manage complex health problems, the current maternity care environment has increased risks for healthy women and their babies. It comes as a surprise to most women that standard maternity care does not reflect best scientific evidence. In this column, evidence-based maternity care practices are discussed with an emphasis on the practices that increase safety for mother and baby, and what pregnant women need to know in order to have safe, healthy births is described.     

In Search of Patient Agency in the Rhetoric of Diabetes Care

Medical rhetoric has long been characterized by a focus on disease and on the physician as healer. Now, in the era of managed health care, patients are increasingly being viewed as agents in the management of their own chronic diseases. This article examines the concept of patient agency from a rhetorical perspective in lay and professional medical discourse relating to diabetes care. Kenneth Burke's dramatistic pentad is used as a tool to help uncover and analyze sites where values appear ambiguous. This study shows that patient agency is closely related to patient compliance in the language of biomedicine. The terms “compliance” and “adherence” operate as terrninistic screens in professional discourse and serve to limit discussion of patient agency. In managed health care, tension is evident between the trend toward greater patient agency and the constraints of biomedical text conventions concerning doctor and patient roles.     

How do women construct adventure recreation in their lives?

Research into adventure recreation has tended to be located in the experiences of men. This is largely due to a history of dominant male participation, though it is acknowledged that more women are accessing these forms of leisure experiences. This paper reports a study of forty-two women who had participated in adventure recreation at some stage throughout their adult lives. These women were interviewed regarding their personal meanings of adventure reaction. This included exploration of how adventure was experienced and the types of issues that affected their participation in adventure recreation. The results showed that adventure for these women incorporated risk and physical challenge, but also a sense of newness, learning, personal development and creativity. The evidence presented suggests that while traditional definitions of adventure recreation offer a general differentiation of adventure activities from other forms of outdoor recreation, they are perhaps too limiting. The women's experiences indicate that adventure extends beyond labeled “adventure” pursuits and that broader understandings need to be incorporated into our meanings of adventure.     

从人本视角看医院阴道镜室的管理

当前随着病人健康意识的加强,阴道镜检查越来越被广大妇女接受,但阴道镜室常常由于管理不善而存在安全隐患。对此,提出加强阴道镜室的工作管理、改善服务态度、提高服务质量等防范措施,确保就医安全。     

Disentangling the effect of education on emergency department utilization

Since Grossman’s seminal paper in 1972, there have been a number of studies concerning the effect of education on health and health care demand. Though several studies have distinguished between preventive and curative care, no study has investigated the effects of general education on the utilization of unnecessary emergency department use. We test whether general education reduces “potentially unnecessary” emergency department utilization and provide a measure of the resulting private benefits associated with increased education. Our results partially confirm our hypothesis regarding “potentially unnecessary” emergency department use. We find that moving from a high school to greater than high school education appears to reduce “potentially unnecessary” emergency department use, with the impact being greater among the insured. However, though reducing the education level from high school to less than high school increases “potentially unnecessary” emergency department use among the insured as predicted, it has the opposite impact on the uninsured.     

Book Review

Abstract

Following incorporation all further education, tertiary and sixth form colleges became independent from their respective local authorities and are now required to manage the health and safety of staff, students and visitors. A questionnaire was sent to colleges in England and Wales to establish the measures in place for measuring health and safety including the provision of a safety policy, a health and safety adviser, how performance is measured and inspection by the Health and Safety Executive. The survey concluded that the provision in sixth form colleges is much less well developed. In particular, they are less likely to have union representation on the safety committee, have a designated safety adviser, or have had a recent inspection by the HSE.     

Youth at work: Adolescent employment and sexual harassment

ObjectiveAn examination of the frequency and impact of workplace sexual harassment on work, health, and school outcomes on high school girls is presented in two parts. The first compares the frequency of harassment in this sample (52%) to published research on adult women that used the same measure of sexual harassment. The second part compares outcomes for girls who experienced harassment versus those who did not.MethodsStudents in a small, suburban high school for girls completed a paper and pencil survey during class. A modified version of the Sexual Experiences Questionnaire (SEQ: Fitzgerald et al., 1988) was used to identify sexually harassed working teenagers. Work attitudes, assessments of physical health and mental health, and school-related outcomes were measured using standardized scales. Data were analyzed using difference of proportions tests, t-tests, and regression.ResultsThe percentage of harassed girls was significantly higher than the figures reported in most studies of working women. Girls who were sexually harassed were less satisfied with their jobs and supervisors, had higher levels of academic withdrawal, and were more apt to miss school than their non-harassed peers.ConclusionsSexual harassment significantly impacts employed high school girls’ connections to work and school. It not only taints their attitudes toward work but it also threatens to undermine their commitment to school. Educators, practitioners and community leaders should be aware of the negative impact this work experience may have on adolescents and explore these issues carefully with students who are employed outside of school.Practice implicationsTeenage students, stressed by sexual harassment experienced at work may find their career development or career potential impeded or threatened due to school absence and poor academic performance. In addition, the physical safety of working students may be at risk, creating a need for teenagers to receive training to deal with sexual assault and other types of workplace violence. Educators, practitioners, and community leaders should be aware of the negative impact this work experience may have on adolescents and their overall school experience and explore the issue of sexual harassment carefully with students who are employed outside of school.     

Development of an Online Education Program for Midwives in Australia to Improve Perinatal Oral Health

It is recommended that all pregnant women should receive a comprehensive oral health evaluation because poor maternal oral health may affect pregnancy outcomes and the general health of the woman and her baby. Midwives are well placed to provide dental health advice and referral. However, in Australia, little emphasis has been placed on the educational needs of midwives to undertake this role. This article outlines the development of an online education program designed to improve midwives’ dental health knowledge, prepare them to assess the oral health of women, refer when required, and provide appropriate dental education to women and their families. The program consists of reading and visual material to assist with the oral health assessment process and includes competency testing.     

Counselling the Gifted and Talented in France: Minimizing Gift and Maximizing Talent

After a presentation of the French school system, we describe how the three principal practices—acceleration, enrichment, and special classes—for the education of the gifted are functioning in France. Then, we deal with the counselling of the gifted through 1) the presentation of the professional involved in these tasks, 2) the role played by the parent associations of gifted children, and 3) the identification practices. For the talented, there are many practices, from primary education onwards, which allow schooling to be reconciled with sports studies or artistic tuition. The concept of “dual project” is introduced: the need for sportsmen/women to elaborate their career plan at the same time as their sporting project. The conclusion stresses that in France, measures for the gifted are not clearly laid out; whereas, provisions benefiting from clear and explicit information have been made for the talented and are encouraged by various institutions.     

Socioeconomic risk factors for gynecologic diseases of married rural women in Zhejiang province

The authors investigated socioeconomic factors associated with prevalent gynecologic diseases in data provided by participants in Women’s Health and Health Education Study Program. In 1997, 1515 Zhejiang married rural women aged 15–49 years completed health questionnaires given them by trained medical students who interviewed them at their homes. Single factor and multiple factors analysis were used to determine the relationship between socioeconomic factors and gynecologic morbidity. The data obtained in this study showed that the gynecologic morbidity of the studied married rural women had certain relationship to age, abortion times postnatal consultation visits and other socioeconomic factors. The finding would be helpful for understanding the current reproductive health of married rural women and preventing gynecologic diseases by controlling the risk factors. Project supported by Dreyfus Health Foundation, USA & Bristol-Myeres Squibb Company, USA (Shanghai)     

Contradictions in theorizing and implementing communities in education

Past educational improvement endeavors were fundamentally centered on the learner as an individual. This changed by the early 1990s after an increasing number of educators and researchers embraced sociocultural learning concepts such as “communities of practice,” “communities of learners,” and “knowledge-building communities.” These ideas are originally grounded in a dialectical materialist, cultural-historical theory of activity, or, as Lev Vygotsky called it, in a “concrete human [social] psychology.” However, as these concepts filtered into Western scholarship, some of their defining characteristics have been lost or downplayed. The intention of this article is thus to offer a more complete theorization of the educational notion of community that is centered on collective activity or practice mediated by history and culture/society. Two case studies, which exemplify learning communities using this lens, conclude the paper.     

So Many Bricks in the Wall: Young women in Nova Scotia speak about barriers to school-based sexual health education

Adolescents are sexual beings, and many are sexually active. They are very often able to develop the knowledge and skills required to protect their sexual health, and to take the action required for doing so. Unfortunately, many experience barriers to accessing information through school-based sexual health education. The research outlined here represents an effort to better understand the origins of barriers which prevent young women from receiving maximally effective sexual health education in their schools in Amherst, Nova Scotia, Canada. Building upon research which the authors carried out in the context of a community development project aimed at enhancing the sexual health of young people in Amherst, the article presents the lived experiences of young women in that community as they have attempted to acquire knowledge related to this very important aspect of their lives. The research examines barriers to learning about sexual health at the levels of the curriculum, teachers, and students themselves, leading to a better understanding of the potential for positive change in these domains.     

Interdisciplinarity and Bibliography in Rhetoric of Health and Medicine

This essay examines the current state of rhetoric of health and medicine as a subfield strongly dependent on interdisciplinary contributions. While some of the field's research comes from scholars trained in rhetorical history and theory, much of it consists of “rhetorical” commentary by nonrhetoricians in disciplines such as anthropology, sociology, psychology, philosophy, history, and cultural criticism. The author examines questions of the relation of rhetorical research to discourse research in other fields, and considers what might count, especially in graduate student training, as rhetorical study of health and medicine.     

Social-Emotional Competence as Support for School Readiness: What Is It and How Do We Assess It?

The overall issue of assessment during early childhood, and its relation to school readiness and other decisions, is currently widely debated. Expanding early childhood education and child care enrollments, better scientific knowledge about early childhood development, and decisions about public spending, necessitate careful consideration of which assessment tools to use, as well as why and when to use them. More specifically, the disconnection between the importance of social and emotional domains of development, and their status within educational programming and assessment, has long been lamented. The last several years have, however, witnessed a blossoming of attention to these areas during early childhood, as crucial for both concurrent and later well-being and mental health, as well as learning and academic success. Teachers view children's “readiness to learn” and “teachability” as marked by positive emotional expressiveness, enthusiasm, and ability to regulate emotions and behaviors. Based on these assertions, I suggest a battery of preschool social-emotional outcome measures, tapping several constructs central to emotional and social competence theory, specifically emotional expression, emotion regulation, emotion knowledge, social problem solving, and positive and negative social behavior.     

Negotiating Shame,Silence, Abstinence,and Period Sex: Women’s Shift from Harmful Memorable Messages about Reproductive and Sexual Health

Abstract

Early messages about reproductive and sexual health influence personal identities, health behaviors, and ongoing perceptions of sex and sexuality. Women are often socialized with negatively-valenced messages toward understanding their reproductive and sexual health. However, scholarship emphasizes a communicative approach for socializing intimate health behaviors and needs. The present study addresses the communication that prompts a shift in perception from early, harmful memorable messages to a more comprehensive perspective on sexuality. To do so, we qualitatively analyze open-ended survey responses from 191 women. Findings reinforce previous memorable message literature by revealing messages of shame, sex, abortion, childbearing, and fears of infertility. In addition, we extend the memorable messages construct by exploring how more positively valenced messages and individual moments of intervention redirect women in how they understand their intimate health and sexuality.     

The influence of model infant—toddler group care on parent-child interaction at home

The effects of day care participation on parent-child interaction at home were assessed using a university-based, half-day model infant—toddler program. Hypotheses concerned whether “child-centered” features of the physical and social environment were carried over by parents to the home. Nineteen matched pairs of center and noncenter children (ages 2 to 24 months at start) were followed for 8 months. All had employed student mothers. Methods included brief parent-reported “spot” observations, a videotaped observation of a bathing or feeding routine, and home environment assessments. Parents showed few group differences during the first half of the study period. At study end, however, center homes were more child-centered with respect to play, safety, and dinner arrangements. Center parents scored higher in proximity and warmth and lower in “teacher-avoided” behaviors. Noncenter parents at study end scored higher in authority (limit setting) and communicating values and labels. The findings are interpreted as supporting an ecological model of substantial intersection and cross-influence between home and day care settings.     

我国妇女劳动权益保障的现状及对策研究

分析了我国妇女劳动权益保护的现状,指出了我国妇女在劳动就业、劳动保护、劳动卫生及职业安全等方面面临的问题,探索了妇女劳动权益受到侵犯的原因,提出了保障妇女劳动权益的对策。     

Helping hospitals change: part 2: childbirth education techniques to empower women

As the director of patient-care services for maternal-child health and clinical practice at two large, metropolitan hospitals, the author of this article outlines ways in which childbirth educators can empower women to receive the birth experience they want. Techniques include offering a special prepregnancy class, helping expectant women to formulate questions for their care providers, and encouraging women to express their perceptions of their birth experience by responding to their hospital's patient-satisfaction survey, writing letters, or nominating mother- and baby-friendly nurses for special recognition.