Modifying CBT for Perinatal Depression: What Do Women Want?: A Qualitative Study

The evidence for the efficacy of CBT for depression during the perinatal period is mixed. This was a qualitative study that aimed to understand the perinatal-specific needs of depressed women in an effort to inform treatment modifications that may increase the relevance and acceptability of CBT during this period. Stratified purposeful sampling resulted in 23 participants selected by pregnancy, socioeconomic, and depression status. Participants completed semistructured interviews exploring their experiences of pregnancy and the postpartum period and its relationship to mood, and perspectives on ideal treatment content. Thematic analysis revealed a number of perinatal-specific themes that were relevant to CBT in three key domains: self, motherhood, and interpersonal. Mothers particularly struggled with: internalization of “motherhood myths,” self-sacrifice, and managing social support during this period. Shifts in women's themes across the perinatal period, and between racial and socioeconomic groups are discussed as are implications for modification of CBT to improve relevance for perinatal depression.     

Geographies of Tolerance: Human Development,Heteronormativity, and Religion

In their work on the human development sequence, Inglehart and Welzel (Modernization, cultural change, and democracy: the human development sequence. Cambridge University Press, New York, 2005) argue that there is a “rising tide” of gender equality across various countries in the system. While the authors propose that the process that holds true for a rising tide in women’s rights is also true for other outgroups including minorities and homosexuals, they do not test their proposed relationship on feelings toward these groups. At the same time, studies on sexuality and tolerance suggest that religious beliefs and government institutions play a significant role in shaping societal attitudes about homosexuality, promulgating beliefs and policies that place homosexuality in a negative light. In the case of government institutions, sexuality may also be framed as a security issue, making homosexuality appear as a threat. The present work performs an empirical test of the mechanisms of the human development sequence on tolerance toward homosexuality, and compares this theory to rival hypotheses regarding the effects of religion and heteronormative policies. Empirical testing using hierarchical linear models shows mixed support for hypotheses drawn from work on the human development sequence, but indicates that religious belief and heteronormativity in government policies have a significant relationship to levels of tolerance.     

Using the CLOX drawing task to educate the public of the effects of hearing loss

We describe a task used to educate the public on the importance of hearing and the experience of hearing loss. During an open day at Nottingham University, participants were presented with verbal instructions (with or without a background masker) and asked to draw the image of a clock face as accurately as possible. Poorest performance was observed when the instructions were presented with a background masker. We suggest that the task could be applied effectively by healthcare professionals who aim to educate younger individuals of the difficulties associated with hearing loss.     

Faith-Based Sex Education Programs: What They Look Like and Who Uses Them

The purpose of this study was to explore the kinds of sex education programs for youth available in mainline churches. This research project sought to identify the kinds of programs developed, the ages of the youth involved, the reasons for implementing the programs, the goals of the programs, the topics covered, and the perceived youth response to these programs as identified by youth ministers and leaders. The sample included 92 churches/synagogues with memberships over 300 that were within a 25-mile radius of our small, urban area in southeast Michigan. Findings from this study lay the groundwork for exploring whether these programs have an impact on adolescents’ sexual behaviors.     

Severity and cost of unsafe abortion complications treated in Nigerian hospitals

CONTEXT: Each year, thousands of Nigerian women have unintended pregnancies that end in illegal abortion. Many such procedures occur under unsafe conditions, contributing to maternal morbidity and mortality. METHODS: In a 2002-2003 survey of women and their providers in 33 hospitals in eight states across Nigeria, 2,093 patients were identified as being treated for complications of abortion or miscarriage or seeking an abortion. Women's abortion experiences and the health consequences and associated costs were examined through bivariate analysis. Multivariate analysis was used to examine the characteristics of women by type of pregnancy loss and to compare characteristics among three groups of women who had induced abortions in differing circumstances. RESULTS: Among women admitted for abortion-related reasons, 36% had attempted to end the pregnancy before coming to the hospital (including 24% with and 12% without serious complications), 33% obtained an induced abortion at the facility (not withstanding the country's restrictive law) without having made a prior abortion attempt and 32% were treated for complications from a miscarriage. Of women with serious complications, 24% had sepsis, 21% pelvic infection and 11% instrumental injury; 22% required blood transfusion and 10% needed abdominal surgery. The women in this group were poorer and later in gestation than those who sought abortions directly from hospitals. They paid more for treatment (about 13,900 naira) than those who went directly to the hospital for an abortion (3,800 naira) or those treated for miscarriage (5,100 naira). CONCLUSIONS: Policy and program interventions are needed to improve access to contraceptive services and postabortion care in order to reduce abortion-related morbidity and mortality.     

Flanders and Helmand: chaplaincy,faith and religious change in the British Army, 1914–2014

Abstract

The year 2014 marked the centenary of the outbreak of the First World War and the end of eight years of major British combat operations in Afghanistan. Against the background of profound religious changes in British society over the course of the intervening century, this article examines the continuities and discontinuities between British army chaplaincy on the Western Front from 1914 to 1918 and in southern Afghanistan from 2006 to 2014, and explores the religious beliefs and practices of British soldiers caught up in the deadly and protracted struggles on the Western Front and in Helmand Province. While acknowledging major differences in the operational contexts involved and seismic shifts in British religious life over the course of the twentieth century, besides important divergences this article identifies striking degrees of continuity between the ministry of army chaplains and the religious attitude and behaviour of soldiers themselves.     

Legal abortion worldwide: incidence and recent trends

CONTEXT: Information on abortion levels and trends can inform research and policies affecting maternal and reproductive health, but the incidence of legal abortion has not been assessed in nearly a decade. METHODS: Statistics on legal abortions in 2003 were compiled for 60 countries in which the procedure is broadly legal, and trends were assessed where possible. Data sources included published and unpublished reports from official national reporting systems, questionnaires sent to government agencies and nationally representative population surveys. The completeness of country estimates was assessed by officials involved in data collection and by in-country and regional experts. RESULTS: In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each on average in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world's legal abortions in 1996. Trends in the abortion rate differed across age-groups in some countries. CONCLUSIONS: The abortion rate varies widely across the countries in which legal abortion is generally available and has declined in many countries since the mid-1990s.