Childlessness in a child-centered environment : the experiences of voluntarily childless female teachers /

In the literature on voluntary childlessness there is a lack of research on the types of occupations held by women who choose not to mother and how their fertility choice influences their occupational experiences. At the same time, the experience ofwomen with regard to the childfree choice has not been adequately addressed in contemporary feminist literature. In the field of education, much has been written about the association between mothering and teaching. Thus, childfree teachers become particularly interesting since they made seemingly paradoxical choices in that they chose not to bear and rear children yet they chose an occupation in which they are surrounded by and responsible for the daily care of many children. To gain an understanding of the work-related experiences of childfree women, in-depth interviews were conducted with 7 voluntarily childless female elementary school teachers from Southern Ontario. In addition, a focus group interview in which 3 of the 7 childfree teachers participated was conducted. Findings revealed that these women's "choice" to be childless was the result of complex circumstances and multiple motivations. Also, despite their decision to forgo the traditional female role of mother, these women held surprisingly conventional beliefs with regard to family and gender roles. In addition, these childfree women at times identified themselves as mother-like when teaching, yet at other times distanced themselves as teachers from mothers. Finally, results showed that these women experienced both direct and indirect pronatalist pressures outside as well as inside the workplace as a result of their childfree status.

Never-married childless women in Australia: Health and social circumstances in older age

A growing proportion of women reach older age without having married or having children. Assumptions that these older women are lonely, impoverished, and high users of social and health services are based on little evidence. This paper uses data from the Older cohort of the Australian Longitudinal Study on Women's Health to describe self-reported demographics, physical and emotional health, and use of services among 10,108 women aged 73-78, of whom 2.7% are never-married and childless. The most striking characteristic of this group is their high levels of education, which are associated with fewer reported financial difficulties and higher rates of private health insurance. There are few differences in self-reported physical or emotional health or use of health services between these and other groups of older women. Compared with older married women with children, they make higher use of formal services such as home maintenance and meal services, and are also more likely to provide volunteer services and belong to social groups. Overall, there is no evidence to suggest that these women are a problem group. Rather, it seems that their life experiences and opportunities prepare them for a successful and productive older age. (c) 2005 Elsevier Ltd. All rights reserved.

Surrogacy : is it harder to relinquish genes?

Surrogacy has produced some positive outcomes creating an opportunity for otherwise childless couples to live their dream of parenthood. However it has also been problematic, particularly where the surrogate mother fails to relinquish a child born as a result of the surrogacy arrangement. This article examines whether a surrogate mother, who is genetically related to the child she delivers, is less likely to relinquish the child than one who has no genetic ties. An examination of empirical evidence provides support for this argument. Legislation and case law in three jurisdictions, Australia, the United States and the United Kingdom, is examined to determine which, if any, of these jurisdictions take into account the existence, or otherwise, of a genetic link between the surrogate mother and the child she bears. The article concludes that surrogacy legislation should, subject to exceptional circumstances, encourage surrogacy arrangements where the child and the surrogate are not genetically related.

Muuttoliike ja vetovoimatekijät Helsingissä : - Kyselyaineiston analyysi

This thesis explores migration and the attractiveness of urban living in the Greater Helsinki region. The aim of the thesis is to explore the attractiveness of the city of Helsinki in terms of regional migration and to identify what characterizes migration to Helsinki. The study focuses in particular on housing, which is a key factor influencing migration decisions in the region. Other central themes in the study are housing policy and regional competition among municipalities. This study focuses solely on households moving within Finnish borders excluding international migration. Migration is examined by comparing in- and out-migration in Helsinki, as well as studying migration to the city s inner and outer areas. The primary research material in the study is a questionnaire data collected by the National Consumer Research Centre. In this thesis the data is used for studying migrants aged 25 45. The main research method is analyzing the data statistically using the SPSS software. Methods include frequency analysis, cross tabulation, factor analysis and descriptive analysis. Additionally, statistical data is used to complement the questionnaire data. The research results indicate that Helsinki s in- and out-migration differs both in terms of the type of households that migrate as well as in the reasons why they migrate. Furthermore, differences can also be detected between migration to the inner and outer parts of Helsinki. According to the research results, a household s current phase of life is crucial in determining where and why they move within the Greater Helsinki region. A household s set of values on the other hand, seems to have a lesser impact on migration within the region, even though households moving to Helsinki seem to value a somewhat more urban lifestyle than the ones moving out of the city. The research also shows a direct correlation between the values of migrants and their current phase of life. Decisions of migrating are heavily influenced by wider societal issues. In the Greater Helsinki region the labor and housing market appear to have a great influence on the direction of migration streams. According to the results, households move to and from Helsinki for different reasons. The primary reasons for moving to Helsinki are related to the city s diverse labor market and to the working careers of households. Issues related to urban living and an urban lifestyle seem to be relevant although not the main reason why people move to Helsinki. The research material indicates that Helsinki s urban environment is both a pull and a push factor affecting the decisions of migrants. The city attracts those seeking urban living, but on the contrary does not appeal to households seeking more space and wishing to live closer to nature. According to the research, Helsinki with its densely built urban environment mainly attracts singles and childless couples, whereas the city region s other municipalities are more attractive for families with children. Housing policy is one of the main reasons determining where people move within the Helsinki region. As for the city of Helsinki, improving the city s attractiveness seems to be closely linked to how well the city manages to execute its future housing policies and how well alternative living preferences can be taken into account in planning.

Theorizing the Nature of Reflection

For the past decades reflection has been the buzzword of adult and higher education. Reflection is facilitated in many practices and there is abundant research on the issue. Despite the popularity of the concept, the reasons why bringing about reflection in educational practices is difficult remain unclear. The prevailing theories inform of the process in its ideal form. However, to a great extent, they fail to offer conceptual tools for understanding and working with the actualities of reflection. The aim of the doctoral thesis was to explore the challenges and prerequisites of reflection in order to theorize the nature of reflection. By the term reflection it is here referred to becoming aware of and questioning the assumptions that orient our thinking, feelings and actions. The doctoral thesis consists of five studies that approach these questions from different viewpoints and within different contexts. The methods involve both a philosophical and an empirical approach. This multifaceted approach embodies the aim of both gaining a more thorough grasp of the phenomenon and to develop the methodology of researching reflection. The theory building is based on conceptual analysis and rational reconstruction (see Davia 1998; Habermas 1979; Rorty1984) of Mezirow s (1981; 1991; 2000; 2009) theory of transformative learning. In order to explore the aspects which, based on the analysis, appeared insufficiently considered within Mezirow s theory, Damasio s (1994; 1999; 2003; 2010) theory on emotions and consciousness as well as Clausewitz s (1985) view on friction are used as complementary theories. Empirical analyses are used in dialogue with the theoretical, in order to challenge and refine the emerging theorization. Reflection is examined in three different contexts; regarding university teachers pedagogical growth, involuntarily childless women recovering from a life-event crisis, and soldiers preparing to act in chaotic situations of the battlefield as well as recovering from it. The choice of these contexts is based on Mezirow s notion of disorienting dilemma as a trigger for reflection. This notion indicates that reflection may more naturally emerge in association to life-event crises or other cumulative sets of instances, which bring our worldview and beliefs under question. Nevertheless, reflection is often being promoted in educational contexts in which the trigger conditions may not readily prevail. These contextual issues as well as the differences between the facilitated and non-facilitated contexts have not, however, been considered in detail within the research on reflection (or transformative learning). The doctoral thesis offers a new perspective into reflection which, as a further development on Mezirow s transformative learning theory, theorizes the nature of reflection. The developed theory explicates the prerequisites and challenges to reflection. The theory suggests that the challenges of reflection are fundamentally connected to the way the biological life-support system affects our thinking through emotions. While depicting the mechanisms that function as a counterforce to reflection, the developed theory also opens a perspective for considering possibilities for carrying out reflection, and suggests ways to locate and deal with the assumptions to be reflected on. The basic dynamic of the challenges to reflection was explicated by conceptually bridging the gap between Mezirow s and Damasio s theories, through exploring the connections between the meaning perspective and the biological functions of emotions. The concepts of comfort zone and edge-emotions were formed so as to depict the emotional orientation of our thinking, as part of the explanation of the nature of reflection.

Perinatal mortality and maternal health in rural China

Background and context Since the economic reforms of 1978, China has been acclaimed as a remarkable economy, achieving 9% annual growth per head for more than 25 years. However, China's health sector has not fared well. The population health gains slowed down and health disparities increased. In the field of health and health care, significant progress in maternal care has been achieved. However, there still remain important disparities between the urban and rural areas and among the rural areas in terms of economic development. The excess female infant deaths and the rapidly increasing sex ratio at birth in the last decade aroused serious concerns among policy makers and scholars. Decentralization of the government administration and health sector reform impacts maternal care. Many studies using census data have been conducted to explore the determinants of a high sex ratio at birth, but no agreement has been so far reached on the possible contributing factors. No study using family planning system data has been conducted to explore perinatal mortality and sex ratio at birth and only few studies have examined the impact of the decentralization of government and health sector reforms on the provision and organization of maternal care in rural China. Objectives The general objective of this study was to investigate the state of perinatal health and maternal care and their determinants in rural China under the historic context of major socioeconomic reforms and the one child family planning policy. The specific objectives of the study included: 1) to study pregnancy outcomes and perinatal health and their correlates in a rural Chinese county; 2) to examine the issue of sex ratio at birth and its determinants in a rural Chinese county; 3) to explore the patterns of provision, utilization, and content of maternal care in a rural Chinese county; 4) to investigate the changes in the use of maternal care in China from 1991 to 2003. Materials and Methods This study is based on a project for evaluating the prenatal care programme in Dingyuan county in 1999-2003, Anhui province, China and a nationwide household health survey to describe the changes in maternal care utilization. The approaches used included a retrospective cohort study, cross sectional interview surveys, informant interviews, observations and the use of statistical data. The data sources included the following: 1) A cohort of pregnant women followed from pregnancy up to 7 days after birth in 20 townships in the study county, collecting information on pregnancy outcomes using family planning records; 2) A questionnaire interview survey given to women who gave birth between 2001 and 2003; 3) Various statistical and informant surveys data collected from the study county; 4) Three national household health interview survey data sets (1993-2003) were utilized, and reanalyzed to described the changes in maternity care utilization. Relative risks (RR) and their confidence intervals (CI) were calculated for comparison between parity, approval status, infant sex and township groups. The chi-square test was used to analyse the disparity of use of maternal care between and within urban and rural areas and its trend across the years in China. Logistic regression was used to analyse the factors associated with hospital delivery in rural areas. Results There were 3697 pregnancies in the study cohort, resulting in 3092 live births in a total population of 299463 in the 20 study townships during 1999-2000. The average age at pregnancy in the cohort was 25.9 years. Of the women, 61% were childless, 38% already had one child and 0.3% had two children before the current pregnancy. About 90% of approved pregnancies ended in a live birth while 73% of the unapproved ones were aborted. The perinatal mortality rate was 69 per thousand births. If the 30 induced abortions in which the gestational age was more than 28 weeks had been counted as perinatal deaths, the perinatal mortality rate would have been as high as 78 per thousand. The perinatal mortality rate was negatively associated with the wealth of the township. Approximately two thirds of the perinatal deaths occurred in the early neonatal period. Both the still birth rate and the early neonatal death rate increased with parity. The risk of a stillbirth in a second pregnancy was almost four times that for a first pregnancy, while the risk of early neonatal deaths doubled. The early neonatal mortality rate was twice as high for female as for male infants. The sex difference in the early neonatal mortality rate was mainly attributable to mortality in second births. The male early neonatal mortality rate was not affected by parity, while the female early neonatal mortality rate increased dramatically with parity: it was about six times higher for second births than for first births. About 82% early neonatal deaths happened within 24 hours after birth, and during that time, girls were almost three times more likely to die than boys. The death rate of females on the day of birth increased much more sharply with parity than that of males. The total sex ratio at birth of 3697 registered pregnancies was 152 males to 100 females, with 118 and 287 in first and second pregnancies, respectively. Among unapproved pregnancies, there were almost 5 live-born boys for each girl. Most prenatal and delivery care was to be taken care of in township hospitals. At the village level, there were small private clinics. There was no limitation period for the provision of prenatal and postnatal care by private practitioners. They were not permitted to provide delivery care by the county health bureau, but as some 12% of all births occurred either at home or at private clinics; some village health workers might have been involved. The county level hospitals served as the referral centers for the township hospitals in the county. However, there was no formal regulation or guideline on how the referral system should work. Whether or not a woman was referred to a higher level hospital depended on the individual midwife's professional judgment and on the clients' compliance. The county health bureau had little power over township hospitals, because township hospitals had in the decentralization process become directly accountable to the township government. In the township and county hospitals only 10-20% of the recurrent costs were funded by local government (the township hospital was funded by the township government and the county hospital was funded by the county government) and the hospitals collected user fees to balance their budgets. Also the staff salaries depended on fee incomes by the hospital. The hospitals could define the user charges themselves. Prenatal care consultations were however free in most township hospitals. None of the midwives made postnatal home visits, because of low profit of these services. The three national household health survey data showed that the proportion of women receiving their first prenatal visit within 12 weeks increased greatly from the early to middle 1990s in all areas except for large cities. The increase was much larger in the rural areas, reducing the urban-rural difference from more than 4 times to about 1.4 times. The proportion of women that received antenatal care visits meeting the Ministry of Health s standard (at least 5 times) in the rural areas increased sharply from 12% in 1991-1993 to 36% in 2001-2003. In rural areas, the proportion increase was much faster in less developed areas than in developed areas. The hospital delivery rate increased slightly from 90% to 94% in urban areas while the proportion increased from 27% to 69% in rural areas. The fastest change was found to be in type 4 rural areas, where the utilization even quadrupled. The overall difference between rural and urban areas was substantially narrowed over the period. Multiple logistic regression analysis shows that time periods, residency in rural or urban areas, income levels, age group, education levels, delivery history, occupation, health insurance and distance from the nearest health care facilities were significantly associated with hospital delivery rates. Conclusions 1. Perinatal mortality in this study was much higher than that for urban areas as well as any reported rate from specific studies in rural areas of China. Previous studies in which calculations of infant mortality were not based on epidemiological surveys have been shown to underestimate the rates by more than 50%. 2. Routine statistics collected by the Chinese family planning system proved to be a reliable data source for studying perinatal health, including still births, neonatal deaths, sex ratio at birth and among newborns. National Household Health Survey data proved to be a useful and reliable data source for studying population health and health services. Prior to this research there were few studies in these areas available to international audiences. 3.Though perinatal mortality rate was negatively associated with the level of township economic development, the excess female early neonatal mortality rate contributed much more to high perinatal mortality rate than economic factors. This was likely a result of the role of the family planning policy and the traditional preferences for sons, which leads to lethal neglect of female newborns and high perinatal mortality. 4. The selective abortions of female foetuses were likely to contribute most to the high sex ratio at birth. The underreporting of female births seemed to have played a secondary role. The higher early neonatal mortality rate in second-born as compared to first-born children, particularly in females, may indicate that neglect or poorer care of female newborn infants also contributes to the high sex ratio at birth or among newborns. Existing family planning policy proved not to effectively control the steadily increased birth sex ratio. 5. The rural-urban gap in service utilization was on average significantly narrowed in terms of maternal healthcare in China from 1991 to 2003. This demonstrates that significant achievements in reducing inequities can be made through a combination of socio-economic development and targeted investments in improving health services, including infrastructure, staff capacities, and subsidies to reduce the costs of service utilization for the poorest. However, the huge gap which persisted among cities of different size and within different types of rural areas indicated the need for further efforts to support the poorest areas. 6. Hospital delivery care in the study county was better accepted by women because most of women think delivery care was very important while prenatal and postnatal care were not. Hospital delivery care was more systematically provided and promoted than prenatal and postnatal care by township hospital in the study area. The reliance of hospital staff income on user fees gave the hospitals an incentive to put more emphasis on revenue generating activities such as delivery care instead of prenatal and postnatal care, since delivery care generated much profits than prenatal and postnatal care . Recommendations 1. It is essential for the central government to re-assess and modify existing family planning policies. In order to keep national sex balance, the existing practice of one couple one child in urban areas and at-least-one-son a couple in rural areas should be gradually changed to a two-children-a-couple policy throughout the country. The government should establish a favourable social security policy for couples, especially for rural couples who have only daughters, with particular emphasis on their pension and medical care insurance, combined with an educational campaign for equal rights for boys and girls in society. 2. There is currently no routine vital-statistics registration system in rural China. Using the findings of this study, the central government could set up a routine vital-statistics registration system using family planning routine work records, which could be used by policy makers and researchers. 3. It is possible for the central and provincial government to invest more in the less developed and poor rural areas to increase the access of pregnant women in these areas to maternal care services. Central government together with local government should gradually provide free maternal care including prenatal and postnatal as well as delivery care to the women in poor and less developed rural areas. 4. Future research could be done to explore if county and the township level health care sector and the family planning system could be merged to increase the effectiveness and efficiency of maternal and child care. 5. Future research could be done to explore the relative contribution of maternal care, economic development and family planning policy on perinatal and child health using prospective cohort studies and community based randomized trials. Key words: perinatal health, perinatal mortality, stillbirth, neonatal death, sex selective abortion, sex ratio at birth, family planning, son preference, maternal care, prenatal care, postnatal care, equity, China

Research Review: Teenage pregnancy and parenthood: the role of fathers

From the research available in America and Britain it would appear that the men who father children by teenage mothers tend to be a few years older than their teenage partners, although a minority may be significantly older. With regard to the factors associated with fatherhood there are striking similarities to the literature on teenage mothers. Like teenage mothers young fathers tend to be from low socio-economic backgrounds, experience lower educational attainment and fewer employment opportunities than their childless peers. Similarly they tend to experience greater psychological and emotional difficulties and may have a history of delinquent behaviour.

These young fathers are involved in a variety of relationships with teenage mothers, few of which result in marriage and many of which result in the breakdown of cohabitation or the termination of the relationship. This pattern of increasing relationship breakdown over time is related to decreasing paternal contact with children in both America and Britain. Often conflictual relationships with teenage mothers or maternal grandparents and a lack of financial resources are cited by young fathers as barriers to their continued involvement and contact with their children. However, the mothers are much more likely to cite paternal disinterest as the reason for a lack of paternal involvement and there is some indication that mothers and fathers have different views on the level of practical involvement expected from fathers. While most of quantitative data on the subject provides a rather negative picture of paternal involvement, qualitative research highlights how many young fathers genuinely want to be involved with their children and would have more contact and input if they could.

While much less is known about the support provided to young fathers in comparison with their female counterparts, there is some suggestion that the support and role expectations provided by the paternal grandmother may influence how involved young fathers are. There is also some indication that a sizeable minority of young men may receive no such support from their family and may also be treated with hostility or ignored by the maternal grandparents. Young fathers also report limited or no contact with midwives, health visitors and social workers.

O processo de herança na família envelhecida

A herança material é um tema fulcral para as pessoas idosas e suas famílias. No entanto, o conhecimento sobre este tema é ainda escasso. Este estudo tem por finalidade explorar o processo de transmissão da herança, analisar os significados e valores das heranças e suas implicações nas relações e bem-estar na velhice. Contempla o enquadramento da herança no ciclo da vida familiar, análise dos perfis de transmissão da herança, organização das relações de entreajuda entre doadores e herdeiros, explorações dos significados e valores dos bens materiais e aprofundamento dos significados e valores emocionais da herança para doadores e herdeiros. Os resultados sugerem que a herança material é um processo normativo no ciclo da vida familiar, constituindo um ponto focal para a reorganização das relações familiares e bem-estar emocional do idoso. O processo é governado por um sistema de significados e valores orientado para a união e lealdade familiar, reciprocidade da ajuda familiar e igualdade (entre irmãos/herdeiros). Este estudo apresenta limitações, sendo relevante melhorar e expandir os resultados através da análise de diferenças, considerando o sexo, classe socioeconómica, contexto de residência e estrutura familiar (nomeadamente, famílias reconstituídas, pessoas solteiras, casais sem filhos), bem como aprofundar a significação dos valores identificados.

Abortion trends 1990-1999 in a Swiss region and determinants of abortion recurrence.

OBJECTIVE: To assess age- and nationality-specific trends in abortion rates over the last decade, and to describe women's characteristics, identifying risk factors for repeated abortion. METHODS: From 1990-1999, the Health Department of Canton Vaud (Switzerland) received 13'857 abortion requests from residents aged 14-49. Population data were obtained to compute rates. RESULTS: Both the number of abortions (1400 annually) as well as their rate (8.9 per thousand women [95% confidence interval (CI) 7.3-10.5]) were stable over the decade in question. The rate of abortion for foreign women, especially from ex-Yugoslavia and Africa, was twice that for Swiss women. Half of the requests came from single women, 43% had a low education level, and half were childless. The main reason for requesting termination of pregnancy was psychosocial (93%). The mean gestational age was 7.7 weeks (SD +/- 2.3), but 96% of requests were submitted before 12 weeks. Sixty-three percent of women reported that they had used no contraception, 36% the condom and 17% the pill. Among requests, the adjusted risk of repeated abortion (22% of abortion candidates) was greater among divorced/separated/widowed women (odds ratio [OR] 1.9 [95% CI 1.5-2.4]), unemployed women (OR 1.8 [95% CI 1.5-2.1]), and those who had not attended university (OR 1.6 [95% CI 1.1-2.2]). CONCLUSIONS: Although Swiss law only permitted abortion under strict conditions, this procedure was widely available in Vaud, which nevertheless has one of the lowest rates worldwide. Efforts must be intensified to ensure universal access to family planning services, especially for foreign women and adolescents. Professionals should also target "repeaters" to provide personalised counselling.

On the health and wellbeing of single working women without children : an analysis of scientific and lay discourse

Cette thèse examine la façon dont on interprète la santé et le bien-être des travailleuses célibataires et sans enfant au sein de deux types de récits : ceux provenant d’études publiées dans des périodiques (récits scientifiques) et ceux provenant d’entrevues qualitatives avec des membres de ce groupe (récits profanes). Sur le plan démographique, leur nombre est significatif; elles représentent 28% des employées canadiennes. Par contre, leur santé/bien-être est peu visible dans les écrits de recherche. Dans les sciences sociales, plusieurs études portent sur l’expérience parfois éprouvante d’être un adulte célibataire vivant dans une culture orientée sur le couple et la famille. Elles mettent l’accent sur le stigma associé à ce statut. Certains suggèrent même que les pratiques de recherche peuvent contribuer à la perpétuation de représentations négatives à l’égard des célibataires. En ayant un profil qui pourrait être symbolique d’une déviation vis-à-vis des attentes normatives entourant la vie de couple ou de famille, les travailleuses célibataires et sans enfant semblent un point de repère utile pour évaluer cette dernière possibilité. S’attarder autant aux récits scientifiques que profanes permettrait d’explorer les tensions et convergences entre eux. Suivant cet objectif, un échantillon de 32 articles scientifiques et de 22 retranscriptions d’entrevues ont été analysés selon une approche d’analyse de discours guidée par les concepts de répertoire interprétatif (une façon cohérente d’aborder un sujet donné) et de position du sujet (une identité mise en évidence par une façon de parler ou d’écrire). Trois articles ont émergé de cette recherche. Suite à une analyse des thèmes communs utilisés dans l’interprétation de la santé/du bien-être du groupe en question, un répertoire interprétatif surnommé la famille comme référence a été identifié. Ce répertoire expliquerait notamment la tendance observée d’expliquer leur santé/bien-être en référant aux états et aux charactéristiques d’être parent ou partenaire. Cette pratique peut avoir l’effet de voiler leur vie privée ou de la construire comme étant relativement appauvrie. L’article 2 examine comment les membres de ce groupe construisent leur propre bien-être. Il identifie la notion d’équilibre entre plusieurs sphères de vie et une identité de femme dynamique comme éléments centraux aux récits sur leur bien-être. Ces derniers vont à l’encontre de la perception des célibataires ou des personnes sans enfant comme ayant des vies moins épanouies ou enrichies et qui ne sont pas touchées par des questions de conciliation travail-vie personnelle. Le troisième article rassemble les deux types de récits autour des sujets de l’emploi et du statut de célibataire en lien avec le bien-être. Il met en évidence de nombreuses similarités et divergences, et théorise la fonction de ces diverses constructions. En conclusion, j’avance qu’une perspective plus critique face au statut de couple ou familial et de ses aspects normatifs pourrait offrir à la recherche en santé publique un point de réflexivité à développer davantage.

Recours à l’avortement provoqué à Lomé (Togo) : évolution, facteurs associés et perceptions

Le sujet de l’avortement provoqué demeure encore tabou au Togo et la compréhension du phénomène reste incomplète. La présente étude vise à dresser un portrait complet de ses divers aspects dans la capitale togolaise, qui a connu une baisse importante de la fécondité au cours des dernières années. À partir des données des Enquêtes démographiques et de santé (EDS) de 1988 et 1998, et de celles de l’Enquête sur la planification familiale et l’avortement provoqué (EPAP) de 2002, l’étude montre que le recours à l’avortement est à la hausse à Lomé, bien que l’estimation de son ampleur dépende de la méthode utilisée. Plus de 32 % des femmes ayant déjà été enceintes ont déclaré avoir avorté au moins une fois. Toutefois, l’avortement est plus fréquent chez les jeunes, qui y ont recours de manière plus précoce et plus rapprochée que leurs aînées. En contribuant ainsi à la régulation des naissances, l’avortement réduit la fécondité de 10 à 12 %. En utilisant les données de l’EPAP, réalisée auprès de 4755 femmes âgées de 15-49 ans, nous avons aussi étudié le recours à l’avortement comme une séquence d’étapes débutant par l’exposition au risque de grossesse jusqu’au recours à l’avortement, en passant par une absence de pratique contraceptive et le fait qu’une grossesse qui survient soit déclarée « non désirée ». L’ethnie et la génération sont associées à certaines étapes de la séquence alors que la religion, la parité, le statut matrimonial et le niveau d’instruction sont associés aux quatre étapes. Ainsi, le risque élevé d’avorter chez les femmes instruites découle en fait de leur risque élevé à toutes les étapes. En étant moins à risque de grossesse, les femmes qui ont au moins deux enfants sont plus susceptibles que les nullipares, d’utiliser une contraception moderne, de déclarer une grossesse comme non désirée et d’avorter. Si plusieurs grossesses non désirées surviennent aux âges jeunes, c’est surtout le caractère « hors union » de la grossesse qui fait qu’elle est considérée comme « non désirée » et interrompue. En outre, les femmes qui ont déjà avorté ou utilisé une contraception sont plus enclines à recourir à un avortement. Les résultats montrent également que le partenaire soutient souvent la femme dans la décision d’avorter et s’acquitte des coûts dans la majorité des cas. Malgré le fait qu’ils soient illégaux, plus de 40 % des avortements sont pratiqués à Lomé dans des centres de santé, par un membre du personnel médical, et à l’aide du curetage ou de l’aspiration. Mais, la moitié de ces avortements (22 %) avait été tentée au préalable par des méthodes non médicales. Plusieurs avortements ont aussi lieu soit à domicile (36 %), soit chez des tradi-thérapeutes (24 %), grâce à des méthodes non médicales. Par ailleurs, près de 60 % des avortements ont entraîné des complications sanitaires, conduisant la majorité des femmes à une hospitalisation. Sur le plan psychologique et relationnel, nous avons montré que la plupart des avortements ont entraîné des regrets et remords, de même que des problèmes entre les femmes et leurs parents. Les parents soutiennent en fait peu les femmes dans la décision d’avorter et interviennent rarement dans le paiement des coûts. L’étude a enfin révélé que la loi sur l’avortement est peu connue. Cependant, être âgée de 25 ans ou plus, en union ou très instruite, connaître des méthodes contraceptives, le recours d’une parente ou amie à l’avortement sont associés, toutes choses égales par ailleurs, à une plus grande chance de connaître la loi. L’analyse, en appuyant des déclarations des professionnels de la santé et des femmes, montre que malgré sa forte prévalence à Lomé, le recours à l’avortement demeure largement stigmatisé. Les quelques professionnels et femmes qui se sont prononcés en faveur de sa légalisation pensent que celle-ci permettrait de « réduire les avortements clandestins et risqués ». En fait, ce sont les femmes les plus instruites, âgées de 25 ans ou plus, utilisant la contraception, ayant déjà avorté ou connaissant quelqu’un l’ayant fait, qui sont plus aptes à approuver la légalisation de l’avortement. Celles qui appartiennent aux églises de type « pentecôtiste », plus sévères quant aux relations sexuelles hors mariage, sont par contre moins susceptibles que les catholiques d’avoir une telle attitude positive.

Housing densities and consumer choice

From 2001, the construction of flats and high-density developments increased in England and the building of houses declined. Does this indicate a change in taste or is it a result of government planning policies? In this paper, an analysis is made of the long-term effects of the policy of constraint which has existed for the past 50 years but the increase in density is identified as occurring primarily after new, revised, planning guidance was issued in England in 2000 which discouraged low-density development. To substantiate this, it is pointed out that the change which occurred in England did not occur in Scotland where guidance was not changed to encourage high-density residential development. The conclusion that the change is the result of planning policies and not of a change in taste is confirmed by surveys of the occupants of new high-rise developments in Leeds. The new flat-dwellers were predominantly young and childless and expressed the intention, in the near future, when they could, of moving out of the city centre and into houses. From recent changes in guidance by the new coalition government, it is expected that the construction of flats in England will fall back to earlier levels over the next few years.

Trajetórias profissionais de executivas aos postos de alto escalão: fatores-chave, barreiras, inibidores de ascensão e estratégias de enfrentamento

Esta pesquisa buscou compreender as trajetórias profissionais de executivas aos postos de alto escalão, os fatores-chave, as barreiras e os inibidores de ascensão por elas enfrentados em seus percursos, bem como as estratégias de enfrentamento empregadas. Para tanto, efetuou-se um estudo de campo eminentemente qualitativo, cuja estratégia de pesquisa baseou-se no método de estudo de casos múltiplos, cuja unidade de análise centrou-se no nível individual, a saber, na exploração das experiências profissionais e de vida de executivas que alcançaram postos de alto escalão. Os dados foram coletados por meio de entrevistas em profundidade com 18 profissionais que atuam, ou atuaram, no board de organizações nacionais e multinacionais localizadas na cidade de Rio de Janeiro. A pesquisa revelou que o trabalho se constitui como fonte de identidade central para essas mulheres, e que suas trajetórias profissionais, apesar de únicas, apresentavam um padrão comum: essas executivas empreenderam trajetórias diagonais, devolvidas ao longo de várias organizações diferentes, o que poderia ser indicativo de como lidaram com a segregação vertical ao longo de seu desenvolvimento profissional. Chegar ao board de grandes organizações é empreendimento desafiador para homens e mulheres, a trajetória é afuniladora para ambos e, portanto, os que chegam lá – sejam homens ou mulheres – compartilham mais características comuns entre si, ou seja, o habitus do alto executivo, do que com o gênero ao qual pertencem. A pesquisa também revelou que os determinantes familiares, em especial a maternidade, somente foram apontados como barreiras de ascensão profissional pelas executivas sem filhos. Para as executivas com filhos, a maternidade foi encarada como um momento natural de suas vidas, que requereu algumas concessões, porém cujos possíveis conflitos foram equacionados de forma a que essa dimensão de suas vidas se equilibrasse com a esfera do trabalho que, para todas, se constitui em importante fonte de identidade.

Prevalence of burnout syndrome in clinical nurses at a hospital of excellence

Background: Burnout syndrome can be defined as long-term work stress resulting from the interaction between constant emotional pressure associated with intense interpersonal involvement for long periods of time and personal characteristics. We investigated the prevalence/propensity of Burnout syndrome in clinical nurses, and the factors related to Burnout syndrome-associated such as socio-demographic characteristics, work load, social and family life, leisure activities, extra work activities, physical activities, and work-related health problems. Method: We conducted a cross-sectional, quantitative, prospective epidemiological study with 188 surgical clinic nurses. We used the Maslach Burnout Inventory (MBI), which is a socio-demographic questionnaire and the most widely used instrument to assess Burnout syndrome (three basic dimensions: emotional exhaustion, despersonalization and professional underachievement). The socio-demographic profile questionnaire wascomposed of questions regarding identification, training, time at work, work characteristics and personal circumstances. Results: The prevalence of Burnout syndrome was higher (10.1%) and 55, 4% of subjects had a propensity to develop this syndrome. The analysis of the socio-demographic profile of the nurse sample studied showed that most nurses were childless married women, over 35 years of age, working the day shift for 36 hours weekly on average, with 2-6 years of post-graduation experience, and without extra employments. Factors such as marital status, work load, emotion and work related stress aggravated the onset of the syndrome. Conclusion: The prevalence and propensity of Burnout syndrome were high. Some factors identified can be useful for the adoption of preventive actions in order to decrease the prevalence of the clinical nurses Burnout syndrome.

Mental health and quality of life after genetic testing for Huntington disease: a long-term effect study in Germany

Predictive genetic testing for Huntington disease (HD) might cause severe short-term psychological reactions in patients with poor mental health. Very few studies exist on the long-term effects of genetic HD testing. The aim of this study was to assess mental health and quality of life in persons who were tested for HD mutation, to compare mental health depending on the result of the genetic test (non-carriers, gene carriers, and patients with HD) and to identify predictors of mental health and quality of life via linear regression. The data were collected by self-report questionnaires. In total, 121 individuals participated in this study: 52 were non-carriers, 54 were gene carriers, and 15 were gene carriers suffering from HD. Non-carriers and gene carriers showed better mental health and quality of life than HD-patients but did not differ from each other. In non-carriers four variables predicted increased depression and low mental quality of life: low perceived social support, no intimate relationship, female sex and younger age. For gene carriers three predictors were found: low perceived social support, the expectation of an unfavorable genetic test result before the testing procedure and being childless. To prevent detrimental effects of HD testing on mental health and mental quality of life, specific attention should be paid to persons with limited social networks during genetic counseling. Assessment of expectations related to the test result and mental health prior to a genetic testing procedure may help to identify gene carriers at risk of poor coping after an unfavorable test result.