Research with Pregnant Women

2019 ◽  
pp. 279-298
Author(s):  
Margaret Olivia Little ◽  
Marisha N. Wickremsinhe ◽  
Elana Jaffe ◽  
Anne Drapkin Lyerly
Keyword(s):  
Infectious Disease ◽  
Clinical Research ◽  
Pregnant Women ◽  
Vulnerable Population ◽  
Lessons Learned ◽  
Pediatric Research ◽  
Research Subject ◽  
Social Investment ◽  
Left Behind ◽  
The Social

Despite progress in representing various populations in clinical research, one group has been left behind: pregnant women. Though millions of pregnant women annually need to use medication, whether to treat chronic illness or prevent infectious disease, pregnant women have been systematically excluded from the social investment in clinical research required to generate evidence to inform their care. This chapter articulates three models that have been advanced for morally framing research with pregnant women: an unfettered protectionist model, in which pregnant women are categorized as a “vulnerable population” for purposes of clinical research; a model of unrestricted deference to the pregnant woman’s autonomy; and a model that construes the fetus as a pediatric research subject. Each, it is argued, is critically flawed. With lessons learned from their respective limitations, the chapter points toward ways in which research during pregnancy must be given unique consideration, and toward development of an adequate framework.

Gaining and maintaining social licence to operate

2012 ◽  
Vol 52 (2) ◽  
pp. 687
Author(s):  
Kylie Cochrane
Keyword(s):  
Local Area ◽  
Lessons Learned ◽  
Social Investment ◽  
Social Risks ◽  
Key Stakeholders ◽  
The Social ◽  
Licence To Operate ◽  
Efficient Program ◽  
Social Licence To Operate ◽  
Power And Energy

Social licence can be defined as the permission by community and key stakeholders underpinning the statutory approval and monitoring of major projects and operations. Due to the rapid growth of the Australian power and energy sector, expansion of exploration activities and increase in the number of stakeholders affected, the need to integrate the social investment dimension with return on investment (ROI) decisions has become an issue critical to efficient program delivery. Public opinion about power projects mainly hinges on how the construction work will affect the environment and community of the local area and how risky the power project is considered once in place. An integrated community and social investment (CSI) program that encourages transparent, socially constructive, environmentally robust and sustainable practices can reduce risk and improve profitability. CSI is presented as a framework for not just encouraging sustainable development, but also mitigating social risks that can have a profound impact on a project’s acceptance, funding and rate of return. This extended abstract documents the business drivers for project-level social investment, CSI lessons learned across multiple project teams within Australia during the past 12 years, and insights into engaging communities in power and energy industry initiatives. The ROI modelling is applied to social licence thinking. Drawing from a series of project vignettes across the water, mining and power and energy sectors, the author discusses some new legal precedents and a framework for approval-centric communication and business planning. This extended abstract provides guidance for companies looking to obtain, maintain or enhance their social licence to operate.

Ukrainian migrant women’s social remittances: Contents and effects on families left behind

2013 ◽  
Vol 10 (1) ◽  
pp. 91-100 ◽  
Author(s):  
Francesca Alice Vianello
Keyword(s):  
Social Impact ◽  
Economic Education ◽  
Cultural Resources ◽  
Migrant Women ◽  
Social Remittances ◽  
Left Behind ◽  
Ethnographic Studies ◽  
Intergenerational Conflicts ◽  
The Social ◽  
The Right

This article examines different forms of Ukrainian migrant women’s social remittances, articulating some results of two ethnographic studies: one focused on the migration of Ukrainian women to Italy, and the other on the social impact of emigration in Ukraine. First, the paper illustrates the patterns of monetary remittance management, which will be defined as a specific form of social remittance, since they are practices shaped by systems of norms challenged by migration. In the second part, the article moves on to discuss other types of social remittances transferred by migrant women to their families left behind: the right of self-care and self-realisation; the recognition of alternative and more women-friendly life-course patterns; consumption styles and ideas on economic education. Therefore, I will explore the contents of social remittances, but also the gender and intergenerational conflicts that characterise these flows of cultural resources. 

Cross-space Consumption among Undocumented Chinese Immigrants in the United States

2016 ◽  
Vol 2 (2) ◽  
pp. 158-182 ◽  
Author(s):  
Min Zhou ◽  
Xiangyi Li
Keyword(s):  
New York ◽  
Social Status ◽  
Chinese Immigrants ◽  
The United States ◽  
Ethnographic Study ◽  
Social Value ◽  
Left Behind ◽  
Currency Exchange ◽  
The Social ◽  
International Migrants

We consider cross-space consumption as a form of transnational practice among international migrants. In this paper, we develop the idea of the social value of consumption and use it to explain this particular form of transnationalism. We consider the act of consumption to have not only functional value that satisfies material needs but also a set of nonfunctional values, social value included, that confer symbolic meanings and social status. We argue that cross-space consumption enables international migrants to take advantage of differences in economic development, currency exchange rates, and social structures between countries of destination and origin to maximize their expression of social status and to perform or regain social status. Drawing on a multisited ethnographic study of consumption patterns in migrant hometowns in Fuzhou, China, and in-depth interviews with undocumented Chinese immigrants in New York and their left-behind family members, we find that, despite the vulnerabilities and precarious circumstances associated with the lack of citizenship rights in the host society, undocumented immigrants manage to realize the social value of consumption across national borders and do so through conspicuous consumption, reciprocal consumption, and vicarious consumption in their hometowns even without being physically present there. We conclude that, while cross-space consumption benefits individual migrants, left-behind families, and their hometowns, it serves to revive tradition in ways that fuel extravagant rituals, drive up costs of living, reinforce existing social inequality, and create pressure for continual emigration.

Dissemination and Implementation in Social Service Settings

2017 ◽  
Author(s):  
J. Curtis McMillen ◽  
Danielle R. Adams
Keyword(s):  
Health Disparities ◽  
Social Services ◽  
Social Service ◽  
Careful Consideration ◽  
Lessons Learned ◽  
Health Interventions ◽  
Dissemination And Implementation ◽  
The Social ◽  
Implementation Models ◽  
Complex Settings

Social service settings offer numerous complexities in their staffing, consumers, and payer mix that require careful consideration in designing dissemination and implementation efforts. However, social services’ unique access to vulnerable populations with health problems may prove vital in efforts to improve the health status of many of our citizens and reduce health disparities. While a number of well-developed, blended dissemination and implementation models are being used in social service settings, they all require additional documentation, research, and field experience. Nonetheless, the lessons learned in the social services may help organizations in other sectors better implement health interventions with complex consumers in complex settings.

The Politics of Social Investment

2017 ◽  
Author(s):  
Silja Häusermann ◽  
Bruno Palier
Keyword(s):  
Latin America ◽  
East Asia ◽  
Family Policy ◽  
Political Support ◽  
Second Step ◽  
South East Asia ◽  
Social Investment ◽  
Middle Classes ◽  
The Social ◽  
Specific Substance

Recent research on the development of social investment has demonstrated reform progress not only in different regions of Europe, but also in Latin America and South-East Asia. However, the specific substance of the social investment agendas varies strongly between these regions. Why have social investment ideas and policies been more developed in some regions and countries than in others? Building on the theoretical framework of this volume, our chapter suggests that the content of regional social investment agendas depends on policy legacies in terms of investment vs consumption-oriented policies and their interaction with structural pressures. In a second step, we argue that the chances of social investment agendas to be implemented depend on the availability of political support coalitions between organizational representatives of the educated middle classes and either business or working-class actors. We illustrate our claims with reference to family policy developments in France, Germany, and Switzerland.

Social Investment as a Policy Platform

2017 ◽  
Author(s):  
Frank Vandenbroucke
Keyword(s):  
Social World ◽  
The European Union ◽  
Social Investment ◽  
Education Spending ◽  
Overlapping Consensus ◽  
Member States ◽  
Policy Perspective ◽  
The Social ◽  
Broad Consensus ◽  
The Eu

This contribution argues for a truly reciprocal social investment pact for Europe: member states should be committed to policies that respond to the need for social investment; simultaneously, member states’ efforts in this direction—notably efforts by those in a difficult budgetary context—should be supported in a tangible way. Social investment is a policy perspective that should be based on a broad consensus between people who may entertain certain disagreements regarding the level of their empirical and/or normative understanding of the social world. For that reason, the expression of an ‘overlapping consensus’ is used for delineating social investment advocacy. Data on education spending show that we are far removed from a social investment perspective at the European Union (EU) level. This underscores the fact that social investment advocates need to clearly consider the role the EU has to play in social investment progress.

The Truncated German Social Investment Turn

2017 ◽  
Author(s):  
Martin Seeleib-Kaiser
Keyword(s):  
Welfare State ◽  
Social Protection ◽  
Family Policy ◽  
First Century ◽  
Social Investment ◽  
Political Determinants ◽  
The Social ◽  
State Regime ◽  
Policy Transformations ◽  
Veto Points

Traditionally Germany has been categorized as the archetypical conservative welfare state, a categorization not systematically questioned in much of the comparative welfare state regime literature. For many scholars Germany was largely stuck and unable to reform its coordinated market economy and welfare state arrangements at the turn of the twenty-first century, due to a large number of veto points and players and the dominance of two ‘welfare state parties’. More recent research has highlighted a widening and deepening of the historically institutionalized social protection dualism, whilst at the same time significant family policy transformations, which can be considered as partially in line with the social investment paradigm, have been emphasized. This chapter sets out to sketch the main policy developments and aims to identify political determinants of social policy change in Germany.

Three Challenges for the Social Investment Strategy

2017 ◽  
Author(s):  
John Myles
Keyword(s):  
Economic Growth ◽  
Population Aging ◽  
Investment Strategy ◽  
First Century ◽  
Social Investment ◽  
Current Consumption ◽  
The Social ◽  
Post War ◽  
Post Industrial ◽  
Wage Outcomes

Three challenges are highlighted in this chapter to the realization of the social investment strategy in our twenty-first-century world. The first such challenge—intertemporal politics—lies in the term ‘investment’, a willingness to forego some measure of current consumption in order to realize often uncertain gains in the future that would not occur otherwise, such as better schooling, employment, and wage outcomes for the next generation. Second, the conditions that enabled our post-war predecessors to invest heavily in future-oriented public goods—a sustained period of economic growth and historically exceptional tolerance for high levels of taxation—no longer obtain. Third, the millennial cohorts who will bear the costs of a new, post-industrial, investment strategy are more economically divided than earlier cohorts and face multiple demands raised by issues such as population aging and global warming, among others.

scholarly journals POS0058-PARE INCREASING PREECLAMPSIA KNOWLEDGE IN SLE WITH A SPECIFIC EDUCATIONAL TOOL: PRELIMINARY RESULTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 235.2-235
Author(s):  
J. Y. E. Lee ◽  
A. Mendel ◽  
I. Malhamé ◽  
S. Bernatsky ◽  
E. Vinet
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Intervention Group ◽  
Standard Of Care ◽  
Vulnerable Population ◽  
Control Group ◽  
Educational Tool ◽  
Second Trimester ◽  
Systemic Lupus

Background:Pregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia, leading to substantial maternal and fetal morbidity. Aspirin reduces preeclampsia risk but recent studies suggest aspirin is used only in a minority of SLE pregnancies. There is an urgent need to improve preeclampsia counselling and management in this vulnerable population.Objectives:We are conducting the PREPARE (PREeclamPsia knowledge & Aspirin adheRence in lupus prEgnancies) trial, a randomized controlled trial (RCT) evaluating an educational tool on preeclampsia knowledge and aspirin adherence among pregnant women with SLE. We present preliminary analyses of the effect of this tool on preeclampsia knowledge.Methods:Consecutive pregnant SLE women are recruited until the 16th gestational week at 5Canadian Systemic Lupus International Collaborating Clinics centres (i.e. Montreal, Halifax, Quebec, Winnipeg, and Calgary) since 05/2018. Subjects are randomly assigned to receive either the specifically-designed educational tool (intervention group) or standard of care (control group). At baseline (i.e. first trimester) and second trimester visits, the participants complete self-administered preeclampsia knowledge questionnaires (scored out of 30 by the research team blinded to the intervention). We restricted the current analysis to participants enrolled in Montreal (accounting for nearly half of the total planned sample size). We performed a univariate linear regression analysis to assess the effect of the educational tool on preeclampsia knowledge (i.e. mean score difference between the two groups from baseline to second trimester visit).Results:Thirty-three pregnant SLE women were included in the study, among which 16 were exposed to the intervention and 17 were unexposed. Baseline characteristics were well balanced between the two groups with similar mean maternal age between intervention group (32.2 years, standard deviation, SD, 4.6) and control group (34.1 years, SD 4.2) and identical proportion of subjects with post-secondary education (i.e. 80%). The difference in mean preeclampsia knowledge scores between second trimester and baseline visits in the intervention group was 4.4 points (95% CI -0.1, 9.0) and in the control group was 1.5 points (95% CI -2.7, 5.7). The mean difference in knowledge scores (from baseline to second trimester) for those receiving the educational tool was 2.7 points higher (95% CI -1.5, 6.9) than those receiving standard of care.Conclusion:Approximately midway into the PREPARE trial, we observed a trend for improvement in preeclampsia knowledge from the baseline to the second trimester visit in pregnant women with SLE who received a specifically-designed educational tool compared to the control group, although the CIs included the null. Our RCT is well-poised to provide a new evidence-based approach to improve preeclampsia knowledge in pregnant women with SLE, which could help to optimize aspirin use and outcomes in this vulnerable population.References:[1]Schramm AM, Clowse ME. Aspirin for prevention of preeclampsia in lupus pregnancy. Autoimmune Dis. 2014;2014:920467. doi:10.1155/2014/920467[2]Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402-414. doi:10.1097/AOG.0b013e3181e9322a[3]Andreoli L, Bertsias GK, Agmon-Levin N, et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017 Mar;76(3):476–85. doi: 10.1136/annrheumdis-2016-209770.[4]Mendel A, Bernatsky SB, Hanly JG, et al. Low aspirin use and high prevalence of preeclampsia risk factors among pregnant women in a multinational SLE inception cohort. Ann Rheum Dis. 2019;78(7):1010-1012. doi:10.1136/annrheumdis-2018-214434Disclosure of Interests:None declared.

scholarly journals Beyond Last Words: Patterns of Linguistic and Interactional Behavior in a Historical Sample of Dying Hospital Patients

2021 ◽  
pp. 003022282110009
Author(s):  
Michael Erard
Keyword(s):  
Clinical Study ◽  
Social Context ◽  
Small Step ◽  
Left Behind ◽  
The Social ◽  
Canadian Physician ◽  
Hospital Patients ◽  
Historical Sample ◽  
William Osler ◽  
Frequent Observation

Patterns of linguistic and interactional behavior by people at the very end of their lives are not well described, partly because data is difficult to obtain. This paper analyzes descriptions of 486 deaths gathered from 1900 to 1904 in the first-ever clinical study of dying by noted Canadian physician, Sir William Osler. Only 16 patients were noted speaking, and only four canonical last words were reported. The most frequent observation by medical staff was that the deaths were quiet ( n = 30), though range of other behaviors were noted (e.g., moaning, delirium, seeming intention to speak). Osler's problematic study left behind data whose analysis is a small step toward empirically characterizing the linguistic and interactional details of a previously under-described phenomena as well as the importance of the social context in which they occur.

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