Background: Although maternity care is linked to improved health outcomes, it is often insufficiently tailored to the needs of low socioeconomic position (SEP) majority population women in high-income countries, leading to obstacles in achieving good health. Cultural competence can contribute to access to adequate care, but no systematic assessment has been conducted. This study aims to examine current evidence about the aspects of cultural competence of maternity care professionals caring for low socioeconomic position (SEP) majority population women. Methods: A scoping review was conducted. Search terms were based on the PCC elements (Participants, Concepts, and Context). Data-extraction and analysis were performed by two researchers according to a predetermined procedure. Data were grouped in the main themes of the Seeleman-framework (2009) and subsequently inductively analyzed. Results: Out of 6954 articles, 35 were eligible for data analysis. To create an overview of available evidence quality assessment of the included studies was not performed. Health professionals express a lack of knowledge and skills to assess socio-economic vulnerabilities in women and to refer to other care options regarding socio-economic vulnerabilities. Although positive experiences with professionals were mentioned, many women experience negative attitudes in terms of a lack of respect and stigmatization issues. Professionals lack the skills to build good relationships with women. Both women and health professionals reported poor communication and collaboration with health care colleagues and with social services. Conclusions: The cultural competence of health professionals in maternity care needs improvement. Professionals should be equipped with sufficient knowledge to identify deprived women and their needs and be trained in skills to effectively communicate and build care relationships. Future research should focus on the reflections of health professionals on their professional role regarding low SEP majority population women. The conditions and maternity care systems health professionals work in to serve low SEP majority women should be studied more closely. Results call for a debate about the scope of professional practice and logistical care structures regarding maternity care for low SEP majority population women. Clinical trial number: Not applicable.
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There is increasing evidence that humans are not living sustainably. There are three major drivers of the unsustainable approach: population, consumption and the growth economy. There is widespread denial about these issues, but they clearly need to be addressed if we are to achieve any of the possible sustainable futures. The first and second versions of the ‘World Scientists Warning to Humanity’ both highlight the problem of increasing human population, as do the IPCC and IPBES reports. However, all have been largely ignored. The size of an ecologically sustainable global population is considered, taking into account the implications of increasing per capita consumption. The paper then discusses the reasons why society and academia largely ignore overpopulation. The claim that discussing overpopulation is ‘anti-human’ is refuted. Causal Layered Analysis is used to examine why society ignores data that do not fit with its myths and metaphors, and how such denial is leading society towards collapse. Non-coercive solutions are then considered to reach an ecologically-sustainable human population. LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Due to a number of factors outlined in this article, the issue of population growth is excluded from the sustainability discussion. In this article, we explore some of the ethical presumptions that underlie the issues linking population growth and sustainability. Critics argue that action to address population creates social and economic segregation, and portray overpopulation concerns as being “anti-poor,” “anti-developing country,” or even “antihuman.” Yet, de-linking demographic factors from sustainability concerns ignores significant global realities and trends, such as the ecological limits of the Earth, the welfare and long-term livelihood of the most vulnerable groups, future prospects of humanity, as well as the ecosystems that support society. https://doi.org/10.1080/10042857.2016.1149296 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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By 2050, 70% of the population will live in cities. The majority of the persons living in cities will be 60 plus years old. Ageing cities demands for cities environments to adapt to an ageing population. Modern cities though, don’t anticipate fast enough and in an adequate manner to face the challenges due to population-related transitions. Modifying and adapting the built environment with a focus on the aged population could help to support older people facing functional and cognitive decline.
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At present, leading international agencies, such as the United Nations Environmental Programme, are largely focused on what they claim to be ‘win-win’ scenarios of ‘sustainable development’ rhetoric. These combine social, economic and environmental objectives. However, as noted by the ‘Scientists’ Warning to Humanity’, environmental integrity is the essential precondition for the healthy functioning of social and economic systems, and thus environmental protection needs to be prioritized in policy and practice. Ecological sustainability cannot be reached without realizing that population growth and economic growth, with attendant increased rates of depletion of natural resources, pollution, and general environmental degradation, are the root causes of unsustainability. This article argues that to strategically address ecological unsustainability, the social, economic and political barriers to addressing the current economic model and population growth need to be overcome. Strategic solutions proposed to the current neoliberal economy are generic – namely, degrowth, a steady-state economy, and a ‘circular economy’. Solutions to demographic issues must be sensitive to the countries' cultural, social, political and economic factors to be effective as fertility differs from country to country, and culture to culture. As discussed here, Mediterranean countries have the lowest fertility in the world, while many countries in Africa, and some in Asia, South America have stable but consistently high birthrates. This is discussed using three case studies - Tanzania, Italy, and Cambodia, focusing on the "best case" policy practice that offers more realistic hope for successful sustainability. https://doi.org/10.1007/s41207-019-0139-4 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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In this chapter it is argued that self-direction is currently well above the head of the majority of youngsters and even of many adults. Evidence for this conclusion stems from developmental and brain research. However, for various reasons it is important that people develop the competences that are necessary for self-direction. To what degree is it possible to develop these competences? Are they 'learnable'? What can education contribute?
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A previous study found a variety of unusual sexual interests to cluster in a five-factor structure, namely submission/masochism, forbidden sexual activities, dominance / sadism, mysophilia, and fetishism (Schippers et al., 2021). The current study was an empirical replication to examine whether these findings generalized to a representative population sample. An online, anonymous sample (N = 256) representative of the Dutch adult male population rated 32 unusual sexual interests on a scale from 1 (very unappealing) to 7 (very appealing). An exploratory factor analysis assessed whether similar factors would emerge as in the original study. A subsequent confirmatory factor analysis served to confirm the factor structure. Four slightly different factors of sexual interest were found: extreme, illegal and mysophilic sexual activities; light BDSM without real pain or suffering; heavy BDSM that may include pain or suffering; and illegal but lower-sentenced and fetishistic sexual activities. The model fit was acceptable. The representative replication sample was more sexually conservative and showed less sexual engagement than the original convenience sample. On a fundamental level, sexual interest in light BDSM activities and extreme, forbidden, and mysophilic activities seem to be relatively separate constructs.
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Population ageing has been a focus of research since the 1960s (Michael et al. 2006), and it has become a domain of international discussions, debates and research throughout a myriad of disciplines including housing, urban planning and real estate (Buffel and Phillipson 2016, van Bronswijk 2015, Kort 2017). Kazak et al. (2017) described how the ageing population has a profound impact on the real estate market, which is transforming in terms of availability of retirement accommodation for older people including accessibility, adaptability, and the availability of single-floor dwellings. Older people usually have a strong connection with the environment they understand and know well (van Hoof et al. 2016), enabling them to spend the latter years of their life in a familiar setting, which, in turn, influences their self-confidence, independence and the potential to successfully age in place. Older people are encouraged to continue living in their homes a familiar environment to them, instead of moving to an institutional care facility, and this is referred to as “ageing-in-place” (van Hoof 2010). This can be supported by creating a functional and spatial structure of cities that are friendly to older people (van Hoof et al. 2018, van Hoof and Kazak 2018). In the domain of environmental design, a series of home modifications can be identified. The most frequently encountered measures in and around the home are adaptations to improve the accessibility of the home (i.e., removal of barriers such as thresholds, installation of stair lifts in multi-storey homes, and the replacement of bath tubs by walk-in showers,). Separately from these expensive measures and adaptations, simple handgrips can improve the accessibility, safety and mobility of older people (van Hoof et al. 2010, van Hoof et al. 2013). A further concern that should be considered within the living environment is the lack of storage space for wheeled walkers and mobility scooters (including a place to charge batteries) whilst living in an apartment block with limited space to manoeuvre on corridors (Kazak et al. 2017). However, with increasing demands for care, it is not always possible to remain living in one’s own home and moving into a residential or nursing facility is the only remaining option; whereby, specialist and/or nursing care can be accessed and provided in these living environments (van Hoof et al. 2009). Policy principles within long-term care aim to provide a home from home environment for their residents (Moise et al. 2004). Several specialised housing models have been developed in order to facilitate this person-centred care approach, as more traditional institutional settings often do not match with the new holistic and therapeutic goals (Verbeek 2017). Radical alterations have been made in comparison with traditional nursing homes, implementing changes in the organisational, physical and social environment of settings (Verbeek et al. 2009, van Hoof et al. 2009). For example, smaller groups of older people (six to seven persons) form a household, with nursing staff having integrated tasks, including assistance with activities of daily living, preparing meals, organising activities and doing household chores together with residents. Daily life is mainly determined by residents and nursing staff, and the physical environment resembles an archetypal house. With this distinct increase and popular notion of the role real estate plays in ageing-in-place and living well in old age, there is also a shifting focus regarding participation, activation, and helping each other. Home modifications and the home environment itself have a profound influence on the care provided and received at home. In short, the fewer barriers there are at home, the easier and less onerous responsibilities placed on the family carer(s) (Duijnstee 1992). Family carers themselves need such environmental interventions that support care, and a sense of community and belonging. Enabling one to age-in-place and to successfully age requires more than a simple occupational therapeutic approach of environmental interventions. It requires innovative new housing encompassing suitable technology arrangements that can facilitate and enable older adults to live comfortably into old age, preferably with others and offer family members (i.e., children, grandchildren and spouse). Furthermore, interconnecting technology into such environments can offer family members the option and opportunity to monitor their loved one remotely whilst all actors know there are additional safety barriers in place. This chapter discusses and provides innovative examples from a Dutch social housing association and their practices, which illustrates a new approach to environmental design that focuses more on building new communities in conjunction with the building itself, as opposed to the occupational therapeutic approaches and environmental support. First, we take a closer look at why we care for each other, which is the basis of the participation society, in which we must look after people who are near to us. This should ideally be at the basis of new housing arrangements -in which people are stimulated to meet, engage, survey and care- that social housing associations are developing, retrofitting and developing.
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Background Anxiety and challenging behaviour (CB) often occur simultaneously in people with intellectual disabilities (ID). Understanding the associations between anxiety and CB may contribute to more accurate diagnoses and management of both anxiety and CB in this population. Aims To examine the relationship between anxiety and CB. Methods A literature review covering the period from January 2000 to January 2012. Results Seven studies about the relationship between psychiatric disorders, including anxiety, and CB were identified. These studies confirm the relationship between anxiety and CB in people with ID, although the precise nature of this relationship remains unclear. Conclusions The study points toward the existence of a moderate association between anxiety and CB. Further research is needed to clarify the complex nature of the association between anxiety and CB.
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Our ageing population is the result of two demographic trends: decreasing fertility levels and higher life expectancy. As a corollary to these demographic trends, the working population is ageing and shrinking at the same time. This development will affect the performance of organizations in the next decades. As today‟s economy and the performance of organizations is mainly based on knowledge, the ageing workforce will mainly affect the organizations ability to be knowledge productive. As current knowledge management (KM) and intellectual capital (IC) literature hardly addresses the issue of ageing, the aim of this paper is to explore this topic in order to formulate an agenda for further KM/IC research. Combining the temporary consequences of ageing (brain drain and talent gap) and the false assumptions about the capabilities of older workers (older workers contribute negatively to a firm‟s performance), the current ageing of the working population reveals two main risks for organizations and management: underutilization of older employees, and loss of knowledge. Based on the exploration of these two risks in this paper, several issues are proposed for further research. These issues focus on the specific competences of the older knowledge worker, the implications for talent development programs, the benefits of inter-generational learning, and effectiveness of knowledge retention strategies. Today, the main fear is that large scale retirement will lead to a shortage of skills, talents, knowledge. Although acknowlegding the risks and threats of this brain drain, the current temporary ageing of our workforce might also contribute to a structural better valuation of the potential of the older knowledge worker and its specific contribution to the process of knowledge creation. In an ageing knowledge economy, increased understanding about the abilities and distinct qualities of older workers will provide opportunities for organizations to enhance knowledge productivity and thus gain competitiveness.
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