Parental Desire Research Articles

Gay Parenthood and the Decline of Paternity as We Knew It

Most analyses of postmodern transformations of intimacy feature adult unions, often placing gays and lesbians on the frontier. The contemporary pursuit of parenthood evinces a similar shift from obligation to desire and from an economic to an emotional calculus. Here too, gay men and lesbians serve as pioneers, with planned gay male parenthood occupying particularly avant-garde terrain and Los Angeles County. This article analyzes gay male narratives of parental desire and decision-making drawn from ethnographic research on gay male intimacy and kinship in Los Angeles, the unlikely global epicenter of gay paternity. It identifies a ‘passion for parenthood’ continuum in which most men occupy an intermediate zone which leads them to situational paternity or childlessness contingent upon intimate relationships. Heterosexual ‘situations’ lead most straight men to paternity, while homosexual ‘situations’ lead a majority of gay men to childlessness. Yet the very success gay men achieve pursuing parenthood against enormous odds exposes conditions governing contemporary family life that represent the decline of paternity as we knew it. This does not augur the demise of male parenthood, however, but its creative, if controversial, reconfiguration.

A Model for Parent-Teacher Collaboration to Promote Self-Determination in Young Children with Disabilities

Promoting self-determination has been a primary focus of transition services for students with disabilities for over a decade (Wehmeyer, Field, Doren, Jones, & Mason. 2004). However, educators of younger children have had limited resources in this area (Wehmeyer & Palmer. 2000), even in the face of parental desires for more independence for their children (Doss & Hatcher. 1996). Although the degree to which very young children with disabilities can be fully self-determined varies, the knowledge, skills, and attitudes that lead to self-determination develop through learning across multiple content or subject areas and across time, starting at an early age (Doll, Sands, Wehmeyer. & Palmer, 1996). If we want children with disabilities to become selfdetermined adolescents, we need to promote this outcome beginning with early education. Considering the importance of family-professional partnerships to positive outcomes for young children with disabilities (Turnbull & nirnbuU. 2001). efforts to promote selfdetermination are more likely to be successful when there is collaboration between parents and teachers. This article introduces the SelfDetermined Learning Model of Support (SDLMS), which parents can use to promote self-determination in young children. SDLMS also offers teachers the opportunity to build a collaborative partnership with parents. Our scenario involving Young and his mother illustrates the process of implementing and using SDLMS.

Parents’ Experiences of Their Rights in the Implementation of Inclusive Education in South Africa

Parental involvement was a driving and decisive factor in the development of inclusive education worldwide. In South Africa parents also became the advocates of the inclusive education movement in the 1990s, paving the way for parents to be involved in the decision-making process regarding the school placement of their children with disabilities. The purpose of this article is to focus on the way in which equity, individual rights and freedom of choice manifest itself in the implementation of inclusive education with specific reference to the way in which parents experience it. Results indicate that the inclusion of a child into mainstream education is a challenging and dynamic process that starts with the parents’ decision to place their child in a mainstream setting. In spite of legislation and the desires of parents, the development of inclusive educational practises in South Africa does not always reflect the values of equity and individual rights. Failure to establish collaborative and trusting relationships between teachers, parents and professionals poses a major challenge and can have a serious impact on the outcomes of inclusive education.

Ethnic Differences in Parent Preference to Be Present for Painful Medical Procedures

To examine ethnic differences between white, black, and Hispanic (English-speaking and Spanish-speaking) parents in their desire to remain present during their children's painful medical procedures. A convenience sample of parents from each of 4 ethnic groups (black, white, and Hispanic [divided into English-speaking Hispanic and Spanish-speaking Hispanic]) was surveyed regarding their preferences for remaining present for 5 hypothetical painful procedures: venipuncture, laceration repair, lumbar puncture, fracture reduction, and critical resuscitation. For each procedure, a short description of the procedure was read to the parent, and a picture of the procedure was shown. The effect of ethnicity on parental desire to stay was examined by using the chi2 test and multivariate logistic regression. Complete data on 300 parents, 72 to 79 from each ethnic group, were obtained. There were no significant demographic differences between groups except that English-speaking Hispanic parents were younger, and black parents were relatively well educated, whereas Spanish-speaking Hispanic parents were relatively less well educated. Overall, the percentages of those who would wish to remain with their child during the procedures were 94% (venipuncture), 88% (laceration repair), 81% (lumbar puncture), 81% (fracture reduction), and 81% (critical resuscitation). The only significant ethnic difference was that English-speaking Hispanic parents were less likely to want to remain present during a critical resuscitation (P = .01). Black parents were less likely, and English-speaking Hispanic parents were more likely, to want physicians to decide for them whether they should remain present. Parents generally preferred to actively participate during the procedure by coaching and soothing their child rather than to just observe. We found few ethnic differences in parents' desire to be present during their child's painful medical procedures. Overall, the vast majority of parents would prefer to remain present even for highly invasive procedures.

Who's Calling the Shots? Pediatricians' Adherence to the 2001–2003 Pneumococcal Conjugate Vaccine–Shortage Recommendations

A national shortage of heptavalent pneumococcal conjugate vaccine (PCV7) occurred from September 2001 through May 2003. In December 2001 and January 2002, the Advisory Committee on Immunization Practices and the American Academy of Pediatrics (AAP) issued PCV7-shortage recommendations, emphasizing that all health care providers decrease the number of doses for healthy children so that more children could receive some PCV7. We assessed (1) how the PCV7 shortage affected pediatricians, (2) whether children in the public and private sectors were vaccinated differently during the shortage, (3) pediatricians' knowledge of and adherence to the Advisory Committee on Immunization Practices/AAP recommendations, (4) and what factors were associated with nonadherence to the recommendations. We conducted a cross-sectional mail survey of 2500 US physician-members of the AAP from November 2002 through March 2003; physicians providing childhood immunizations were eligible. We asked about PCV7-shortage experience, assessed recommendation adherence through clinical scenarios, and modeled potential factors associated with reported nonadherence to the recommendation to defer the fourth PCV7 dose. Of 2478 surveys sent to valid addresses, 1412 (57%) completed surveys were received; 946 (67%) of these were from eligible pediatricians. Overall, 79% experienced a PCV7 shortage, 94% reported being aware of the recommendations, and 42% reported barriers to recommendation adherence. Ninety-four percent reported vaccinating 6-month-old infants with private or public insurance in the same manner. As recommended, 91% reported fully vaccinating high-risk patients. Contrary to recommendations, 49% reported sometimes or always administering the fourth PCV7 dose to healthy children 12 to 15 months old; their reasons included recurrent otitis media, childcare attendance, and parental desire. Controlling for other characteristics, pediatricians who had no PCV7 shortage in their practices were significantly more likely to report administering the fourth dose than pediatricians who had a shortage (odds ratio [OR]: 3.67; 95% confidence interval [CI]: 2.40-5.63). Other factors associated with nonadherence were being in solo private practice (OR: 2.18; 95% CI: 1.26-3.77) or being male (OR: 1.51; 95% CI: 1.08-2.12). Among pediatricians deferring PCV7, 36% reported having no system to track children for whom PCV7 was deferred. Many pediatricians, both with and without a PCV7 shortage, administered more PCV7 doses than recommended. Pediatricians without a shortage were less likely to limit use, which suggests that they might have focused on the perceived value of administering the full schedule to their patients in preference to broader public health goals. Providing more information to physicians on the effectiveness of a fewer-dose schedule and the risk of disease when vaccine is deferred and educating parents might increase adherence to recommendations and achieve more equitable coverage during vaccine shortages.

Witnessing invasive paediatric procedures, including resuscitation, in the emergency department: A parental perspective

To determine whether parents prefer to be present during invasive procedures performed on their children in the ED. A prospective study using a written survey was carried out in the ED of a secondary level regional hospital in south-east Queensland. The survey conducted between August 2003 and November 2003 consisted of parental demographics, seven theoretical paediatric procedural scenarios with increasing level of procedural invasiveness (including resuscitation) and reasons for the decisions of parents to either stay with the child or leave the room. Parents of children with Australasian Triage Scale (ATS) triage category 3, 4 and 5 were surveyed. Of 573 surveys collected, 553 (96.5%) were completed correctly. The number of parents expressing a desire to be present during a procedure performed on their child was 519 (93.9%) for phlebotomy or i.v. cannulation of an extremity, 485 (87.7%) for nasogastric tube insertion, 461 (83.4%) for lumbar puncture, 464 (83.9%) for urinary catheter insertion, 430 (77.8%) for suprapubic bladder aspiration, 519 (93.4%) during procedural sedation and 470 (85%) during a resuscitation where the possibility existed that their child may die. The most common reason for wanting to be present was to provide comfort to their child (542/98%). The most common reason for not wanting to be present was a parental concern of getting in the way (181/33%). Most parents surveyed would want to be present when invasive procedures are performed on their children in the ED. With increasing invasiveness, parental desire to be present decreased. However, the overwhelming majority of parents would want to be in attendance during procedural sedation or resuscitation.

The Families of Man: Gay Male Intimacy and Kinship in a Global Metropolis

Previous articleNext article No AccessThe Families of Man: Gay Male Intimacy and Kinship in a Global MetropolisJudith Stacey Judith StaceyDepartment of SociologyNew York University Search for more articles by this author Department of SociologyNew York UniversityPDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Signs Volume 30, Number 3Spring 2005 Article DOIhttps://doi.org/10.1086/426797 Views: 403Total views on this site Citations: 40Citations are reported from Crossref © 2005 by The University of Chicago. All rights reserved.PDF download Crossref reports the following articles citing this article:Tina Fetner Feminist Identity and Sexual Behavior: The Intimate Is Political, Archives of Sexual Behavior 51, no.11 (Jan 2022): 441–452.https://doi.org/10.1007/s10508-021-02158-7Eric Filice, Diana C. Parry, Corey W. Johnson Traditions in (re)Negotiation: Geosocial Networking Apps and Intimate Relationships Among Men Seeking Men, Sexuality & Culture 25, no.11 (Jun 2020): 189–216.https://doi.org/10.1007/s12119-020-09765-xLuca Guizzardi Contrattualità, giustizia riproduttiva e istanze LGBT nella surrogacy: alcune riflessioni, SOCIOLOGIA DEL DIRITTO , no.11 (Jan 2021): 119–142.https://doi.org/10.3280/SD2021-001005Phillip L. Hammack, David M. Frost, Sam D. Hughes Queer Intimacies: A New Paradigm for the Study of Relationship Diversity, The Journal of Sex Research 56, no.4-54-5 (Oct 2018): 556–592.https://doi.org/10.1080/00224499.2018.1531281Oluwafemi Adeagbo Relationship Formation, Division of Housework and Power Negotiation, (Dec 2018): 37–52.https://doi.org/10.1007/978-3-030-03922-6_3Alessandro Pratesi The End of Inequality as We Know It, (Nov 2017): 37–61.https://doi.org/10.1007/978-3-319-63109-7_3Alessandro Pratesi Macro-Structural Relevance of Emotions, (Nov 2017): 63–90.https://doi.org/10.1007/978-3-319-63109-7_4Phillip L. Hammack Gay Men’s Identity Development in the Twenty-First Century: Continuity and Change, Normalization and Resistance, Human Development 61, no.22 (Apr 2018): 101–125.https://doi.org/10.1159/000486469Clare Forstie A new framing for an old sociology of intimacy, Sociology Compass 11, no.44 (Apr 2017): e12467.https://doi.org/10.1111/soc4.12467Z Nicolazzo, Erich N. Pitcher, Kristen A. Renn, Michael Woodford An exploration of trans* kinship as a strategy for student success, International Journal of Qualitative Studies in Education 30, no.33 (Jan 2017): 305–319.https://doi.org/10.1080/09518398.2016.1254300María Ibarra The Ties that Bind: Mexicana Caretakers and Aging Americans Construct Kinship, Anthropology of Work Review 37, no.22 (Nov 2016): 79–90.https://doi.org/10.1111/awr.12099Oluwafemi Adeagbo ‘Love beyond colour’: the formation of interracial gay men's intimate relationships in post-apartheid South Africa, National Identities 18, no.33 (Mar 2015): 241–264.https://doi.org/10.1080/14608944.2014.990957Adam Isaiah Green, Jenna Valleriani, Barry Adam Marital Monogamy as Ideal and Practice: The Detraditionalization Thesis in Contemporary Marriages, Journal of Marriage and Family 78, no.22 (Dec 2015): 416–430.https://doi.org/10.1111/jomf.12277Doug Allen More Heat Than Light: A Critical Assessment of the Same-Sex Parenting Literature, 1995–2013, Marriage & Family Review 51, no.22 (Mar 2015): 154–182.https://doi.org/10.1080/01494929.2015.1033317Andrea Doucet, Robyn Lee Fathering, Feminism(s), Gender, and Sexualities: Connections, Tensions, and New Pathways, Journal of Family Theory & Review 6, no.44 (Dec 2014): 355–373.https://doi.org/10.1111/jftr.12051 Bibliographie, (Mar 2014): 213–225.https://doi.org/10.3917/arco.uries.2014.01.0213Douglas W. Allen High school graduation rates among children of same-sex households, Review of Economics of the Household 11, no.44 (Sep 2013): 635–658.https://doi.org/10.1007/s11150-013-9220-yDean A. Murphy The Desire for Parenthood, Journal of Family Issues 34, no.88 (Apr 2013): 1104–1124.https://doi.org/10.1177/0192513X13484272Alessandro Pratesi Please, Just Call us Parents, (Jan 2012): 183–198.https://doi.org/10.1007/978-94-6091-849-0_13Tey Meadow ‘Deep down where the music plays’: How parents account for childhood gender variance, Sexualities 14, no.66 (Mar 2012): 725–747.https://doi.org/10.1177/1363460711420463Alessandro Pratesi The Productivity of Care: Contextualizing Care in Situated Interaction and Shedding Light on its Latent Purposes, Ethics and Social Welfare 5, no.22 (Jun 2011): 123–137.https://doi.org/10.1080/17496535.2011.571063Julie Abraham The Homosexuality of Cities, (May 2012): 586–595.https://doi.org/10.1002/9781444395105.ch51Meg Barker, Darren Langdridge Whatever happened to non-monogamies? Critical reflections on recent research and theory, Sexualities 13, no.66 (Dec 2010): 748–772.https://doi.org/10.1177/1363460710384645Myra Marx Ferree Filling the Glass: Gender Perspectives on Families, Journal of Marriage and Family 72, no.33 (Jun 2010): 420–439.https://doi.org/10.1111/j.1741-3737.2010.00711.xTimothy J. Biblarz, Evren Savci Lesbian, Gay, Bisexual, and Transgender Families, Journal of Marriage and Family 72, no.33 (Jun 2010): 480–497.https://doi.org/10.1111/j.1741-3737.2010.00714.xTimothy J. Biblarz, Judith Stacey Ideal Families and Social Science Ideals, Journal of Marriage and Family 72, no.11 (Feb 2010): 41–44.https://doi.org/10.1111/j.1741-3737.2009.00682.x A Class Analysis of Interracial Intimacy, (Jan 2010): 31–59.https://doi.org/10.1215/9780822393559-002 Disciplining Racial Dissidents, (Jan 2010): 60–88.https://doi.org/10.1215/9780822393559-003 The Concept of Racial Literacy, (Jan 2010): 89–115.https://doi.org/10.1215/9780822393559-004 Racial Literacy in Practice, (Jan 2010): 116–145.https://doi.org/10.1215/9780822393559-005 Written on the Body, (Jan 2010): 146–170.https://doi.org/10.1215/9780822393559-006 Archives of Interracial Intimacies, (Jan 2010): 171–194.https://doi.org/10.1215/9780822393559-007 White Like Who?, (Jan 2010): 195–222.https://doi.org/10.1215/9780822393559-008 Gender Gaps in the Experience of Interracial Intimacy, (Jan 2010): 223–255.https://doi.org/10.1215/9780822393559-009 Conclusion, (Jan 2010): 257–265.https://doi.org/10.1215/9780822393559-010 Notes, (Jan 2010): 267–277.https://doi.org/10.1215/9780822393559-011 References, (Jan 2010): 279–295.https://doi.org/10.1215/9780822393559-012Arlene Stein Feminism's Sexual Problem, Gender & Society 22, no.11 (Feb 2008): 115–119.https://doi.org/10.1177/0891243207310030France Winddance Twine, Amy C. Steinbugler THE GAP BETWEEN WHITES AND WHITENESS: Interracial Intimacy and Racial Literacy, Du Bois Review: Social Science Research on Race 3, no.0202 (May 2007).https://doi.org/10.1017/S1742058X06060231Judith Stacey Gay Parenthood and the Decline of Paternity as We Knew It, Sexualities 9, no.11 (Aug 2016): 27–55.https://doi.org/10.1177/1363460706060687

Factors associated with reproductive options in HIV-infected women

A cross-sectional study was conducted in Campinas, Brazil, in HIV-infected women to evaluate factors associated with reproductive practices. A total of 112 HIV-infected women, 13 to 45 years old, with previous sexual experience were included in the study. Three groups were compared: pregnant women aware of their infection before current pregnancy, sterilized women who had made their reproductive choice after serodiagnosis and women using any reversible contraceptive method. Fisher's Exact Test and multivariate correspondence analysis were used in the statistical analysis. Among women interviewed, 23% were pregnant, 18% had been sterilized and 59% were using a reversible contraceptive method. Being younger was associated with reproductive practices that preserved the possibility of having a child. Reversible contraceptive users had fewer pregnancies and more often reported a desire to have children compared to the other groups. Partner's desire for parenthood was associated with pregnant and sterilized women. The clinical condition of the women and their partners, the serologic status of partner nor counseling about contraceptive choices influenced reproductive practices.

The Web of Desire and the Narcissistic Trap

This paper seeks to provide an alternative reading of Re Alex: Hormonal Treatment for Gender Identity Dysphoria [2004] FamCA 297 (13 April 2004) from a psychoanalytic perspective. The claim of this paper is that psychoanalytic theory can provide an alternative reading of Alex’s case that emphasises the social and cultural construction of gender. The implications of such an alternative reading are both particular and more general: the particular implications for this case are that gender reassignment may not free Alex from the web of parental desire and narcissism, and therefore it is difficult to say with any confidence that the decision was in the best interests of the child; and the more general implications of the reading are that gender is largely the product of convention and should not be viewed as inherently natural, inevitable and dichotomous.

How many more times do I have to tell you?

The discussion paper will focus on continuity of care relating to previous NZ research, specifically to transitioning complex preterm infants from NICU to home based on parent experiences, and on the practice developments that have occurred, to ensure optimal health outcomes. Previous NZ research discovered parent desire a consistent service delivery for the entire transition journey from NICU and at home.An informative and comprehensive opportunity has occurred for reflective professional practice, evaluation, development and implementation which have transpired in positive change through innovative practice developments and support change implementation in Wellington, NZ. This has resulted in the articulation of a model of care that has both embraced and integrated parental desires for a continuity of care process for complex preterm infants. This has been achieved by having the same Discharge Facilitator/Key Case Manager present within the NICU and external to the NICU for Home-based infants for the entire transition journey.The paper will focus and emphasis additional practice development changes and furthermore, will present a real purpose, for other countries to learn of such practice developments that have exemplified a celebratory success for families of Wellington, NZ.

Compliance as strategy: the importance of personalised relations in obstetric practice

This paper highlights the importance of personalised relations in institutionalised obstetric care. It seeks to explore the link between objectification and agency, by examining the way in which women find a new subjectivity in motherhood within the walls of the obstetric institution. The paper focuses on obstetric encounters through the lens of labour and intrapartum routine procedures, and argues that when expectant women enter the obstetric institution, a series of relations ensue through their efforts to become connected with the official obstetric system. The hospital organisation and network of relations that originate in it reflect and reproduce a passive role for expectant women and mothers; however, it would be misleading to represent their behaviour as simply “compliant”. Expectant mothers value the connectedness with the obstetric system exemplified by personalised patient–practitioner relations because it is a guarantee of safety. They are happy to follow clinicians’ instructions, even when this implies significant sacrifice or suffering because they are projected towards fulfilling their parenting desires. Compliance, like resistance then, is here intended to be understood as yet another maternal strategy, and as such it is the most widespread, deployed by women in order to achieve their ideals and desires.

The Namesake (review)

Reviewed by: The Namesake Nathan Oates The Namesake by Jhumpa LahiriHoughton Mifflin, 2003, 291 pp., $24 Readers of Jhumpa Lahiri's Pulitzer Prize-winning collection of short stories, Interpreter of Maladies, will find many of the same themes—immigration, assimilation, travel—as well as the same reticent elegance that made those stories so remarkable, in her new novel, The Namesake. As with her short stories, Lahiri's novel is at once expansive and intimate, [End Page 177] never stooping to noise or flash, instead focusing its energy on the creation of a wide cast of characters who are touching, complex and profoundly human. The Namesake tells the story of Go-gol Ganguli, a first-generation Indian American. The novel begins in 1968, before Gogol's birth, when Gogol's father, Ashoke, is nearly killed in a train disaster in India. His father is rescued from the wreckage because "he was still clutching a single page of 'The Overcoat,' crumpled tightly in his fist, and when he raised his hand the wad of paper dropped from his fingers." Years later, when Ashoke's wife Ashima gives birth to their first child, Ashoke names the boy Gogol, in honor of the writer who, in a way, saved his life. Lahiri gracefully shifts the narrative focus from the Ganguli parents to Gogol as he reaches school age. Gogol struggles with his name, which he regards as absurd and inappropriate, as well as with his Bengali American heritage. The issue of culture—What constitutes it? Who is a part of which culture? Is Gogol Bengali, American or Bengali American?—permeates the novel, from the early dislocation of immigration in the first half of the novel to Gogol's departure from home to Yale University. This transition is marked by Gogol's decision to change his name to Nikhil, the formal name his parents had chosen for him as a child, which had never stuck. Gogol's college experience in one way resembles what might be called typical: he falls in love and loses it; he discovers architecture; he begins to assert, against his parent's desires, his independence and individuality. And yet his experiences are always complicated by the particular, as in any life. Gogol can never, even when he moves to New York to work in a large architecture firm, shake his past, his culture or his name as he wishes to do. He moves through a number of relationships of varying quality and eventually marries, much to his surprise, a Bengali woman he knows from his childhood. What Gogol wants is to be his own person, and the novel exposes the fallacy of the American myth of self-creation. The novel ends with Gogol in his early thirties in—as is always the case in this novel—a state of flux. Although the novel never feels busy or hectic, the characters are always in transit. The plot's unfolding resembles the flow of life: various, full and at times chaotic; at the same time, the narrative remains always anchored in the perceptions of its characters. Here is Gogol, on a train ride to visit his parents' home: "Abandoned factories, with rows of small square windows partly bashed in, ravaged as if by moths. On the trees the topmost branches are bare, the remaining leaves yellow, paper-thin. The train moves more slowly than usual and when he looks at his watch he sees that they are running well behind schedule." The novel works in the style of William Trevor, never removing us from the characters' experience of the world, so the characters' thoughts feel as natural as our own. Lahiri's elegant prose guides us through their lives. Toward the end of the novel Gogol's mother, Ashima, thinks, "They are not willing to accept, to adjust, to settle for something less than their ideal of [End Page 178] happiness. That pressure has given way, in the case of the subsequent generation, to American common sense." The perpetual tensions be-tween cultures, between individual minds, between the mind and the world beyond it, run through this empathetic, beautiful novel. Copyright © 2004 The Curators of the University of Missouri

Child Care Use and Parental Desire to Switch Care Type Among a Low-Income Population

This study investigates the use of and satisfaction with child care among low-income families, who are those likely to be affected by recent changes in public policy that emphasize increased work effort. Data from the Survey of Wisconsin Works Families portray differences in the use of center-based care depending on whether or not the family received a child care subsidy. A multivariate analysis of a measure of parental satisfaction, whether a parent would switch child care sources if all care were available at no charge, suggests that parents tend to be more satisfied with center-based care than with alternative forms of care. The analysis also suggests that mothers who received a child care subsidy were significantly more likely to have their children in center-based care.

Factors associated with parental desire for knowledge of fetal gender

Factors associated with parental desire for knowledge of fetal gender

The Right to Love: The Desire for Parenthood among Men Living with HIV

Drug regimens and procedures now exist that will prevent parents from transmitting HIV to infants, and the ethical and legal obligation to promote and protect the reproductive rights of those living with HIV should form part of training for HIV/AIDS care and prevention. This paper reports a study that investigated issues of sexuality and reproduction with 250 Brazilian men living with HIV in São Paulo. We asked whether they wished to have children and whether health professionals in HIV/AIDS treatment clinics that they attended were supportive of their wishes. Health professionals were not considered by most participants to be supportive enough or even impartial about HIV-positive people having children, and paid little attention to men's fathering role. 80% of the men had sexual relationships, and 43% of them wanted children, especially those who had no children, in spite of expectations of disapproval. Few of the men received information about treatment options that would protect infants, however. In previous studies with HIV-positive women attending the same clinics, by comparison, greater knowledge about prevention of perinatal HIV transmission was reported, but women had fewer sexual relationships, fewer desired to have children, and they expected even more disapproval of having children from health professionals. We conclude that the rights of those with HIV to found a family depend as much on curing the ills of prejudice and discrimination, including among health professionals, as on medical interventions.

The Relationship Between Awake Positioning and Motor Performance Among Infants Who Slept Supine

The purpose of this study was to describe the gross motor development of infants who slept supine and spent different amounts of time in the prone position when awake. Thirty infants who were six months old and slept supine were evaluated using the Alberta Infant Motor Scale (AIMS) and then divided into two groups: prone (n = 16) and no prone (n = 14) based on the number of times per day they were placed in prone position while awake. The prone group scored higher than the no prone group on the AIMS total scores (U = 36, p = 0.004), total percentile scores (U = 42, p = 0.003), and prone subscale scores (U = 25, p < 0.001). Gross motor performance as measured by the AIMS was more advanced in infants who slept supine and had been placed in the prone position when awake than in infants who slept supine but had limited or no experience in the prone position while awake. The influence of awake positioning needs to be considered when interpreting the developmental motor performance of infants who are six months old.

Perfil de los fumadores que solicitan tratamiento en una unidad de tabaquismo

The variety of smoking cessation therapies that have proven effective ranges from simple counseling to intensive interventions. The objective of our study was to identify the characteristics of smokers who currently seek treatment at a smoking cessation clinic. Descriptive observational study. The target population consisted of smokers who sought treatment at a smoking cessation clinic. The following variables were studied: sex; age; referral source; marital status; educational level; age at which smoking began, age at which it became a regular habit and the time elapsed between the two moments; level of nicotine dependence (Fagerström Test for Nicotine Dependence); number of cigarettes per day; number of years smoking; use of other potentially-addictive substances (alcohol, caffeine, psychotropic medications and other drugs); presence of concomitant disease; previous attempts to quit smoking; current reasons for smoking cessation; and concentration of expired air carbon monoxide (CO). An initial medical history was taken from each smoker on the waiting list for treatment at the clinic in order to gather data on the study variables; these individuals were then enrolled in a 3-month group smoking cessation program that utilized both medication and cognitive-behavioral therapy. The results are presented in percentages and means with standard deviations (SD) and 95% confidence intervals (CI). 385 smokers were studied--239 (62%) men and 146 (38%) women--the average age being 43.05 years (SD: 9.07). Mean nicotine-dependence (Fagerström Test score) was 6.05 (SD: 2.19); mean number of cigarettes per day: 25.9 (SD: 12.11); mean number of years as a smoker: 25.3 (SD: 9.04); and mean expired air CO: 39.30 (SD: 25.18). Associated disease was present as chronic bronchitis for 27.5% and cardiovascular risk factors for 15%. Previous attempts to quit smoking were reported by 72%; the reasons for the present attempt to quit smoking were the prevention of disease (38%), awareness of dependence (20%) and parental desire to serve as a positive role model for children (10%). At present, the smokers who attend a smoking cessation clinic are young, severely-dependent adults in the initial stage of preparing to quit. The prevalence of symptoms in this population is low. The profile of the population seeking specialized smoking cessation treatment is expected to change in the future as those with smoking-related diseases and other specific populations of smokers become included.

Richer Views of the Ethics of Reproduction

Writing in the Wall Street Journal in March, Jerome Groopman discussed the recent case of the thirty-year-old woman who screened her IVF embryos for the early-onset Alzheimer's gene that she herself carries. Although the woman will likely succumb to Alzheimer's disease before her daughter reaches her tenth birthday, the girl at least will presumably be free of this disease. Groopman had little patience with the reservations raised about this case by physicians and ethicists. Those who oppose preimplantation genetic diagnosis (PGD) to screen for genetic disease, he wrote derisively, so primarily because of religious beliefs. To the concern that this girl would grow up in a household where her mother would soon be neurologically compromised and incapable of caring for her, Groopman simply affirmed the judgment of the physician who performed the PGD that such decisions be left to the parents. I begin with this op-ed piece because it illustrates the sort of narrow, individualistic model of moral reflection that often passes for serious analysis of reproductive medicine. Groopman would do well to read both of the books under review, for both Shanley and Ryan--albeit in very different ways--make the case that it is not enough simply to attend to the desires of prospective parents. Indeed, both Shanley and Ryan argue that we need to reconceptualize debates about reproductive medicine in order to discharge the grave responsibility we have in bringing children into the world. Shanley examines this responsibility to children through the lens of family law. As we have responded to the challenges posed to traditional definitions of parenthood and family by reproductive technology, there has been a tendency to rely, as apparently Groopman does, on the principle of the primacy of individual liberty. The problem with this, says Shanley, is that we live in a society structured by sexual, racial, and economic inequality and governed by market mechanisms. In such a society, unregulated procreative liberty is not likely to safeguard the welfare of children. In order to articulate an alternative to an atomistic, individualistic approach to family law, Shanley undertakes a child-centered analysis of various ways of creating families, including adoption, sperm and egg donation, and surrogate motherhood. Although she continues to use the language of rights, her nuanced analysis of parenthood demonstrates that parental rights should not be viewed as pertaining to an individual per se, but only to an individual-in-relationship with a dependent child (p. 63). For this reason, parental rights are grounded on more than genetic connection; they rest on a foundation of concrete acts of care and commitment to children. This analysis of parenting and parental rights grounds most of the normative claims Shanley makes. She argues, for example, that unwed biological fathers may have parental rights, but not simply on the basis of genetic connection. Because parental rights are based on both genetic connection and concrete care, unwed fathers cannot seek custody merely by asserting genetic paternity and meeting a minimal fitness test. Instead, a genetic relationship, writes Shanley, becomes a reason to look to see if he has attempted to assume responsibility for the child, and has done so without interfering with the mother's well-being (p. 62). Her reasoning about the system of gamete transfer in the United States is similarly shaped by a child-centered perspective. According to Shanley, the current policies and practices governing gamete transfer are designed to serve the interests of adults rather than of children. For example, the practice of secrecy and anonymity fails to recognize that children may have interests in knowing the identity of their genetic forebears (p. 90). So, too, does a market in gametes create the possibility that children may come to see themselves as worth less, if the gametes used in their conception were not highly valued. …

Effect of Parental Education on Decision-Making About Neonatal Circumcision

We investigated the impact of unbiased, published, easily accessible brochures on the parental decision about circumcision.A total of 190 women who were delivered of healthy male infants at Memorial-Hermann Hospital and Woman's Hospital of Texas from December 1, 1999, to April 30, 2000, were asked to complete a brief demographic self-description and questionnaire regarding their attitudes and beliefs about circumcision. The most recent American Academy of Pediatrics (AAP) brochure about circumcision was then distributed, and subjects completed the questionnaire a second time after reading the brochure.Eighty-five percent of participants opted for circumcision. No woman altered her decision on the basis of information in the AAP brochure. Regardless of parental desire for circumcision, responses to all questions before and after distribution of the AAP brochure were highly correlated. Circumcision status of the father and the parents' education and age were significantly associated with the decision to circumcise. There was no significant association between this decision and marital status, race, or religion.Parental education about the medical indications and possible risks of circumcision has no impact on the decision-making process about neonatal circumcision.

Effect of Parental Education on Decision-Making About Neonatal Circumcision

We investigated the impact of unbiased, published, easily accessible brochures on the parental decision about circumcision. A total of 190 women who were delivered of healthy male infants at Memorial-Hermann Hospital and Woman's Hospital of Texas from December 1, 1999, to April 30, 2000, were asked to complete a brief demographic self-description and questionnaire regarding their attitudes and beliefs about circumcision. The most recent American Academy of Pediatrics (AAP) brochure about circumcision was then distributed, and subjects completed the questionnaire a second time after reading the brochure. Eighty-five percent of participants opted for circumcision. No woman altered her decision on the basis of information in the AAP brochure. Regardless of parental desire for circumcision, responses to all questions before and after distribution of the AAP brochure were highly correlated. Circumcision status of the father and the parents' education and age were significantly associated with the decision to circumcise. There was no significant association between this decision and marital status, race, or religion. Parental education about the medical indications and possible risks of circumcision has no impact on the decision-making process about neonatal circumcision.