Health risk perception in Canada II: Worldviews,attitudes and opinions

In this article, we present the results of a national survey of 1500 Canadians on their attitudes and opinions about health risks. Ratings of perceived risk, sources of information on health risks and responsibility for risk management were also investigated, with findings reported separately. A high degree of concern about health risks was associated with industrial pollution and chemical products (with the exception of medicines), with almost complete agreement that the land, air and water are more contaminated than ever. In addition, there was widespread belief that a risk‐free environment was an achievable goal, and an unwillingness to accept some health risks to improve the economy. Lifestyle factors such as diet, exercise, and tobacco smoking were perceived to be important modifiers of health risk. On the other hand, many respondents endorsed the idea that they had little control over the risks to their health.     

Muslim immigrants and religious group feelings: self-identification and attitudes among Sunni and Alevi Turkish-Dutch

Affective ratings of multiple religious (sub)groups (Muslims, Christians, Jews and non-believers, as well as Sunni, Alevi and Sjiit Muslims), the endorsement of Islamic minority rights and religious group identification were examined among Sunni and Alevi Turkish-Dutch participants. The findings show that both groups differ in important ways. Some Alevi participants considered themselves Muslims but others interpreted Alevi identity in a secular way. The Sunnis were quite negative towards Jews and non-believers, they more strongly endorsed Islamic minority rights and they had very high Muslim group identification. Furthermore, the Sunnis were negative towards Alevis and the Alevis were negative towards the Sunnis. Muslim group identification was positively and strongly related to feelings towards Muslims and to the endorsement of Islamic group rights.     

Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

Background

Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC).

Methods

We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews.

Results

Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence.

Conclusions

Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians.     

The Perspective of Rural Physicians Providing Abortion in Canada: Qualitative Findings of the BC Abortion Providers Survey (BCAPS)

Background

An increasing proportion of Canadian induced abortions are performed in large urban areas. For unknown reasons the number of rural abortion providers in Canadian provinces, such as British Columbia (BC), has declined substantially. This study explored the experiences of BC rural and urban physicians providing abortion services.

Methods

The mixed methods BC Abortion Providers Survey employed self-administered questionnaires, distributed to all known current and some past BC abortion providers in 2011. The optional semi-structured interviews are the focus of this analysis. Interview questions probed the experiences, facilitators and challenges faced by abortion providers, and their future intentions. Interviews were transcribed and analyzed using cross-case and thematic analysis.

Results

Twenty interviews were completed and transcribed, representing 13/27 (48.1%) rural abortion providers, and 7/19 (36.8%) of urban providers in BC. Emerging themes differed between urban and rural providers. Most urban providers worked within clinics and reported a supportive environment. Rural physicians, all providing surgical abortions within hospitals, reported challenging barriers to provision including operating room scheduling, anesthetist and nursing logistical issues, high demand for services, professional isolation, and scarcity of replacement abortion providers. Many rural providers identified a need to “fly under the radar” in their small community.

Discussion

This first study of experiences among rural and urban abortion providers in Canada identifies addressable challenges faced by rural physicians. Rural providers expressed a need for increased support from hospital administration and policy. Further challenges identified include a desire for continuing professional education opportunities, and for available replacement providers.     

Explaining religious differences in immigrants' gender role attitudes: the changing impact of origin country and individual religiosity

Religion is often perceived as one of the main barriers to immigrant integration in Europe. By focusing on the contested area of immigrants' gender role attitudes, this study analyses data of first- and second-generation immigrants from multiple origin countries and of different religious affiliations in comparison to the native population. It shows that higher levels of religiosity can explain immigrants' more traditional attitudes to some extent, but that origin country socialization acts as an important additional determinant of attitudes of the first generation. Among second-generation migrants, only Muslims continue to hold more traditional attitudes. Acculturation for longer-staying migrants is partly explained by declining religiosity, with some evidence for a decoupling of attitudes from religious beliefs among female migrants in particular. Intergenerational change, on the other hand, cannot be attributed to a decline in the role of religiosity.     

Women's absence,women's power: indigenous women and negotiations with mining companies in Australia and Canada

This article documents the agency of indigenous women in negotiations surrounding major resource projects on indigenous lands. The dominant view in the academic and activist literature is that indigenous women are excluded from negotiations, which helps explain their failure to share in project benefits. The author's experience as a negotiator for indigenous communities in Australia and his research in Canada reveals a different picture, indicating that indigenous women often play a central role in negotiations. The article seeks to explain the inconsistency between the findings reported here and much of the literature, in terms of a broader tendency in the latter to downplay the agency of women in relation to mining; and its failure to adequately recognize the multiple and complex ways in which indigenous women can influence negotiations, and the role of specific cultural, institutional and political contexts in shaping women's participation.     

How the religious context affects the relationship between religiosity and attitudes towards immigration

This article approaches two shortcomings in previous research on religiosity and prejudice: (1) the lack of cross-country comparative studies; and (2) a failure to consider any moderating effects of religious contexts. We examine whether the relationship between religiosity and anti-immigration attitudes varies depending on religious contexts in Europe, and we find two things. First, strongly religious people are on average less likely to oppose immigration than non-religious people. Second, different religious contexts moderate the religiosity–attitude relationship in that religious people in Protestant countries and in countries with a low proportion of majority adherents are more tolerant than religious people in Catholic countries and in religiously homogenous countries. State policies also matter in that religious people are more negative where the government favours the majority religion. This calls into question the taken-for-granted understanding of religiosity and out-group attitudes found in the USA.     

Older women's attitudes towards breast disease,self examination,and screening facilities: implications for communication.

Qualitative research techniques were used in two studies in Edinburgh to explore older women''s attitudes and motivations towards breast disease, self examination, and screening, with a view to identifying appropriate strategies for communication. The results indicated that knowledge of breast disease and screening facilities was poor and that many psychological and emotional issues inhibited self examination. Increasing information about self examination and clinics is unlikely to influence uptake unless it is presented together with emotional support rather than through conventional mass media channels. Such support may best be provided by setting breast screening within general health screening rather than emphasising the single disease.     

Psychosocial correlates of pregnant women's attitudes toward prenatal maternal serum screening and invasive diagnostic testing: beyond traditional risk status

This study examined whether psychosocial variables predict pregnant women's attitudes toward maternal serum screening and invasive diagnostic testing, beyond the influence of traditional obstetric risk status (based on advanced maternal age, history of genetic disorders, etc.). In a sample of 612 pregnant women (66.5% high risk, 33.5% low risk) we assessed responses to hypothetical scenarios of invasive testing following normal or abnormal maternal serum screening. We also assessed psychosocial variables stemming from the theory of planned behavior (e.g., knowledge, concern for fetus, attitudes toward termination, health locus of control). Overall, two thirds of the women would want serum screening. Follow-up invasive diagnostic testing would be sought by 37.2% of the women after a negative screening, and by 75.0% after a positive screening. As expected, traditional risk status predicted desire for screening and also invasive testing following either a negative or positive screen. Yet, controlling for risk status, many psychosocial variables predicted a women's interest in screening and in invasive testing: more knowledge about prenatal testing, concern about fetal health, willingness to terminate a pregnancy, and an internal or medical profession health locus of control. We conclude that psychosocial variables influence women's desire for screening or invasive testing beyond traditional risk status.     

A survey of Calgary paediatricians' attitudes regarding the treatment of defective newborns: a report from Canada

... Premature infants and those born with severe abnormalities have stimulated the creation of neonatal units, but advances in medicine have created the dilemma of whether to sustain life in neonates who would otherwise die from their abnormalities. Often these methods are sophisticated and costly, and carry their own share of iatrogenic complications... It is crucial that the infant -- unable to be directly involved -- have an advocate, whose role it is to act in the best interests of the patient in determinations of the latter's treatment. Under most circumstances that role is occupied by the child's physician and family... For this reason, it is imperative to discern physicians' -- and specifically pediatricians' -- attitudes towards the treatment of defective newborns. To accomplish this, a survey was taken in Calgary... It is the purpose of this paper to provide information regarding local physicians' views and how they compare with the opinions of their colleagues from other countries.     

Menopause and the transmission of women's knowledge: African American and white women's perspectives

Recent menopause literature does not sufficiently explore women's attitudes on the transmission of knowledge about menopause from sources other than biomedical providers. Analysis of 70 interviews with African American and Euro-American women shows that their perceptions of the intergenerational transfer of knowledge about menopause from their mothers shaped their attitudes toward menopause and the health-care technologies surrounding it. African American women who grew up in the segregated South frequently expressed that their mothers provided them with the knowledge and power to negotiate difficulties during the menopausal process, while many middle-class Euro-American women expressed that their mothers did not. Drawing on literature that examines the effects of race, class, and kinship on mother/daughter relationships, this article explores the reasons for this divergence.     

Wrath of God: religious primes and punishment

Recent evidence indicates that priming participants with religious concepts promotes prosocial sharing behaviour. In the present study, we investigated whether religious priming also promotes the costly punishment of unfair behaviour. A total of 304 participants played a punishment game. Before the punishment stage began, participants were subliminally primed with religion primes, secular punishment primes or control primes. We found that religious primes strongly increased the costly punishment of unfair behaviours for a subset of our participants--those who had previously donated to a religious organization. We discuss two proximate mechanisms potentially underpinning this effect. The first is a 'supernatural watcher' mechanism, whereby religious participants punish unfair behaviours when primed because they sense that not doing so will enrage or disappoint an observing supernatural agent. The second is a 'behavioural priming' mechanism, whereby religious primes activate cultural norms pertaining to fairness and its enforcement and occasion behaviour consistent with those norms. We conclude that our results are consistent with dual inheritance proposals about religion and cooperation, whereby religions harness the byproducts of genetically inherited cognitive mechanisms in ways that enhance the survival prospects of their adherents.     

Dignity,conscience and religious pluralism in healthcare: An argument for a presumption in favour of respect for religious belief

Religious pluralism in healthcare means that conflicts regarding appropriate treatment can occur because of convictions of patients and healthcare workers alike. This contribution argues for a presumption in favour of respect for religious belief on the basis that such convictions are judgements of conscience, and respect for conscience is core to what it means to respect human dignity. The human person is a subject in relation to all that is. Human dignity refers to the worth of human persons as members of the species with capacities of reason and free choice that enable the realisation of dignity as self-worth through morally good behaviour. Conscience is both a feature of inherent dignity and necessary for acquiring dignity as self-worth. Conscience enables a person to identify objective values and disvalues for human flourishing, the rational capacity to reason about the relative importance of these values and the right way to achieve them and the judgement of the good end and the right means. Human persons are bound to follow their conscience because this is their subjective relationship to objective truth. Religious convictions are decisions of conscience because they are subjective judgements about objective truth. The presumption of respect for religious belief is limited by the normative dimension of human dignity such that a person's beliefs may be overridden if they objectively violate inherent dignity or morally legitimate acquired dignity.