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Background: Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward school-based youth violence prevention program development. Methods: Eight focus groups involving 86 community stakeholders included 51 adults (parent, teachers, school staff, community leaders) and 35 children aged 8-15 years old (3rd- to 10-th grade). Qualitative narrative analysis elicited major themes. Results: Five themes emerged: (1) School-community violence takes on many forms that become entrenched in local culture. (2) Disintegration of community resources and a sense of learned helplessness underlie the escalation of youth violence. (3) Inadequate role modeling coupled with behavioral ambivalence among adults has sustained a climate of local cultural acceptance with youth violence. (4) Connection to cultural values has diminished, leading to a sense of loss in cultural identity among students. (5) Cultural values and practices are potential strategies for youth violence prevention. Conclusions: Cultural and community contextual factors contributed to youth violence in rural Hawaiian communities. Study implications include the need to further investigate the impact of vigilant, community involvement of stakeholders in school-based youth violence prevention program development. Cultural revitalization at family, school, and community levels may be critical success factors of such programs.

The article highlights a National Institutes of Health State of the Science Conference which was convened in March 2006 to identify outcomes from research studies addressing cesarean delivery on maternal request (CDMR) in the U.S. Research studies indicate that no strong quality evidence was found comparing CD and normal vaginal delivery outcomes. Research about modifiable factors during labor and delivery, including the risk for future pelvic floor disorders was recommended in the conference.

The article focuses on cognitive adaptation in women for reducing stress during childbearing. It presents a study that evaluated the psychological changes in women of three minority ethnic groups in the United States, in a program of psychosocial services, that promoted positive cognitive adaptation to childbearing. In this longitudinal study, both cognitive adaptation and generalized stress were measured at each trimester of pregnancy as well as after birth and 3 months postpartum. The article deliberates that negative adaptation to stressors that women develop during childbearing, reflects itself in psychological symptoms of distress, stressful life events, and either heightened prenatal anxiety or risks for developing postpartum depression. In addition, stressors and their negative effects on maternal psychological adaptation have been cited as factors affecting poor birth outcomes. The study found that, for women in the program, results of the psychological adaptation measures and the stress measures had improved from their first trimester value by the time of birth. Stress levels of women in the program were less than for women in the corresponding comparison sample from the third trimester on.

Worry is a cognitive activity that can be a behavioral expression to better understand how a person is coping and will adapt to his or her situation. The content and expression of worries are influenced by characteristics, such as personality, coping styles, cultural orientation, and social environment. Women experience multiple worries during the childbearing period, such as how pregnancy affects one's body image, whether the baby will be normal and healthy, how being pregnant affects the relationship with spouse/mate, whether to continue employment during or after pregnancy, and uncertainties about adequate finances to support the new or growing family. In this article we present the conceptual dimensions of worries with application to women's childbearing adaptation. Implications for development of research studies and the design of clinical practice strategies are identified. [ABSTRACT FROM AUTHOR]