My Research Year in Review: Publications, Citations, and Attractions

Last year I wrote a blog post about my research from 2008 until the present (2014).

Today, I’ll write my one year review.

Clearly the highlight of my year was writing, publishing, and defending my PhD dissertation (PhD avhandling) entitled An Unequal Chance to Parent: Examples on Support Fathers Receive from the Swedish Child Health Field.

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Preparing the dissertation, as well as preparing to defend took nearly half a year, starting at the tail-end of 2014, and on through until April 29th, 2015…the magical defense day. You can read more information about the artwork, the spikning, the final product (aka the defense), and the party.

While working on my dissertation, I had two other main projects: 1) to mentor a medical student in how to conduct research and 2) to plan and execute the itinerary for my former master’s advisor, Dr. Sarah Schoppe-Sullivan. After receiving a travel grant, we flew her over from the USA to Sweden to have her provide lectures to different groups of researchers, individually work with various PhD Students, and to have her promote her research to different researchers.

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Sarah flew over to support our research group, and provided invaluable advice while preparing for my defense.

It was a highlight of my year to be able to give a little something back to my former advisor…even if preparing for my PhD defense was a full-time job.

Research Gap

The most unfortunate thing after graduating was having to leave the country for an unknown period of time, while I waited for my visa to change from a student visa to a visiting researcher visa. But at least I was employable!

I had two job offers: one as a postdoc at the Child Health and Parenting (CHAP) Research Group in Women’s and Children’s Health at Uppsala University (AKA- the same research group I earned my PhD from) (60%) and a researcher position via St. Goran’s Hospital & Women’s and Children’s Health at Karolinska Institutet (40%). In the latter position, I started working with Dr. Malin Bergström.

Malin was the first person to ever approach me at a conference and utter the words “I’ve read your work.” That simple sentence led us down a path to our current projects (and obviously made me feel super cool!).

While my postdoc position at CHAP was to continue finishing up current projects, I was to start a very natural progression of analyzing data on Swedish child health nurses’ current attitudes toward father involvement at the child health centers, and to start helping to develop an evaluation protocol for a new program the nurses were providing to families of three-year-olds with Malin (as well as Dr. Emma Fransson & Dr. Anders Hjern via CHESS, Stockholm University).

Publications

  1. Wells, M.B., Salari, R., & Sarkadi, A. (In Press). Mothers’ and Fathers’ Attendance in a Community-Based Universally Offered Parenting Program in Sweden. Scandinavian Journal of Public Health, Volume (Issue), page numbers.
  2. Wells, M.B., Engman, J., & Sarkadi, A. (2015). Gender equality in Swedish child health centers: An analysis of their physical environments and parental behaviours. Accepted for publication in Semiotica: Journal of the International Association for Semiotic Studies.
  3. Wells, M.B. (2015). Predicting Preschool Teacher Retention and Turnover in Newly Hired Head Start Teachers Across the First Half of the School Year. Early Childhood Research Quarterly. 30, 152-159.

Article 1 is my fourth and final article that completes my PhD dissertation! It is the first article to explore gender differences between parents (e.g. mothers and fathers) in relation to why they participate in a parent support program (e.g. Triple P Positive Parenting Program).

Of those researchers on ResearchGate, this article was the most read article from Women’s and Children’s Health (for that week). It felt cool to see that people were interested in my research, especially since there are so many researchers doing really highly quality research.

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Article 2 was also in my PhD dissertation. This was the first article I ever collected data on, and the first article I ever tried to get published. The fact that I have since had five other publications before this one though is a tribute to the valuable lessons I learned from this first research project: how to collect data, how to write an article for publication, and the most valuable lesson–learning the importance of developing a strong methodology. But now it’s finally published! :)

Article 3 was discussed in last year’s update.

Technically, a 4th article was published:

  • Wellander, L., Wells, M.B., & Feldman, I. (2015). Does prevention pay?: Health and economic impact of preventive interventions for school children aimed to improve mental health. Journal of Mental Health Policy and Economics, 18(S1).
    *The actual citation writes Inna Feldman’s name as “Jima Feldman”.

This article is published in a supplementary edition of the journal since it is a conference abstract (the conference took place in Venice, Italy and was run by the aforementioned journal).

Citations

My citations greatly increased this year according to ScholarGoogle from 19 in 2014 to 34 in 2015.

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I have also learned some valuable lessons about citations:

  1. Self-citations definitely happen
    • My dissertation alone vastly boosted my alleged citations
  2. Your research network cites your work
    • Maintain healthy relationships to get more citations
  3. Masters and doctoral students will cite you
    • Apparently established researchers are mainly only following lesson number 2 (above); even if your research would fit in perfectly with their own
  4. Use conferences and send personal emails to promote your work
    • People will cite you if they 1) know that your research exists and 2) if you take a few minutes to introduce yourself

I haven’t had too many citations from professional researchers who either my colleagues or myself do not already know. Hopefully this will be a nut that gets cracked as I build my resume, produce more, and establish a bigger name for myself…either that or networking is just as important in garnering citations, as it is in getting employed.

Downloads
My PhD dissertation has been viewed and downloaded quite a bit (relative to others).

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ResearchGate also states that my articles (as a group) have been “read” (a combination of viewed and downloaded) over 1000 times. It’s hard to compare from 2014, since they changed their terminology. For example last year, I had 816 views and 969 downloads.

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These numbers though must pale in comparison to downloaded articles from the actual journal (imagine that, a professional organization does better than my personal website ;)

For example, in just looking at my Early Childhood Research Quarterly article, over a 9-month period, this one article was viewed 655 times.

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Invited Talks

I was invited to provide a conference talk for the Stockholm University Demography Unit and the Linnaeus Center on Social Policy and Family Dynamics in Europe at Stockholm University. I gave a presentation and a paper entitled “The Swedish Ploy of Promoting Equal Parenting:  Paradoxes in Policy Implementation Regarding Paternal Involvement in Childcare.”

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Click here to see the presentation.

I was also invited to speak at the 6th Annual Conference: Focus on Fatherhood for around 100 child health nurses in Kista, Stockholm, Sweden. I gave a presentation called “Father Involvement is Important: Ways to Decrease Paternal Barriers.”

My Blog
This blog has increased traffic quite a bit as well. While my blog received 15,000 views in 2014, my views significantly increased to 25,000 in 2015. The most common views are by far the posts related to different questionnaires and scales (e.g. not my personal work).

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I find this interesting because it tells me that 1) people want to look up questionnaires and scales to learn more about them and 2) there aren’t many websites that promote questionnaires and scales.

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I wrote about the different questionnaires and scales (e.g. research tools) that I use in my own research–not so much to inform others, but just to remind myself what that tool could be used for. However, it seems that people crave more knowledge about particular tools. So far though, I have taken little responsibility in updating and adding to the tool-related posts–since they aren’t my tools that I’ve developed.

Even so, my website often comes up as the number one hit on Google. People who have invested interests in these tools could benefit from promoting them to a greater extent….and other researcher would also benefit from their knowledge.

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Summary
Researchers always question if they have done enough throughout the year. Writing about a few of my highlights puts my accomplishments in perspective.

And I haven’t even written about the “soft” accomplishments–like learning new methodologies and statistics, mentoring PhD students, leading seminars, teaching, and presenting at conferences.

Keeping in mind what I have accomplished all year helps raise my self-esteem and lowers my self-deprecating thoughts of not doing enough.

Future Research:

As 2015 winds down, I look forward to starting a new postdoc position in Public Health at Karolinska Institutet working in Dr. Finn Rasmussen’s research group (80%) and another postdoc position with Dr. Malin Bergström, Dr. Emma Fransson, and Dr. Anders Hjern at the Centre for Health Equity Studies (CHESS) at Stockholm University/Karolinska Institutet in the Elvis Project.

I am eager to see what 2016 brings!

Too Many PhD Positions: Uppsala, Sweden

There are a lot of articles out there on the absurdity regarding the number of PhD students universities bring in (and quickly push out), while neglecting the fostering of high quality researchers.

For example, Larson et al., 2014 suggests that there are too many PhD students to ever replace the professors they worked for. Knowing this, The Economist  argues that the universities see PhD students as “cheap, highly motivated and disposable labour.”

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Larson et al. notes that less than 17% of new PhDs in science, engineering, and health-related fields find tenure track positions within three years after graduating. Three years!  For a less than one-in-five chance of stable employment.

The Times Higher Education states that since there are not enough tenured positions for PhD students to eventually get, many are left to only hold temporary contracts (and have lots of stress).

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The Guardian argues that this emphasis on PhD Students and much less on tenure track positions shows a lack of accountability by the departments and heads of the university.

Clauset et al. (2015) says that you stand a better chance of getting a tenure track position if you attended an elite university. For example, they found gross social inequality when they analyzed their data, noting that just a quarter of all universities in the USA and Canada equate to around 75% of all tenure-track faculty in the USA and Canada.

In the most simple terms: The field is saturated with PhD students.

Lessons:

  1. Go to the best university you can to earn your PhD. Note that “best” does not necessarily mean a) the hardest to get into, b) a good geographical location, or even c) a professor/research you want to work for/with. Best, in this case, means those elite schools that will connect you to the job market.
  2. Professors and various management administrators should work on revising plans to a) hire people who already hold PhDs and b) cut-back on hiring PhD students.
  3. There should be less emphasis placed on professors for hiring PhD students, and more emphasis placed on the quality of research they complete.

I recently checked Uppsala University’s website for job postings.

In rank order of the diversity of the jobs available:

Full professor positions = 0

Associate professor positions = 0

Assistant professor positions = 0

Postdoc positions = 0

Administrative positions = 0

PhD positions = 19

There were no less than 19 PhD positions, and no other career opportunities. In other words, don’t try to find a job in academics after you’re done with that PhD–there are no openings for you.

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New PhD students– you now have four years to find a job. Start looking!

Dissertation (Avhandling) Cover Photo

I’m often asked by fellow PhD students–what should I have on the cover of my dissertation (avhandling) book?

To me, the answer was very clear–I wanted the overall message, the theme, of my dissertation to be front and center on the cover.

If a picture is worth a thousand words, then I should shorten my dissertation ;)

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I had a childhood friend, Kirb Brimstone (also found on Facebook here), do the artwork. I advised him what I wanted and he drew it.

Here’s the significance of my cover art:

Since my dissertation is about how fathers are not provided with an equal chance to parent, both through the Swedish family policies and through the institutions, like the child health field, I had this represented on the cover.

There’s an illustration of Sweden in the background, with a father, presumably from Uppsala University, holding his daughter’s hand as he walks towards a nurse and a preschool teacher.

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The nurse and preschool teacher are both women, signifying the gender difference men/fathers face at the outset of garnering parenting advice from these individuals.

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However, he is stopped at a fence, with a lock, signifying the gatekeeping that is happening as those who have knowledge about young children’s health hold the keys (and therefore the power) to inform or not inform others about young children’s health.

In this case, fathers feel like the gate is closed, and that they have several barriers to break down before they can be fully accepted into the child health world.

Even my own institution highlights the lack of the importance of fathers, as it is aptly named “Women’s and Children’s Health“.

Mainly people in Sweden and around the world believe that Sweden is a very gender equal country. And to its credit, it most certainly is, especially relative to other countries. But that doesn’t mean that there isn’t a vast amount of work still needed before achieving gender equality. While many people work with the struggle for equal rights for women, few pose the argument on ways men/fathers are discriminated against, not the least of which is through the Swedish child health field.

With that in mind, the sign on the gatekeeping fence has a sign saying “Nullius in Verba” which is Latin for “take nobody’s word for it”. In other words, just because people believe Sweden is a gender equal country, and that men/fathers hold all of the power–do not take societies word for it.

Seek out the truth…..by reading my dissertation.

You can find a copy of my dissertation by clicking here.

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One last thing–I gave a tip of my hat to the father-figures in my life: my father (JSW), my two grandfathers (KFE & CRW), and my best childhood friends dad (SP) by having their initials “carved” into the fence on the right-hand side. This was also intended as a symbolic gesture, suggesting that these fathers had reached the gate, but were stopped and couldn’t be as involved in all aspects of childrearing as they might have liked due to the various levels of gatekeeping that they encountered.

A Swedish Spikning–Nailing my Dissertation

After sitting and writing your dissertation (avhandling) for months, the day comes when it’s is printed.

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It looks so real! A book, with my name as the author is coming into being. Are all of my citations correct? Are my results right? I didn’t mess up any of the decimal places, did I?

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After a thorough checking of your printed dissertation is completed, you send it in for processing and you get a real book!

Once your dissertation is complete, you have a spikning. A spikning is when you nail your avhandling (dissertation) to the wall.

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Everyone used to nail it to a door/wall at the main university building, but today, it’s more common to only nail it within your own office space or to not even literally nail it, but rather just celebrate the accomplishment.

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Either way, I did feel a bit like Martin Luther, although I think my findings were a bit less controversial.

And of course, it’s always nice to hear toasts, make toasts.

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And celebrate the accomplishment with cake.

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Now just a few short weeks until the actual defense.

#nailedit

My Research in Review: 2008-2014

My first publication came in 2012. I worked with a colleague, the lead author of the manuscript, Christina Stenhammar (now Dr Stenhammar) on her article entitled “Children are exposed to temptation all the time –Parents’ lifestyle-related discussions in focus groups” published in Acta Paediactrica.

But that was my first peer reviewed article. Although I worked, mainly for Head Start, between 2008 and 2012, I had published two documents in 2008: 1) my master’s thesis entitled Father-Child Play: A Longitudinal Study on Fathers’ Parenting and Child Cognitive Development and Academic Achievement Across the Transition to School with Dr Sarah Schoppe-Sullivan as my main advisor and a book chapter published in Swedish called “BVC ur ett genusperspektiv” (Child Health Centers from a Gendered Perspective) published in Föräldrastöd I Sverige idag: Vad, när och hur? (Parents in Sweden Today: What, When and How?). This book chapter was co-authored by Jonas Engman and later revised and turned into a peer-reviewed journal article with Dr. Anna Sarkadi: “Gender equality in Swedish child health centers: An analysis of their physical environments and parental behaviours” published in Semiotica: Journal of the International Association for Semiotic Studies (2015).

This article is one of five that will comprise my PhD thesis. The other articles are:

Wells, M.B. & Sarkadi, A. (2012). Do father-friendly policies promote father-friendly child-rearing practices? Reviewing Swedish Parental Leave and Child Health Centers. Journal of Child and Family Studies, 21(1), 25-31.

Wells, M.B., Varga, G., Kerstis, B., & Sarkadi, A. (2013). Swedish child health nurses’ views of early father involvement: A qualitative study. Acta Paediatrica, 102(7), 755-761.

Wells, M.B., Salari, R., & Sarkadi, A. Who participates in a Swedish parenting intervention: A look at mothers and fathers self-selection to participate in Triple P. (Currently under review).

Rahmqvist, J., Wells, M.B., & Sarkadi, A. (2014). Conscious parenting: A qualitative study on Swedish parents’ motives to participate in a parenting program. Journal of Child and Family Studies, 23(5), 934-944.

My two PhD advisors are Dr Anna Sarkadi and Dr Raziye Salari, and therefore, it only makes sense that the three of us would collaborate to publish a paper together:

Salari, R., Wells, M.B., & Sarkadi, A. (2014). Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden. Scandinavian Journal of Public Health, 42, 547-553.

After having spent time living in Sweden and writing a well-cited article on the interplay of Sweden’s parental leave policies and their child health care program, I wanted to dig deeper in Sweden’s family policies. And so I started working with Dr Disa Bergnehr on a book chapter “Families and Family Policies in Sweden” in Dr Mihaela Robila‘s edited Handbook of Family Policies Across the Globe.

Having worked with my advisors, collaborated with other researchers, and supported PhD students in their research, I thought it was time to see if I could design, implement, analyze, write, and publish an article on my own.

Now that it’s January 1, 2015, I’m extremely delighted to say that I was able to accomplish this. Not only to publish my own research, but to publish it in one of the best education journals (and the best early childhood education journal) Early Childhood Research Quarterly (currently has an impact factor of 2.058 with a 5-year impact factor of 3.657, making ECRQ the best journal I’ve been published in so far (see below for a debate I had with myself on this statement).

Wells, M.B. (2015). Predicting Preschool Teacher Retention and Turnover in Newly Hired Head Start Teachers Across the First Half of the School Year. Early Childhood Research Quarterly. 30, 152-159.

Another published article was in the Scandinavian Journal of Public Health, which has an impact factor of 3.125, but ECRQ is ranked 19th out of 219 in Education (best 8.7%), while SJPH 21st out of 162 in Public, Environmental, and Occupational Health (best 13%); making ECRQ “better”.

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Beyond these publications are two published abstracts and a published report:

Wells, M.B. (2013). A quantitative look at preschool teachers’ retention: A study on Head Start teachers. 23rd EECERA Conference: Values, Culture and Contexts, 243.

Wells, M., Varga, G., & Sarkadi, A. (2012). Wanting to actively promote fathers: A qualitative study on Swedish child health nurses’ views of father involvement. International Journal of Behavioral Medicine, 19, Supplement 1, S195.

Feldman, I., Wellander, L., Sampaio, F., Wells, M., & Sarkadi, A. (2014). Med manga bäcker att stämma i – hur ska vi prioritera och hur beräknar vi kostnaden? En förstudie om beräkningar av kostnader och potentiella besparingar vid förebyggande insatser kring barn och unga i riskzon.

DOWNLOADS & CITATIONS

ResearchGate, a personal website for individual researchers to share their work, says that my publications have been downloaded 969 times with an RG score of 15.14 (a score higher than 57.5% of other ResearchGate users). I’m not sure how many other downloads my articles have had, nor am I ultimately sure if nearly 1000 downloads is a high or low number–but it sounds like a lot of people are at least interested in downloading my research.

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In 2012 I had my first citation according to Scholar Google. Now, Scholar Google overexaggerates the citations, as it includes non-peer reviewed manuscripts, but still, others are reading my research and citing them.

In 2012, I had 5 citations, by 2013 that number over doubled to 13, and in 2014 my citations increased an additional 19, for a total of 37 citations. Will be terrifyingly interesting to see if these numbers continue increasing for 2015!

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These citations should be increased though, as I know I was cited in The invisible father: How can child healthcare services help fathers to feel less alienated? in Anna Sarkadi’s editorial, where she cites Gender equality in Swedish child health centres: An analysis of their physical environments and parental behaviours but instead called it Who is most welcome here? A qualitative study on Swedish child health centre’s environment from a gender perspective (a previous title we had given the same paper prior to its acceptance for publication—this is a nice reminder to always check and update CVs to make sure they include the latest article titles).

Beyond the citations, I am most grateful for being invited to three talks to discuss my research. Of course, like all researchers, I have attended and presented at several national and international conferences, but to be invited to speak at different venues highlights that others acknowledge the importance of my research and want to hear more about it. In fact, for the Barnhälsovård Nationell Konferens in Umeå, I had my flight paid for (first time to be compensated for a talk!).

Wells, M.B. (2014, Oct.). Advocating for Father Involvement in Swedish Child Health Care. Barnhälsovård Nationell Konferens (National Child Health Conference) in Umeå, Sweden.

Wells, M.B. (2013, Oct.). Fathers in the Swedish Healthcare System: Are They Treated Equally? Barnklinikens fredagsmöten (Children’s Clinic Friday Meetings) in Uppsala, Sweden.

Wells, M.B. (2013, May). Almost a Parent: The Treatment of Fathers in Sweden and Internationally. Välkommen till våra Vårluncher: Socialpediatriska forskargruppen (Welcome to our Spring Lunches: Social Pediatrics Research Team) in Uppsala, Sweden.

Most recently, the popular media has picked up on my research, and thanks to Dr Malin Bergström, I was interviewed for a piece on father involvement at the Swedish child health centers in the very popular Swedish parenting magazine Vi Föräldrar! The title of the piece is Äntligen! Papporna får Egentid på BVC (Finally, Fathers get their own time at the Child Health Centers).

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At the end of April I will finish my PhD and it will be interesting to look back at my accomplishments posted here, because I suspect nothing else will have been accomplished, since my focus will be primarily on my dissertation, as well as mentoring a final year medical student, attending two international conferences, and finishing writing another article (with Lisa Wellander and Dr Inna Feldman).

All in all, not a bad start!

To my Followers: New Traveling Website

I have noticed that many of my 27 follows (so many followers) have blogs about traveling; and therefore may not be interested in my fatherhood research.

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So, I have created a new blog called Swedish Traveling, which emphasizes my travels throughout Sweden, Swedish culture, and my travels throughout the world.

If you feel like this is more interesting, please feel free to visit my Swedish Traveling blog and sign-up to be a follower there.

Subsequently, I have removed the traveling blogs from my Researching Parents blog, so that that blog focuses solely on my research.

Families and Family Policies in Sweden: My Book Chapter

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A year ago I received notice that the book Handbook of Family Policies Across the Globe would be coming out in the summer of 2013. I was so elated, as Disa Bergnehr and I had spent time researching and writing a chapter of this book entitled Families and Family Policies in Sweden.

 

And then the book arrived and has been sitting on my bookshelf ever since, pulling it out to find sources or pretend to show-off by having my name in a book. But that’s because I know the material.

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The information in my book chapter is highly important. The chapter consists of Sweden’s family policies, ranging from domestic abuse to same-sex marriage to children’s rights to parental leave.

Anyone wanting to know more about Sweden and how it operates can easily read this chapter and get a nice overview of the benefits and struggles within Swedish family policy.

To see the abstract click here or read below.

To read an unpublished version of this book chapter click here.

To read my official book chapter and learn about all of the family policies across the globe, you can purchase the book here. The book includes reviews from 28 countries around the globe and from every continent (minus Antarctica).

Abstract:

Sweden is known as a social welfare state, whereby the people who reside in Sweden are entitled to certain public benefits at little or no cost to the individual. Over the past century, Sweden has reshaped its culture, growing from one of the poorest nations in Europe to a flourishing country that others emulate, especially with respect to their family policies. Sweden has developed several foundational family policies that have helped to encourage equality, while establishing a sense of individuality. Sweden has created similar rights for cohabiters/married couples, as well as for same-sex/opposite-sex couples. Parents receive a generous parental leave package, flexible employment choices, and there is a low gender wage gap, while children receive high-quality childcare, free health care, free dental care, free mental health services, and a substantial child welfare program. Swedish family policies encourage both parents to work and to help each other with household and childcare tasks. Despite the public benefits that Sweden provides for mothers, fathers, and children, there is still a need for further improvements regarding policies on domestic violence, poverty, and child welfare. Assessments of Sweden’s family policies are discussed.

Inequalities in Parenting Support for Fathers of Young Children in Sweden: ISSOP Conference Presentation 2014

The International Society for Social Pediatrics and Child Health (ISSOP) Conference 2014 was held in Gothenburg, Sweden at the Nordic School for Public Health.

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While at the conference, I had one oral and one poster presentation.

The oral presentation was entitled “Inequalities in Parenting Support for Fathers of Young Children in Sweden: Looking at Child Health Centers and Parent Support Programs.

Take-home message:

Sweden prides itself on gender equality and fathers have been show to be beneficial to child development. However, the Swedish child health centers and parents support programs create barriers to father entry.

If fathers are to be involved, then we must encourage them to come; and definitely not use the same tactics with fathers as we do with mothers, as they have different needs.

To see the presentation, please click on the attached powerpoint.

 

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There were about 60-70 people who listened to my talk, which felt great to have such an audience. But even better, after this talk, five different people approached me to congratulate my work, share their experiences, and to network. And two more expressed their interest via email after the conference.

One man came up to shake my hand, and then stepped away. I started speaking with others who had questions for me, but noticed that he started talking to my supervisor, Anna Sarkadi.

When I finally caught up with my group (having missed lunch thanks to all of the wonderful and interested audience members), I heard what the man talked to Anna about.

“We would like Michael to come give his presentation to all of the nurses in Umeå this fall,” he said.

“But he doesn’t speak Swedish. Do you think that’ll be a problem for the nurses,” Anna replied.

“I don’t care if it’s a slight problem,” he said. “This is information they need to hear.”

Nothing makes a researcher feel better than when others say that their work is  important :)

And so I will present at the Barnhälsovårdens nationella konferens (National Child Health Conference) in October 2014.

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I also had a poster presentation. This received much less attention, as posters normally do. I had printed handouts for both my oral and my poster sessions. After 2.5 days at the conference, only 3 poster handouts had been taken.

So when I went to give my oral presentation, I figured I’d lay them out, along with the oral presentation handouts. After my oral presentation, all handouts were gone!

My poster was called “A Qualitative Study on Parental Participation and their Perceptions of the Triple P Curriculum.”

Click on the poster below:

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ISSOP is a wonderful conference if you’re in the field of social pediatrics and child health.

Click here to read about my Social Pediatrics colleagues’ presentations, click here to read about how we brought our research to the streets of Gothenburg, click here to read about the ISSOP conference overall, and click here to see the pictures of sites I saw in Gothenburg.

Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden

Publishing aScreen Shot 2014-07-09 at 1.59.00 PM peer-reviewed article is always important in the academic world. Not only do you get to promote yourself and your abilities, but more importantly, you get to promote your findings. Better still would be for someone to pick up your work and institute change based on your findings.

It is our hope that Swedish politicians and bureaucrats take heed of the messages within this article, and further help in providing needed support to parents who struggle with child behavior problems.

Raziye Salari was the lead author on a paper entitled Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden. Anna Sarkadi and myself were co-authors.

The article is published in the Scandinavian Journal of Public Health.

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The abstract and link to the full article can also be found on my researchgate page.

Main message:

Although Sweden is seen as a country that promotes parenting and has lots of family policies to encourage strong parent-child relationships, parents in Sweden still may struggle with child behavioral issues. Therefore, support for these parents is still needed and warranted.

To see the abstract, click here (or read below):

Aims: We aim to examine the relationship between child behavioural problems and several parental factors, particularly parental behaviours as reported by both mothers and fathers in a sample of preschool children in Sweden.

Methods: Participants were mothers and fathers of 504 3- to 5-year-olds that were recruited through preschools. They completed a set of questionnaires including the Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting
Scale, Parent Problem Checklist, Dyadic Adjustment Scale and Depression Anxiety Stress Scale.

Results: Correlational analyses showed that parent-reported child behaviour problems were positively associated with ineffective parenting practices and interparental conflicts and negatively related to parental competence. Regression analyses showed that, for both mothers and fathers, higher levels of parental over-reactivity and interparental conflict over child-rearing issues and lower levels of parental satisfaction were the most salient factors in predicting their reports of disruptive child behaviour.

Conclusions: This study revealed that Swedish parents’ perceptions of their parenting is related to their ratings of child behaviour problems which therefore implies that parent training programs can be useful in addressing behavioural problems in Swedish children.

 

Now I can officially call myself a public health researcher!

 

Ph.D. Half-time Seminar: Parenting Support for Fathers in Sweden: The Role of Child Health Centers and Parent Support Programs for Young Children

On March 30th, 2014 I completed my half-time (halvtid) seminar at Uppsala University in Sweden. The title of my half-time was called Parenting Support for Fathers in Sweden: The Role of Child Health Centers and Parent Support Programs for Young Children.

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The half-time is important: It stresses that you’re half-way completed with your Ph.D. Since you should have four publications to earn your Ph.D. in Medicine at Uppsala University, two articles should be completed (or mostly completed) before hosting your half-time.

I, Michael Wells, am in Social Pediatrics (Dr Anna Sarkadi) which is part of the Department of Women’s and Children’s Health in the Faculty of Medicine at Uppsala University.

My half-time committee including Dr. Sven Bremberg, Dr. Pia Enebrink, and Dr. Birgitta Essen.

My half-time consisted of three studies:

  • Wells, M.B., Engman, J., & Sarkadi, A. Gender equality in Swedish child health centres: An analysis of their physical environments and parental behaviours. Accepted for publication in Semiotica: Journal of the International Association for Semiotic Studies.
  • Wells, M.B., Varga, G., Kerstis, B., & Sarkadi, A. (2013). Swedish child health nurses’ views of early father involvement: A qualitative study. Acta Paediatrica, 102(7), 755-761.
  • Salari, R., Wells, M.B., & Sarkadi, A. Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden. Scandinavian Journal of Public Health. (Revise and Resubmit).

Along with that, you should have taken two compulsory courses:

  • Introduction to Doctoral Studies (1.5 credits)
  • Introduction to Scientific Research (9.0 credits).

These are the only two mandatory courses a student has to take if they are in the Faculty (Department) of Medicine.

Thankfully I not only had taken those two courses, but I had also sat through several other lectures, including a week long lesson in York, England called Foundations of Economic Evaluation in Health Care (through the York Expert Workshops found here).

Only one other requirement is needed (and to be fair, it’s only needed before graduating): the Ph.D. student should also attend conferences, presenting at least two posters and one oral presentation. Thankfully I had completed this requirement, and therefore don’t need to worry about that before graduating (although I will still go to many more, as I love presenting my research and spreading the word about gender equality in Sweden).

Months before your half-time, your supervisor should select three committee members. This is because people are quite busy and trying to book them last minute can be quite tedious and even cause delays. These three committee members may or may not be at your Ph.D. defense, but they will provide valuable insight into your research by challenging your research, as well as providing guidance as you move forward with your final studies and framing the four manuscripts into a logical story (e.g. the red thread).

To see the official list (in Swedish) of the guidelines for half-time, click here (these may be specific to Women’s and Children’s Health, but provide good overall advice as well).

A Basic Breakdown of the Guidelines:

Three weeks before your half-time, you should email your kappa (aka jacka–as a jacka is jacket, while a kappa [your actual Ph.D. defense book] refers to a long overcoat; hence jacka is used as a funny term to describe being half-way completed) to your three committee members. Your jacka/kappa contains two things:

  1. The Jacka: This is a manuscript telling the story of your research, including your published studies, and a discussion and future research section. When writing the jacka/kappa, the Introduction should frame your studies into the larger picture of where your studies fit. Your studies, especially the Methods and Results sections are then added into the jacka, but severely trimmed down: so that they don’t exactly repeat what the articles say, but still can stand on their own, possessing all of the really important information from your studies. The Discussion section should be next, followed by a Future Research section, which typically highlights your other papers that will comprise your Ph.D. defense. These are added in so that the half-time committee can understand how all of the studies tie together, as well as provide advice on the additional papers. A basic abstract is warranted on each manuscript in the Future Research section.
  2. Attach the full-length studies your half-time is based on (whether actually published or in manuscript form). This is done so that the half-time committee may read more specifically what you have done. All three committee members may or may not fully read your actual articles, which is why the jacka is so important.

About a week before the half-time defense, your half-time is made public (i.e. university emails are sent out reminding everyone of your seminar and when and where it’s located). People may or may not show up.

Screen Shot 2014-04-02 at 12.29.04 AMPreparing for your half-time is extremely important; after all, you’re representing your supervisors, your research team, and of course yourself. Plus, making good impressions on your committee may help lead to further job prospects. Dr Raziye Salari helped me tremendously in preparing for my half-time, especially in understanding my statistics on a deeper level (specific statistics questions may or may not be asked, but confidence levels sure rise if a greater level of understanding is achieved [aka learn as much as you can]). But to see a list of the Top 10 most frequently asked questions, click here. Knowing the answers to these questions will greatly help when preparing for your half-time or a Ph.D. defense!

The total half-time defense lasts for about three hours. The day of the half-time consists of several things:

  1. Make sure lunch and fika (snacks) are ordered as appropriate
  2. Give a 20 (to 30) minute presentation to the general public and your 3 committee members
  3. Defend your thesis and participate in a constructive research dialogue with your 3 committee members in front of the general public for about an hour and 45 minutes
  4. Committee members meet privately with your supervisor and co-supervisors to discuss your progress
  5. Committee members meet privately to decide if you’ve passed your half-time
  6. Your supervisor is notified by the committee members, who then informs you of the decision
  7. Pay raise is given :)

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Attached here are my powerpoint slides, as well as my half-time jacka (even with the various editing errors that I realized after I had sent it out).

Parenting Support for Fathers in Sweden Half Time Jacka

Parenting Support for Fathers in Sweden Half-time Jacka Pdf

 

 

After the committee deliberation, I found out that I had passed my half-time!

 

Bringing Swedish Lessons to Australia: Presenting at the 16th Annual Helping Families Change Conference

I recently had the opportunity to present some of my research findings at the 16th Annual Helping Families Change Conference (HFCC) in Sydney, Australia. In order to see a list of all the presentations, along with most of their respective powerpoints, click on this HFCC link or click here to read presenters’ abstracts.

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The symposium I was in was called Parenting in a Cross-Cultural Context, and I was able to present next to Dr Rachel Calam from the University of Manchester and PhD Candidate Konstantinos Foskolos (his ResearchGate link) from Oxford University. Another researcher, Dr Susan Stern from the University of Toronto was supposed to present her findings, but unfortunately she fell ill right before the conference.

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Dr. Calam was presenting on behalf of one of her students who couldn’t make it to the conference. They had completed an RCT in central America, showing that parents (mothers) who received Triple P could benefit from the program.

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Konstantinos Foskolos presented his findings from his RCT on Cypriot parents (mothers) receiving Triple P, although some of the findings were not significant.

Below is his powerpoint presentation (click on it to open the full powerpoint):

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I, Michael Wells, along with Dr Raziye Salari presented findings on which background factors mothers and fathers have when comparing those who do and do not participate in a universally-offered, practitioner-led parent support program (Triple P).

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As it turns out from our Swedish sample, mothers possessed 5 characteristics that made them more likely to participate: 1) if they were born in Sweden, 2) had a college degree, 3) were overreactive with their parenting, 4) had a boy, and 5) if they perceived their child as having behavior problems.

Fathers were more likely to participate if they perceived themselves as stressed and if they perceived emotional problems in their children.

Clearly mothers and fathers participated for different reasons. Therefore, when marketing a parent support program or when giving the intervention, practitioners should be aware of the parents’ different needs, especially if trying to recruit and retain fathers.

In other words, just talking about behavior problems in children will not get fathers in the door nor keep them attending sessions–as they are not concerned with this problem, mothers are. Fathers would like more information on how to manage children’s emotional problems.

Additionally, we found that the more background factors a parent had, the more likely they were to attend. Therefore, if mothers were only struggling with behavior problems, but did not have a college degree, were from another country, had a girl, and didn’t overreact when managing their child’s behaviors, then they weren’t likely to attend, even though they could still benefit from the program.

Therefore universally-offered programs may be reaching the parents most in need, but that doesn’t mean they’re reaching all of the parents in need.

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In another symposium entitled Implementation Issues: Current and Future Issues of Significance, my co-researcher, Dr Raziye Salari, gave a presentation. 

Dr Raziye Salari also gave a presentation on marketing parenting programs to families through online advertisements. One picture had a preventative message, while the other showed a promotion ad. The prevention picture is highlighted by a child giving “the finger” while the promotion ad is highlighted by a child giving the peace sign–with the idea being that you either don’t want this to happen to your child or come get the skills so that life can go well.

Dr Salari and her co-researcher, Anna Backman, concluded that while the prevention ad receives more clicks, neither program is more likely to have parents actually sign-up for the parent support program; These findings are contrary to the theoretical work that these researchers found, where parents stated that they would be more likely to join if they saw the promotion ad.

However, both ads may attract different parents, and therefore both types of ads should be used when trying to promote a parent support program to parents.

Click here to read about the conference as a whole.

16th Annual Helping Families Change Conference 2014: Sydney, Australia

The 16th Annual Helping Families Change Conference (HFCC) was held on February 19th – 21st, 2014 in Sydney, Australia.

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After receiving a travel grant from FORTE, I was on my way to the land down under. I attended the actual conference (2 days), while sadly, missing the day prior to the conference; the workshop.

Screen Shot 2014-03-17 at 1.12.05 PMThis was sad, as I had heard several people talk about how amazing the talks were; and for me, I wish I was able to hear the talk on father involvement (a talk that at least 7 people told me was great to listen to) given by Dr Louise Keown and Tenille Frank (PhD Candidate).

The Audience: About 300 researchers, practitioners, and policy makers attended the conference. Most speakers appeared to be researchers, while most audience members seemed to be practitioners (with a few policy makers sprinkled in). People were very easy to talk to, friendly, and helpful!

Peculiar Phrases: An interesting outsiders note was that nearly every keynote speaker gave a nod to the indigenous people of Australia. I found it peculiar to thank the indigenous population for allowing research to occur on their land–after all, most Australians were born in Australia. Click here to read a bit about Australia and their reconciliation ideas for past wrong-doings.

Another interesting factoid was that nearly all speakers said “Parent support programs, like Triple P,…” It was just peculiar to constantly hear that phrase repeated.

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Keynote Speakers: The conference had a number of keynote speakers, and they were, as a whole, quite good at discussing research, while speaking in practical tones and relating the importance of the findings to practitioners. Really, a great way to connect with all members of the audience. To see the keynote speakers’ powerpoints (and nearly every other presenters’ powerpoints) click this HFCC website.

In fact the whole first half of each day was devoted to keynote speakers. To see a pdf list of all of the keynote speakers and the titles of their talks click here and click here to see a pdf of everyone’s names and abstracts. Or consequently, you can click here to see the webpage with all of the abstracts.

20140219_233204Being a conference that promotes Triple P – Positive Parenting Program, Dr Matthew Sanders spoke, both at the workshop and as a keynote speaker, and is fantastic to listen to. He, perhaps giving a nod to some of my co-researchers in Sweden, spoke about the past, present, and future of parent training programs, and specifically talked for a while on the cost-effectiveness of a population shift.

20140220_013020Another wonderful talk was given by Dr Rachel Calam from the University of Manchester speaking about reaching vulnerable families.

The Venue: HFCC was held at the Sheraton in Sydney–a very lovely hotel, with fast internet, and amazing food. In fact, I can honestly say that we were served the best seafood, salads, meats, and desserts that I’ve ever had at a conference! It was served buffet style (always risky on quality), the food was quite good quality…and never-ending.

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Posters and Symposium: Since half of the day was spent listening to keynote speakers and the other half listening to symposiums, there weren’t many posters, and posters, although on display during the whole conference, were only subject for review during lunch. And therefore, I felt that the posters weren’t given a lot of respect.

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Having said that, I noticed a unique feature about the posters–it was really hard to find a poster that just discussed one study. Most of the posters were either grouped studies or were theoretical/methodological. In other words, if you want to present your findings on a particular study at HFCC, give a presentation.

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The symposiums were well attended, with 20-30 people listening to the symposium. Having been at conferences where the only audience are the speakers, this was great. And the audience, mostly practitioners, were quite keen on what they could take away from the talks. Therefore, the talks that were less researchy and more applicable received more attention from the audience (aka–less stats/more findings and implications).

Overall, the conference was of high quality on all accounts: organized very well, with email reminders being sent, devoted and friendly staff helping to find symposium rooms, great opportunities to network, passionate keynote speakers, and they even collected the powerpoints from the various symposiums so that others could have access to the talks after the conference. To see those powerpoints, click on this HFCC website, and then feel free to rummage through and find the talk you’re looking for :)

Click here to read about my presentation at the conference.

First (book chapter) publication: Using Semiotics to Research Father Involvement in Sweden Child Health Care Centers

In the summer of 2008, I flew over to Sweden for the first time. In fact, I flew the day I graduated from Ohio State University with my master’s degree in Human Development and Family Science.

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I was offered a 3 month summer job doing fatherhood research for Dr Anna Sarkadi (see her blog here), Uppsala University.

I was quickly assigned to travel around Sweden in order to see why fathers weren’t visiting the Child Health Centers (Barnavårdscentral [BVC] in Swedish) as often as mothers. I went to 6 different counties; heading into cities like Stockholm, Gothenburg and Uppsala to rural areas like Tanumshede and in between places like Mora and Leksand.

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I set off to find out what some of the barriers and obstacles might be by interviewing nurse from the Child Health Centers on how they involve fathers, as well as assessed the waiting room environment.

Assessing the waiting room was quite novel and unique. We used a process called semiotics, which helps people to understand a picture at both its manifest and latent level. The manifest level tells exactly what’s seen in a picture, while the latent analysis tells what is meant by that picture.

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So for example, when looking at gender differences:  At the manifest level, these pictures on the bulletin board shows a woman running (physical activity), while a man is smoking (tobacco habits). The other two pictures are not of people, and therefore are excluded from this analysis. Latent: These pictures convey a positive health message about women and a negative health message about men.

Before this analysis, semiotics was just used to describe one picture. What we’ve since done was to say that an entire environment can be assessed using this technique. So we (Jonas Engman, Anna Sarkadi, and myself) analyzed each picture of men, women, and children (differentiating men from fathers and women from mothers if there were or were not children in that picture) and then tallied them up to see how many messages on the manifest level were there related to men/fathers, women/mothers, and children and then how many of those were positive or negative.

If the room was mostly equal between these three groups, then it was termed Family Oriented, meaning that all members of the family were welcome. However, if one of the family members was missing, then different terms were used such as, mother-child oriented, woman oriented, and child oriented. A fifth group was termed neutral, as there were no pictures of people on the wall within the waiting room.

My first book chapter was published with co-author Jonas Engman in the Swedish-written book Föräldrastöd i Sverige idag – Vad, När, och Hur? (Parental Support in Sweden today – What, When and How?

The book chapter is linked in here: BVC Book Chapter

My chapter

The English article is published in the journal Semiotica.

If you analyzed this picture, what would be the manifest and latent analysis (viewing only the picture, not the words):

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Presenting to Swedish Pediatricians on the Fathers’ Role within Hospitals

At the end of May 2013, I was asked to give a presentation on father involvement in the international medical sphere. Click here to see that posting.

The talk was so well-received that Dr Jan Gustafsson, the head of the Department of  Women’s and Children’s Health, which is part of the Faculty of Medicine at Uppsala University, asked me to come to a Friday lunch.

I was asked to expand my talk from 20 minutes into an hour long presentation. What a great honor to highlight a topic that I’m so passionate about!

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Since I would only be speaking to pediatricians who work at the University Hospital (Akademiska Sjukhuset) in Uppsala, I tailored my lecture towards them, focusing only on Swedish medical research related to father involvement, and of course including my take on the pictures/posters/brochures that were advertised throughout their hospital and how those represent (don’t represent) fathers.

See the slides from my talk here:

Fathers in Swedish Child Health Care

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The room was packed with 20-30 pediatricians. However, they were mandated to be at my lecture, so I was a bit unsure of how intrigued they would be.

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To my chagrin, the pediatricians didn’t challenge me on how medical staff in Sweden treats fathers compared to mothers

Screen Shot 2013-11-20 at 1.00.51 PM(although I was challenged a couple of times on the concept of father involvement and how important their role is–despite citing literature and showing text books).

After the talk, many pediatricians asked questions and acknowledged that they didn’t treat fathers as equally as mothers.

But some who spoke stated that they wanted to change their behavior:

One pediatrician told me that she only calls the mother, except when she doesn’t have her phone number, but now would start consciously thinking about calling fathers.

Another person said “maybe we should rethink our Department name: ‘Women’s and Children’s Health’, and call it something else like ‘Family and Children’s Health.'”

Maybe nothing will change within the hospital setting, but I had done my job–provoke the pediatricians to start a discussion on increasing their responsibilities in involving fathers. Step 1 accomplished.

Google and Father Gender Equality

There is a new UN campaign that uses Google to make a point on women’s rights by typing in simple search terms into Google (i.e. women can’t, women can, women shouldn’t, etc) and seeing what the auto-fill completes.

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Click here to see the UN Women Ad Campaign.

Naturally, as the ad campaign wanted me to feel, I felt quite appalled at the search terms people use for “women”.

As a fatherhood researcher, I wondered what search terms people use. Unfortunately there seemed to be a lot of songs about fathers, like when I type “fathers cannot” or “fathers can” I get the following responses:

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Two out of the four auto-fills for “fathers can” suggest that people search for the extent that fathers can be involved– they can “support breastfeeding” and they can “be mothers”.

Below are other findings using different search terms:

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These search terms suggest that people are still craving knowledge about the fathers’ role (e.g. “can fathers…”, as well as fighting for fathers’ rights (e.g. “fathers are…”).

However other fill-ins belittle fathers (e.g. “fathers are the curse,” “why father’s shouldn’t change diapers”).

Being asked to present to Swedish doctors on father involvement

Social Pediatrics sits just beyond the others in the Faculty of Medicine (and even beyond those in the Department of Women’s and Children’s Health) at Uppsala University, both literally and figuratively.

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So, in order to help bridge that gap, Anna Sarkadi, the leader of the Social Pediatrics Research Group, thought that it would be a nice idea to bring in three presenters to speak about important topics related to health, while at the same time promoting our team by hosting the presentations and having a poster session prior to the presentations.

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One guest speaker came each month for three months to give a 20 minute presentation on some topic involving families and health. Click here to see the monthly schedule of speakers (written in Swedish and English depending on the presenters language).

Screen Shot 2013-09-04 at 11.45.43 AMThe first speaker was Sven Bremberg (pictured left), a huge name in Sweden, especially when talking about child health, is an Associate Professor at Karolinska Institutet in Stockholm.

Bendeguz Nagy, a Hungarian traveller, explores the world in his wheelchair, allowing him to photograph and experience the world from a different view-point. He gave a speech on a few different cultures he encountered, highlighting through pictures the differences in family life. To see some of his pictures click here for his photography website.

The third presenter was myself, Michael Wells, who talked about father involvement within the healthcare field in Sweden and Internationally. Click here to see the slides from my presentation.

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Unfortunately, beyond our research group, only a handful of people showed up for Sven’s and Bendeguz’s talks, so I wasn’t expecting much of a crowd. So when I saw that the room was not only packed, but people were standing, I thought that this must be an important topic that Swedish medical workers care about.

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The talked reverberated with the audience, with several people afterwards giving testimonials as fathers, while workers from the hospital described how they involved (didn’t involve) fathers. Since the talk was such a hit, Jan Gustafsson, the Head of the Department of Women’s and Children’s Health, asked me to come to a lunch seminar for all pediatricians in the fall of 2013 to present for an hour and 15 minutes on the topic of father involvement in healthcare.

A Quantitative Look at Preschool Teachers’ Retention: A Study on Head Start Teachers

 

Screen Shot 2013-09-02 at 10.39.13 AMI was just at the 23rd EECERA Conference: Values, Culture and Contexts hosted by the European Early Childhood Education Research Association (EECERA) in Tallinn, Estonia where I gave a presentation entitled A Quantitative Look at Preschool Teachers’ Retention: A Study on Head Start Teachers. Click here to see my presentation.

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I presented in an oral session under the heading Leadership and Quality, which felt quite fitting, as this research was completed in an effort to improve the quality of classroom instruction by motivating the leadership to make

Screen Shot 2013-09-02 at 10.53.59 AMneeded changes in order to keep preschool teachers teaching. My research was on head start teacher retention, and comparing those preschool teachers who stayed versus those who quit working for Head Start. I found that the reasons preschool teachers quit are due to five main factors: the center director (their boss), their stress levels, their amount of paperwork, their wanting to stay in Early Childhood Education as a career and their level of higher education.

There were two other presenters in this session: Elina Fonsen from the University of Screen Shot 2013-09-02 at 3.32.20 PMTampere (Finland) who gave a presentation called “Dimensions of pedagogical leadership in Early Childhood Education and Care” and Geraldine Davis from Anglia Ruskin University (UK) talked about “Graduate Leader Plus. Making a difference beyond education.”

Elina promoted her new book chapter, while Geraldine discussed teachers’ education levels and the benefits from those who participated in Leadership Plus.

Read about the overall aspects of the conference here.

To read more about Tallinn, Estonia (and the Old Town in Tallinn) click here.

Sixth Parental Group Meeting:

This is the last parent group meeting pre-children. It was held in the morning (second meeting at this time point), and every parent showed up for this final meeting.

The meeting opened with a psychologist talking about the post-pregnancy blues. She defined that has the mother having a lot of hormonal changes, often leading to crying, especially for the first three days, as well as having symptoms of depression.

The psychologist further stated that if the depressive symptoms lasted for 10 days or more, then the parent (either the mother or the father may have postpartum depression) should call the psychologist (who seemed to be funded through the antenatal clinics).

Her main message:

  1. Don’t be too hard on yourself
  2. Call a psychologist sooner rather than later
    • So symptoms don’t get worse
    • The parent can start receiving support.

The midwife then took over and advised us to break into groups, while eating fika, to discuss how we currently divide our time as a couple and for personal time (today) and how we plan to divide our time as an individual, a couple, and as a family once the baby arrives.

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The midwife though didn’t offer any sage advice. Rather, she simply listened as each group described their time spent with the family, the relationship, and by themselves.

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Our answers: Notice our alone time didn’t change, but we increased our overall family hours by 14 hours believing we’d receive 2 hours less sleep per night spent on the baby.

She then thanked us and wished everyone a Merry Christmas!

We will meet one more time in March, after everyone has their baby.

Fifth Prenatal Parent Group Meeting: Visiting the Labor & Birth Ward

At the fifth prenatal parent group meeting we were told to not come to our usual meeting place; instead, go to Uppsala’s Academic Hospital.

Everything suddenly became so real. The ultrasound brought the baby to life. Charting the growth of the uterus was exciting!

Going to the hospital where my baby will one day be born = slightly scary and exhilarating.

One couple and one expectant father did not show up to this meeting. The rest of us searched for where we were supposed to go….but luckily we had found each other :)

Eventually we worked our way down to a basement, and found the rest of the group. A midwife from Hjärtet met us there, introduced us to another midwife who works in the labor & birth ward, and then left us with her, while we got the grand tour.

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We started by seeing the waiting room, where we were told that while expectant mothers are fed, there is no food for the expectant fathers; therefore, they are encouraged to bring their own food, label and date it, and put it in the fridge. Or they could go upstairs and buy food at the food court (if you happen to give birth during normal business hours).

Then we made our way to the bathing area. There was a large bathtub that expectant mothers are encouraged to go in while they’re in labor. There’s even enough room for the expectant father; although we’re told he should wear a bathing suit (apparently because the medical staff may walk in, and for some unknown reason, seeing a naked man, but not a naked woman, is unacceptable).

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Then we made our way to a potential birthing room. It was dull and drab. The midwife pointed out that there were no curtains. And then pointed out that we should feel free to bring objects and entertainment with, since we could be there for several hours before actually giving birth.

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We all sat around the rim of the room, while the midwife sat in the middle, demonstrating to us different tools that could be used, as well as different ways expectant mothers could use the room.

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The size the baby will be, along with a demonstration of holding the baby, resting on the mothers’ chest, and cutting the umbilical cord.
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A cord used to measure the infant’s heartbeat.
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A close-up of the bit that actually measures the heart beat.
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A manual vacuum extraction pump.

This was a very informative visit, and let expectant parents know what to expect, see where to go, and feel more comfortable in their soon-to-be surroundings.

Side note: Interestingly, nearly all of the expectant fathers asked various questions about the birthing process, the medical instruments the midwife described, and made joking comments, while only one expectant mother (Lisa) asked a question.

Second (cultural) side note: There was one comfy leather chair to sit on, while nearly all other chairs were hard metal (e.g. not comfortable). In typical Swedish fashion, no one took the comfy chair until the last couple came in. And then the expectant mother sat on the only remaining metal chair, giving the comfy leather chair to the expectant father….a few minutes later he got up and gave it to his partner.

 

Fourth Prenatal Parent Group Meeting: Tragedies of Giving Birth

At the fourth prenatal parent group meeting we discussed some of the complications and tragedies of childbirth.

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Some people did not attend this meeting. While all of the previous meeting had been held in the afternoon, this was the first meeting held in the early morning. One couple came late (traveling from Uplands Väsby), one researcher couple did not attend, and an expectant father (who lives in Örebro).

All expectant parents who attended noted how tired they were.

Quick side note: The midwife always uses the term “pappa/partner” despite the fact that everyone is an expectant father, and one person will be an expectant grandma.

The meeting kicked off by having a child health nurse from the child health centers (barnvårdcentral [BVC]) come in and introduce herself, as well as discuss what the BVC is good for:

  • A place to visit while the child is 0 – 6 years old
  • Do child health check-ups (preventive work)
    • Growth and development
    • Weight and height
  • Offers parenting advice
  • Parent education classes during the infant’s first year

Then the midwife re-entered the room to start discussing the complications of pregnancy.

Pre-Birth

A rehash from the third meeting was stated–where expectant parents should stay comfortable prior to coming to the hospital via massages, baths, and doing other soothing activities (e.g. petting your pets).

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When to go to the Labor & Birth Ward

We were instructed to go to the labor and birth ward not when the expectant mothers’ water breaks, but when she has had three contractions in the span of ten minutes. Each contraction, we’re told, should last for about a minute and will be intense and mildly painful (I say mildly only in comparison for what’s to come).

Prior to this, she may have a contraction every hour (or even more often), but if they are that far apart, there is no reason to rush to the hospital.

We’re told that the water breaking can be quite different for different people. Some actually have a gush of fluid come out of their vagina, letting everyone around them know they’re going into labor soon, while others have little to no liquids leaving their body.

Ways to Give Birth

There are a variety of ways to give birth–laying on your back, kneeling, standing up, in water, etc. In Sweden, we’re told by the midwife, that they encourage expectant mothers to walk around, to use their hospital room, to use a pilates ball prior to giving birth.

If expectant mothers are having pain, they can use epidurals, laughing gas, sterile hot water, acupuncture, and a few other things. Little information is given about the consequences of using any of these methods; although each method is described (e.g. how it works, how you feel if you take it).

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Different methods of pain relief.

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A Normal Birth

We were told by the midwife that in most cases, parents have a normal birth, meaning that they do not need to have a cesarean section, that the father will cut the umbilical cord, and that the baby will immediately start to breastfeed, while the mother is topless (skin-to-skin contact).

Immediately following birth, the baby will be placed on the mothers’ chest, and be encouraged to start breastfeeding. After one to three minutes, the umbilical cord will be cut. We’re told that this will allow all of leftover nutrients still in the umbilical cord to reach the baby.

The placenta, we’re told, should come out within the first 30 minutes. If not, a procedure will need to be done in order to remove it.

Breastfeeding
The importance of breastfeeding immediately following birth and the baby’s first meal is stressed. Apparently there are extra vitamins/nutrients in the first eating that are stored in the mothers’ breast; therefore, expectant mothers shouldn’t try to pump breast milk prior to giving birth. This process could take a while, and complications do arise with baby’s potentially not having a good sucking reflex. Of course, mothers may also experience tender nipples.

The Fathers’ Turn

Due mainly to breastfeeding, after the mother has had the infant for about an hour, the father can than start to hold the baby, with skin-to-skin contact being the preferred method.

Vacuum Extraction

Some infants require birth via vacuum extraction. This can happen in one of two ways-either they put a suction-cup on the baby’s head via the vaginal canal and then pull the baby out using the strength from their hand (and only pulling when there are contractions) or to use an electrical machine that does basically the same job as the manual vacuum extraction.

Doing this, we’re told, will not damage the infant, but will leave a red mark (bruise-like feature) on the top of the baby’s head (where the suction-cup was placed).

Acute and Super Acute Cesarean Sections

While some expectant mothers will have a planned cesarean section, others, she warned, will have either an acute cesarean section or a “super acute” cesarean section.

The main difference refers to the amount of prep time doctors, midwives, nurses, and other staff have to prepare for the cesarean section. In a typical acute situation, the midwife said that they normally have about thirty minutes to prepare pre-cesarean. Life is less chaotic for the expectant parents and for the medical staff. However, if a “super acute” cesarean needs to happen, then it means that either the infant or expectant mothers’ life is in danger and the infant needs to be removed (for lack of a better word) immediately. In this scenario, medical staff have maybe up to 15 minutes to prepare, and the expectant parents’ hospital room is typically swarmed with multiple medical personnel, which can cause not only chaos between the two expectant parents, but also added stress, frustration, and alarment. Therefore, it’s important to be aware that this scenario could happen.

After the C-section

We were then warned by the midwife that after a cesarean section, the new father would be handed the baby, and they would be left to their own devices for probably 2-4 hours, while the mother is taken to an operating room to be sown up and recover from surgery.

Only after she’s alert again, will the father, infant, and mother finally unite as one family, and breastfeeding can then commence.

Conclusions:

Since many expectant parents can have great amounts of fear regarding giving birth, it’s great to know what your options are and what to expect. This meeting provided a lot of useful advice.

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Lisa took copious notes.

 

Third Prenatal Parent Group Meeting: Preparations for Birth

At the third parent group meeting we discussed what would happen right before you go to the hospital to give birth.

No one was missing, except my partner.

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We first went over topics we had discussed at the previous meeting (e.g. relationships), and then started jumping into preparations for giving birth.

We were all handed a book on breastfeeding (slightly weird, since we talked at length about breastfeeding during the first meeting).

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The midwife checked in with all people present about their current pregnancy situation–one by one. In other words, expectant mothers were not given any extra time or questioning compared to expectant fathers.

Most expectant mothers complained about losing sleep, changing their walking habits, and looking forward to not being pregnant. While most of the guys either agreed with their partner or restated similar sentiments.

Two women complained about a pain in her side. The midwife, later in the evening brought up this ligament in her talk, and suggested that due to the baby growing, the pain from the ligament could affect every expectant mother.

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Since Lisa wasn’t present, I spoke for her, saying that she was losing sleep, but that she was waking up a couple of times a night due to her acid (no solutions or suggestions were provided).

I then said that I was losing sleep and needed to support Lisa during the night with her acid. This was met with laughter from the parents, with one expectant mother exclaiming “oh, poor you.”

“No seriously,” I replied. “And I can see the lack of sleep starting to affect both of us. Now not just one person is irritable, but two people are, which can add to various relationship problems.”

People still laughed, although not as much as the first time. The midwife waited a second before moving on to the next person. Actually, in thinking about it, not only did the midwife not validate my concerns, but she failed to provide any insight to any individual or couple–she let everyone talk about their problem(s), but offered no sage advice or even thoughts.

Sage Advice

After we were all done sharing our problems and concerns (and joys) related to the pregnancy, the midwife then went over several “useful” tips for preparing for birth.

  • Take baths to relax your body
  • Have your partner give you a massage
  • Do relaxing things in your house
  • Play with your pets
  • Take a shower/bath before going to the hospital
  • Eat food before going to the hospital

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We then did a basic profylax course. Profylax is a type of massage that you can give to your partner to make them feel better. There are whole courses that you can take (for a fee) that teach you how to do profylax massages so that when you give birth, your partner can massage the expectant mother to 1) make her feel more comfortable and 2) give the expectant father a role in the birthing process.

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A couple practicing profylax

Side note: I heard from people who took the profylax course that the course had good information, brought the couple closer together (in that they were now both focused on the pregnancy and the importance of giving birth), but that it wasn’t necessarily worth the money. (Sadly I can’t remember how much it costs, maybe 2000 SEK? or thereabouts).

Partners’ Role

The partners’ role was quite basic–be there for the expectant mother. There was little discussed in the way that expectant fathers are important and that they have a right to be at the birth; let alone, what the experience of being there means for the father, for the couple, and for the family. Father’s (partners) were discussed, but mainly in terms of taking care of the expectant mother, and mainly via making her feel comfortable (destressing her in various ways, especially via massages).

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At the end of the meeting, I approached the midwife to go over the highlights from the night (just to make sure I understood everything–after all, I knew Lisa would be asking). After going through the key material, she also handed me an extra book on having a baby (in English)…just to make sure I understood everything that was in the seminar.

Second Prenatal Parent Group Meeting: Relationships

Unli2000px-Svenska_kyrkan_vapen.svgke the first prenatal parent group meeting, not everyone showed up. Two couples did not come: expectant mom/dad who live in Uppsala and an expectant mom/grandma who live in Upplands Väsby.

This second meeting was not led by the midwife, but rather by two people from the Swedish church.

Their topic of the day: Relationships.

They talked a bit about the importance of maintaining a healthy relationship (surface level information): life is tough, having a baby complicates the relationship, make time for each other, support each other, etc.

They then kept the meeting quite interactive, either in small groups, as a large group, or with your partner.

We then broke up into groups, purposefully separated from our partners. In these groups we were to discuss what we need to have a strong loving relationship.

Expectant parents discussed typical things like supporting each other, listening to each other, discussing financial issues, and help each other feel good (see complete list [in Swedish] below).

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After this, we broke for fika. During fika, several expectant parents joked and commented that we were receiving relationship advice from two members of the Swedish church. Apparently, being connected to the Swedish church, at least as far as relationships is concerned, isn’t so highly respected.

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When class started back up, we played a game: To what extent do you agree with the following financial statement:

  • I charge all of my items on a credit card.
  • I just want to have new products for the baby.
  • I like to save as much money as possible.
  • I want to buy used baby products.

If you completely agreed, we were to walk to a woman and if we disagreed, we were to walk to a man (or end up somewhere in between). This would then inform us where we stood, especially relative to our partners. After talking with a few couples (and my own relationship)–no one seemed surprised about where they and their partner ended up. In other words, we all seemed to at least know the spending habits of our partners.

We then met one-on-one with our partners to discuss three things that we think will make our partner a great parent.

The night finished up with some communication tips:

  • “I statements” were emphasized
    • I feel; I need
  • Remember to take a step back before having a big discussion
  • Talk with each other when you start having feelings about something

Then just to be cheeky, I wrote”make-up sex”.

Turns out the leaders actually liked this (or it was coincidence), because then they went into a 10 minute diatribe about the importance of maintaining a healthy sex life and to talk with each other about your sexual feelings.

We then wrote down on a piece of paper things that turn us on–and we were to discuss that with our partners once we went home.

Lacking Couple Relationships within the Context of Parenting
The information covered was fine and fun, but had little to do with becoming a parent. I felt like the leaders could have tailored the meeting better to talk about relationships pre- and post-children: what to expect, and how to deal with problems while raising a child.

For example, how not to fight in front of the child, how the baby alters relationship roles, how conflicts can intensify when new parents are stressed and lacking sleep, how conversations become duller because of exhaustion from parenting, etc.

Oh well–you get what you pay for (#free).

 

 

A Discussion on Fatherhood with Swedish Child Health Professionals

Starting in 2012, a conference is organized once a semester for those child health professionals in Stockholm working in the prenatal clinics, child health centers, preschools, and social services with children (aged 0-6) and their families.

The conference was organized by Åsa Heimer and Catharina Neovius.

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A large hotel where the conference was held in Rinkeby-Kista.

In March of 2015, the conference topic was on the importance of fathers. Mats Berggren from Män för Jämställdhet (Men for Gender Equality) and myself would be giving the main lectures for the day. 

Those in attendance are all Swedish-speaking (while I’m not so much), and they mainly work with non-native Swedish families (around 80% of their families are not originally from Sweden), with many of them working in the Rinkeby-Kista area (Stockholm).

I didn’t see a huge difference in how these professionals should treat fathers, based on their country of origin (except to note that some fathers would be less involved and feel like they should be less involved in childrearing compared to Swedish fathers). However, since the Swedish child health field typically doesn’t involve fathers via providing them with support (at least not to the same extent as mothers), I felt like the advice could be more general and simple:

                   Treat mothers and fathers similarly, by giving                                                    them each the individual support that they require.

So I made both an English version (not presented) and a Swedish version (presented).

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Click on the picture to see the English presentation.
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Click on the picture to see the Swedish presentation

The audience, however, was much larger than I expected. There were maybe 100+ professionals eagerly listening. In addition, they didn’t want to hear research, but rather more practical advice on how and why to interact and involve fathers–so that’s what I tried to gear my talk towards.

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Having worked in Quality Assurance in Head Start for three years, you come to quickly realize that no one likes their jobs being critiqued. So I was super-glad when several audience members spoke up acknowledging the problems they face, watching professionals take notes, and having all of my printed copies of the powerpoint snatched up.

I then received a wonder gift package for presenting :)

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My only regret was not approaching these professionals individually and in small groups afterwards to get their feedback–after all, I’m not lecturing to hear myself, but because I believe that behavior changes are important, but difficult and that we all need to work together to make the important changes that we desire.

Neurobiology of Parenting Conference (2015): Swedish Child Health Fields’ Treatment of Fathers

The Neurobiology of Parenting Conference (2015) took place in Stockholm, Sweden. The conference was organized by the Swedish Society of Medicine, but also with Acta Paediatrica (an academic journal), Sällskapet Barnavård, John Lind Stiftelsen, and Karolinska Institutet

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Swedish doctor holds his cigar: A bygone time of medical astuteness that’s still amply displayed at the Swedish Society of Medicine.

There were probably 150-200 people, with researchers from around the world attending.

Great view from the windows of the Swedish Society of Medicine.
Great view from the windows of the Swedish Society of Medicine.

I have been locked into the psychological world of parenting, only minorly breaking out into public health and sociology. Therefore, learning about the neurobiology of parenting was a true gift and opened my eyes to a wealth of research that I hadn’t contemplated (or as the colloquial axiom goes: you don’t know, what you don’t know).

Naturally, a history lesson helped kick-off the conference.

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It was interesting to see all of the research on skin-to-skin contact.

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As well as the research on the alleged plasticity of the human brain with respect to parental caregiving. Apparently our brains can change based on the amount of caregiving we do (or at least that’s a basic way of stating intricate diagrams).

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In other words, fathers can be just as caring and sensitive as mothers, but they need to take on primary parenting roles for these chemical changes to occur. This flies in the face of previous research which suggested that mothers gain their maternal instincts by virtue of being pregnant and the chemical changes that occur during gestation.

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I presented less on neurobiology (since that’s certainly not my field) and more on the Swedish child health field’s attitude and (lack of) support they provide fathers.

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My poster based on my PhD dissertation.

Despite my poster not being on neurobiology, I ran into several other researchers who were interested in my research and who, themselves, conducted very similar research….so I fit right in.

The 2.5 day conference may not have been my area of expertise, but I still learned a lot, and will use a lot!

Education, Health, Mental Health, and Public Policy

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