Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women

The researchers’ aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.     

A Randomized Control Trial of Using Baby Books to Reduce New Mothers’ Feelings of Stress and Depression

Maternal and Child Health Journal - To determine whether embedding educational information about child development and optimal parenting practices from the Bright Futures Guidelines for Health...     

Is Gender a Risk Factor for Pesticide Intoxications Among Farmers in Bolivia? A Cross-Sectional Study

ABSTRACT

This study compares gender differences regarding knowledge, practice, and symptoms of intoxication when handling pesticides in farming. Data were gathered in La Paz County, Bolivia, in 2008 and 2009. Poor knowledge on safe handling, hazardous working practices, and use of very toxic pesticides were seen. Being a female and having a low educational level were risk factors for “poor knowledge on pesticides” and a “risky behavior when handling pesticides.” Females reported more symptoms of intoxication. The gender differences on knowledge and handling practices might explain why females report more symptoms. To minimize this gap, education and agricultural services should be made more accessible to female farmers in Bolivia.     

Work–Family Trajectories and the Higher Cardiovascular Risk of American Women Relative to Women in 13 European Countries

Objectives. To investigate whether less-healthy work–family life histories contribute to the higher cardiovascular disease prevalence in older American compared with European women.Methods. We used sequence analysis to identify distinct work–family typologies for women born between 1935 and 1956 in the United States and 13 European countries. Data came from the US Health and Retirement Study (1992–2006) and the Survey of Health, Aging, and Retirement in Europe (2004–2009).Results. Work–family typologies were similarly distributed in the United States and Europe. Being a lone working mother predicted a higher risk of heart disease, stroke, and smoking among American women, and smoking for European women. Lone working motherhood was more common and had a marginally stronger association with stroke in the United States than in Europe. Simulations indicated that the higher stroke risk among American women would only be marginally reduced if American women had experienced the same work–family trajectories as European women.Conclusions. Combining work and lone motherhood was more common in the United States, but differences in work–family trajectories explained only a small fraction of the higher cardiovascular risk of American relative to European women.Life expectancy is shorter in the United States than in many Western European countries. Older Americans are also more likely to report poorer health and to suffer chronic conditions, particularly American women.1,2 Explanations for this so-called US health disadvantage include differences in the prevalence of smoking and other behavioral risk factors, rates of disease and injury, financial barriers to health care access, and psychosocial stress.2–6 Although higher smoking prevalence histories among older women in the United States is one of the driving explanations,3 none of these factors fully accounts for the female US health disadvantage.Lives of American women changed substantially in the second half of the previous century. Female labor force participation increased more in the United States than in many European countries,7 and marriage rates decreased more rapidly for US women as a result of a higher fraction of American women never marrying as well as higher divorce rates.8,9 By contrast, although fertility rates declined in all countries,10 they declined less in the United States than in many European countries, leaving more American women facing the prospect of combining work and family roles, often in the context of lone motherhood.Women who are married, employed, and have children are generally healthier than their unmarried, nonemployed, and childless counterparts.11,12 Whereas the role accumulation theory suggests that combining family and work roles is beneficial for women’s health, the multiple role theory poses that combining these roles may increase levels of stress, which has a negative impact on health.13 These negative impacts may, however, depend on the availability of supportive policies that enable parents to combine work with family roles.We hypothesized that work–family trajectories may be differentially related to cardiovascular health in the United States than in Europe, as a result of the different work–family policy environment in the United States and Europe. If combining family and work roles is beneficial for a woman’s health, women experiencing a more family-friendly policy environment such as that in Europe may benefit more from role accumulation, resulting in better cardiovascular health. If combining roles is detrimental for a woman’s health, American women may experience more strain from work–family stress than European women as a result of a less supportive policy environment in the United States.The aim of this study was to assess whether less-healthy work–family life histories among American women have contributed to their cardiovascular health disadvantage in older age relative to women in 13 European countries. We used unique retrospective data for 13 European countries and the United States to construct full life histories and work–family trajectories, and linked them to stroke and heart disease outcomes in older ages. We examined the association between work–family trajectories and late-life cardiovascular outcomes and assessed whether the distribution and risks associated with these work–family trajectories explain why older American women have higher stroke and heart disease prevalence than older women in Europe.     

Exploring the Roles of Family Members in Women’s Decision to Use Postpartum Healthcare Services from the Perspectives of Women and Health Care Providers

Although the postpartum period is a significant time in a family’s life, few studies have addressed the lack of continuity of care and service use during the postpartum period. The aim of this study was to explore the roles of family members in Jordanian women’s decision to use postpartum health care services. An exploratory qualitative design was employed to elicit the perspectives of 24 women and 30 health care providers through six focus groups discussions conducted in April 2006. Interviews were transcribed verbatim, translated to English, and analyzed using an inductive content analysis approach. In our study, three roles of family members influencing Jordanian women’s decision to use postpartum health care services emerged: supporter role, opponent role, and active participant in care role. Findings supported the need for a family-centered approach when providing postpartum care to enhance positive family roles and limit negative ones to promote continuity of healthcare services use during the postpartum period.     

Perinatal Periods of Risk: A Community Approach for Using Data to Improve Women and Infants’ Health

This paper provides an overview of the origins, purpose, and methods of the Perinatal Periods of Risk (PPOR) approach to community-based planning for action to improve maternal and infant health outcomes. PPOR includes a new analytic framework that enables urban communities to better understand and address fetal and infant mortality. This article serves as the core reference for accompanying specific PPOR methods and practice articles. PPOR is based on core principles of full community engagement and equity and follows a six stage community-based planning process. In Stage 1, communities are mobilized and engaged, related planning efforts aligned, and community and analytic readiness assessed. In Stage 2, feto-infant mortality is mapped, excess mortality is estimated, likely causes of feto-infant mortality are determined, and appropriate actions are suggested. Stage 3 produces action plans for targeted prevention strategies. Stages 4 and 5 include implementation, monitoring, and evaluation. Stage 6 fosters political will to sustain efforts. PPOR can be used in local maternal child health (MCH) practice for improving perinatal outcomes. MCH programs can use PPOR to integrate health assessments, initiate planning, identify significant gaps, target more in-depth inquiry, and suggest clear interventions for lowering feto-infant mortality. PPOR enables greater cooperation in improving MCH through more effective data use, strengthened data capacity, and greater shared understanding of complex infant mortality issues. PPOR offers local health departments and their community partners a comprehensive approach to address the health of women and infants in their jurisdictions.     

Family Structure as a Risk Factor for Women’s Sexual Victimization: A Study Using the Danish Registry System

This study estimated the risk of sexual victimization associated with different family structures. Based on the Danish Civil Registration System, all female visitors to the Centre for Rape Victims (CRV) at the University Hospital in Aarhus, during a two-year period (January 2005 to December 2006) were identified (N = 214) along with a control group (N = 4,343) that was matched by age and residential location. The family structure in the preceding year was used as a predictor variable in a logistic regression model. Results indicted that, compared to those who were married with children at home, being single with children at home significantly increased the likelihood of having visited the CRV. This is consistent with the research literature that has shown that single women with children are at risk for disadvantage on a range of socioeconomic and psychological factors as well as at risk for interpersonal violence.     

Who Is Likely to Quit Nursing Jobs? A Study in the Turkish Republic of Northern Cyprus

The study reported in this article examines the nature of relationships between organizational and personal resources and nurses' turnover intentions. A sample of 124 nurses in the Turkish Republic of Northern Cyprus serves as the study setting. Results of the study reveal that a form of organizational support (empowerment) and two personal resources (customer orientation, job resourcefulness) are the best predictors of turnover intentions. Implications of these results are discussed and avenues for future research are offered.     

Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?

This paper assesses the causal impact on child health of borrowing formal microcredit for Chinese rural households by exploiting a panel dataset (2000 and 2004) in a poor northwest province. Endogenous borrowing is controlled for in a dynamic regression‐discontinuity design creating a quasi‐experimental environment for causal inferences. There is causal relationship running from formal microcredit to improved child health in the short term, while past borrowing behaviour has no protracted impact on subsequent child health outcomes. Moreover, formal microcredit appears to be a complement to health insurance in improving child health through two mechanisms—it enhances affordability for out‐of‐pocket health care expenditure and helps buffer consumption against adverse health shocks and financial risk incurred by current health insurance arrangements. Government efforts in expanding health insurance for rural households would be more likely to achieve its optimal goals of improving child health outcomes if combined with sufficient access to formal microcredit. Copyright © 2015 John Wiley & Sons, Ltd.     

Does Tenure Security Reduce Disaster Risk?A Comparative Study of the Nairobi Settlements of Kibera and Kawangware

While scholarship suggests that improving tenure security and housing significantly reduces disaster risk at the household level within urban settings,this asse...     

Sleep Duration and Diet Quality Among Women Within 5 Years of Childbirth in the United States: A Cross-Sectional Study

Objective Only 9 % of women with young children consume a high quality diet. The association between sleep duration and health may be U-shaped. We examined diet quality in relation to sleep duration among US women within 5 years of childbirth. Methods Data were from non-pregnant women aged 20–44 years within 5 years of childbirth who completed two 24-h dietary recalls (N = 896) in the National Health and Nutrition Examination Survey 2005–2012. Self-reported weekday/workday sleep duration was categorized as short (≤6 h), adequate (7–8 h), or long (≥9 h). The Healthy Eating Index (HEI-2010, range 0–100) estimated overall and components of diet quality. Multivariable-adjusted linear regression models estimated the association between sleep duration and diet quality, adjusting for age, race/ethnicity, and education. Results Thirty-four percent of women reported short, 57.1 % adequate, and 8.6 % long sleep duration. The average diet quality total score was 47.4 out of 100. Short sleep duration was not associated with diet quality. Long sleep duration was associated with lower quality diet (β = ?4.3; 95 % CI ?8.1 to ?0.4), lower consumption of total fruit (β = ?0.7; 95 % CI ?1.3 to ?0.1), whole fruit (β = ?0.9; 95 % CI ?1.6 to ?0.2), and total protein (β = ?0.7; 95 % CI ?1.3 to ?0.03), and higher consumption of empty calories (β = 2.2; 95 % CI ?4.3 to ?0.1). Conclusions for practice Future studies should examine the longitudinal association between sleep duration and diet quality among women following childbirth and whether interventions to improve sleep can enhance diet quality.     

Is LARC for Everyone? A Qualitative Study of Sociocultural Perceptions of Family Planning and Contraception Among Refugees in Ethiopia

Objective Ethiopia is home to an increasingly large refugee population. Reproductive health care is a critical issue for these groups because refugee women are at high risk for unmet family planning needs. Efforts to expand contraceptive use, particularly long acting reversible contraceptive (LARC) methods are currently underway in several Ethiopian refugee camps. Despite availability of LARC methods, few refugee women opt to use them. The purpose of this study was to explore how culture influences contraceptive attitudes and behaviors, particularly towards LARC methods, among Ethiopia’s refugee populations. Methods Focus group discussions and individual interviews were conducted with Eritrean and Somali refugees living in Ethiopia. The qualitative data was analyzed to identify important themes highlighting the relationship between cultural values and contraceptive attitudes and behaviors. Results Childbearing was highly valued among participants in both study groups. Eritreans reported desire to limit family size and attributed this to constraints related to refugee status. Somalis used cultural and religious faith to deal with economic scarcity and were less likely to feel the need to adapt contraceptive behaviors to reduce family size. Participants held overall positive views of the contraceptive implant. Attitudes toward the intrauterine device (IUD) were overwhelmingly negative due to its long-acting nature. Conclusions Culture, religion and refugee status form a complex interplay with family planning attitudes and behaviors among Eritrean and Somali refugees. For these populations, the three-year implant appears to be a more acceptable contraceptive method than the longer-acting IUD because it is in line with their reproductive plans.     

What Do We Know about the Microbiome in Cystic Fibrosis? Is There a Role for Probiotics and Prebiotics?

Cystic fibrosis (CF) is a life-shortening genetic disorder that affects the cystic fibrosis transmembrane conductance regulator (CFTR) protein. In the gastrointestinal (GI) tract, CFTR dysfunction results in low intestinal pH, thick and inspissated mucus, a lack of endogenous pancreatic enzymes, and reduced motility. These mechanisms, combined with antibiotic therapies, drive GI inflammation and significant alteration of the GI microbiota (dysbiosis). Dysbiosis and inflammation are key factors in systemic inflammation and GI complications including malignancy. The following review examines the potential for probiotic and prebiotic therapies to provide clinical benefits through modulation of the microbiome. Evidence from randomised control trials suggest probiotics are likely to improve GI inflammation and reduce the incidence of CF pulmonary exacerbations. However, the highly variable, low-quality data is a barrier to the implementation of probiotics into routine CF care. Epidemiological studies and clinical trials support the potential of dietary fibre and prebiotic supplements to beneficially modulate the microbiome in gastrointestinal conditions. To date, limited evidence is available on their safety and efficacy in CF. Variable responses to probiotics and prebiotics highlight the need for personalised approaches that consider an individual’s underlying microbiota, diet, and existing medications against the backdrop of the complex nutritional needs in CF.     

Which Type of Risk Information to Use for Whom? Moderating Role of Outcome-Relevant Involvement in the Effects of Statistical and Exemplified Risk Information on Risk Perceptions

The extant empirical research examining the effectiveness of statistical and exemplar-based health information is largely inconsistent. Under the premise that the inconsistency may be due to an unacknowledged moderator (O’Keefe, 2002), this study examined a moderating role of outcome-relevant involvement (Johnson & Eagly, 1989) in the effects of statistical and exemplified risk information on risk perception. Consistent with predictions based on elaboration likelihood model (Petty & Cacioppo, 1984), findings from an experiment (N = 237) concerning alcohol consumption risks showed that statistical risk information predicted risk perceptions of individuals with high, rather than low, involvement, while exemplified risk information predicted risk perceptions of those with low, rather than high, involvement. Moreover, statistical risk information contributed to negative attitude toward drinking via increased risk perception only for highly involved individuals, while exemplified risk information influenced the attitude through the same mechanism only for individuals with low involvement. Theoretical and practical implications for health risk communication are discussed.     

Are There Differences in the Impact of Partner Violence on Reproductive Health Between Postpartum Women and Women Who Had an Elective Abortion?

The aim of this study was to determine if the effects of intimate partner violence (IPV) in the previous 12 months (current IPV) on newborn’s health, pregnancy outcomes and couple’s reproductive behaviours were different for postpartum (PP) women as compared to women who had undergone an elective abortion (EA) in Trieste (Italy). This study is part of an unmatched case–control study. The major findings are that current IPV was positively associated with previous stillbirth among both groups of women, but the association was only marginally significant. Among EA women only, current IPV was significantly associated with previous miscarriages (adjusted odds ratio, 2.41; 95 %CI, 1.13–5.14). In both groups of women, current IPV was associated with a lack of joint couple decision making about contraception; however, the magnitude of this effect was higher among PP women. This study reveals that IPV was associated with poor obstetrical history among both groups of women. But the associations of current IPV with previous EA and couple reproductive behaviours were stronger among PP women.