传统人流与无痛人流终止早孕的临床对比研究

目的评价传统人流与无痛人流对于早孕终止的临床效果,为人工流产的选择提供理论依据。方法选取2010年6月至2012年8月间来我院就诊并行人工流产的患者246例,按照患者自主意愿实施手术,分为无痛人流组150例和传统人流组96例,对比评价两组的临床效果。结果①与传统人流相比,无痛人流组患者的手术时间显著缩短(P<0.05),但两组术中出血量差异无统计学意义(P>0.05)。②无痛人流组9例出现疼痛,显著低于传统人流组(P<0.05)。③两组均无流产失败的病例出现。④无痛人流组术后并发症的发生率为2.67%,显著低于传统人流组(P<0.05)。结论无痛人流显著缩短了手术时间,改善了患者的疼痛感,对于术后并发症的发生也起到良好的抑制作用,对于终止早孕是一种安全有效的方法,值得在临床广泛应用。     

Preventing High-Risk Sexual Behavior in Early Adulthood with Family Interventions in Adolescence: Outcomes and Developmental Processes

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention’s effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N?=?998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23 % of the intervention families engaged in the FCU and approximately 18 % engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.     

Preventing High-Risk Sexual Behavior in Early Adulthood with Family Interventions in Adolescence: Outcomes and Developmental Processes

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention’s effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23 % of the intervention families engaged in the FCU and approximately 18 % engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.

     

Defining the Family in Family Medicine

Physicians and social workers in the family medicine setting anticipate that a substantial portion of their practice will consist of intact, nuclear families. This study examined that expectation by collecting data on age, sex, and marital status of the patients in a family practice residency. Two separate methods of sampling the practice were used, and each resulted in a different picture of the practice. A dramatic finding was that 9% of the patients with active medical charts consumed 45% of the medical care. WOmen and patients over age 40 were overrepresented in the sample of frequent-user patients. Social work implications are presented.     

Effect of ACASI on Reporting of Abortion and Other Pregnancy Outcomes in the US National Survey of Family Growth

Abortion is a behavior that is stigmatized and difficult to measure. To improve reporting of abortion and other sensitive behaviors in the United States, the National Survey of Family Growth (NSFG) supplements the interviewer administered face‐to‐face (FTF) interview with audio computer‐assisted self‐interviewing (ACASI). This paper estimates differential reporting of abortion and other pregnancy outcomes (miscarriage, live birth) in the NSFG (2002, 2006–2010, 2011–2015) between women's ACASI and FTF interviews. Examining reporting of less stigmatized pregnancy outcomes can help understand the relative contributions of stigma and survey‐level factors in reporting of abortions. More women reported abortions, miscarriages and births in the ACASI than the FTF interview. Differences in reporting were moderated by the length of recall. The ACASI elicited relatively more reporting of abortions and miscarriages among non‐white and low‐income women. Reporting ratios increased over time. ACASI is a tool that may work differently across time, for different measures, and with varying survey contexts.     

早期人工流产者情况调查分析

当避孕失败或未采取避孕措施而发生非意愿妊娠,人工流产(包括药物流产和手术流产)是有效的补救措施,但其对身体和心理都有负面的影啊[1]. 近两年,上海市长宁区各计划生育手术点人工流产数居高不下,据长宁区妇幼保健所统计资料:2005年人工流产总数17 491例(其中上海市户籍已婚4 418例,未婚2 664例;外来户籍已婚4 511例,未婚5 898例);2006年人工流产总数19 192例(上海市户籍已婚4 705例,未婚2 523例;外来户籍已婚5 469例,未婚6 495例).     

早孕妇女人工流产方式意向的临床调查研究

人工流产(简称人流)是各种避孕失败的主要补救措施,目前早孕妇女人流的主要方式有吸刮术与药物流产两种。本文通过对天津市黄河医院意外早孕妇女选择人流方式意向的临床调查研究,探讨现阶段该两种人流方式的可接受性,结果:1000例早孕妇女中选择药物流产(简称药流)者666例(66.6％),吸刮术者334例(33.4％)。本组选择人流方式的理由,其中519例(51.9％)认为药流痛苦少,占第一位,认为手术干脆而选择吸刮术的217例(21.7％),占第二位,其它依次为吸刮术费用低、药流不必手术、吸刮术流产完全、药流不需请假、吸刮术出血时间短、药流安全、吸刮术副作用少、药流保密。药流是近年来使用的流产新方法,本组研究资料及意向选择只反映现阶段早孕妇女的接受状况。     

早期人工流产者情况调查分析

当避孕失败或未采取避孕措施而发生非意愿妊娠,人工流产（包括药物流产和手术流产）是有效的补救措施,但其对身体和心理都有负面的影响。     

Family Science: Generating Early Learning in Science

This paper explores a semi-formal Intervention which involves school children and their family adults in project work in astronomy. Mixed generation 'family teams' attended two 'family science evenings' at the children's primary schools and undertook to tackle and report on home-based projects over the intervening six week period. The projects required the family teams to collaborate in their learning and the results, in terms of enhanced interest and enjoyment of astronomy, were very positive. The evaluation of the research data considers outcomes at two levels: (i) general evaluative comments, and (ii) gains for the family teams involved. The research raises a number of issues, and highlights that, particularly In such a mixed context as this, precise learning gains are difficult to assess.     

Family Science: Generating Early Learning in Science

This paper explores a semi‐formal Intervention which involves school children and their family adults in project work in astronomy. Mixed generation ‘family teams’ attended two ‘family science evenings’ at the children's primary schools and undertook to tackle and report on home‐based projects over the intervening six week period. The projects required the family teams to collaborate in their learning and the results, in terms of enhanced interest and enjoyment of astronomy, were very positive. The evaluation of the research data considers outcomes at two levels: (i) general evaluative comments, and (ii) gains for the family teams involved. The research raises a number of issues, and highlights that, particularly In such a mixed context as this, precise learning gains are difficult to assess.