北京市社区脑卒中高危人群血压干预效果的评价

目的 了解北京市45-79岁社区脑卒中高危人群的血压干预效果.方法 2011年5月至2012年4月对北京市7604名45-79岁社区脑卒中高危人群每月随访-次,由社区医生制定个体化的随访管理方案,分析干预后血压平均水平、高血压控制率、脑卒中发病率.结果 干预前高血压患病率为64.1％.干预后,收缩压、舒张压分别下降2.9、1.5 mm Hg,血压下降明显(t值分别为-20.987、-15.494,P值均为0.000);前四次随访血压下降幅度最大;收缩压下降幅度表现为高年龄组下降幅度大(F=14.287,P=0.000),男性高于女性(t=-2.885,P=0.004),郊区人群高于城区(t=5.314,P=0.000),初中及以下文化程度者下降幅度大(t=-6.943,P=0.000);舒张压下降幅度表现为低年龄组人群下降幅度大(F=22.864,P=0.000),男性高于女性(t=-2.259,P=0.024),初中以上文化程度者下降幅度大(t=2.428,P=0.015).干预后高血压控制率由67.7％上升到87.9％,明显升高(χ²=324.595,P=0.000).脑卒中发病率为2.7‰,郊区人群明显高于城区(χ²=5.293,P=0.021).结论 社区干预可降低脑卒中高危人群的血压平均水平,提高高血压控制率,进而降低脑卒中发病率;以早期血压干预效果好,其中男性血压下降明显.     

天津市2005-2017年医疗机构新报告HIV/AIDS特征分析

目的 分析天津市2005-2017年医疗机构新报告HIV/AIDS特征,为更好地在医疗机构中开展相关的艾滋病防治工作提供依据。方法 对新报告HIV/AIDS的流行病学调查及随访资料进行分析,同时回顾调查2005-2017年医疗机构新报告HIV/AIDS的科室来源及主要就诊疾病。结果 2005-2017年天津市医疗机构新报告HIV/AIDS 3 035例,医疗机构报告HIV/AIDS病例年均增长24.8%,其中49.2%（1 343/2 728）来源于住院病例,50.8%（1 385/2 728）来源于门诊病例,性病门诊就诊者检测在2011-2017年HIV阳性检出率呈现增长趋势（χ²=18.469,P=0.005）;医疗机构住院病例、门诊病例首次CD₄⁺T淋巴细胞计数（CD₄）（χ²=17.189,P=0.000）及新报告当年发生死亡比例（χ²=61.198,P=0.000）差异有统计学意义;二级医院与三级医院新报告HIV/AIDS首次CD₄值（χ²=16.751,P=0.000）及新报告当年发生死亡比例（χ²=18.926,P=0.000）差异有统计学意义;不同科室新报告HIV/AIDS首次CD₄值（χ²=37.620,P=0.000）及新报告当年发生死亡比例（χ²=95.489,P=0.000）差异有统计学意义。结论 2005-2017年天津市医疗机构门诊新报告HIV/AIDS较为及时,二级医院新报告HIV/AIDS比三级医院及时。在医疗机构重点科室门诊积极倡导医务人员中主动提供HIV检测服务,对于天津市艾滋病防治工作具有重要意义。     

不同性别人群免疫球蛋白G N-糖基化结构谱型比较

目的 对不同性别人群的免疫球蛋白G（IgG） N-糖基结构谱型进行分析比较。方法 采用整群抽样,以2012年1-6月在北京市宣武医院体检的669名居民为研究对象,留取空腹静脉血5 ml,对IgG N-糖基进行分离、纯化、标记后,采用超高压液相色谱串联质谱法对IgG N-糖基进行检测,最终得到24个色谱峰,每个峰代表不同的糖基结构。不同性别人群的糖基结构比较采用两独立样本t检验或非参数检验,P<0.05为差异有统计学意义。结果 669名参与者中男性235人（35.13%）,女性434人（64.87%）,平均年龄为（44.23±9.82）岁。女性核心岩藻糖基化水平Fⁿ（Z=-2.192,P=0.028）高于男性;女性半乳糖基化水平G0ⁿ（Z=-7.898,P<0.001）、G1ⁿ（Z=-2.343,P=0.019）低于男性,而G2ⁿ（Z=-8.414,P<0.001）水平高于男性;女性唾液酸化水平F^totalS1/F^totalS2（Z=-5.049,P<0.001）、FS1/FS2（Z=-3.336,P=0.001）高于男性。结论 IgG N-糖基结构水平可能与性别有关。     

下丘脑-垂体-肾上腺轴昼夜节律指标随青春期发育变化的特征

目的 描述下丘脑-垂体-肾上腺（HPA）轴昼夜节律指标随青春期发育变化的特征。方法 2015年10月选择安徽省马鞍山市3所小学1 070名2~3年级学生为研究对象,并于2016年和2017年开展随访调查。调查内容包括体格发育、青春期发育和HPA轴昼夜节律。收集清晨觉醒时、醒后30 min和晚上入睡时3个时点唾液样本,并计算HPA轴昼夜节律指标：皮质醇觉醒应答（CAR）、昼间皮质醇总分泌量及昼夜皮质醇斜率（DCS）。采用睾丸容积、乳房发育分别评价男女童青春期发育阶段。采用问卷调查收集出生日期、入睡与起床时间和每周体力活动等信息。采用非参数检验比较HPA轴昼夜节律基线各指标在基线、随访期及不同青春期发育进程中的差异。结果 随访期间,青春期发育启动组和持续发育组CAR值、CAR变化值均高于与持续未发育组,差异有统计学意义（CAR：Z值分别为8.551和4.680,均P<0.01;CAR变化值：Z值分别为4.079和2.700,均P<0.01）;青春期启动组昼间皮质醇总分泌量高于持续未发育组,差异有统计学意义（Z=2.591,P=0.010）。与持续未发育组相比,DCS变化值在青春期启动组和持续发育组中下降明显,差异有统计学意义（Z=-2.450,Z=-2.151;均P<0.05）。昼间皮质醇总分泌量变化值与DCS在不同青春期发育进程组儿童中差异无统计学意义（昼间皮质醇总分泌量变化值：χ²=2.747,P=0.253;DCS：χ²=4.554,P=0.032）。结论 HPA轴昼夜节律指标与青春期发育有关,CAR、昼间皮质醇总分泌量随青春期发育进行而升高,昼间皮质醇差值随青春期发育而下降。     

老年居民抑郁与情绪调节策略的相关性研究

目的 探讨银川市老年居民抑郁与情绪调节策略的现况及两者的关系。方法 2016年3-5月选择银川市5所养老机构505名老年人及5个社区的538名老年人,共1 043名。抑郁调查采用老年抑郁量表（GDS）,情绪调节策略调查采用Gross情绪调节问卷和反刍思维量表。结果 银川市老年居民抑郁发生率为32.0%,其中社区老年人为35.5%,养老机构老年人为28.3%,差异有统计学意义（χ²=6.187,P<0.05）。经倾向值匹配分析法分析,社区老年人和养老机构老年人抑郁发生率差异无统计学意义（χ²=0.066,P=0.798）。1 043名老年居民GDS得分为（9.1±5.7）分,老年人认知重评得分为（26.7±8.0）分,表达抑制得分为（16.3±6.6）分,反刍思维得分为（34.5±11.7）分。不同性别、兴趣爱好、体育锻炼的老年人认知重评得分差异有统计学意义（均P<0.05）;不同文化程度、经济收入的老年人表达抑制得分差异有统计学意义（均P<0.05）;不同年龄、婚姻状况、文化程度、兴趣爱好的老年人反刍思维得分差异有统计学意义（均P<0.05）。抑郁得分与认知重评负相关（r=-0.400,P<0.01）、与反刍思维呈正相关（r=0.652,P<0.01）。结论 银川市老年居民抑郁发生率较高,老年人抑郁与情绪调节策略有关。     

新疆维吾尔自治区疏附县中小学生病毒性肝炎血清流行病学调查

目的 了解新疆维吾尔自治区（新疆）疏附县中小学生甲、乙、丙型病毒性肝炎流行情况及评估免疫接种效果。方法 2015年2-5月通过整群随机抽样方法对疏附县4个乡镇中小学生进行病毒性肝炎血清流行病学调查,检测HAV-IgG、HBsAg、HBsAb和HCV-IgG。结果 疏附县4 830名中小学生HAV-IgG阳性率为99.75%,男生为99.92%,女生为99.57%,差异有统计学意义（χ²=5.798,P=0.016）;HBsAg阳性率为3.02%,男生为3.55%,女生为2.47%,差异有统计学意义（χ²=4.782,P=0.029）;各年龄组的HBsAg阳性率差异有统计学意义（χ²=71.990,P=0.000）,农村地区（3.28%）高于城镇地区（1.61%）,差异有统计学意义（χ²=6.019,P=0.014）;HBsAb阳性率为38.84%,各年龄组的HBsAb阳性率差异有统计学意义（χ²=837.699,P=0.000）,城镇地区（42.36%）高于农村地区（38.20%）,差异有统计学意义（χ²=4.598,P=0.032）。HBsAg和HBsAb均为阴性的学生有2 815人,占总人数的58.28%。HCV-IgG阳性率为0.19%,阳性者均为维吾尔族农村学生。结论 疏附县中小学生甲型肝炎疫苗的免疫效果较好,处于乙型肝炎免疫空白状态的学生较多,丙型肝炎感染率较低,应及时对适龄儿童进行免疫接种和查漏补种。     

1996-2014年中国HIV-1毒株CRF01_AE亚型传播簇和传播网络研究

目的 了解我国HIV-1毒株CRF01_AE亚型在省内和省际的传播规律和风险因素,为实施精准干预提供参考依据。方法 收集我国19个省份1996-2014年已有的2 094条CRF01_AE pol区基因序列,利用PhyML 3.0软件构建系统进化树,确定传播簇,利用Cytoscape 3.6.0软件构建传播网络,结合背景信息分析传播风险。结果 发现82个传播簇,包含255条序列（12.18%,255/2 094）,省内传播簇数量和包含序列数（61个,173条）明显多于跨省传播簇（21个,82条）。传播簇中男男性传播人群的成簇比例随时间上升趋势明显,由1996-2008年的2.41%（2/83）上升为2013-2014年的23.61%（72/305）（χ²=27.800,df=1,P=0.000）。跨省传播簇的男男性传播人群比例明显高于省内传播簇,由1996-2008年的0.67%（2/297）上升为2013-2014年的6.36%（30/472）,具有随时间的上升趋势（χ²=20.276,df=1,P=0.000）。跨省传播簇中男男性传播的比例（86.59%,71/82）明显高于省内传播簇（56.65%,98/173）,差异有统计学意义（χ²=22.792,P=0.000）。含2种及以上传播途径的跨省传播簇的比例（33.33%,7/21）明显高于省内传播簇（13.11%,8/61）,差异有统计学意义（χ²=4.273,P=0.039）。传播网络分析发现,跨省传播簇内高传播风险人群比例（51.22%,42/82）明显高于省内传播簇（26.59%,46/173）,差异有统计学意义（χ²=14.932,P=0.000）。跨省传播簇以男男性传播人群为主。结论 我国HIV-1毒株CRF01_AE亚型存在复杂的传播网络,跨省传播簇快速增长,其中高风险传播者对HIV-1亚型的大范围传播起到重要作用,应深入进行传播网络研究以指导精准干预。     

浙江省台州市2013-2015年男男性行为者人群同性群交行为调查

目的 了解浙江省台州市MSM同性群交行为特征及其相关因素。方法 2013年3月至2015年9月,经浴室、酒吧等场所招募MSM,通过问卷调查收集其性行为等信息,并进行HIV检测。使用logistic回归模型分析群交行为相关因素。结果 共调查1 435名MSM,HIV阳性率为12.5%（179/1 435）。16.1%（231/1 435）报告在最近1年曾有群交行为。最近1年有群交行为的MSM与最近1年无群交的MSM相比,一生同性性伴数≥10个（53.7%比19.0%,χ²=125.527,P<0.01）、有异性性伴（86.6%比68.2%,χ²=31.935,P<0.01）、最近1年与女性发生性行为未使用安全套（28.1% 比19.8%,χ²=6.540,P<0.05）的比例更高。多因素logistic回归模型分析显示,与MSM群交行为相关因素包括年龄（≥50岁比≤24岁,aOR=2.25,P=0.027）,与女性婚姻（离异或丧偶比未婚,OR=0.29,P=0.001）,户籍（本地比外地,aOR=1.56,P=0.023）,一生同性性伴数（≥21个比2~5个,aOR=8.06,P<0.001;11~20个比 2~5个,aOR=3.25,P<0.001）,一生异性性伴数（≥6个比0个,aOR=2.63,P=0.005;2~5个比0个,aOR=2.58,P=0.001;1个比0个,aOR=2.01,P=0.010）。结论 台州市MSM人群群交行为比例较高、安全套使用率低、性行为关系复杂,HIV感染率高、传播风险较大。     

新型冠状病毒肺炎患者焦虑和抑郁状况研究

目的 了解新型冠状病毒肺炎患者焦虑、抑郁现况，探索新型冠状病毒肺炎患者的护理干预模式。方法 选取解放军总医院第五医学中心2020年1月23日—2月10日收治的新型冠状病毒肺炎患者为研究对象。运用焦虑自评量表（SAS）和抑郁自评量表（SDS）统计患者焦虑和抑郁得分情况。制定相应护理干预措施并评估疗效。结果 共收治40例新冠肺炎患者。10例（25.00%）患者出现焦虑，SAS平均得分（42.94±8.33）分。14例（35.00%）患者出现抑郁，SDS平均得分（46.41±13.37）分。患者焦虑与抑郁得分均高于常模，差异有统计学意义（P<0.05）。女性患者焦虑得分高于男性，差异有统计学意义（P=0.02）。不同年龄、文化程度组患者焦虑和抑郁得分比较，差异均无统计学意义（均P>0.05）。护理干预后，SAS量表平均得分（37.94±5.67）分，SDS量表平均得分（39.93±8.55）分，均较干预前降低，差异有统计学意义（均P<0.05）。结论 新型冠状病毒肺炎患者焦虑和抑郁高于普通人群，通过有效的护理干预可降低患者的焦虑和抑郁，长期的护理干预需要持续进行。     

黑龙江省大庆市社区老年人社会隔离与认知功能关联的研究

目的 探讨老年人社会隔离与认知功能间的关联。方法 采用横断面调查对黑龙江省大庆市社区981位≥60岁社区居民采用结构化问卷进行调查。用LSNS-6量表筛查老年人的社会隔离情况、蒙特利尔认知评估量表汉化长沙版评估认知功能。采用多元线性回归分析社会支持网络与认知功能的关系；采用累积比数logit模型分析社会支持网络与不同认知维度的关系。结果 调查对象平均年龄71岁；LSNS-6量表筛查出10.60%（104/981）的老年人存在社会隔离情况；9.48%（93/981）的老年人存在家庭联系疏松；13.97%（137/981）的老年人存在朋友联系疏松。LSNS-6量表得分与认知功能得分存在相关关系，与社会联系越紧密的老年人，认知功能得分越高，偏回归系数为0.10（P< 0.01）。存在社会隔离的老年人认知功能得分为20.38±5.54，而社会联系正常的老年人认知功能得分为22.10±5.01，两者差异有统计学意义（P< 0.01）；与无社会隔离相比，社会隔离与视空间/执行能力（P=0.02）、命名（P=0.03）、语言（P=0.01）和延迟记忆（P< 0.01）等认知维度有关联，而与注意力（P=0.33）、抽象（P=0.49）和定向（P=0.27）方面无明显关联。结论 社会隔离与认知功能密切相关，朋友联系疏松是老年人社会隔离的主要来源。     

分阶段转变理论护理对产妇母乳喂养知识及母乳喂养自我效能的影响

目的探讨分阶段转变理论护理对产妇母乳喂养知识及母乳喂养自我效能的影响。方法132例产妇依据护理干预方案的不同分为对照组(常规护理模式,66例)与观察组(分阶段转变理论护理模式,66例),比较两组产妇干预前后的母乳喂养知识掌握情况及自我效能。结果干预后,观察组产妇的喂养姿势、含接姿势、托乳姿势及挤奶手段评分,以及母乳喂养自我效能评分均显著高于对照组(P<0.05)。结论分阶段转变理论护理模式可有效提高产妇的母乳喂养知识水平及自我效能。     

Effect of childbirth education on the perceptions of childbirth and breastfeeding self-efficacy and the obstetric outcomes of nulliparous women*,**,***

Abstract

In this quasi-experimental and prospective study, we aimed to determine the effect of education about childbirth on the perceptions of nulliparous women regarding the experience of childbirth, obstetric outcomes (e.g., type of delivery, use of induction, and instrument-assisted delivery), and breastfeeding self-efficacy. The study population comprised 121 women, of whom 64 and 57 were classified into the education and control groups, respectively. Study data were collected using a participant identification form, the Perception of Birth Scale, Visual Analog Scale, and Breastfeeding Self-Efficacy Scale-Short Form. Compared to the control group, participants in the education group held significantly more positive birth-related perceptions (p?=?0.000) and experienced a lower level of pain during delivery (p?=?0.016). However, education did not affect the obstetric outcomes. During the first month postpartum, a higher level of breastfeeding self-efficacy was reported by mothers in the education group than by those in the control group. In conclusion, systematic childbirth education positively affected the mothers’ perceptions of the childbirth experience and their breastfeeding self-efficacy, but had no effect on the type of delivery or other birth-related obstetric interventions.     

Effectiveness of a Breastfeeding Self-efficacy Intervention: Do Hospital Practices Make a Difference?

Breastfeeding self-efficacy interventions are important for improving breastfeeding outcomes. However, the circumstances that may influence the effectiveness of the interventions are unclear, especially in the context of hospitals with suboptimal infant feeding practices. Thus, we aimed to evaluate the effect of a self-efficacy intervention on breastfeeding self-efficacy and exclusive breastfeeding, and further assessed the difference in its effect by hospital-routine type. In this intervention study with a control group, 781 pregnant women were recruited from 2 “Baby-Friendly”-certified hospitals (BFH) and 2 non-Baby-Friendly Hospitals (nBFH) in Japan, and were allocated to an intervention or control group. Participants in the intervention group were provided with a breastfeeding self-efficacy workbook in their third trimester. The primary outcome was breastfeeding self-efficacy and the secondary outcome was infant feeding status. All analyses were stratified by the type of hospital, BFH or nBFH. In BFHs, the intervention improved both breastfeeding self-efficacy through 4 weeks postpartum (p = 0.037) and the exclusive breastfeeding rate at 4 weeks postpartum (AOR 2.32, 95 % CI 1.01–5.33). In nBFHs, however, no positive effect was observed on breastfeeding self-efficacy (p =? 0.982) or on the exclusive breastfeeding rate at 4 weeks postpartum (AOR 0.97, 95 % CI 0.52–1.81); in nBFHs, supplementation was provided for breastfed infants and the mother and infant were separated in the vast majority of cases. Infant feeding status at 12 weeks was not improved in either hospital type. The intervention improved breastfeeding self-efficacy and exclusive breastfeeding at 4 weeks postpartum only in BFHs. When breastfeeding self-efficacy interventions are implemented, hospital infant feeding practices may need to be optimized beforehand.     

信息-动机-行为干预对剖宫产孕妇健康行为及心理的影响

目的 探讨信息-动机-行为(IMB)干预对剖宫产孕妇健康行为及心理的影响。方法 选取本院2019年3月—2021年3月84例行剖宫产的孕妇作为研究对象,按照随机数表法分为观察组和对照组,各42例。对照组采取常规产后护理,观察组在对照组基础上采用IMB干预。对比2组干预后健康行为[健康行为能力自评量表(SRAHP)评分],评估2组干预前后自我效能感[自我效能感量表(GSES)]和心理状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]评分。结果 干预后观察组SRAHP各维度评分(健康责任、心理安适、运动、营养)及总分分别为(18.75±5.58)分、(14.41±4.65)分、(14.85±4.79)分、(19.98±6.94)分、(67.85±17.59)分,与对照组(15.14±4.05)分、(11.15±3.78)分、(11.74±3.67)分、(14.75±4.87)分、(52.41±17.45)分]比较,差异有统计学意义(t=3.393、3.526、3.340、3.998、4.028,P 均≤0.001)。重复测量方差分析结果显示:症状管理自我效能、产后康复共性管理自我效能、总均分随时间变化有统计学意义(F时间=11.524、10.857、7.891,P均<0.001),HAMA、HAMD评分随时间变化,差异有统计学意义(F时间=7.242、6.481,P均<0.001)。结论 IMB用于剖宫产孕妇产后护理可提高孕妇健康行为能力水平和自我效能感,改善孕妇负性情绪,促进产后恢复。     

延续性护理干预对初产妇母乳喂养的影响

目的:研究分析延续性护理干预对初产妇母乳喂养的影响效果。方法:选取2018年4月至2019年11月就诊于我院产科二病区的初产妇100例,将所选患者分为实验组与对照组,对照组给予常规护理方案,实验组在对照组相关护理基础上加入延续性护理。对比分析两组产妇对母乳喂养知识掌握情况、自我效能以及母乳喂养率。结果:两组患者出院前母乳知识得分(实验组73.64±11.73,对照组74.32±11.61)、自我效能得分(实验组95.52±25.99,对照组94.18±25.21)比较无较大差异,(P>0.05)差异无统计学意义;产后42天母乳知识得分(实验组79.92±9.41,对照组79.22±7.42)、自我效能得分(实验组122.52±24.11,对照组118.65±23.36)比较无较差差异,(P>0.05)差异无统计学意义;产后6个月母乳知识得分(实验组84.94±9.03、对照组83.26±8.39)比较均无较大差异,(P>0.05)差异无统计学意义;实验组产妇产后6个月自我效能评分(130.16±23.99)显著高于对照组(120.28±22.94),(P<0.05)差异具有统计学意义。实验组纯母乳喂养率(70%)显著高于对照组(50%),(P<0.05)差异具有统计学意义;人工喂养率(20%)显著低于对照组(34%),(P<0.05)差异具有统计学意义;两组混合喂养率(观察组10%,对照组16%)比较无较差差异,(P>0.05)差异无统计学意义。结论:延续性护理干预有助于提高初产妇产后对母乳喂养知识的了解、自我效能以及母乳喂养率。     

Predictors of Breastfeeding in Overweight and Obese Women: Data From Active Mothers Postpartum (AMP)

Excess maternal weight has been negatively associated with breastfeeding. We examined correlates of breastfeeding initiation and intensity in a racially diverse sample of overweight and obese women. This paper presents a secondary analysis of data from 450 women enrolled in a postpartum weight loss intervention (Active Mothers Postpartum [AMP]). Sociodemographic measures and body mass index (BMI), collected at 6 weeks postpartum, were examined for associations with breastfeeding initiation and lactation score (a measure combining duration and exclusivity of breastfeeding until 12 months postpartum). Data were collected September 2004–April 2007. In multivariable analyses, BMI was negatively associated with both initiation of breastfeeding (OR: .96; CI: .92–.99) and lactation score (β −0.22; P = 0.01). Education and infant gestational age were additional correlates of initiation, while race, working full-time, smoking, parity, and gestational age were additional correlates of lactation score. Some racial differences in these correlates were noted, but were not statistically significant. Belief that breastfeeding could aid postpartum weight loss was initially high, but unrelated to breastfeeding initiation or intensity. Maintenance of this belief over time, however, was associated with lower lactation scores. BMI was negatively correlated with breastfeeding initiation and intensity. Among overweight and obese women, unrealistic expectations regarding the effect of breastfeeding on weight loss may negatively impact breastfeeding duration. In general, overweight and obese women may need additional encouragement to initiate breastfeeding and to continue breastfeeding during the infant’s first year.     

Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model

PurposeTo validate the predictive value of the Information-Motivation-Behavioral Skills (IMB) model of human immunodeficiency virus (HIV) prevention for sexually active juvenile offenders and to explore gender differences in IMB model constructs for condom-protected vaginal intercourse.MethodsSelf-report measures of acquired immune deficiency syndrome (AIDS) knowledge, pro-condom peer influence, risk perception, condom attitudes, condom use self-efficacy, frequency of vaginal intercourse, and frequency condom-protected vaginal intercourse were collected from predominantly African-American adolescent detainees. Analysis consisted of structural equation models for the combined sample (N = 523) and for separate gender groups (328 males and 195 females).ResultsIn the combined model, condom use was significantly predicted by male gender, peer influence, positive condom attitudes, and condom self-efficacy. In separate gender analyses, condom use among adolescent males was predicted by peer influence (modestly) and by positive condom attitudes, whereas condom use among females was predicted by peer influence, self-efficacy, and condom attitudes. Compared with males, females reported significantly greater knowledge, less peer influence, higher perceived risk for infection, more positive condom attitudes, and more self-efficacy, but they reported less condom use.ConclusionsFemales may find it difficult to use condoms consistently despite their awareness of their efficacy. Power imbalances or other dynamics operating in their relationships with males need further exploration. Gender differences in the relationship between condom self-efficacy and condom use were masked in the analysis of the total sample, indicating the value of testing theories of HIV prevention separately by gender.     

Factors Associated with Very Early Weaning Among Primiparas Intending to Breastfeed

Objectives: The major objective of this study was to identify predictor variables that accurately differentiated breastfeeding women who weaned during the first 4 weeks, those who weaned between 5 and 26 weeks, and those who weaned after 26 weeks. Predictors were demographic variables, Theory of Planned Behavior (TPB) variables, breastfeeding knowledge, and difficulties experienced during the first month. Methods: Primiparas who delivered healthy infants in an urban midwestern hospital provided initial data prior to discharge. Follow-up occurred at 1,3,6,9, and 12 months. Following appropriate bivariate analyses, polychotomous logistic regression was used to determine predictors of weaning group. Linear multiple regression was used to predict intended duration. Results: Most of the 84 women who weaned very early had intended to breastfeed considerably longer. According to the multivariate analysis, women who weaned earlier were younger, had completed fewer years of education, had a more positive bottle-feeding attitude and a less positive breastfeeding attitude, intended to breastfeed less time, had lower knowledge scores, had higher perceived insufficient milk scores, and planned to work outside the home. Variables postulated by the TPB to be direct predictors of intention explained 36% of the variance in intended duration. Conclusions: Women at risk for early weaning can be identified with reasonable accuracy using a TPB-based conceptual framework expanded to include breastfeeding specific variables. Casefinding using empirically derived screening methods and careful postpartum follow-up, along with professional intervention, should be used to avert unintended early weaning.     

Effects of breastfeeding on postpartum weight loss among U.S. women

ObjectiveThe aim of this study is to evaluate the effects of breastfeeding on maternal weight loss in the 12 months postpartum among U.S. women.MethodsUsing data from a national cohort of U.S. women conducted in 2005–2007 (N = 2102), we employed propensity scores to match women who breastfed exclusively and non-exclusive for at least three months to comparison women who had not breastfed or breastfed for less than three months. Outcomes included postpartum weight loss at 3, 6, 9, and 12 months postpartum; and the probability of returning to pre-pregnancy body mass index (BMI) category and the probability of returning to pre-pregnancy weight.ResultsCompared to women who did not breastfeed or breastfed non-exclusively, exclusive breastfeeding for at least 3 months resulted in 3.2 pound (95% CI: 1.4,4.7) greater weight loss at 12 months postpartum, a 6.0-percentage-point increase (95% CI: 2.3,9.7) in the probability of returning to the same or lower BMI category postpartum; and a 6.1-percentage-point increase (95% CI: 1.0,11.3) in the probability of returning to pre-pregnancy weight or lower postpartum. Non-exclusive breastfeeding did not significantly affect any outcomes.ConclusionOur study provides evidence that exclusive breastfeeding for at least three months has a small effect on postpartum weight loss among U.S. women.