Factors associated with adolescent pregnancy- a sample of Taiwanese female adolescents

This study was designed to explore the factors that differentiate sexually experienced teenagers who become pregnant from those who do not. The study examined the differences between pregnant and never-pregnant female adolescents in personal background characteristics, family characteristics, substance use, contraceptive attitude, contraceptive knowledge, contraceptive self-efficacy, sexual history, and effective contraceptive use. Sexually experienced but never-pregnant female adolescents were selected from two vocational high schools. Pregnant adolescents were recruited by convenience sampling from obstetric clinics and health stations in Tainan City, Taiwan. Multiple logistic regression analysis identified six factors associated with pregnancy: poor contraceptive knowledge, poor contraceptive self-efficacy, low socioeconomic status, low effective contraceptive use scores, more frequent sexual intercourse, and older age. The results of this study provide health professionals with information to develop more-effective prevention and intervention programs to reduce adolescent pregnancy. The results also could be used as a reference for related research and policy development in other countries.     

Always, never, or sometimes: examining variation in condom-use decision making among Black adolescent mothers

Our purpose in this study was to describe Black adolescent mothers' decisions regarding condom use and non-use with their male sex partners, including their children's fathers. Research on partner type and condom use has been insufficiently focused on understanding the specific influence that the biological father of the baby has on condom use among adolescent mothers. We conducted five focus groups and three interviews with 31 predominantly African-American mothers. We found that their decisions to use condoms always, never, or sometimes were based on partner type and on emotional and relationship factors. The "baby daddy" was the only partner with whom they never used condoms. HIV/STI prevention interventions for adolescent mothers must address risk taking with their children's biological fathers.     

Depression, perceived stress, and social support among first-time Chinese mothers and fathers in the postpartum period

We compared the prevalence of depression in the postpartum period and its relationship with perceived stress and social support in first-time mothers and fathers. A cross-sectional study was conducted in mainland China with a convenience sample of 130 pairs of parents. Measures taken at 6-8 weeks after delivery included the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the Social Support Rating Scale. Eighteen (13.8%) of the mothers and 14 (10.8%) of the fathers were suffering from depression. No signficant differences were found in their prevalence rates. Perceived stress, social support, and partner's depression were significantly associated with depression. These findings suggest counseling, support, and routine screening for depression should be provided to both mothers and fathers.     

Racial differences in parenting dimensions and adolescent condom use at sexual debut

OBJECTIVES: Parenting style may be a determinant in reducing adolescent risk behavior. Previous studies have relied on a typological parenting approach, with classification into four groups: authoritative, authoritarian, permissive, and neglectful. In this study, two distinct parenting dimensions, demandingness and responsiveness, were examined as independent predictors of adolescent condom use. DESIGN AND SAMPLE: This study used a subsample of the National Longitudinal Study of Adolescent Health (Add Health) that included 153 adolescent-mother pairs. MEASUREMENT: Maternal demandingness and responsiveness were measured using Wave I mother interviews. Logistic regression analyses were used to predict adolescent condom use at sexual debut at Wave II and to assess moderation by gender and race. RESULTS: (1) Maternal demandingness predicted increased likelihood of condom use in African American adolescents but decreased likelihood of condom use in White adolescents; (2) maternal responsiveness did not predict condom use; and (3) gender moderation was not present. CONCLUSIONS: To provide appropriate family counseling, public health nurses need to consider racial differences in contraceptive practices. Education regarding parental supervision practices should be considered as part of nursing interventions intended to increase condom use in African American adolescents.     

Predictors of psychological distress in low‐income mothers over the first postpartum year

Up to 25% of postpartum women experience psychological distress including stress, depressive, or anxiety symptoms during the postpartum period. The purpose of this study was to explore the extent to which social determinants of health and allostatic load score, a 10‐item index of biologic measures of chronic stress, predict psychological distress in low‐income pregnant women over the first postpartum year. We conducted a secondary data analysis of the Child Community Health Research Network data set. The psychological distress outcome variables were perceived stress (n = 842), depression ( n = 845), and anxiety ( n = 846) symptoms, all measured categorically over the first year postpartum (T1:1 month, T2: 24–29 weeks, and T3: 50–65 weeks). Our predictors were social determinants of health (e.g., demographics, maternal hardship, percent poverty level, interpersonal violence, and food security) and allostatic load score. Generalized linear mixed models were used to determine which predictors were significantly associated with psychological distress symptoms across the first postpartum year. Interpersonal violence was a statistically significant risk factor for stress, depression, and anxiety symptoms over the first year postpartum. Other significant risk factors included low‐income level, nativity, and perceived food security. Receiving food stamps was a significant protective factor for stress symptoms. The significance of risk factors for psychological distress, both modifiable and nonmodifiable, can be used as potential targets for further research, screening, and intervention. Future work should explore why and in what conditions these risk factors vary over time.     

Initiation of postpartum contraception: A survey among health centre physicians and nurses in Finland

Objective

To examine self-reported professional practices of postpartum contraceptive counselling at Finnish community health centres.

Design

A survey study with self-administered online questionnaires.

Setting

All local municipalities (n = 107) in the Expert Responsibility Area of Tampere University Hospital in Western Finland in 2005.

Subjects

A total of 69 (64% of 107) health centre physicians and 80 (75%) nurses performing postpartum check-ups.

Main outcome measures

Contraceptive method most often initiated or recommended to breastfeeding women at postpartum visit; timing of postpartum initiation of hormonal and intrauterine contraceptive methods in relation to breastfeeding and resumption of menses.

Results

The most common contraceptive method initiated or recommended to breastfeeding women by both physicians (41%) and nurses (45%) was the condom, followed by progestin-only pills and intrauterine contraception. Few professionals recommended breastfeeding (lactational amenorrhea) as the only contraceptive method. Only eight (12%) physicians inserted a copper-releasing intrauterine device and five (7%) a levonorgestrel-releasing intrauterine system typically at the postpartum visit; the majority delayed the insertions until the resumption of menses. Fifty-three (77%) physicians initiated combined oral contraceptives mostly when breastfeeding was terminated and menses had returned. Over half of the municipalities involved in the study did not provide any medical contraceptives free of charge postpartum.

Conclusion

Professionals’ reports indicate that initiation of effective contraceptive methods is delayed after childbirth. In order to promote better postpartum contraception practices, updated evidence-based guidelines are needed.     

Consequences of adolescent drug use on psychiatric disorders in early adulthood

This article summarizes the existing literature on the relationship between adolescent drug use and abuse and the development of psychiatric disorders in adulthood. In recent years, there has been increased awareness of the co-occurrence of drug abuse and psychiatric disorders in adolescence and young adulthood. Few longitudinal studies, however, have examined specifically the impact of earlier drug use and abuse on later psychiatric disorders. The literature suggests three possible models to explain the relation between drug use and abuse and psychiatric disorders. According to the first model, adolescent psychiatric disorders precede drug use and abuse. A second model postulates that psychiatric disorders and drug use are correlated because they share one or more common aetiological factor(s). The third model posits that drug use and abuse predict or precede certain psychiatric disorders. We present data from a recent longitudinal study to support this latter model. As drug use and abuse have been shown to increase the likelihood of psychiatric disorders, it is clear that medical attention needs to be given to adolescents who use drugs of abuse. It is expected that a decrease in adolescent drug abuse should lead to an accompanying reduction in later psychiatric disorders.     

澳门住院产妇婴儿喂养态度影响因素的研究

目的:探讨澳门住院产妇婴儿喂养态度的现状及其影响因素。方法:2009年12月至2011年12月,在澳门一间公立医院住院部,采用方便抽样法对468名华裔产妇在产后3天应用中文版婴儿喂养态度量表(IIFAS)进行横断面调查。结果:产后3天IIFAS总分为(58.94±6.21)分;多元线性回归分析发现有4个因素进入回归方程,其中产妇持有奶粉喂养意图、产后3天采取奶粉喂养方法、产妇的母乳喂养知识不充足与母乳喂养态度呈负相关(β=-0.267、-0.101、-0.087,P<0.05)。孕期接受过母乳喂养卫教与母乳喂养态度呈正相关(β=0.103,P<0.05)。产后3天IIFAS总分在产妇的教育程度、年龄、分娩方式、婚姻、家庭月收入、有无产假、是否饮酒、在澳门居住年限和有无喂奶经验等方面无统计学差异(P>0.05)。结论:澳门产妇的婴儿喂养态度处于中高水平,婴儿喂养态度总分越高越趋向于采取母乳喂养行动。婴儿喂养意图、孕期母乳喂养卫教、母乳喂养知识和产后早期婴儿喂养方式是影响澳门产妇婴儿喂养态度的主要因素。     

Sociodemographic and clinical factors associated with comorbid hazardous cannabis use among psychiatric patients at a tertiary hospital in Jamaica

Objective: This research aimed at assessing comorbid cannabis use among psychiatric patients and the factors associated with it at a tertiary hospital in Jamaica.

Methods: This was a hospital-based cross-sectional study of patients accessing psychiatric services at a tertiary hospital. Pearson chi-squared test for independence used to assess subgroup differences on categorical variables. Multivariate logistic regression analyses were used to assess the sociodemographic characteristics and clinical factors associated with hazardous cannabis use. Statistical significance was taken at p < 0.05.

Results: Among the 280 patients, 68% were males. The mean age was 33.88 ± 14.38 years. Approximately half (48%) of the participants were cannabis users. In bivariate analysis, cannabis use was associated with male gender (p < 0.001), being 30 years of age or younger (p < 0.001), being unemployed (p < 0.05), religiously affiliated (p < 0.01), and having a past history of aggression (p < 0.001). In multivariate analysis, residing in Kingston/St Andrew [urban locality] (AOR: 7.74, 95%CI: 2.18–27.49) and being affiliated with a religion (AOR: 3.50, 95%CI: 1.20–10.19) were significantly positively associated with hazardous cannabis use.

Conclusion: Comorbid cannabis use was high among the patients. Parish of residence and religious affiliation were independent predictors of hazardous cannabis use. Clinical factors had no significant association with hazardous cannabis use.     

Comparison of substance use knowledge and attitude among senior students in military secondary schools in Ibadan,Nigeria

Introduction: The purpose of this study was to compare the knowledge and attitudes regarding substance use of senior students attending military secondary schools in Ibadan, Nigeria.

Methods: Cross‐sectional surveys were carried out in two schools located within different military barracks at Ojoo and Apata areas of Ibadan, using a self‐administered questionnaire.

Results: The mean age was 15±1.2 years and 15±1.3 years for respondents in Ojoo and Apata schools, respectively. Out of a maximum score of 30, the mean knowledge scores were 12.4±4.2 and 12.1±3.4 for the Ojoo and Apata schools, respectively. The difference in the mean scores between the two schools was not statistically significant p = 0.457. High disapproval rates were obtained for tobacco use (75.8 vs 76.5%) and for cocaine use (73.4 vs 70.6%) by the respondents in Ojoo and Apata schools, respectively. Positive attitudes were shown by respondents towards acceptance of substances as only 6.3 and 10.6% of respondents from Ojoo and Apata schools, respectively, indicated willingness to accept substances, if offered.

Conclusion: Although similar knowledge and attitudes regarding substance use were found among senior students in the military schools in Ibadan, the gap in knowledge identified suggests the need for health education intervention.     

The impact of education and media on contraceptive use in Bangladesh: A multivariate analysis

In this paper, an attempt is made to show the impact of education and media on contraceptive use and also to identify the factors that associated with the current use of contraception and continuing of contraception. To reach our goal, Bangladesh Demographic and Health Survey (BDHS 2007) data were used. Findings of this study reveal that education, age of the respondents, religion, media exposure, area of residence and if they belong to any of the non‐governmental organizations (Grameen Bank, Bangladesh Rural Advancement Committee, ASA, Mother's club, etc.) have significant contribution to current use of contraception and continuing of contraception. Media, particularly TV, and education play the leading role regarding this issue, whereas the others have an indirect relationship. Multivariate analyses showed that contraceptive use were higher among educated women and those women who watch TV at least once a week as compared with their respective counterpart. The results indicate urgent need to give emphasis on education, ensuring electronic media exposure, head‐to‐head communication programme, institutional‐based family planning education and necessary information to learn about the impact of overpopulation for the people all over the country.     

孕晚期BAPT得分对产妇产后六个月停止母乳喂养行为的影响

目的 分析、评价孕晚期断奶预测量表（Breastfeeding Attrition Prediction Tool,BAPT）得分对产后早期停止母乳喂养行为影响,为相关干预措施的制订和实施提供依据。方法 采用前瞻性观察性研究,选取2019年6-10月在上海市某妇产科医院进行产检的孕妇为研究对象370例,随访至产后6个月。分别于建卡时、孕晚期32-36周,使用一般资料问卷和断奶预测量表（The Breastfeeding Attrition Prediction Tool,BAPT）BAPT进行问卷调查,并在产后7-12个月采用电话随访母乳喂养情况。 结果 最终纳入数据分析的328例研究对象中产后6个月断奶率为23.2%。计划母乳喂养的产妇消极母乳喂养情绪量表（Negative Breastfeeding Sentiment,NBS）得分最低,而积极母乳喂养情绪量表（Positive Breastfeeding Sentiment,PBS）和母乳喂养控制量表（Breastfeeding Control Scale,BFC）得分最高;不同母乳喂养持续时间计划BAPT得分有统计学差异。多因素分析显示BAPT相关得分与产后6个月断奶行为无关,而丈夫吸烟和婴儿出生时添加配方奶显著增加产妇产后6个月断奶的风险（OR=2.325,95%CI:1.156-4.678, P=0.018;OR=3.887,95%CI:2.147-7.035,P<0.001）。结论 医疗机构可针对相关因素提供干预措施,进一步减少产后早期断奶率,促进母婴健康。     

Mental stress and psychosocial factors at work in relation to multiple‐site musculoskeletal pain: A longitudinal study of kitchen workers

Among 385 female kitchen workers, we examined (1) whether mental stress and psychosocial factors at work (job control, skill discretion, supervisor support, co‐worker relationships, and hurry) predict multiple‐site musculoskeletal pain (MSP; defined as pain at ≥3 of seven sites) and (2) reversedly, whether MSP predicts these psychosocial factors. Data were collected by questionnaire at 3‐month intervals during 2 years. Trajectory analysis was applied. Four trajectories of MSP prevalence emerged: Low, Descending, Ascending, and High. For the psychosocial factors, a two‐trajectory model (Ascending or High vs. Low) yielded the best fit. In logistic regression analysis, with the Low MSP trajectory as reference, poor co‐worker relationships (odds ratio [OR] 3.9), mental stress (3.1) and hurry (2.1) at baseline predicted belonging to the High MSP trajectory. Also MSP at baseline predicted the trajectories (Ascending vs. Low) of low job control (2.2) and mental stress (3.2). Adverse changes in most psychosocial factors were associated with belonging to the High (ORs between 2.3 and 8.6) and Ascending (2.7–5.5) MSP trajectories. In generalized estimating equations, time‐lagged by 3 months, all psychosocial factors but two predicted MSP (1.4–2.1), allowing, e.g. for MSP at baseline, and vice versa, MSP predicted low job control, low supervisor support, and mental stress (1.4–2.0), after adjustment for e.g. the relevant psychosocial factor at baseline. In conclusion, we found that several psychosocial factors predicted MSP and that MSP predicted several psychosocial factors. The results suggest a cumulative process in which adverse psychosocial factors and MSP influence each other.