Socio-Economic Determinants and Self-Reported Depressive Symptoms During Postpartum Period

The researchers' aims were to estimate the prevalence of postpartum depressive symptoms in Italy. Cross-sectional data from the survey, “Health and use of health care in Italy” were analyzed. The authors focused on 5,812 women, pregnant some time during five years before the survey. Multiple logistic regression was used to evaluate risk factors independently associated with postpartum depressive symptoms. Evaluation of seasonal trends was also performed.In the total sample, 23.5% (n = 1,365) reported having suffered postpartum depressive symptoms: 20.7% experienced baby blues, and 2.8% postpartum depression. Factors significantly associated with baby blues were, among others, living in northern or central areas (adjusted odds ratio [aOR] 1.88; 95%CI 1.57–2.15 and 1.40; 95%CI 1.20–1.63, respectively), history of depression (aOR 1.34; 95%CI 1.15–1.56), and attendance at antenatal classes (aOR 1.13; 95%CI 1.04–1.22). Factors significantly associated with postpartum depression were: anamnesis of depression (aOR 3.32; 95%CI 2.69–4.09), gaining more than 16 kg of weight during pregnancy (aOR 1.48; 95%CI 1.03–2.12), and undergoing a cesarean section (planned: aOR 1.56; 95%CI 1.05–2.29; unplanned: aOR 1.78; 95%CI 1.16–2.73). Multiparity was a protective factor both for baby blues (aOR 0.80; 95%CI 0.70–0.91), and postpartum depression (aOR 0.71; 95%CI 0.51–0.98). No clear seasonality was observed for postpartum depression, while for baby blues a certain aggregation of events was registered during the central months of the year. The authors' study highlighted variables associated with baby blues and postpartum depression to target screening for women for postpartum depressive symptoms.     

Socio-economic determinants and self-reported depressive symptoms during postpartum period

The researchers' aims were to estimate the prevalence of postpartum depressive symptoms in Italy. Cross-sectional data from the survey, "Health and use of health care in Italy" were analyzed. The authors focused on 5,812 women, pregnant some time during five years before the survey. Multiple logistic regression was used to evaluate risk factors independently associated with postpartum depressive symptoms. Evaluation of seasonal trends was also performed.In the total sample, 23.5% (n = 1,365) reported having suffered postpartum depressive symptoms: 20.7% experienced baby blues, and 2.8% postpartum depression. Factors significantly associated with baby blues were, among others, living in northern or central areas (adjusted odds ratio [aOR] 1.88; 95%CI 1.57-2.15 and 1.40; 95%CI 1.20-1.63, respectively), history of depression (aOR 1.34; 95%CI 1.15-1.56), and attendance at antenatal classes (aOR 1.13; 95%CI 1.04-1.22). Factors significantly associated with postpartum depression were: anamnesis of depression (aOR 3.32; 95%CI 2.69-4.09), gaining more than 16 kg of weight during pregnancy (aOR 1.48; 95%CI 1.03-2.12), and undergoing a cesarean section (planned: aOR 1.56; 95%CI 1.05-2.29; unplanned: aOR 1.78; 95%CI 1.16-2.73). Multiparity was a protective factor both for baby blues (aOR 0.80; 95%CI 0.70-0.91), and postpartum depression (aOR 0.71; 95%CI 0.51-0.98). No clear seasonality was observed for postpartum depression, while for baby blues a certain aggregation of events was registered during the central months of the year. The authors' study highlighted variables associated with baby blues and postpartum depression to target screening for women for postpartum depressive symptoms.     

Police-Reported Intimate Partner Violence During Pregnancy and the Risk of Antenatal Hospitalization

OBJECTIVES: Intimate partner violence (IPV) is a significant public health problem and the abuse of women during pregnancy is of particular concern. Few studies have addressed the relationship between IPV and antenatal hospitalization. This study utilized a novel approach to examine the impact of IPV during pregnancy on antenatal hospitalization not associated with delivery. METHODS: This retrospective cohort study included Seattle women residents 16-49 years of age. Exposed subjects were women with a police-reported IPV incident during pregnancy in the years 1995 through 1998 and who subsequently had a singleton live birth or fetal death. The unexposed group was composed of randomly selected residents with a singleton birth or fetal death and without a police-reported IPV incident during the study period. Linked hospital discharge files and birth records were utilized to determine study outcomes. Logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Women reporting any IPV during pregnancy were twice as likely as unexposed women to experience an antenatal hospitalization not associated with delivery (aAOR 2.39, CI 1.77, 3.24). Women with IPV were more likely to have been hospitalized with a substance abuse-related diagnosis (aOR 2.70, CI 1.52, 4.78) or a mental health-related diagnosis (aOR 1.93, CI 0.96, 3.91). Physical IPV was more strongly associated with antenatal hospitalization than nonphysical IPV or IPV overall. CONCLUSION: This study suggests that women hospitalized during pregnancy, particularly those with substance abuse and mental health-related conditions, may be at high risk for concurrent IPV.     

Preconception Health Promotion Among Maryland Women

Despite current guidelines that all reproductive age women receive preconception care (PCC), most US women do not, especially women with a prior birth. The objective of our study was to identify factors associated with receipt of PCC health promotion counseling among Maryland women and to assess whether prior birth outcome affects receipt of counseling. We analyzed Maryland pregnancy risk assessment monitoring system data for a stratified random sample of women with a live birth in 2009–2010; 3,043 women with PCC data were included in the analysis. The dependent variable was receipt of any PCC counseling, and the primary independent variable, prior pregnancy outcome (no prior live birth, term, preterm). 33.1 % of the weighted sample received PCC. Odds of PCC were similar for women with a history of prior prior preterm birth (aOR 1.00, 95 % CI 0.57–1.78) and no prior live birth, but decreased for women with a prior full term delivery (aOR 0.69, 95 % CI 0.51–0.94). They were decreased for women with unintended births (aOR 0.36, 95 % CI 0.26–0.51) and increased for women with a diagnosis of asthma (aOR 1.74, 95 % CI 1.05–2.89) or diabetes (aOR 2.79, 95 % CI 1.20–6.45), who used multivitamins (aOR 2.58, 95 % CI 1.92–3.47), and had dental cleanings (aOR 1.60, 95 % CI 1.16–2.18). Although selected preventive health behaviors and high-risk conditions were associated with PCC, most women did not receive PCC. Characterization of women who do not receive PCC health promotion counseling in Maryland may assist in efforts to enhance service delivery.     

Prevalence and Associated Factors of Intimate Partner Violence Among Pregnant Women Attending Kisumu District Hospital, Kenya

To determine prevalence and factors associated with intimate partner violence (IPV) among pregnant women seeking antenatal care. This was a cross-sectional study conducted at Kisumu District Hospital, Kenya amongst randomly selected pregnant women. A structured questionnaire was used to collect data. Participants self-reported about their own IPV experience (lifetime, 12 months prior to and during index pregnancy) and associated risk factors. Data were analyzed using Epi-info. The mean age of the 300 participants was 23.7 years. One hundred and ten (37 %) of them experienced at least one form of IPV during pregnancy. Psychological violence was the most common (29 %), followed by sexual (12 %), and then physical (10 %). Women who experienced IPV during pregnancy were more likely to have witnessed maternal abuse in childhood (aOR 2.27, 95 % CI = 1.05–4.89), been in a polygamous union (aOR 2.48, 95 % CI = 1.06–5.8), been multiparous (aOR 1.94, 95 % CI = 1.01–3.32) or had a partner who drank alcohol (aOR 2.32, 95 % CI = 1.21–4.45). Having a partner who attained tertiary education was protective against IPV (aOR 0.37, 95 % CI = 0.16–0.83). We found no association between HIV status and IPV. IPV is common among women seeking antenatal care at Kisumu District Hospital. Health care providers should be alerted to the possibility of IPV during pregnancy in women who witnessed maternal abuse in childhood, are multiparous, polygamous, have a partner who drinks alcohol or has low level education. Screening for IPV, support and referral is urgently needed to help reduce the burden experienced by pregnant women and their unborn babies.     

Effect of Multiple Previous Miscarriages on Health Behaviors and Health Care Utilization During Subsequent Pregnancy

BackgroundWomen with a history of miscarriage report feeling emotionally guarded during a subsequent pregnancy and may be at increased risk for pregnancy-related anxiety and greater health care utilization compared with women without a history of miscarriage. However, these behaviors have not been studied in women with a history of multiple miscarriages.MethodsWe examined the effect of a history of multiple miscarriages on health behaviors and health care utilization in 2,854 women ages 18 to 36 years expecting their first live-born baby. Self-reported health behaviors and use of health care resources during pregnancy were compared for women with a history of two or more miscarriages and women with one or no miscarriages.FindingsWomen with a history of multiple miscarriages were more than four times as likely to smoke during pregnancy (adjusted odds ratio [aOR], 4.69; 95% CI, 2.63–8.38) compared with women without a history of multiple miscarriages. They initiated prenatal care earlier (7.0 vs. 8.2 weeks gestation), had higher odds of third trimester emergency department visit (aOR, 2.21; 95% CI, 1.24–3.94), higher odds of hospitalization during pregnancy (aOR, 1.66; 95% CI, 1.01–2.73), and twice the mean number of third trimester emergency department visits and hospitalizations during pregnancy.ConclusionsWomen with a history of multiple miscarriages may be more likely to smoke and may demonstrate increased health care utilization during a subsequent pregnancy. Compassionate, individualized, and supportive counseling by providers may address smoking and other health behaviors as well as increased health care utilization.     

上海市徐汇区非本地户籍孕妇的性传播疾病感染及相关因素分析

目的探究上海市徐汇区非本地户籍孕妇的性传播感染情况并分析高发病种的相关因素。方法选取2020年4月—2022年3月在徐汇区某综合医院进行初次产前检查的非本地户籍孕妇，并进行性传播疾病感染的调查；采用logistic回归模型分析细菌性阴道病和解脲脲原体感染的相关因素。结果徐汇区非本地户籍孕妇性传播疾病感染率由高到低的前3位是解脲脲原体感染、细菌性阴道病及霉菌性阴道炎，感染率分别为13.2%、9.8%和4.7%。孕妇年龄为25~35岁（调整后的OR值aOR=0.53，95%CI:0.28~0.98）和月收入≥8 000元（aOR=0.30，95%CI:0.11~0.82）与解脲脲原体感染明显相关。妊娠次数为2次（aOR=4.95，95%CI:1.59~15.46）、第1次性关系发生于婚前（aOR=2.83，95%CI:1.04~7.74）、丈夫酗酒（aOR=3.83，95%CI:1.08~13.56）、文化程度为高中（aOR=0.27，95%CI:0.08~0.93）及丈夫曾有外地旅居史（aOR=0.30，95%CI:0.12~0.79）与细菌性阴道病明显相关。结论年龄较小、收入较低的孕妇更可能感染解脲脲原体。妊娠次数较多、第1次发生性关系于婚前及丈夫酗酒的孕妇较易感染细菌性阴道病。应加强这些人群的随访监测。     

Violence in childhood,attitudes about partner violence,and partner violence perpetration among men in Vietnam

PurposeWe assess the association of men’s exposure to violence in childhood—witnessing physical violence against one’s mother and being hit or beaten by a parent or adult relative—with their attitudes about intimate partner violence (IPV) against women. We explore whether men’s perpetration of IPV mediates this relationship and whether men’s attitudes about IPV mediate any relationship of exposure to violence in childhood with perpetration of IPV.MethodsFive hundred twenty-two married men 18–51 years in Vietnam were interviewed. Multivariate regressions for ordinal and binary responses were estimated to assess these relationships.ResultsCompared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of reporting more reasons to hit a wife (aOR, 1.43; 95% CI, 1.03–2.00 and aOR, 1.66; 95% CI, 1.05–2.64, respectively). Men’s lifetime perpetration of IPV accounted fully for these associations. Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of ever perpetrating IPV (aOR, 3.28; 95% CI, 2.15–4.99 and aOR, 4.56; 95% CI, 2.90–7.17, respectively). Attitudes about IPV modestly attenuated these associations.ConclusionsAddressing violence in childhood is needed to change men’s risk of perpetrating IPV and greater subsequent justification of it.     

Associations of intimate partner violence with unintended pregnancy and pre-pregnancy contraceptive use in South Asia

ObjectiveTo assess associations of intimate partner violence (IPV) with pregnancy intendedness and pre-pregnancy contraceptive use among pregnant women in South Asia.Study designCross-sectional analyses were conducted using the most recent Demographic and Health Surveys from Bangladesh, India and Nepal for married, pregnant women aged 15–49 years who responded to IPV assessments specific to current marriage (N= 4738). Adjusted logistic and multinomial regression analyses were conducted with pooled data to assess associations of IPV ever (sexual only, physical only, sexual plus physical or none) with the outcomes of pregnancy intendedness (wanted, mistimed or unwanted) and pre-pregnancy contraceptive use (no, traditional or modern) for the current pregnancy.ResultsIPV was not associated with a mistimed or unwanted pregnancy. Sexual IPV was associated with pre-pregnancy modern contraceptive use (aOR=2.32, 95% CI=1.24, 4.36); sexual plus physical IPV was associated with pre-pregnancy traditional contraceptive use (aOR=1.85, 95% CI=1.12, 3.07). Post hoc analysis of reasons for pre-pregnancy contraceptive discontinuation revealed that women with a history of IPV, particularly sexual IPV, had higher prevalence of contraceptive failure (sexual only, 37.3%; sexual plus physical, 30.9%; physical only, 22.6%; no IPV, 13.6%).ConclusionPregnant women who experienced sexual IPV from husbands were more likely to use contraceptives pre-pregnancy but had no reduced risk unintended pregnancy, possibly due to higher rates of pre-pregnancy contraceptive failure among those with this history. These findings suggest that victims of sexual IPV are able to acquire and use family planning services but require more support to sustain effective contraceptive use.ImplicationsFamily planning services are reaching women affected by sexual IPV, and programs should be sensitive to this concern and the heightened vulnerability to contraceptive failure these women face. Long-acting reversible contraception could be beneficial by allowing women to have greater reproductive control in situations of compromised sexual autonomy.     

Discussions About Intimate Partner Violence During Prenatal Care in the United States: The Role of Race/Ethnicity and Insurance Status

Over 1.5 million women are physically, sexually, and emotionally abused by intimate partners in the U.S. each year. Despite the severe health consequences and costs associated with intimate partner violence (IPV), most health providers fail to assess patients for abuse. It was of interest to examine the occurrence of IPV discussions during prenatal care (PNC) visits among women who experienced IPV. This study analyzed data from the 2004–2008 National Pregnancy Risk Assessment Monitoring System which included 195,687 women who delivered a live birth in the U.S. IPV victimization was measured using four items that addressed physical abuse by a current or former husband/partner in the 12 months before or during pregnancy. Responses were categorized as preconception, prenatal, preconception and prenatal, and preconception and/or prenatal IPV. The outcome was IPV discussions by health providers during PNC. Separate logistic regression models provided odds ratios and 95 % confidence intervals. Women who reported prenatal IPV were less likely to have IPV discussions during PNC (OR = 0.81, 95 % CI = 0.70–0.94). Results were similar for women experiencing IPV during the prenatal and preconception periods. Among racial/ethnic minorities, women who experienced preconception IPV were less likely to have discussions about IPV during PNC. Further, Medicaid recipients who reported preconception and/or prenatal IPV were less likely to report IPV discussions (OR = 0.75, 95 % CI = 0.69–0.82). This study underscores a public health problem and missed opportunity to connect battered victims to necessary services and care. It elucidates the state of current clinical practice and better informs policies on incorporating universal IPV screening.     

Detecting intimate partner violence during pregnancy: awareness-raising indicators for use by primary healthcare professionals

BACKGROUND: Given the deleterious consequences of intimate partner violence (IPV) for gestation, it is important to promote a more effective and amicable approach that engenders greater receptiveness, stimulates more open communication and, ultimately, facilitates addressing the problem. In this regard, active primary care professionals need to be educated about the different profiles of violence found in domestic environments. The aim of this study is to make the identification of those subgroups of pregnant women most likely to be living in IPV situations both practical and simple. Its ultimate goal is to give healthcare professionals who work directly with the public the tools to anticipate such events. To this end, this study presents a profile of IPV during pregnancy according to different characteristics observed among primary health service users. METHODS: Five hundred and twenty-seven women who carried children to term in Rio de Janeiro were interviewed. A Portuguese version of the Revised Conflict Tactics Scale (CTS2) was used to detect IPV. Several sociodemographic factors, life habits and reproductive health characteristics of pregnant women and their partners were scrutinized. Prevalence projections by subgroup were obtained using a multinomial logit model. RESULTS: The projected prevalences for negotiation, psychological violence, minor physical violence and severe physical violence were, respectively, 0.1% [95% confidence interval (CI) 0.0-0.6], 2.6% (95%CI 0.7-6.9), 7.0% (95%CI 1.7-18.5) and 90.3% (95%CI 77.2-96.8) for the extreme scenario, i.e. women <20 years of age, non-White, living in house with inadequate garbage disposal, previous history of abortion, reporting fear of someone, reporting lack of affective social support, and reporting drug use by woman or spouse. In the absence of these characteristics, the projected prevalences were 51.3% (95%CI 38.5-64.6), 40.0% (95%CI 28.5-51.9), 7.6% (95%CI 4.2-12.7) and 1.1% (95%CI 0.3-2.4), respectively. CONCLUSION: This study found that knowledge of certain characteristics of pregnant women who attend health services can alert professionals to the high probability of IPV, facilitating early identification of the problem and subsequent implementation of proactive measures.     

How rates of perinatal mental health screening in Australia have changed over time and which women are missing out

Objectives : To report rates of perinatal mental health screening from 2000 to 2017 and investigate factors associated with not being screened both antenatally and postnatally more recently (2013–2017). Methods : A longitudinal community‐based study of self‐reported perinatal mental health screening with a national sample of 7,566 mothers from the Australian Longitudinal Study on Women's Health reporting on 9,384 children. The main outcome measure was whether mothers were asked about their emotional wellbeing by a health professional, including completing a questionnaire. Results : From 2000 to 2017, the percentage of women not screened decreased from 40.6% to 1.7%. The percentage of women screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013 to 2017, women who were older (aOR, 0.65; 95%CI, 0.52–0.81) or had reported emotional distress (aOR, 0.77; 95%CI, 0.60–0.99) were less likely to have been screened both antenatally and postnatally. Conclusions : Despite improvements, perinatal mental health screening is not yet universal. One‐in‐five women are not screened both antenatally and postnatally, including women in high‐risk populations such as those who have reported emotional distress. Implications for public health : Women are in regular contact with health professionals in the perinatal period. This opportunity to detect women at risk of perinatal mental health issues is too important to be missed.     

Determinants of influenza and pertussis vaccine uptake in pregnant women in Ireland: A cross-sectional survey in 2017/18 influenza season

In Ireland seasonal influenza and pertussis vaccination during pregnancy is recommended and every year national campaigns are organised to raise awareness and improve uptake. We estimated influenza and pertussis vaccine uptake and identified factors associated with vaccination status in pregnant women in 2017/18.We conducted a face-to-face omnibus survey, with quota sampling, among women aged 18–55 years and collected socio-demographic characteristics, self-reported vaccination status, awareness of vaccine campaigns, and attitudes towards vaccination. Sample was weighted to ensure representativeness with the target population. We performed univariate and multivariable logistic regression analyses on survey data.Overall, 241 pregnant women were enrolled. Influenza and pertussis vaccine uptake was 61.7% and 49.9%, respectively. Awareness of vaccine campaign and socio-economic status (SES) were associated with both influenza and pertussis vaccine uptake. The association between SES and uptake of vaccines differed by awareness. Women aware of the influenza vaccine campaign and with mid and low SES were less likely to be vaccinated, compared to those with high SES (aOR = 0.46; 95%CI: 0.22–0.97; aOR = 0.27; 95%CI: 0.12–0.60, respectively); women not aware of the pertussis vaccine campaign and with mid and low SES were less likely to be vaccinated, compared to those aware and with high SES (aOR = 0.15; 95%CI: 0.04–0.48; aOR = 0.05; 95%CI: 0.01–0.24, respectively).General practitioner (GP) recommendation was the main reason for receiving influenza vaccine (39.2%), and 71.8% of women were recommended pertussis vaccination from their GPs.The survey reports moderate uptake of vaccines among pregnant women, inequalities in uptake by SES and identifies GPs as primary source for vaccine recommendation. We recommend multifaceted campaigns, by engaging GPs, to target all socio-economic groups.     

Prevalence and severity of intimate partner violence in women living in eight indigenous regions of Mexico

The aim of this study was to identify the prevalence and severity of intimate partner violence (IPV) in eight indigenous regions of Mexico, as well as the socioeconomic and demographic variables that are associated with this phenomenon. A cross-sectional study was conducted in indigenous regions that have a greater availability of government medical services than other indigenous regions. Interviews were conducted with female patients (n = 3287) seeking medical care in either of the two public health institutions in these regions. The severity of intimate partner violence (SIPV) during the previous 12 months was measured using a 33-item scale. Multinomial logistic regression analyses were performed to explore the factors associated with SIPV. Intimate partner violence prevalence was 25.5% (95%CI 24.93–25.26). Female partner variables such as personal history of child abuse (OR_A 3.48; 95%CI 2.48–4.89) and work outside the home (OR_A 1.74; 95%CI 1.22–2.49) and male partner variables such as unemployment (OR_A 2.31; 95%CI 1.34–3.97) and a high frequency of alcohol use (OR_A 13.35; 95%CI 7.02–25.39) were the main predictors for IPV. We found a three-fold higher risk of IPV for women living in the Los Altos de Chiapas region (OR_A 3.01; 95%CI 1.88–4.79) compared with women in the Mayan region (reference category). Such results should aid decision makers in the development of extended public policies and interventions to address violence against women in the indigenous populations of Mexico.     

Cueing prenatal providers effects on discussions of intimate partner violence

BACKGROUND: Intimate partner violence (IPV) during pregnancy poses a significant health risk to the mother and developing fetus. Practice guidelines recommend that prenatal providers screen for and counsel their patients about IPV, yet many physicians express reluctance or discomfort regarding such discussions. The Health in Pregnancy (HIP) computer program was designed to improve prenatal providers' counseling about behavioral risks. METHODS: English-speaking women 18 years or older, less than 26-weeks pregnant, and receiving prenatal care at one of the five participating clinics in the San Francisco area, were randomized in parallel groups in a controlled trial (June 2006-present; data analyzed June 2007). Participants reporting one or more risks were randomized to intervention or control in stratified blocks. Providers received summary "cueing sheets" alerting them to their patient's risk(s) and suggesting counseling statements. RESULTS: Thirteen percent (37/286) of the sample reported current IPV. Provider cueing resulted in 85% of the IPV-intervention group reporting discussions with their provider, compared to 23.5% of the control group (p<0.001). CONCLUSIONS: IPV discussions were influenced strongly by cueing providers. Provider cueing is an effective and appropriate adjunct to routine risk counseling in prenatal care.     

Prospective Association of Intimate Partner Violence with Receipt of Clinical Preventive Services in Women of Reproductive Age

BackgroundWomen who experience intimate partner violence (IPV) have a greater risk for adverse health outcomes, suggesting the importance of preventive services in this group. Little prior research has explored how IPV exposure impacts receipt of relevant preventive services. We assess the prospective association of IPV exposure with receiving specific preventive services.MethodsWomen in the Central Pennsylvania Women's Health Study's longitudinal cohort study (conducted 2004–2007; n = 1,420) identified past-year exposure to IPV at baseline and receipt of IPV-relevant preventive services (counseling for safety and violence concerns, tests for sexually transmitted infections [STIs], counseling for STIs, Pap testing, counseling for smoking/tobacco use, alcohol/drug use, and birth control) at 2-year follow-up. Multiple logistic regression analysis assessed the impact of IPV on service receipt, controlling for relevant covariates.FindingsWomen exposed to IPV had greater odds of receiving safety and violence counseling (adjusted odds ratio [AOR], 2.40; 95% confidence interval [CI], 1.25–4.61), and tests for STIs (AOR, 2.46; 95% CI, 1.41–4.28) compared with women who had not been exposed to IPV. Independent of other predictors, including IPV, women who saw an obstetrician-gynecologist were more likely to receive Pap tests, STI/HIV testing and counseling, and birth control counseling, compared with women who had not seen an obstetrician-gynecologist.ConclusionOverall rates of preventive service receipt for all women in the sample were low. Women exposed to IPV were more likely to receive safety and violence counseling and STI testing, and seeing an obstetrician-gynecologist increased the odds of receiving several preventive services.     

Impacts of social integration and loneliness on mental health of humanitarian migrants in Australia: evidence from a longitudinal study

Objective: To examine the impacts of social integration and loneliness on the mental health of humanitarian migrants (HMs) in Australia over time. Methods: A total of 1,723 HMs who held permanent visas from the first to third waves (2013–2016) of a longitudinal study in Australia (Building a New Life in Australia) were included in the study. Dependent variables included poor general health, post‐traumatic stress disorder (PTSD) and severe mental illness (SMI). Predictors were social integration stressors and loneliness. We used generalised linear mixed models to assess impacts of the changing status of social integration and loneliness on dependent variables over time. Results: HMs with increased social integration stressors reported poor general health (aOR:1.56, 95%CI:1.19–2.03); PTSD (aOR:1.67; 95%CI: 1.32–2.13); and SMI (aOR: 1.46; 95%CI: 1.15–1.86) over time when compared to those without stressors. Increased loneliness during resettlement was also associated with poor general health (aOR: 1.56; 95%CI:1.28–1.91); PTSD (aOR: 1.57; 95%CI: 1.28–1.93) and SMI (aOR: 1.59; 95%CI: 1.31–1.94). HMs who reported overcoming loneliness (aOR:1.50, 95%CI: 1.24–1.83 for SMI and aOR:1.51; 95%CI: 1.22–1.86 for PTSD) and persistent loneliness (aOR:1.99; 95%CI: 1.51–2.61 for SMI) reported poorer mental health over time than those who did not report loneliness. Implications for public health: Culturally competent settlement services addressing social integration stressors and loneliness are required to improve the mental health of humanitarian migrants.     

Breast screening attendance of Aboriginal and Torres Strait Islander women in the Northern Territory of Australia

Objective : To compare breast screening attendances of Indigenous and non‐Indigenous women. Methods : A total of 4,093 BreastScreen cases were used including 857 self‐identified Indigenous women. Chi‐squared analysis compared data between Indigenous and non‐Indigenous women. Logistic regression was used for groupings based on visits‐to‐screening frequency. Odds ratios and 95% confidence intervals were calculated for associations with low attendance. Results : Indigenous women were younger and had fewer visits to screening compared with non‐Indigenous women. Non‐English speaking was mainly associated with fewer visits for Indigenous women only (OR 1.9, 95%CI 1.3‐2.9). Living remotely was associated with fewer visits for non‐Indigenous women only (OR 1.3, 95%CI 1.1‐1.5). Shared predictors were younger age (OR 12.3, 95%CI 8.1‐18.8; and OR 11.5, 95%CI 9.6‐13.7, respectively) and having no family history of breast cancer (OR 2.1, 95%CI 1.3‐3.3; and OR 1.8, 95%CI 1.5‐2.1, respectively). Conclusions : Factors associated with fewer visits to screening were similar for both groups of women, except for language which was significant only for Indigenous women, and remoteness which was significant only for non‐Indigenous women. Implications for public health : Health communication in Indigenous languages may be key in encouraging participation and retaining Indigenous women in BreastScreen; improving access for remote‐living non‐Indigenous women should also be addressed.     

Determinants of school injury proneness in adolescents: a prospective study

OBJECTIVE: Injury proneness is common in adolescents, but the role of individual factors has received little attention. This study assessed the relationships of a number of individual characteristics with frequency of school injuries. METHODS: This prospective study was conducted on 2396 students from middle schools and high schools in an urban area in France over one school year. A questionnaire was completed by each student at the beginning of the school year, and an injury questionnaire was completed for all injuries that occurred at school during the year. Data were analysed using the chi2 independence test and logistic models. RESULTS: Over the study year, 10.6% of the students had a single injury. Frequent injuries (two or more) were common (2.3%) and were strongly related to younger age [adjusted odds ratio (aOR) 1.52, 95% confidence interval (95%CI) 1.28-1.79], frequent use of psychotropic drugs (aOR 2.03, 95%CI 1.06-3.86) and a poorer average school mark (<10/20, aOR 2.58, 95%CI 1.30-5.12). The occurrence of a single injury was less strongly related to younger age (aOR 1.20, 95%CI 1.11-1.30) and frequent use of psychotropic drugs (aOR 1.43, 95%CI 1.04-1.96), and was also associated with parental absence (aOR 1.33, 95%CI 1.00-1.77), not being calm (aOR 1.41, 95%CI 1.03-1.89) and not being easily irritated (aOR 1.56, 95%CI 1.14-2.13). CONCLUSIONS: This study identified a number of factors associated with injury frequency. This information could be useful for injury prevention. Physicians could help students, parents, teachers and school staff to be more aware of the risks and to find remedial measures.     

Multistate analysis of factors associated with intimate partner violence

BACKGROUND: Reports on prevalence estimates and risk factors of intimate partner violence (IPV) are limited in that they (1) focus on specific subgroup populations that are not representative of all women or (2) involve long questionnaires that are not useful as surveillance tools. OBJECTIVES: To report prevalence estimates and identify demographic and lifestyle factors associated with IPV in a large population-based sample of U.S. women using surveillance data. METHODS: Behavioral Risk Factor Surveillance System (BRFSS) data from eight U.S. states were analyzed individually and as a pooled sample (N=18,415). Multivariate logistic regression models were used to examine associations between IPV and the factors of interest. RESULTS: Factors consistently associated with IPV across the majority of states and in the pooled analysis included young age (pooled adjusted odds ratio [aOR], 3.07), single marital status (pooled aOR, 2.89), divorced/separated marital status (pooled aOR, 4.67), and annual household income <$25,000 (pooled aOR, 1.89). In addition, lack of health insurance, receipt of Medicaid, cigarette smoking, presence of children in the home, self-reported fair/poor health, and frequent mental distress were associated with IPV after adjustment for covariates. CONCLUSIONS: This study provides population-based estimates of IPV prevalence and factors associated with IPV using surveillance data. By pooling BRFSS data from individual states, the resulting large sample has adequate power to detect significant associations and has increased precision in the estimates of IPV risk. In addition, this study identifies high-risk populations to target for education and intervention programs and demonstrates the need for improved IPV surveillance.