Substance Use and Intimate Partner Violence: Clarifying the Relevance of Women’s Use and Partners’ Use

Research has shown that, when women and/or their partners are involved in substance use, women’s risk for intimate partner violence (IPV) is higher. Prior research has not examined whether substance use by both women and their partners contributes independently or interactively to women’s risk of victimization and has not identified factors moderating the effect of substance use by victim or partner. Mental health and social support are explored as moderators of the association between women’s victimization and substance use by victim or partner in a study of 590 impoverished women residing in the Los Angeles area. This study found that substance use by both the woman and her partner independently predicted IPV and that social support moderated the effect of women’s substance use. These findings clarify the relevance of substance use in the context of intimate relationships and that of social support as a buffer against IPV among impoverished women.     

A Mixed-Methods Exploration of Women’s Experiences of Anal Intercourse: Meanings Related to Pain and Pleasure

The aim of this mixed-methods study was to document and analyze the dimensions and meanings of anoreceptive pain and pleasure among heterosexual women. An online survey was carried out on a convenience sample of 1,893 women aged 18–60 years. Qualitative data were collected using open-ended questions mailed to women who expressed interest in continuing participation in the study; narratives from 68 women who had experienced anal intercourse were collected and analyzed for pain themes. Most surveyed women had experienced anoreceptive intercourse. A majority of women (79.1 %) reported their first anal intercourse to be painful, but for most of them the intensity and duration of pain/discomfort substantially diminished over time. Less than a third (27.7 %) of participants who regularly engaged in anoreceptive intercourse in the past 12 months stated that they rarely or never experience pain/discomfort with the practice. Nevertheless, most women who continued to practice anal intercourse (58.1 %) reported it to be very arousing and pleasurable. The pleasure associated with anoreceptive intercourse was best predicted by masturbatory frequency and orgasmic ability (with sexual intercourse). The qualitative assessment pointed to a wide range of personal experiences with and meanings attached to pain/discomfort associated with anoreceptive intercourse. Three broad pain themes emerged: (1) pain as insurmountable obstacle, (2) strategic management of pain, and (3) pain eroticization. The study findings suggested that the successful inclusion of anal intercourse into a couple’s sex life is often dependent on a specific learning process.     

Understanding the Psychological Distress of Food Insecurity: A Qualitative Study of Children’s Experiences and Related Coping Strategies

BackgroundFood insecurity, a condition of inadequate household food availability, affects 15.7% of US households with children. Food insecurity is generally believed to affect the quantity and quality of food consumed. However, an understudied but important aspect of the experience of food insecurity is psychological distress.ObjectiveTo critically explore the psychological distress associated with children’s food insecurity using children’s own reports of their experiences.DesignIn-depth qualitative interviews conducted with children to better understand the psychological distress associated with food insecurity.Participants/settingSixty children (aged 7 to 14 years) were recruited from the San Francisco Bay Area. Children were eligible in the case that they spoke English fluently and their parent reported any experience of household food insecurity during the past year.ResultsChildren discussed six themes related to the psychological distress associated with food insecurity: worrying about not having enough food, worrying about their parents’ well-being, anger and frustration about not having enough food, embarrassment about their family’s food situation, strain on the family’s dynamics due to food insecurity, and sadness over not having enough food. After describing their experiences, children described strategies they employed to tolerate or cope with food insecurity, including distracting from or using their imagination to cope with food insecurity, increasing tolerance of their family’s food situation, and appreciating their parents for providing food and resources.ConclusionsFood insecurity contributes to children’s psychological distress. Given the known effects of chronic stress in childhood, the psychological distress of food insecurity may represent an important mechanism by which food insecurity adversely influences children’s growth and development and deserves investigation in future studies.     

U.S. Minority Homeless Youth’s Access to and Use of Mobile Phones: Implications for mHealth Intervention Design

Few interventions for homeless youth have leveraged the potential of mHealth technologies, in part because of the limited data on phone behaviors, perceptions, and intervention preferences among youth experiencing homelessness. We conducted 9 focus groups (n = 52 homeless youth) and 41 individual structured interviews also with homeless youth in underserved communities in Baltimore and Washington, DC, to ascertain how youth perceived their mobile phone, acquired and maintained mobile services over time, and thought mHealth programs for this population should be designed. We also measured phone use, functionality, source, duration of ownership, and reasons for changing phones or numbers. Results showed that mobile coverage was high, as most youth self-purchased phones or received gift payments from others. Maintaining mobile connectivity was often challenging because of financial constraints and interpersonal conflict. Youth valued phones to access social support but used several tactics to avoid perceived negative consequences of phone ownership, such as harassment, theft, or relational disputes. Youth most preferred mHealth content relating to sexual, reproductive, and mental health provided that mobile communication was confidential, empowering, and integrated with other digital media. Integrating hidden phones, financial support, and safety management may improve homeless youth’s access to and engagement with mHealth strategies over time.     

Prenatal Substance Use and Perceptions of Parent and Partner Use Using the 4P’s Plus Screener

Maternal and Child Health Journal - Background Prenatal substance use screening is recommended. The 4 P’s Plus screener includes questions on perceived problematic substance use in parents...     

Children’s health and the environment. A global perspective

Book review | Buchbesprechung

Children’s health and the environment. A global perspective     

Measuring Men’s Gender Norm Beliefs Related to Contraception: Development of the Masculine Norms and Family Planning Acceptance Scale

Male partner resistance is identified as a key factor that influences women’s contraceptive use. Examination of the masculine norms that shape men’s resistance to contraception—and how to intervene on these norms—is needed. To assess a gender-transformative intervention in Kenya, we developed and evaluated a masculinity-informed instrument to measure men’s contraceptive acceptance—the Masculine Norms and Family Planning Acceptance (MNFPA) scale. We developed draft scale items based on qualitative research and administered them to partnered Kenyan men (n?=?150). Item response theory-based methods were used to reduce and psychometrically evaluate final scale items. The MNFPA scale had a Cronbach’s α of 0.68 and loaded onto a single factor. MNFPA scores were associated with self-efficacy and intention to accept a female partner’s use of contraception; scores were not associated with current contraceptive use. The MNFPA scale is the first rigorously developed and psychometrically evaluated tool to assess men’s contraceptive acceptance as a function of male gender norms. Future work is needed to test the MNFPA measure in larger samples and across different contexts. The scale can be used to evaluate interventions that seek to shift gender norms to increase men’s positive engagement in pregnancy spacing and prevention.

     

Chinese-Australian Women’s Knowledge,Facilitators and Barriers Related to Cervical Cancer Screening: A Qualitative Study

Understanding the different facilitators and barriers to screening within cultural and ethnic groups is important for developing appropriate education and outreach programs to underserved groups. Qualitative methods were employed to gain a rich understanding of participant views. In-depth interviews were conducted with 18 Chinese Australian women in their native languages and analysed using content analysis. Knowledge of cervical cancer was low, and few participants understood the benefits and purpose of screening. Having a doctor’s recommendation was a strong motivator, and returning for screening was encouraged by having a female Chinese doctor perform the exam, receiving a reminder letter and the absence of cost for screening participation. However, participation was inhibited by logistical barriers, cultural beliefs and previous painful screening experiences. A range of multifaceted facilitators and barriers must be considered when developing interventions to increase the rates of cervical screening in this population.     

“Educate the Individual . . . to a Sane Appreciation of the Risk”A History of Industry’s Responsibility to Warn of Job Dangers Before the Occupational Safety and Health Administration

The Occupational Safety and Health Act of 1970 and the Workers Right to Know laws later in that decade were signature moments in the history of occupational safety and health. We have examined how and why industry leaders came to accept that it was the obligation of business to provide information about the dangers to health of the materials that workers encountered. Informing workers about the hazards of the job had plagued labor–management relations and fed labor disputes, strikes, and even pitched battles during the turn of the century decades. Industry’s rhetorical embrace of the responsibility to inform was part of its argument that government regulation of the workplace was not necessary because private corporations were doing it.Open in a separate windowThe Occupational Safety and Health Act of 1970 and the Workers Right to Know laws later in that decade were signature moments in the history of occupational safety and health. They enshrined in law the principle that employers had a responsibility to protect their workforce in part by informing them of the potential hazards of the substances they worked with and the chemical makeup of the materials they encountered as part of their work. Today, we take for granted the idea that workers have a right to know about the dangers of the job. Under new federal and state regulations, the means of informing workers about the hazardous materials they use can take many forms: material safety data sheets, container labeling, warning posters, even lectures on safety and health organized by formal labor–management committees. Although there is a rich literature about warnings for consumers, particularly as it addresses pharmaceuticals and food safety,1 there is relatively little that explores the rich, often fraught, history of warnings and education about danger in the workplace in the era before the passage of the Occupational Safety and Health Act.2We look at part of that history, and we show that modern “standards of behavior,” that is, ethical responsibilities of industries to protect the workforce by educating them “to a sane appreciation of the risk” developed during the first half of the 20th century. In the face of labor challenges regarding the control of the work process and the resistance of management to labor demands, industry reasserted its “right” to control the work floor and, at least rhetorically, acknowledged its obligation to provide a safe workplace for its workforce. Part of that obligation, industry said, was to provide information to their workers about the dangers they faced from the machinery and materials with which they came in contact.Through a variety of trade associations, federations, and organizations, such as the National Civic Federation, the National Safety Council, and the Manufacturing Chemists Association, industry engaged in “preemptive reform,” a “co-optation” of challenges that radicals and unions, such as the Industrial Workers of the World during the progressive era and the Congress of Industrial Organization during the Great Depression, were incorporating into their demands over wages, hours, and working conditions.3 “Progressive” industry initiatives on warnings and safety campaigns would hopefully eliminate or delay blame of and litigation and regulatory efforts against industry for many decades. It was not until the late 1960s that the inadequacy of such a voluntary approach was challenged by labor and the left. The Occupational Safety and Health Act and other regulatory legislation put in place legal mandates to require information and warnings on the variety of chemicals, asbestos, lead, and other dangerous materials. In response, major industrial leaders argued that such legislation was unnecessary because of business’s existing codes of conduct.     

The Causal Mediation Formula—A Guide to the Assessment of Pathways and Mechanisms

Recent advances in causal inference have given rise to a general and easy-to-use formula for assessing the extent to which the effect of one variable on another is mediated by a third. This Mediation Formula is applicable to nonlinear models with both discrete and continuous variables, and permits the evaluation of path-specific effects with minimal assumptions regarding the data-generating process. We demonstrate the use of the Mediation Formula in simple examples and illustrate why parametric methods of analysis yield distorted results, even when parameters are known precisely. We stress the importance of distinguishing between the necessary and sufficient interpretations of "mediated-effect" and show how to estimate the two components in nonlinear systems with continuous and categorical variables.     

SafeMotherMedicine: Aiming to Increase Women’s Empowerment in Use of Medications During Pregnancy and Breastfeeding

Maternal and Child Health Journal - Approximately 80% of pregnant women use medications. There is a need for evidence based medicines information that provide realistic risk estimates as pregnant...     

Use of cellular or cordless telephones and the risk for non-Hodgkin’s lymphoma

Objectives: To evaluate the use of cellular and cordless telephones as the risk factor for non-Hodgkin’s lymphoma (NHL). Methods: Male and female subjects aged 18–74 years living in Sweden were included during a period from 1 December 1999 to 30 April 2002. Controls were selected from the national population registry. Exposure to different agents was assessed by questionnaire. Results: In total, 910 (91%) cases and 1016 (92%) controls participated. NHL of the B-cell type was not associated with the use of cellular or cordless telephones. Regarding T-cell NHL and >5 year latency period, the use of analogue cellular phones yielded: odds ratio (OR) = 1.46, 95%; confidence interval (CI) = 0.58–3.70, digital: OR=1.92, 95%; CI=0.77–4.80 and cordless phones: OR=2.47; CI=1.09–5.60. The corresponding results for certain, e.g. cutaneous and leukaemia, T-cell lymphoma for analogue phones were: OR=3.41, 95%; CI=0.78–15.0, digital: OR=6.12, 95%; CI=1.26–29.7 and cordless phones: OR=5.48, 95%; CI=1.26–23.9. Conclusions: The results indicate an association between T-cell NHL and the use of cellular and cordless telephones, however based on low numbers and must be interpreted with caution. Regarding B-cell NHL no association was found.