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Sarah Averbach Othman Kakaire Rachel McDiehl Christine Dehlendorf Felicia Lester Jody Steinauer 《Contraception》2019,99(2):87-93
Objective
This study assessed whether immediate postpartum insertion of levonorgestrel contraceptive implants is associated with a difference in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 and 6 months postpartum compared to delayed insertion at 6 to 8 weeks postpartum.Study design
We conducted a randomized trial of women in Uganda who desired contraceptive implants postpartum. We randomly assigned participants to receive either immediate (within 5 days of delivery) or delayed (6 to 8 weeks postpartum) insertion of a two-rod levonorgestrel contraceptive implant system. This is a prespecified secondary analysis evaluating breastfeeding outcomes. The primary outcome of this secondary analysis was change in infant weight; infants were weighed and measured at birth and 6 months. We used a validated questionnaire to assess onset of lactogenesis daily in person while participants were in the hospital, and then daily by phone after they left the hospital, until lactogenesis was documented. We used interviewer-administered questionnaires to assess breastfeeding continuation and concerns at 3 months and 6 months postpartum.Results
Among the 96 women randomized to the immediate group and the 87 women to the delayed group, the mean change in infant weight from birth to 6 months was similar between groups: 4632?g in the immediate group and 4407?g in the delayed group (p=.26). Among the 97 women who had not experienced lactogenesis prior to randomization, the median time to onset of lactogenesis did not differ significantly between the immediate and delayed groups (65?h versus 63?h; p=.84). Similar proportions of women in the immediate and delayed groups reported exclusive breastfeeding at 3 months (74% versus 71%; p=.74) and 6 months (48% versus 52%; p=.58).Conclusion
We found no association between the timing of postpartum initiation of levonorgestrel contraceptive implants and change in infant growth from birth to 6 months, onset of lactogenesis, or breastfeeding continuation at 3 or 6 months postpartum.Implications
This study provides evidence that immediate postpartum initiation of contraception implants does not have a deleterious effect on infant growth or initiation or continuation of breastfeeding. 相似文献3.
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Rachel A. Woolrich Myra J. Cooper Hannah M. Turner 《Cognitive therapy and research》2006,30(6):735-748
Objective: The study explored the semantic content and origins of negative self-beliefs, and their functional links to “not eating enough” and other behaviors, in participants with anorexia nervosa (AN). Method: Fifteen women meeting DSM-IV criteria for AN were compared with 17 dieting and 18 non-dieting women matched on age and number of years of education. The main outcome measure was a semi-structured interview. Results: Six themes were identified in the beliefs of participants with AN. These were, in order of decreasing frequency, powerlessness (present in all but three AN participants), failure, defectiveness, unattractiveness, worthlessness and emptiness. Importantly, powerlessness and failure beliefs were consistently present independent of Beck Depression Inventory-II scores. The negative early life experiences associated with these beliefs had high distress and responsibility ratings. Participants with AN reported that they employed specific behaviors, particularly ‘not eating enough,’ and ‘placating others,’ to try to reduce the cognitive and emotional impact of their negative self-beliefs. Discussion: The findings are discussed in relation to the role of powerlessness and the function of “not eating enough” in cognitive theory and therapy for AN.
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Rachel Yaff Zisk 《Pain Management Nursing》2003,4(1):40-51
Though human pain has existed since the dawn of time, formal medical pain relief in the form of anesthesia and analgesia has been available only since the mid-nineteenth century. Even after these measures became available, they were used very selectively for the first 100 years of their existence. The youngest patients, especially, were denied pain relief, probably because they could not complain about their pain as articulately and as effectively as adult patients could. A desperate need existed for health care professionals to recognize and appreciate the fact that their youngest patients could suffer immensely and to adequately address the issue. This article reviews the evolution of knowledge and attitudes regarding young patients' pain and addresses why and how this process occurred. The evolution of knowledge was traced by reviewing the literature found in MEDLINE, CINAHL, and LEXIS-NEXIS searches and through hand searches of articles that were frequently cited. Physiologic, pharmacologic, ethical, and psychologic aspects of young patients' pain are addressed. A unique phenomenon arose from the data reviewed. The process of belief and changes in practice were encouraged not only by advances in science, but also by consumer demand. Advances in the past decade in the management of young patients' pain were profound, but are still not complete. Understanding the evolution surrounding pain recognition in young patients provides a stepping stone that can facilitate further improvements in the management of pain in young patients. 相似文献
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Sheela R Geraghty Barbara S Davidson Barbara B Warner Amy L Sapsford Jeanne L Ballard Betsy A List Rachel Akers Ardythe L Morrow 《Journal of human lactation》2005,21(1):59-66
Although there are well-established clinical human milk banks in the United States, there are no milk banks specifically intended to foster research on human milk. The authors' goal was to establish a milk bank with a core data set to support exploratory and hypothesis-driven studies on human milk. Donations to the Cincinnati Children's Research Human Milk Bank are accepted within the context of ongoing, hypothesis-driven research or on an ad hoc basis. Donors must give informed consent, and scientists wishing to use the samples must have Institutional review board approval for their use. Development of more research human milk banks can potentially provide resources for multidisciplinary collaboration and advance the study of human milk and lactation. 相似文献
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