Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study

<p>Abstract</p> <p>Background</p> <p>Although studies have shown an association between anxiety and depression and obesity, psychological health among obese women during and after pregnancy has not been carefully studied. The aim of this study was to investigate psychological well-being using symptoms of depression and/or anxiety among obese pregnant women attending a weight gain restriction program and to then compare this group with a control group receiving traditional antenatal care.</p> <p>Methods</p> <p>151 obese pregnant women in an intervention group and 188 obese pregnant women in a control group answered the Beck Anxiety Inventory (BAI) and the Edinburgh Postnatal Depression Scale (EPDS). Group differences between the two groups were estimated by using the χ²- test on categorical variables. The Student's <it>t</it>-test on continuous, normally distributed variables measuring changes in mean score on BAI and EPDS over time was used. To make a more comprehensive assessment of group differences, between as well as within the two groups, logistic regressions were performed with the BAI and EPDS as dependent variables, measured at gestational weeks 15 and 35 and 11 weeks postnatal. The grouping variable has been adjusted for socio-demographic variables and complications.</p> <p>Results</p> <p>The prevalence of symptoms of anxiety during pregnancy varied between 24% and 25% in the intervention group and 22% and 23% in the control group. The prevalence of symptoms of anxiety postnatally was 9% in the intervention group and 11% in the control group. Five percent of the women in the intervention group and 4% of the women in the control group showed symptoms of anxiety during the course of pregnancy and at the postpartum assessment. The prevalence of symptoms of depression during pregnancy varied between 19% and 22% in the intervention group but was constant at 18% in the control group. Postnatal prevalence was 11% in both groups. Six percent of the women in the intervention group and 4% in the control group showed symptoms of depression during the course of pregnancy and at the postpartum assessment. We found no differences between the two groups as concerns demographic characteristics, weight gain in kg, or the distribution of scores on anxiety and depressive symptoms nor did we find differences in the fluctuation of anxiety and depressive symptoms over time between the women in the intervention group and in the control group.</p> <p>Conclusion</p> <p>Obese pregnant women attending an intervention program seem to have the same risk of experiencing anxiety and/or depressive symptoms as do obese pregnant and postnatal women in general.</p

The Law of Lenity: Enacting a Codified Federal Rule of Lenity

The rule of lenity is an ancient canon of statutory construction that requires courts to find in favor of criminal defendants charged under ambiguous statutes. Traditionally, lenity endorses important constitutional concerns regarding due notice, consistent enforcement of law, and legislative supremacy. In modern courts, if lenity were regularly—and properly—applied, it could combat important social problems that plague our criminal justice system. Ambiguous laws allow government actors to arbitrarily target disfavored groups. And more generally, ambiguity within criminal law contributes to overcriminalization, wanton punishment, and capricious enforcement. As the volume of federal criminal law continues to expand, this overcriminalization leads to extreme mass incarceration in the United States. Lenity, if applied more potently in the federal courts, could help combat these serious social issues by supplying a safety valve against the multitude of ambiguous statutes written by Congress. The problem with lenity today, however, is that courts are rarely clear where lenity should fit within criminal statutory interpretation. Federal courts, including the Supreme Court, alter how they apply lenity case by case. This Note argues that lenity should be codified federally as a clear statement rule, as several states have already done. Specifically, to achieve a consistent and strong application of lenity in the federal courts, Congress should direct the federal courts to apply lenity immediately after an initial textual analysis fails to clarify an ambiguous statute. Codified lenity would guide courts in lenity’s application and underscore its fundamental importance to the criminal justice system

Информационные технологии в обучении компьютерному моделированию узлов и агрегатов уборочных машин

Материалы III Респ. науч.-метод. конф., Гомель, 31 окт.–1 нояб. 2013 г

Weight gain restriction for obese pregnant women : An Intervention study

Introduction: Obesity is a growing global public health problem and is as prevalent among pregnant women as in the general population. It is well known that obese women have an increased risk for several complications during pregnancy and delivery and this is also true for the neonate. Excessive gestational weight gain among obese women seems to further increase these risks for adverse outcomes. It has not been known up to the time of this study whether a behavioral intervention program designed for obese pregnant women could result in a reduction of gestational weight gain. Aim: The overall aim of the present thesis was to study the effect of an intervention program designed to control weight gain among obese pregnant women during pregnancy and to then observe the outcomes of their pregnancies. In addition we wanted to learn if this behavioral intervention program could result in a weight gain of less than seven kilograms. Material and methods: The intervention group consisted of 155 obese (BMI &gt;30 kg/m2) pregnant women at the antenatal care clinic (ANC) in Linköping; the control group consisted of 193 obese pregnant women in two other cities. The women in the intervention group were offered, in addition to regular care at the ANC, motivational interviewing in weekly visits to support them in making this behavioral change. They were also offered aqua aerobic class once or twice a week. The women in the control group attended the routine antenatal program in their respective ANCs. Outcome measures were: weight in kg, pregnancy-, delivery and neonatal outcomes, prevalence of anxiety- and depressive symptoms and attitudes and experiences of participating in an intervention program. Results: The women in the intervention group had a significantly lower gestational weight gain and also had a lower postnatal weight than the women in the control group. The percentage of women in the intervention group who gained &lt;7 kg was greater than the percentage in the control group. There were no differences between the two groups in pregnancy-, delivery- and neonatal outcomes. In addition, there was no difference in prevalence of symptoms of anxiety and depressions between the intervention- and control group and the gestational weight gain did not have any effect on symptoms of depression or anxiety. The women in the intervention group with gestational weight gain &lt;7 kg, weighed less at the two years follow-up than the women in the control group. Most of the women who participated in the intervention program expressed positive attitudes and were positive towards their experiences with the intervention program and their efforts to manage the gestational weight gain. Conclusion: The intervention program was effective in controlling weight gain during pregnan-cy and did not change the pregnancy, delivery or neonatal outcomes or the prevalence of anxie-ty- and depressive symptoms. The group with a gestational weight gain &lt;7 kg showed the same distribution of complications as the group with a higher weight gain. The intervention program seems to influence the development of weight in a positive direction up to two years after childbirth. The women were also satisfied with their participation in the intervention program

Lifestyle habits and womens attitudes towards discussing them at a visit for contraceptive advice

Objective: The aims of this study was to use visits for contraceptive counselling as opportunities for examining womens actual life style habits with the main focus being placed on alcohol consumption but also to evaluate the womens opinions about discussing their alcohol and tobacco habits and their weight status. Methods: A total of 535/802 (67%) women completed a study-specific anonymous questionnaire after a contraceptive counselling visit with a midwife. Results: A majority of the women thought that a discussion concerning alcohol habits at a contraceptive counselling session was important (85.5%) and not intrusive (86.4%) neither embarrassing (81.7%). Women with high-risk drinking habits were younger, more often tobacco users and more often planning for childbirth in the future, compared with women who did not display high-risk drinking behaviour. A significantly higher percentage of women who practiced high-risk drinking thought that a discussion of alcohol was intrusive (10.9%) and embarrassing (46.7%), compared with women not practicing highrisk alcohol consumption. Most women (72.9%) stated that no other caregiver during the preceding year except the midwife had discussed drinking habits with them. The weight was a good thing that the midwife brought up for discussion according to 82.5% of the women but the discussions about weight was more often found embarrassing (18.4%) than the discussion about alcohol habits. Conclusion: Women who came for contraceptive counselling found the discussion concerning alcohol habits important, not intrusive or embarrassing and a good thing to be brought up by the midwife. (C) 2014 Elsevier B.V. All rights reserved.Funding Agencies|Swedish Risk Drinking Project</p

The Association Between Covariates, with Emphasis on Maternal Body Mass Index, and Duration of Exclusive and Total Breastfeeding

Objective:The aim of this study was to evaluate the association between possible covariates, with emphasis on maternal body mass index (BMI), on exclusive breastfeeding and on total breastfeeding during the first postnatal year. Design:A longitudinal study encompassing 723 women who were followed during the first postnatal year Methods:Data concerning pregnancy, delivery, neonatal period, and breastfeeding were extracted from respective medical records. Sociodemographic data on the participants were self-reported. The Cox Proportional Hazard Model was used for investigating the effects of different covariates. Results:Compared with women with BMI &amp;lt;25.0, obese women ran a higher risk of ceasing exclusive breastfeeding prematurely (Hazard ratio [HR] = 1.38,p = 0.009). Multiparous women had a lower risk of ceasing the exclusive breastfeeding prematurely, than primiparous women (HR = 0.78,p = 0.009). Concerning exclusive breastfeeding as well as total breastfeeding, the risk of prematurely ceasing the breastfeeding decreased with increasing age (p = 0.028 andp &amp;lt;= 0.001, respectively). Median duration of exclusive breastfeeding was shorter among obese women compared with women with BMI &amp;lt;30.0 (3.0 months versus 6.0 months). Corresponding figures for total breastfeeding were 4.0 months versus 8.0 months. Concerning parity and exclusive breastfeeding, there was no difference in median duration between primiparous women and multiparous women (4.0 months), whereas multiparous women had a longer median duration of total breastfeeding, than primiparous women (8.0 months versus 7.0 months). Conclusion:The risk of ceasing exclusive breastfeeding prematurely is high among obese women. This result indicates the need for targeted supportive interventions, individualized according to BMI. With increasing age, the risk of ceasing breastfeeding prematurely decreases, and compared with primiparous women, multiparous women run a lower risk of ceasing exclusive breastfeeding prematurely

Weight six years after childbirth : a follow-up of obese women in a weight-gain restriction programmme

OBJECTIVE: to compare weight development in an intervention group and a control group, six years after participation in a gestational weight-gain restriction programme. DESIGN: follow-up of a prospective intervention study. SETTINGS: antenatal care clinics. PARTICIPANTS: a total of 129 women (88.4%) from the original intervention group and 166 women (88.8%) from the original control group. MEASUREMENTS: the women answered a study specific questionnaire, covering socio-demographic data and health- and weight status. FINDINGS: after adjusting for socio-demographic factors, the mean weight was lower (4.1kg) among the women in the intervention group, compared to the controls (p=0.028). Furthermore, the mean weight change, e.g. the weight at the six year assessment compared with the weight at the start of the intervention at the first antenatal care visit, was greater in the intervention group than in the control group. The women in the intervention group had a larger mean weight change (-5.2kg), e.g. weighed less than the women in the control group (-1.9kg) (p=0.046). Mean weight change expressed in 5kg classes also showed a significant difference between the two groups (p=0.030). KEY CONCLUSIONS: the results indicate that attending a gestational weight-gain-restriction programme can have a positive effect on weight up to six years after the intervention. IMPLICATION FOR PRACTISE: a restrictive gestational weight gain can result in a positive weight development during the first years after childbirth. It might provide both short- and long term medical health benefits for the mother as well as the child

Weight six years after childbirth : a follow-up of obese women in a weight-gain restriction programmme

OBJECTIVE: to compare weight development in an intervention group and a control group, six years after participation in a gestational weight-gain restriction programme. DESIGN: follow-up of a prospective intervention study. SETTINGS: antenatal care clinics. PARTICIPANTS: a total of 129 women (88.4%) from the original intervention group and 166 women (88.8%) from the original control group. MEASUREMENTS: the women answered a study specific questionnaire, covering socio-demographic data and health- and weight status. FINDINGS: after adjusting for socio-demographic factors, the mean weight was lower (4.1kg) among the women in the intervention group, compared to the controls (p=0.028). Furthermore, the mean weight change, e.g. the weight at the six year assessment compared with the weight at the start of the intervention at the first antenatal care visit, was greater in the intervention group than in the control group. The women in the intervention group had a larger mean weight change (-5.2kg), e.g. weighed less than the women in the control group (-1.9kg) (p=0.046). Mean weight change expressed in 5kg classes also showed a significant difference between the two groups (p=0.030). KEY CONCLUSIONS: the results indicate that attending a gestational weight-gain-restriction programme can have a positive effect on weight up to six years after the intervention. IMPLICATION FOR PRACTISE: a restrictive gestational weight gain can result in a positive weight development during the first years after childbirth. It might provide both short- and long term medical health benefits for the mother as well as the child