163 research outputs found
Attitudes Toward Intimate Partner Violence and Associations With Condom Use Among Men in Haiti: An Analysis of the Nationally Representative Demographic Health Survey
Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes towards intimate partner violence, knowledge of and use of condoms among 9,493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time they had sex. Logistic regression revealed that believing it was justified for a man to hit or beat his wife if she refuses to have sex with him was associated with a lower odds of condom use. The odds of using a condom during last sex was higher among men who reported knowing condoms can prevent HIV and who had been tested for HIV. Given the low rate of condom use among men in Haiti, these findings suggest that interventions promoting HIV knowledge, HIV testing, and gender-violence prevention among men may also increase condom use
A Qualitative Study of Georgian Youth Who Are on the Street or Institutionalized
Street children, or children who live and/or spend time on the streets, are a vulnerable group of considerable concern to the global public health community. This paper describes the results of two linked qualitative studies conducted with children living or spending time on the street and in orphanages in and around urban areas in the Republic of Georgia between 2005 and 2006. The studies examined perceived causes of children going to the street, as well as indicators of healthy functioning and psychosocial problems among these children. Results on causes indicated a range of âpushâ factors leading children to the street and âpullâ factors that keep children living on the street. Findings also showed a range of internalizing and externalizing mental health symptoms among children on the street and within orphanages. Some differences in responses were found between children living on the street and in institutions. It is important to understand the perspectives of these vulnerable populations to guide decisions on appropriate interventions that address their primary problems
Perspectives on Transitioning Uninsured Persons from an Emergency Department to Federally Qualified Health Centers in East Baltimore
Many people in the United States rely on the emergency department (ED) for their usual source of primary care. Linking these ED users to a source of longitudinal primary care could provide significant health benefits. To assess an intervention attempting to connect ED users to federally qualified health cents (FQHCs), we conducted semi-structured, in-depth interviews with volunteers, health facility providers, and a patient and a focus group with program volunteers. All sessions were digitally recorded, transcribed and analyzed to develop emergent themes highlighting the barriers and facilitating factors that affect the process of connecting patients to primary care. Themes included that 1) the ED is the preferred source of primary care over FQHCs, 2) there are limited links between EDs and FQHCs and 3) the evaluated intervention acts through and depends on patientsâ prioritization of health and access to resources. Our findings suggest that, in addition to addressing individual needs, social services programs are well positioned to help increase communication between providers at FQHCs and EDs about both the services available to patients and patientsâ medical care histories
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Early maternal depressive symptoms and child growth trajectories: a longitudinal analysis of a nationally representative US birth cohort
Background: Maternal depressive symptoms are negatively associated with early child growth in developing countries; however, few studies have examined this relation in developed countries or used a longitudinal design with data past the second year of the childâs life. We investigated if and when early maternal depressive symptoms affect average growth in young children up to age 6 in a nationally representative sample of US children. Methods: Using data from 6,550 singleton births from the Early Childhood Longitudinal Study -- Birth Cohort (ECLS-B), we fit growth trajectory models with random effects to examine the relation between maternal depressive symptoms at 9 months based on the twelve-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) and child height and body mass index (BMI) to age 6 years. Results: Mothers with moderate/severe depressive symptoms at 9 months postpartum had children with shorter stature at this same point in time [average 0.26 cm shorter; 95% CI: 5 cm, 48 cm] than mothers without depressive symptoms; children whose mothers reported postpartum depressive symptoms remained significantly shorter throughout the childâs first 6 years. Conclusions: Results suggest that the first year postpartum is a critical window for addressing maternal depressive symptoms in order to optimize child growth. Future studies should investigate the role of caregiving and feeding practices as potential mechanisms linking maternal depressive symptoms and child growth trajectories
Ready for School? A Systematic Review of School Readiness and Later Achievement
The association between specific school readiness skills and long-term school-related outcomes are still unclear and under debate It is the first study to systematically review the literature on factors associated with school readiness evaluation about school-age achievement This review included longitudinal studies with a minimum follow-up of five years these studies performed the assessments during early childhood The authors registered the study in the PROSPERO database CRD42018089694 Five databases were searched PubMed Scielo Scopus ERIC and Psyc Articles Independent reviewers screened a total of 4 278 articles that were retrieved and 13 were eligible for inclusion Results showed that early language and math abilities at preschool age middle to higher socioeconomic status and socialemotional skills were the most significant variables in the promotion of positive school-age development Preschool education and socioe motional or behavioral skills may compensate for academic difficulties in later school achievemen
Impact of stressful life events on central adiposity in the Pelotas Birth Cohort
OBJECTIVE: To investigate how stressful life events and social support relate to central adiposity in Southern Brazil. METHODS: Data included information from 802 participants in the 1982 Pelotas Birth Cohort that was collect in 2004â2005 and 2006. Stratifying by sex, we studied self-reported stressful life events during the year before 2004â2005 in relation to change in waist circumference between 2004â2005 and 2006 and waist-to-hip ratio in 2006, using both bivariate and multivariate linear regression models. RESULTS: In adjusted models, the experience of stressful life events during the year before 2004â2005 predicted a change in waist circumference in 2006 in men and a change in both waist-to-hip ratio in 2006 and waist circumference between 2004â2005 and 2006 in women. Men who experienced two or more stressful events had on average a one centimeter increase in their waist circumference between 2004â2005 and 2006 (β = 0.97, 95%CI 0.02â1.92), compared to those reporting no stressful events. For women, those who had one and those who had two or more stressful life events had over a 1 cm increase in their waist circumference from 2004â2005 to 2006 (β = 1.37, 95%CI 0.17â2.54; β = 1.26, 95%CI 0.11â2.40, respectively), compared to those who did not experience any stressful event. For both sexes, social support level was not significantly related to either waist-to-hip ratio or change in waist circumference, and it did not modify the association between stress and central adiposit
Family concerns and relationship problems in anxious pregnant women and their associations with postnatal functional disability in Pakistan.
ObjectiveExpanding on existing research suggesting that strategies to reduce prenatal anxiety can decrease functional disability (e.g., difficulties in performing everyday activities and social participation), we examined if this effect varied by type of anxiety-producing problem (i.e., having family concerns and relationship problems versus other problems) reported during pregnancy. Further, we explored if perceived social support mediated this relationship.MethodsWe used longitudinal data on 310 anxious Pakistani women who received any psychosocial intervention sessions as part of a program that was based on Cognitive Behavioral Therapy. The Psychological Outcome Profiles (PSYCHLOPS) was used to assess whether women had 'family concerns and relationship problems' or 'other problems.' The WHO Disability Assessment Schedule 2.0 assessed functional disability at six-weeks after delivery. Lack of support was measured using a 12-item Multi-dimensional Scale of Perceived Social Support. We employed linear regression to examine associations between types of problems reported during pregnancy and postnatal functional disability. Causal mediation analysis was used to assess whether postnatal social support mediated this relationship.ResultsOf anxious pregnant women, 34% reported family concerns or relationship problems as primary problems in pregnancy. They were more likely to report higher functional disability at six-weeks after delivery than women who reported other problems (adjusted B = 2.40, 95% CI: 0.83-3.97). Lack of overall social support (Estimateindirect = 0.69, 95% CI: 0.04-1.38) and lack of support from friends (Estimateindirect = 0.62, 95% CI: 0.01-1.29) significantly mediated the relationship.ConclusionsFindings suggest that complementing pre- and post-natal care with support programs and services that address family concerns and relationship problems, as well as enhancing social support is important to functional disability
Exploring preference for delivery methods for a psychosocial intervention for prenatal anxiety: A qualitative study from a tertiary care hospital in Pakistan.
ObjectiveThis qualitative study explores therapists' and participants' preferences for delivery methods (face-to-face and phone sessions) of a cognitive behavioral therapy-based psychosocial intervention for prenatal anxiety delivered in a tertiary care hospital.SettingThe research was conducted in a randomized controlled trial in Pakistan, where a shift from face-to-face to phone-based therapy occurred during the coronavirus disease-2019 (COVID-19) pandemic.ParticipantsTwenty in-depth interviews and a focus group discussion were conducted with participants and therapists, respectively. Transcripts were analyzed using thematic analysis.ResultsParticipants generally preferred face-to-face sessions for rapport building, communication, and comprehension. However, barriers like venue accessibility, childcare, and lack of family support hindered engagement. Telephone sessions were favored for easy scheduling and the comfort of receiving the session at home, but there were challenges associated with phone use, distractions at home, and family members' limited mental health awareness. A mix of face-to-face and telephone sessions was preferred, with rapport from in-person sessions carrying over to telephone interactions.ConclusionThis study underscores the need for adaptable intervention delivery strategies that consider cultural norms, logistical challenges, and individual family dynamics. By combining the benefits of both delivery methods, mental health interventions can be optimized to effectively address prenatal anxiety and promote well-being in resource-constrained settings like Pakistan
The Role of Zinc and Iron-Folic Acid Supplementation on Early Child Temperament and Eating Behaviors in Rural Nepal: A Randomized Controlled Trial
Child eating behaviors play an important role in nutrient intake, ultimately affecting child growth and later outcomes in adulthood. The study assessed the effects of iron-folic acid and zinc supplementation on child temperament and child eating behaviors in rural Nepal. Children (N = 569) aged 4â17 months in Sarlahi district, southern Nepal were randomized to receive daily supplements of placebo, iron-folic acid, zinc, or zinc plus iron-folic acid and followed for approximately 1 year. At baseline and four follow-up visits mothers completed questionnaires including information on demographic characteristics and child temperament and eating behaviors. The main effects of zinc and iron-folic acid supplementation on temperament and eating behaviors were assessed through crude and adjusted differences in mean cumulative score changes between visits 1 and 5. The adjusted rate-of-change for these outcomes was modeled using generalized estimating equations. Mean changes in temperament scores and in eating behavior scores between visits 1 and 5 were not significant in either the zinc or non-zinc group. Children in the iron-folic acid group increased temperament scores by 0.37 points over 5 visits (95% CI 0.02, 0.7), which was not significant after adjustment. Neither the adjusted rate-of-change in temperament scores between zinc and non-zinc (β = â0.03, 95% CI â0.3, 0.2) or iron-folic acid and non-iron-folic acid (β = 0.08, 95% CI â0.2, 0.3) were significantly different. Adjusted rate of change analysis showed no significant difference between zinc and non-zinc (β = â0.14, 95% CI â0.3, 0.04) or between iron and non-iron eating behavior scores (β = â0.11, 95% CI â0.3, 0.1). Only among children with iron-deficiency anemia at baseline was there a significant decrease in eating behavior score, indicating better eating behaviors, when supplemented with zinc (β = â0.3, 95% CI â0.6, â0.01), Ultimately, this effect of zinc on eating behaviors was the only effect we observed after approximately one year of micronutrient supplementation
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