Protective Factor For Women Research Articles

Nationwide surveys of awareness of tuberculosis in India uncover a gender gap in tuberculosis awareness

BackgroundTuberculosis remains a major challenge in India, with an estimated 2.69 million cases each year. Although men are more affected than women, gender differences and related factors affect awareness of tuberculosis and thus impact tuberculosis diagnosis and access to treatment. Understanding the gender-specific needs and complexities when diagnosing and treating tuberculosis is essential to manage cases in India.MethodsWe undertook a comparative study using data from three National Family and Health Surveys (NFHS), specifically NFHS-3, NFHS-4 and NFHS-5. We investigated the prevalence and gender disparity in awareness about tuberculosis, and associated factors, using regression analysis.ResultsMost men and women surveyed are between the ages of 15 and 19. Across the surveys, the proportion of men and women who are unaware of spreading of tuberculosis decreases from 44.9% during NFHS 3 to 29.6% during NFHS 5. However, the prevalence ratio of men to women with no knowledge about modes of transmission of Tuberculosis increases from 0.92 during NFHS 3 to 0.98 during NFHS 5. Higher odds with younger age (NFHS 5, aOR: 1.07 (1.01–1.13)) and rural residency (NFHS 5, aOR: 1.12 (1.06–1.18)), and lower odds with unmarried marital status (NFHS 5, aOR: 0.92 (0.86–0.98)) are noteworthy associations. Women and men have differences in knowledge.ConclusionsGender disparity associated with awareness about tuberculosis in India is observed across all three nationwide surveys. Being aged fifteen to nineteen years and residing in rural area are risk factors. Being unmarried is a protective factor for women, but not for men.

Associations between serum uric acid and breast cancer incidence: A systematic review and meta-analysis

BackgroundSerum uric acid (SUA) may be involved in the development of cancer by inhibiting oxidative stress, but its relationship with breast cancer remains unclear. Materials and MethodsThe PubMed, Embase, and Web of Science databases were searched systematically for studies on SUA levels in women with breast cancer and the effect of SUA levels on the risk of breast cancer. The Newcastle‒Ottawa Quality Assessment Scale (NOS) was used to assess the quality of all relevant studies included. ResultsA total of 19 studies were included, including 75,827 women with breast cancer and 508,528 healthy controls. A meta-analysis found that SUA levels were negatively correlated with breast cancer risk in women (HR = 0.94, 95% CI: 0.89 - 0.99, p = 0.003). SUA levels in female breast cancer patients were not significantly different from those in healthy controls (SMD = 0.49, 95% CI = -0.09 - 1.08, p = 0.10), while SUA levels were increased in female breast cancer patients in articles published after 2010, SUA concentration detected by spectrophotometry, and non-Asian populations, regardless of menopausal state and treatment state. ConclusionHigh levels of SUA may reduce the risk of breast cancer in women, suggesting that SUA was a protective factor in women.

Changes in bowel symptoms after different pelvic organ prolapse surgeries among elderly women at the 1-year follow up.

To investigate the prevalence of bowel symptoms in patients with pelvic organ prolapse (POP), to evaluate the changes in bowel symptoms after different POP surgeries, and to identify risk factors for unrelieved bowel symptoms. This was an observational prospective cohort study conducted at Peking University First Hospital from 2020 to 2021. Demographic, clinical, and therapeutic data were collected. Participants underwent POP Quantification examination and completed the Pelvic Floor Distress Inventory-20 questionnaire at baseline and 1 year postoperatively. The prevalence of bowel symptoms and bothersome bowel symptoms in women with POP was 46.38% and 24.40%, respectively. Surgical correction of prolapse was associated with significant relief in bowel symptoms (P < 0.05). Colpocleisis may relieve bowel symptoms better than reconstructive surgeries (41% vs. 31%, P = 0.048). However, 35% of women had at least one bowel symptom at the 1-year follow up. A long perineal body (Pb) and levator ani muscle injury were found to be predictors of unrelieved bowel symptoms in patients undergoing colpocleisis and those undergoing reconstructive surgery, respectively (odds ratio [OR] 2.306, 95% confidence interval [CI] 1.112-4.783, P = 0.025 and OR 3.245, 95% CI 1.266-8.317, P = 0.014, respectively), and perineoplasty was a protective factor for women who underwent colpocleisis (OR 0.102, 95% CI 0.025-0.417, P = 0.001) CONCLUSION: Women with POP have a high prevalence of bowel symptoms. Although bowel symptoms can be relieved after POP surgeries, one-third of women still experience bowel symptoms. A long Pb and levator ani muscle injury were associated with unrelieved bowel symptoms, while perineoplasty was a protective factor.

Factors Associated with the Place of Delivery among Urban Poor Societies in Indonesia.

Pregnant women in urban poor societies are vulnerable groups. Due to low financial capacity, there are obstacles to accessing delivery in an institution for poor women in urban areas. The study analyses factors associated with the delivery place among pregnant women in urban poor society in Indonesia. The study analyzed secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 1,562 samples were childbearing-age women (15-49 years) who gave birth in an urban poor society in Indonesia in the last 5 years. The study examined some variables, such as delivery place, age, education, employment, marital status, parity, insurance, knowledge of pregnancy danger, antenatal care (ANC), the autonomy of health, and family finance autonomy. The study employed binary logistic regression in the final stage. The results show that age is associated with the place of delivery. The higher the education, the higher the possibility for delivery in an institution. Being employed and having partners are protective factors for women in institution delivery. The likelihood of giving birth in a medical facility decreases as more children are born alive. In addition, having health insurance, thorough ANC visits, knowledge of pregnancy danger symptoms, and health autonomy are protective factors for pregnant women having deliveries in medical facilities. On the contrary, pregnant women who rely solely on family financing have a higher chance of delivering in a medical facility. The study concluded that 10 variables were associated with pregnant women's delivery in Indonesia's urban poor society: age, education, employment, marital, parity, insurance, pregnancy danger knowledge, ANC, health autonomy, and family finance autonomy.

Practicing Sport in the Age Group 21-34 and the Risk of Breast Cancer - Analysis of the Results of a Retrospective Study

Breast cancer is the most common malignant tumor in women, so it is important to study the factors that can protect against it. One of them is physical activity, which has become the area of our interest, especially the practice of sports by women aged between 21 and 34. The aim of this retrospective study was to check how practice of sport in the age group of 21-34 in women from the research group diagnosed with breast cancer and in the control group (healthy women from families burdened with this cancer) influences the risk of developing breast cancer. The study showed that healthy women from families with a burden of breast cancer practiced sports in the age range 21-34 more frequently and intensively than women who had a history of breast cancer. (Sport 1-highest intensity P = 0.002 Sport 2-medium intensity P &lt; 0.001 Sport 3-the lowest intensity P &lt; 0.001.) It can be concluded that practicing sport in the age group of 21-34 is an important factor in the prevention of breast cancer, although the influence of other protective factors in women from the control group cannot be ruled out.

Gender discrepancies in predictors for newly onset cardiovascular events and metabolic syndrome in elderly patients from rural China.

The study aimed to estimate the possible predictors of cardiovascular events (CVEs) in elderly patients with metabolic syndrome (MetS) from rural China. Moreover, we also attempted to find the potential risk factors for newly diagnosed MetS. The Northeast China Rural Cardiovascular Health Study (NCRCHS) is a community-based prospective cohort study carried out in rural areas of northeast China. Approximately 1,059 elderly patients with MetS but no cardiovascular diseases and 1,565 elderly patients without MetS at baseline were enrolled in this study. They underwent a physical examination, completed a questionnaire in 2012-2013, and were followed up during 2015-2017. Cox proportional hazard analysis was conducted to assess the possible predictors of newly developed CVEs, and multivariate analysis was used to estimate the risk factors of newly diagnosed MetS. The common predictors of newly developed CVEs in both men and women were family history of stroke (HR [hazard ratios] female: 1.696; HR male: 2.504) and soybean consumption (HR female: 0.253; HR male: 0.130). Moreover, minority race (HR: 0.109), systolic blood pressure (SBP) (HR: 1.021), current drinking habits (HR: 2.551), family history of hypertension (HR: 2.297), LDL-C (HR: 1.669), 5,000-20,000 CNY/year annual income (HR: 0.290), and strenuous physical activity (HR: 0.397) were predictors of CVEs only in male elderly patients. For newly diagnosed MetS, body mass index (OR female: 1.212; OR male: 1.207) and fasting blood glucose (OR female: 1.305; OR male: 1.217) were common risk factors in both genders, whereas age (OR:0.958) was a protective factor in men and > 9-h/day sleep duration (OR:0.212) was a protective factor in women. In addition, SBP (OR:1.014) ≥4 times/day, bean consumption (OR:1.955), and uric acid (OR:1.005) increased the risk of MetS in men but not in women. Our study identified many effective predictors of CVEs in rural elderly patients with MetS and confirmed the presence of a gender-based discrepancy. Moreover, we also identified additional risk factors, along with the traditional ones, for newly diagnosed MetS in rural elderly patients.

O7 - Informed decisions in the third stage of labour – midwives experiences through the lens of portraiture

Using the qualitative methodology of portraiture, this study aims to develop an in-depth understanding of midwives’ experiences of facilitating informed decision-making relating to the management of the third stage of labour. Five (5) Victorian midwives with varying experience working across the continuum of maternity care in diverse midwifery settings, were engaged in one-on-one semi-structured interviews. The qualitative data of each interview was analysed and presented according to the portraiture approach outlined by Lawerence-Lightfoot & Davis and Clarke, Reed & Keyes, as individual in-depth case studies. The purpose of portraiture is to tell a story that allows the reader to see themselves captured in the research. This provokes readers to reflect, feel and think about where they can enact change. Portraits are examined against one another, to search for themes and commonalities, as well as discrepancies. Due to the in-depth understanding of the background of each participant, this allows for a rich insight into midwives’ experiences of facilitating informed decision-making in the third stage of labour. At the time of submitting this abstract, data analysis is still underway. This project is due to be completed by June 2022. Early findings from our analysis of the portraits has led us to understand that midwives identify multiple barriers to truly facilitating informed decision-making for third stage, but continue to advocate for women’s choices in practise. Informed decision-making is a protective factor for women’s mental and physical health in pregnancy and the puerperium, and also has significant implications for midwives’ job satisfaction. This study portrays the unique, and detailed experiences of five thought-provoking, powerful and yet ordinary midwives at differing points in their diverse careers.

Body shame among Asian American college women: the roles of sexual objectification, internalized racism, and ethnic identity strength

ABSTRACT Informed by objectification theory’s tenet that sexual objectification and racism are powerful sociocultural forces that perniciously impact women of color’s mental health, the present study examined the longitudinal links of sexual objectification and three forms of internalized racism (i.e. self-negativity, weakness stereotype, appearance bias) with body shame among Asian American college women (N = 146). Ethnic identity strength, a theorized protective factor in body image literature, was examined as a moderator for the hypothesized longitudinal links. Results indicated that sexual objectification and self-negativity measured at Time 1 had significant and positive bivariate associations with body shame measured at Time 2. However, these variables no longer predicted body shame when body mass index (BMI) was included as a covariate. A significant interaction between appearance bias and ethnic identity strength emerged in predicting body shame. Specifically, high ethnic identity strength exacerbated the detrimental effect of appearance bias on Asian American women’s body shame, whereas low ethnic identity strength buffered this effect. This finding contradicts theoretical views of ethnic identity strength as a protective factor in women of color’s body image development. Practice implications and future research directions are discussed.

FADS1 and FADS2 Gene Polymorphisms Modulate the Relationship of Omega-3 and Omega-6 Fatty Acid Plasma Concentrations in Gestational Weight Gain: A NISAMI Cohort Study.

The polymorphisms of fatty acid desaturase genes FADS1 and FADS2 have been associated with an increase in weight gain. We investigated FADS1 and FADS2 gene polymorphisms and the relation between ω-3 and ω-6 fatty acid plasma concentrations and gestational weight gain. A prospective cohort study of 199 pregnant women was followed in Santo Antônio de Jesus, Brazil. Plasma levels of polyunsaturated fatty acids (PUFAs) were measured at baseline and gestational weight gain during the first, second, and third trimesters. Fatty acid recognition was carried out with the aid of gas chromatography. Single nucleotide polymorphisms (SNPs) were genotyped using real-time PCR. Statistical analyses included Structural Equation Modelling. A direct effect of FADS1 and FADS2 gene polymorphisms on gestational weight was observed; however, only the SNP rs174575 (FADS2) showed a significant positive direct effect on weight over the course of the pregnancy (0.106; p = 0.016). In terms of the influence of SNPs on plasma levels of PUFAs, it was found that SNP rs174561 (FADS1) and SNP rs174575 (FADS2) showed direct adverse effects on plasma concentrations of ω-3 (eicosapentaenoic acid and alpha-linoleic acid), and only SNP rs174575 had positive direct effects on plasma levels of ARA and the ARA/LA (arachidonic acid/linoleic acid) ratio, ω-6 products, while the SNP rs3834458 (FADS2) had an adverse effect on plasma concentrations of EPA, leading to its increase. Pregnant women who were heterozygous and homozygous for the minor allele of the SNP rs3834458 (FADS2), on the other hand, showed larger concentrations of series ω-3 substrates, which indicates a protective factor for women’s health.

Body appreciation as a protective factor in women with fibromyalgia: an examination of associations between pain perception, social comparison and psychological distress.

While symptoms of fibromyalgia (FM) and psychological distress are directly linked, indirect effects are also apparent. The aim of the present study was to develop an explanatory model for the effect of FM on women's psychological distress and identify possible protective and risk factors. This study comprised of total of 293 women aged 20-68 (M= 34.3, SD = 12.1), of which 141 were women with FM and 152 healthy peers (HP), who completed questionnaires regarding demographic characteristics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), social comparison strategies, and pain assessment (SF-MPQ). FM patients demonstrated higher psychological distress, i.e., depression and anxiety and lower body appreciation. Body appreciation significantly correlated with social comparison coping strategies. Body appreciation and social comparison strategies mediated the link between FM and psychological distress. Among FM patients, body appreciation moderated the links between pain intensity and aspects of social comparison strategies, thus explaining the link between pain intensity and psychological distress. Women with FM demonstrated higher levels of anxiety and depression symptoms and lower body appreciation compared to HP. The unique role of body appreciation in moderating the indirect link between pain and psychological distress appears to be protective.

Clinical and economic burden of comorbid coronary artery disease in patients with acute exacerbation of chronic obstructive pulmonary disease: sex differences in a nationwide cohort study

BackgroundCoronary artery disease (CAD) is a common comorbidity of chronic obstructive pulmonary disease (COPD). However, data related to the impact of CAD on outcomes of acute exacerbation of COPD (AECOPD) are limited and whether the relationship depends on sex remains unknown. Our aim was to determine the impact of comorbid CAD on clinical outcomes among men and women with AECOPD.MethodsWe used data from the acute exacerbation of chronic obstructive pulmonary disease inpatient registry (ACURE) study, which is a nationwide observational real-world study conducted between September 2017 and February 2020 at 163 centers in patients admitted with AECOPD as their primary diagnosis. Patients were stratified according to the presence or absence of CAD in men and women. The primary outcomes were the length of hospital stay and economic burden during hospitalization.ResultsAmong 3906 patients included in our study, the prevalence of CAD was 17.0%, and it was higher in women than in men (19.5% vs. 16.3%; P = 0.034). Age and other cardiovascular diseases were common factors associated with comorbid CAD in men and women, while body-mass index, cerebrovascular disease, and diabetes were determinants in men and pre-admission use of long-acting beta-adrenoceptor agonist and home oxygen therapy were protective factors in women. Only in men, patients with CAD had a longer length of hospital stay (median 10.0 vs. 9.0 days, P < 0.001), higher total cost during hospitalization (median $1502.2 vs. $1373.4, P < 0.001), and more severe COPD symptoms at day 30 compared to those without CAD. No significant difference was found in women. Comorbid CAD showed no relationship with 30-day readmission or death regardless of sex. In our real-world study, mortality/readmission risk within 30 days increased in patients with previous frequent hospitalizations and poorer pulmonary function.ConclusionsIn hospitalized AECOPD patients, comorbid CAD was significantly associated with poorer short-term outcomes in men. Clinicians should have heightened attention for men with comorbid CAD to achieve an optimal management of AECOPD patients.

Особенности течения COVID-19 у женщин в пери- и постменопаузе. Роль менопаузальной гормональной терапии

A literature review on the effect of peri- and postmenopausal period on the course of novel coronavirus infection and post-COVID-19 syndrome was performed. The aspects of hormone replacement therapy against the background of therapy for COVID-19 and post-COVID-19 syndrome were studied. The postmenopausal period in women was found to be a risk factor for a more severe course of COVID-19. Estradiol may act as a protective factor for women with COVID-19 by regulating cellular and humoral immunity factors such as interleukin-2, -6, -8, tumor necrosis factor-α and C3. Prolonged course of COVID-19, persistence of its symptoms and development of severe post-COVID-19 syndrome are associated with female sex, with women in peri- and postmenopausal period being most vulnerable. Symptoms of estrogen deficiency and menopause may be similar to the manifestations of post-COVID-19 syndrome, and these conditions can coexist and aggravate each other. According to international experts, the use of hormone replacement therapy will help to improve the well-being of women, their quality of life, and relieve the symptoms typical of menopause and post-COVID-19 syndrome. Key words: coronavirus infection, COVID-19, menopause, post-COVID-19 syndrome, hormone replacement therapy, estrogen

The disparities in health insurance ownership of hospital-based birth deliveries in eastern Indonesia

BackgroundDevelopment in Eastern Indonesia tends to be left behind compared to other Indonesian regions, including development in the health sector. The study aimed at analyzing the health insurance ownership disparities in hospital delivery in Eastern Indonesia.MethodsThe study draws on secondary data from the 2017 Indonesia Demographic and Health Survey. The study population was women aged 15–49 years who had given birth in the last five years in Eastern Indonesia. The study analyzes a weighted sample size of 2299 respondents. The study employed hospital-based birth delivery as a dependent variable. Apart from health insurance ownership, other variables analyzed as independent variables are province, residence type, age group, marital status, education level, employment status, parity, and wealth status. The final stage analysis used binary logistic regression.ResultsThe results showed that insured women were 1.426 times more likely than uninsured women to undergo hospital delivery (AOR 1.426; 95% CI 1.426–1.427). This analysis indicates that having health insurance is a protective factor for women in Eastern Indonesia for hospital delivery. There is still a disparity between insured and uninsured women in hospital-based birth deliveries in eastern Indonesia. Insured women are nearly one and a half times more likely than uninsured women to give birth in a hospital.ConclusionThe study concludes that there are health insurance ownership disparities for hospital delivery in eastern Indonesia. Insured women have a better chance than uninsured women for hospital delivery.

Associations among weight suppression, self-acceptance, negative body image, and eating disorder behaviors among women with eating disorder symptoms

ABSTRACT The present study aimed to clarify existing research that has inconsistently shown that weight suppression (differences between individuals’ highest and current body weights) is associated with worse eating disorder (ED) behaviors and negative body image among women with lifetime EDs, by examining whether an understudied client-supported protective factor for ED pathology – self-acceptance – moderates these associations. Currently symptomatic women with lifetime EDs (N = 108) completed measures assessing self-acceptance and ED symptoms via an online survey. Moderated regressions examined whether self-acceptance moderated associations between weight suppression and both body image (weight/shape preoccupation, overvaluation, dissatisfaction) and ED behavior (dietary restraint, compensatory behaviors, binge eating) outcomes. Results indicated that weight suppression was associated with more severe negative body image and dietary restraint, but not compensatory behaviors or binge eating. In contrast, self-acceptance consistently emerged as a protective factor relative to all negative body image and ED behavior indices. This protective effect did not offset apparent risk factor associations between weight suppression, and negative body image and ED behavior outcomes. These results support further assessment of self-acceptance as an understudied protective factor for women’s ED symptoms and as a mechanism of change in EDs intervention research. Women’s weight suppression should be assessed during ED prevention initiatives.

Estrogens in schizophrenia: What do we know?

IntroductionSchizophrenia is a chronic disease that significantly impacts cognitive functioning. Sex differences in incidence, onset and course of schizophrenia suggest estrogens have a protective role.ObjectivesOur aim is to review the state of the art on this matter.MethodsThrough a selection of the most relevant articles found on PubMed and ClinicalKey searching the keywords: “estrogens” and “schizophrenia”.Results Accumulating evidence has led to the hypothesis that estrogens act as a protective factor in women regarding the onset of schizophrenia as their increase in puberty may help delay the onset of symptoms. Also, the estrogens abrupt decline in menopause may account for a second peak of onset and greater severity of the symptoms. During the menstrual cycle, when serum estrogens are at their lowest, there is an increase in the number of psychotic episodes and an exacerbation of psychotic symptoms. Pregnancy leads to an improvement of psychotic symptoms, which then worsen in postpartum. Clinical trials testing the efficacy of estrogens have been promising, which suggest they might be a useful adjuvant treatment. Despite the evidence of clinical efficacy, health risks for women using estrogen therapy should be considered, as they decrease its acceptability as a viable treatment option. The use of selective estrogen receptor modulators (SERMs), as raloxifene, could be a favorable and safer alternative.ConclusionsIn conclusion, estrogens are proving to be a promising option as a complementary therapy for schizophrenia; however, further studies are needed to investigate whether they might be overall beneficial.DisclosureNo significant relationships.

Postpartum stress and protective factors in women who gave birth in the United States during the COVID-19 pandemic.

Objectives:The COVID-19 pandemic has caused considerable stress throughout the world. Little is known about how postpartum women who gave birth during the early months of the pandemic were impacted. The purpose of this study was to explore and describe the associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during the early months of the COVID-19 pandemic.Methods:Postpartum women over the age of 18 years who gave birth in the US hospitals between March and July of 2020 and spoke English completed a survey about their experiences. Demographic and health variables were measured via self-report. Stress was measured using the Perceived Stress Scale-10. Mastery was measured with the Pearlin Mastery Scale. Resilience was measured with the Connor–Davidson Resilience Scale-2.Results:This study included 885 women. Participants had higher stress and lower resilience relative to pre-pandemic norms. Participants had high levels of depression, anxiety, and stress. Women who had an infant admitted to the neonatal intensive care unit had more stress. Income, full-time employment, and partnered relationships were associated with lower stress. Resilience and mastery were related to lower stress, depression, and anxiety. Black, Indigenous, or People of Color women showed higher stress and lower resiliency. Single women were likely to report lower levels of mastery than partnered women.Conclusion:Stress, depression, and anxiety were high in postpartum women in this study. Income, partnered relationships, and employment security, along with protective traits such as mastery and resilience, may reduce the impact of stress on postpartum women in a pandemic. Care models should be modified to support women during a pandemic. Health disparities exist in postpartum stress. Future interventions should focus on building resiliency and mastery and ensuring appropriate resources are available to postpartum women in a pandemic.

Military sexual trauma among women Veterans: The buffering effect of coworker support

ABSTRACT Prior research has demonstrated the impact of military sexual trauma (MST) on health and well-being. However, little empirical work has been published identifying protective factors for women who have experienced MST. We examined the impact of two different forms of MST, harassment-only and assault MST, on PTSD symptoms and social functional impairment in a sample of women Veterans employed in the civilian workforce. The effects of MST were examined at three different times over a period of 9 months. We found that MST that included both harassment and assault was associated with significantly higher levels of PTSD symptoms and social functional impairment across three different time points among women Veterans employed in civilian jobs. Further, the pattern of results suggested that coworker support can buffer against these negative outcomes experienced by women who reported assault MST. Overall, findings suggest that coworker support is one critical resource for women Veterans who experienced assault MST.

Symptoms of postpartum anxiety and depression among women in Canada: findings from a national cross-sectional survey

ObjectiveThis study presents national estimates on symptoms consistent with postpartum anxiety (PPA) and postpartum depression (PPD) and the association between these conditions and possible risk and protective factors in women who gave birth in Canada.MethodsData were collected through the Survey on Maternal Health, a cross-sectional survey administered in Canada’s ten provinces between November 2018 and February 2019 among women who gave birth between January 1 and June 30, 2018. A total of 6558 respondents were included. Weighted prevalence estimates were calculated, and logistic regression was used to model the relationship between symptoms consistent with PPA, PPD, and potential risk factors.ResultsOverall, 13.8% of women had symptoms consistent with PPA, while the prevalence of having symptoms consistent with PPD was 17.9%. Results of the logistic regression models indicated that women who had a history of depression were 3.4 times (95% CI 2.7–4.2) more likely to experience symptoms consistent with PPA and 2.6 times more likely to experience symptoms consistent with PPD (95% CI 2.2–3.2) compared with those who did not. Women who reported good, fair, or poor physical health were 2.4 times more likely to experience symptoms consistent with PPD (95% CI 2.0–2.9) and 2.0 times more likely to experience symptoms consistent with PPA (95% CI 1.7–2.4) compared with those who reported very good or excellent health. Maternal marital status, other postpartum maternal support, and sense of community belonging were also significant.ConclusionThis study highlights that a history of depression and good, fair, or poor physical health are associated with an increased odds of symptoms consistent with PPA and PPD, while other maternal support and sense of community belonging are associated with a decreased odds of these conditions.

Suicidal ideation among North Korean refugees in South Korea: Exploring the influence of social network characteristics by gender.

Rates of death by suicide among North Korean refugees are three times higher than those among their host-country counterparts in South Korea. However, social and cultural factors predicting suicidality among North Korean refugees are not well known. Thus, we explored how social networks affect suicidal ideation in a sample of 405 North Korean refugees in South Korea using egocentric network data. Network diversity (number of different types of ties) was a protective factor for suicidal ideation among women. Having a help-providing and trustworthy church-based tie was a protective factor for women, whereas it was a risk factor for men. It is likely that women connected to people in diverse social contexts received more support to effectively deal with adversities. Because South Korean churches provide tailored worship services and financial aid to North Korean refugees, women might receive emotional comfort from church-based ties whom they can trust and receive help from, whereas men might become distressed about being financially dependent on others, which contradicts cultural expectations of a man's traditional role. Our findings have implications for mental health practitioners serving vulnerable populations, and highlight the importance of understanding the cultural context of social networks and gender in suicide research.

Maternal Smoking and Psychosocial Functioning: Impact on Subsequent Breastfeeding Practices.

Introduction: Breastfeeding is a protective factor for women and children. Women who smoke cigarettes during pregnancy are less likely to initiate or persist in breastfeeding. However, less is known about why this is the case. Materials and Methods: The present study (n = 247) prospectively examined maternal/child factors that influence breastfeeding in a low-income, racially diverse at-risk sample of smoking and nonsmoking women. Pregnant women were recruited at their first prenatal appointment in an urban hospital and followed through 24-month postnatally. Women reported on the average number of cigarettes smoked/day during pregnancy, psychopathology, breastfeeding behavior, and infant reactivity. Results: Although a greater number of cigarettes smoked/day during pregnancy was associated with a lower likelihood of initiating or persisting in breastfeeding, maternal age, education, and infant reactivity offered predictive utility above and beyond maternal smoking. Conclusion: Smokers were less likely to initiate breastfeeding and breastfed for shorter duration than demographically similar nonsmokers; however, one of the mechanisms for reduced breastfeeding may be the psychosocial factors of younger age and lower education. Further, infant reactivity was also found to reduce the likelihood of initiating and persisting with breastfeeding.