RESUMEN
Zika virus is an emerging infection transmitted in multiple ways. In 2016 we assessed the level of knowledge about Zika virus transmission in an underserved, predominantly Hispanic, mixed gender population living in suburban New York City, many of whom potentially travel to affected regions. Based on a convenience sample of 147 participants, 134 (91%) were aware of Zika virus transmission by mosquitoes; 116 (79%) knew about transmission from a pregnant female to the fetus; and 89 (61%) were aware of sexual transmission. Age, marital status, education, and native language were unrelated to knowledge (Pâ¯>â¯0.10). Women, however, were significantly more likely than men to know about sexual transmission (Pâ¯=â¯0.023) and about maternal transmission to the fetus (Pâ¯=â¯0.044). Travel to Zika virus endemic areas was unrelated to level of knowledge (Pâ¯=â¯0.40). Greater awareness of the risk of sexual transmission of Zika virus is needed for at risk populations in the US, especially for males.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Población Suburbana , Infección por el Virus Zika/epidemiología , Virus Zika , Femenino , Humanos , Masculino , Ciudad de Nueva York/epidemiología , Vigilancia de la Población , Embarazo , Complicaciones Infecciosas del Embarazo , Medición de Riesgo , Factores de Riesgo , Factores SexualesRESUMEN
OBJECTIVES: This study examined women's perceptions of early infant feeding experiences and identified early postpartum barriers to successful breastfeeding. SUBJECTS AND METHODS: We conducted semistructured exit interviews at 6 months postpartum with a subsample of participants (n=67) enrolled in two randomized controlled trials of breastfeeding promotion. Study arms included (1) routine pre- and postnatal visits with an International Board Certified Lactation Consultant (IBCLC) (LC group), (2) electronically prompted guidance from prenatal care providers (EP group), (3) EP+LC combined, and (4) standard of care (control group). Interview transcripts were coded using grounded theory and analyzed in MAXqda. Code matrices were used to identify early postpartum breastfeeding barriers and were further examined in relation to treatment group using a mixed methods analysis. RESULTS: The majority of the participants reported experiencing at least one barrier to breastfeeding. Barriers to breastfeeding were more commonly reported in the early postpartum than late postpartum period. The most common barrier during the early postpartum period was the perception of inadequate milk supply ("lactational") (n=18), followed by problems with latch, medical problems that were perceived as precluding breastfeeding, and medical staff and hospital practices. Participants frequently reported that the IBCLCs assisted them in anticipating, managing, and overcoming these barriers. CONCLUSIONS: Our findings underscore the importance of integrating IBCLCs into routine pre- and postpartum care because they provide critical support that effectively addresses early postpartum barriers to breastfeeding.
Asunto(s)
Lactancia Materna/psicología , Percepción , Atención Posnatal , Mujeres/psicología , Adulto , Estudios de Evaluación como Asunto , Conducta Alimentaria , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Periodo Posparto , Adulto JovenRESUMEN
OBJECTIVE: To examine the effect of abuse history, other major trauma, and posttraumatic stress disorder (PTSD) on medical symptoms and health-related daily functioning in women with chronic pelvic pain. METHODS: We administered a questionnaire to 713 consecutive women seen in a referral-based pelvic pain clinic. RESULTS: We found that 46.8% reported having either a sexual or physical abuse history. A total of 31.3% had a positive screen for PTSD. Using regression and path analysis, controlling for demographic variables, we found that a trauma history was associated with worse daily physical functioning due to poor health (P<.001), more medical symptoms (P<.001), more lifetime surgeries (P<.001), more days spent in bed (P<.001), and more dysfunction due to pain (P<.001). Furthermore, a positive screen for PTSD was highly related to most measures of poor health status (P<.001) and somewhat explained the trauma-related poor health status. CONCLUSION: The association of trauma with poor health may be due in part to the development of PTSD resulting from trauma. These findings demonstrate the importance of screening for trauma and PTSD in women with chronic pelvic pain. LEVEL OF EVIDENCE: II.