Effects of mindfulness-based stress reduction on prenatal stress,anxiety and depression

Low well-being is common among Chinese pregnant women but few effective interventions currently exist to improve prenatal stress and negative emotions. Mindfulness-based stress reduction (MBSR) has been proved to be effective in reducing stress and rarely studies were focused on Chinese pregnant women. The aim of the current paper is to investigate the effects of 8-week MBSR on prenatal stress, anxiety and depression among Chinese pregnant women. A sample of 66 pregnant women randomly allocated into either the MBSR group (n=34) or the control group (n=32). Participants in the MBSR group received a group 8-week, 90-min each time intervention. The results found a significant interaction between time and condition for prenatal stress (F=45.51, p<0.001, η ²=0.427), anxiety (F=19.30, p<0.001, η ²=0.240), while depression showed no time-by-group interaction (F=0.29, p=0.589, η ²=0.005). As for the sub-scale of state anxiety, while there was only no time effect (F=3.68, p=0.060, η ²=0.057). The findings of this study preliminary indicated effects of the MBSR intervention on self-reported prenatal stress and anxiety in comparison to a treatment-as-usual control. Effect on depression was not observed may due to the low level of depression of participants. This study provides preliminary evidence that MBSR is suitable for Chinese pregnant women and be effective in decreasing prenatal stress, anxiety.     

妊娠期肝内胆汁淤积症研究中的认识论

妊娠期肝内胆汁淤积症是一种常见的妊娠晚期并发症,临床上以皮肤瘙痒和黄疸为特征,伴有胆汁酸、肝酶等生化指标的异常。其对母体影响较小,但可以引起早产、胎窘和不明原因的死胎,对围生儿的严重危害使其受到了产科医生的重视。因此,有必要通过回顾妊娠期肝内胆汁淤积症的认识过程来看医学认识发展中所体现的哲学观点。     

1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会。     

Programmatic prevention of adolescent problem behaviors: The role of autonomy,relatedness, and volunteer service in the teen outreach program

Explored the mechanisms by which a well-validated intervention to prevent school failure, suspension, and teenage pregnancy produces its effects, using site-level data from 66 sites involving over 1,000 students participating in national replication of the Teen Outreach Program. Multiple informants provided data on operating characteristics of each site. These were then used to explain differences across sites in levels of success in reducing youth problem behaviors using a pre-post design and a well-matched comparison group. In accord with predictions from developmental theory, middle school sites that promoted student autonomy and relatedness with peers and with site facilitators achieved significantly greater levels of success in reducing problem behaviors. Offering volunteer experiences perceived as teaching middle school students new skills and leaving them real choices about the type of work they did was also linked to program success. Although the program was equally sucessful with students from a wide range of sociodemographic backgrounds, links of program factors to site-level outcomes were found only for middle school but not high school sites. Implications of these findings for the development of programmatic interventions targeted at adolescents are discussed. The Teen Outreach program and its evaluation have been supported by grants from the Charles Stewart Mott Foundation, the Lila Wallace Reader's Digest Fund and other sources. We also thank the Association of Junior Leagues International, local Junior Leagues around the country, and the students and facilitators who made this program possible. The Spencer and W. T. Grant Foundations also provided support to the first author for the write-up of this study.     

Reproductive issues in adults with cystic fibrosis: Implications for genetic counseling

This article reviews reproductive issues faced by the growing number of individuals with cystic fibrosis (CF) who reach adulthood. Approximately 97–98% of males with CF are infertile and they may have an increased risk for genitourinary anomalies. Females with CF may experience delayed puberty, irregular menstrual cycles, and decreased fertility. Women with CF who have good clinical scores, good nutritional status, and normal lung volumes with mild to moderate airway obstruction, have a better chance for successful pregnancies. The role of the genetic counselor in counseling adults with CF is discussed and resources for CF adults are provided.     

一例隐瞒多次婚育史的妊娠高风险患者助孕的伦理探讨

以一例隐瞒多次婚育史、再次妊娠高风险的患者要求行夫精人工授精助孕的案例为例,探讨特殊情形下辅助生殖技术实施时存在的伦理冲突及可能引发的伦理问题。辅助生殖技术的实施,首先要符合我国现行法律法规政策,符合技术实施的适应证;其次,在技术实施前要充分预估风险及获益,加强医患沟通。遵循有利于患者原则、充分知情同意原则、保密原则等辅助生殖技术伦理原则,权衡患者隐私权与配偶知情权,在夫妇双方充分知情同意下,帮助患者解决实际问题。

     

Miscarriage,Religious Participation,and Mental Health

Approximately 15–20 percent of pregnancies result in miscarriage, yet pregnancy loss remains a socially taboo topic and one that has received limited attention in the literature. Utilizing nationally representative longitudinal data from the NLSY97, this study examines the influence of miscarriage on mental health and whether this relationship is moderated by religious participation. Results from this study suggest that miscarriage is associated with lower mental health among women who also experience a live birth. Results also suggest that religious participation moderates the relationship between miscarriage and mental health; religion is more likely to lead to increases in mental health among women who experience a miscarriage than among women who do not experience a miscarriage. Overall, evidence suggests that religion may be an important coping mechanism for women who deal with pregnancy loss.     

妊娠期肝内胆汁淤积症胎儿不良预后原因探索

妊娠期肝内胆汁淤积时,在各种机制作用下,往往在妊娠晚期发生胎儿猝死等不良预后,但机制尚不清楚,还在不断的探索之中。主要从胎盘结构因素、胆汁酸的作用、血管及血管调节因素三个方面分析妊娠期肝内胆汁淤积症不良预后的原因,旨在研究妊娠期肝内胆汁淤积症患者胎儿不良预后的原因中所体现的哲学观点。     

Family Support and Mental Health in Pregnant Women Experiencing Interpersonal Partner Violence: An Analysis of Ethnic Differences

This study investigated the relationship between family support and mental health in a community sample of pregnant women experiencing interpersonal partner violence (IPV). This study also examined how family support may differentially affect mental health in Black and White women experiencing IPV. A total of 110 participants (32 Black and 78 White) were obtained from the first time period of a longitudinal study examining the effects of domestic violence on women. The model was supported (χ² = 142.55; df = 72, p > .001, RMSEA = .07). Black women had better mental health than White women. However, ethnicity was not a significant predictor of family support. Implications from this study highlight the need for further research on the role of family support in the lives of physically abused women as well as the need to incorporate cross cultural perspectives when examining this issue.     

Genetic Evaluation and Counseling of Couples with Recurrent Miscarriage: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic evaluation and counseling of couples with recurrent miscarriage (RM). The recommendations are the opinions of the multidisciplinary Inherited Pregnancy Loss Working Group (IPLWG), with expertise in genetic counseling, medical genetics, maternal fetal medicine, internal medicine, infectious disease, cytogenetics, and coagulation disorders. The IPLWG defines RM as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (<24 weeks gestation). These recommendations are provided to assist genetic counselors and other health care providers in clinical decision-making, as well as to promote consistency of patient care, guide the allocation of medical resources, and increase awareness of the psychosocial and cultural issues experienced by couples with RM. The IPLWG was convened with support from the March of Dimes Western Washington State Chapter and the University of Washington Division of Medical Genetics. The recommendations are U.S. Preventive Task Force Class III, and are based on clinical experiences, review of pertinent English-language published articles, and reports of expert committees. This document reviews the suspected causes of RM, provides indications for genetic evaluation and testing, addresses psychosocial and cultural considerations, and provides professional and patient resources. These recommendations should not be construed as dictating an exclusive course of medical management, nor does the use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the circumstances of a specific case, should always supersede these recommendations.