High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first‐time‐pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long‐term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.     

From “dot.org” to “dot.gov”: Professional Crossings in the Brazilian National Policy on HIV/AIDS

This article reflects on the importance of the relations between state and society in policy-making in the area of public health. Several studies in various sectors such as health, education, and social services have made similar observations on organizational dynamics and the institutionalization of different models of partnerships or contracts, often based on the analytical model of three sectors. Individuals and their networks of relationships, however, remain an almost unexplored dimension in these types of research. Against this backdrop, this study seeks to analyze the movement of HIV/AIDS activists to governmental organizations working in this same field. The analysis raises questions concerning the forms of individual and institutional learning that help to maintain the distinct character of innovation of the Brazilian policy. Professionals who cross the borders hold a different profile once they have accumulated experience working with grassroots and local NGOs, and have also had the chance to be trained and enhance their technical and managerial capacities, since the government has supported NGOs for a long period. When combined, these experiences allow them to maintain relationships with social movements and give them the ability to navigate through the government bureaucracy and handle technical information about fighting AIDS epidemics, making it possible for them to negotiate strategic collaborations reflecting the interests of different groups. Hence, they constantly reflect on the differences between government and social spaces, and keep questioning and modifying their roles in the light of potential and existing complementarities.     

Potential strategies to avoid progestogen-induced premenstrual disorders

Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced - it never will - and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense.     

Disparities in Healthcare Utilization Among Adults with Obesity in the United States,Findings from the NHIS: 2006–2015

Population Research and Policy Review - Few studies of disparities consider logistical hurdles faced by adults with obesity in obtaining needed healthcare. This study compared adults with obesity...     

Using relative utility curves to evaluate risk prediction

Summary.  Because many medical decisions are based on risk prediction models that are constructed from medical history and results of tests, the evaluation of these prediction models is important. This paper makes five contributions to this evaluation: the relative utility curve which gauges the potential for better prediction in terms of utilities, without the need for a reference level for one utility, while providing a sensitivity analysis for misspecification of utilities, the relevant region, which is the set of values of prediction performance that are consistent with the recommended treatment status in the absence of prediction, the test threshold, which is the minimum number of tests that would be traded for a true positive prediction in order for the expected utility to be non-negative, the evaluation of two-stage predictions that reduce test costs and connections between various measures of performance of prediction. An application involving the risk of cardiovascular disease is discussed.     

“It's like he just goes off,BOOM!”: mothers and grandmothers make sense of child‐to‐parent violence

Child to parent violence (CPV) involves continual and cumulative abusive actions perpetrated by children and adolescents towards their parents or caregivers. This abuse produces short‐term distress and ongoing long‐term harmful consequences for parents and their families. Practitioners, researchers and policy‐makers are increasingly challenged to identify, conceptualize and respond to this form of family violence. A major challenge is that parents and caregivers under‐report this abuse so there is a lack of awareness and understanding of their psychological experiences in relation to CPV. This research adopts an interpretative phenomenological approach to explore the psychological experience of CPV. Interviews were conducted with six New Zealand mothers and two grandmothers who all experienced CPV. This abuse was experienced as an ‘emotional bloody roller coaster’ of unconditional love through to hatred; as ‘judgement’ – self‐blame and others' blame of their parenting skills; and the ‘absent father’ in their adolescents' lives was drawn on as an explanation for the abuse. Taken together, these psychological experiences identify the silencing of CPV is related to parents' conflicting emotions towards their children, their thoughts and feelings about themselves and how other people view them, and the impact of an absent father figure in their children's everyday lives.