scholarly journals P7: POSTPARTUM DEPRESSION POSITIVE SCREEN PREDICTORS IN A PEDIATRIC ED

2016 ◽  
Vol 64 (3) ◽  
pp. 820.1-820
Author(s):  
L Jarvis ◽  
G Badolato ◽  
K Breslin ◽  
M Goyal

Purpose of StudyThe World Health Organization (WHO) and Toronto Public Health (TPH) performed a systematic literature review to identify predictors for different risk categories for postpartum depression (PPD). This review did not include patients in the pediatric emergency department (PED) setting. This study determines if the predictors identified in the WHO/TPH review are associated with positive PPD screens in an urban PED.Methods UsedWe performed a prospective, cross-sectional survey of a convenience sample of mothers presenting with low-acuity triage level infants </=six months old to a PED. We calculated frequency of positive PPD screen predictors and performed multivariable logistic regression to identify association with a positive PPD screen.Summary of Results121 mothers were screened for PPD during presentation to the PED with their infant; 27 (22%) screened positive. Adjusting for maternal age, race/ethnicity, and insurance status, WHO/TPH “strong” predictors of a previous history of depression (aOR 6.7; 95% CI 1.6, 28.6), a previous history of anxiety (aOR 16.1; 95% CI 2.1, 125.5), depressed mood or anxiety during this pregnancy (aOR 25.6; 95% CI 6.7, 98.2), a recent stressful life event (aOR 5.4; 95% CI 1.9, 15.2), and lack of social support (report that they did not have someone they could count on to help with the baby; aOR 6.5; 95% CI 1.6, 26.9) were significantly associated with a positive PPD screen. “Moderate” predictors of infant fussiness, (all/most of the time; aOR 8.4; 95% CI 2.0, 35.3) and high levels of childcare stress (all/most of the time; aOR 4.6; 95% CI 1.7, 12.4) were significantly associated with a positive screen. “Small” predictors of quality of relationship with the partner (sometimes vs. all/most of the time having a good relationship with the partner; aOR 3.8; 95% CI 1.0, 6.3) was significantly associated; obstetric and pregnancy complications and socioeconomic status were not significantly associated. Our study was consistent with the WHO/TPH review which found no association of PPD with ethnicity, maternal age, education level, parity, or gender of the child.ConclusionsResults in this urban PED are largely consistent with WHO/TPH predictors of PPD developed in other settings. Understanding PPD predictors can help physicians to improve screening and identification of PPD positive mothers.

2005 ◽  
Vol 35 (10) ◽  
pp. 1485-1492 ◽  
Author(s):  
GIOVANNI MARCOS LOVISI ◽  
JOSÉ RAMON R. A. LÓPEZ ◽  
EVANDRO SILVA FREIRE COUTINHO ◽  
VIKRAM PATEL

Background. Depression in women is associated with social deprivation and violence. We describe the prevalence and risk factors for depression during pregnancy, in particular the association with poverty and violence, in a Brazilian setting.Method. A cross-sectional survey of women in the third trimester of pregnancy attending a public hospital maternity clinic from August 2003 to July 2004 in Rio de Janeiro. Participants were interviewed about their sociodemographic status, obstetric and medical conditions, substance use, stressful life events, and social support. Depression was diagnosed through the Composite International Diagnostic Interview (CIDI).Results. A total of 230 of 240 eligible women consented to participate. The 12-month prevalence of depression was 19·1% (95% CI 14·4–24·9). On multivariate analyses, having been educated beyond primary school was protective (OR 0·5, 95% CI 0·2–0·9). Risk factors were: being divorced or widowed (OR 4·9, 95% CI 1·3–18·3); a history of depression before pregnancy (OR 7·9, 95% CI 3·1–20·5); loss of an intimate relationship (OR 8·4, 95% CI 3·3–21·4), experienced financial difficulties (OR 6·6, 95% CI 2·5–17·2) and having been exposed to violence in the previous year (OR 4·2, 95% CI 1·5–11·8).Conclusions. Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.


2014 ◽  
Vol 29 (S3) ◽  
pp. 624-625
Author(s):  
D. Sebbane

BackgroundA decline of recruitment into psychiatry has been observed in low and high income countries. It has been suggested that the negative image of psychiatrists may play a role in this issue. Thus, one mission of the AFFEP (French National Association of Psychiatric Trainees) is to improve the image of psychiatry and to fight the related stigma.ObjectiveThis study aimed to highlight prejudices about psychiatric trainees.MethodsThis study is a descriptive cross-sectional survey conducted toward French residents specialized in psychiatry, anaesthesia, neurology, paediatrics, orthopaedic surgery or general medicine, between June and July 2013. An invitation email and an anonymous web-based auto-questionnaire were sent to the residents through their national associations mailing-lists. AFFEP local representatives also disseminated the survey to psychiatric trainees. The survey, hosted by the MODALISA software was made of four sections:– sociodemographic data;– school records;– prejudices from the other specialities towards psychiatric trainees;– professional identity.A statistical analysis was performed using MODALISA in order to describe and compare the data.ResultsOne thousand two hundred and ninty-six trainees participated in the study, including 760 psychiatrists, 253 residents in general practice, 123 anaesthetists, 60 neurologists, 57 paediatrics and 43 orthopaedics. 56% of the participants think that psychiatrists are odd trainees with previous history of mental health, 42% consider they are not doctors, and 37% describe them as lazy persons. Comparisons of personal history cases did not show any significant difference between psychiatric trainees and non-psychiatric trainees (12.6% vs. 9,3%, P = 0.074). Besides, the results show that almost all psychiatric trainees (95%) are happy becoming a psychiatrist.ConclusionsThese results suggest that prejudices about psychiatric trainees exist and are wrong. They will allow to work on the image of psychiatry and psychiatrists, to communicate about the great satisfaction of the psychiatric trainees and to break down old “cliché”.


2020 ◽  
Vol 7 (2) ◽  
pp. 182-189
Author(s):  
Endriyani Syafitri ◽  
Suyanti Suwardi

Pendahuluan: Perdarahan Antepartum adalah perdarahan yang terjadi setelah kehamilan 28 minggu. Perdarahan khususnya akibat plasenta previa 15-20% menyebabkan  kematian ibu. World Health Organization (WHO) 2014 menyebutkan bahwa angka kematian ibu diperkirakan seluruh dunia lebih dari 585 ribu meninggal tiap tahun saat hamil atau bersalin. Berdasarkan persentase penelitian di RSUP H. Adam Malik Medan  periode tahun 2016-2017 didapatkan sekitar 42,1% yang mengalami plasenta previa. Tujuan: untuk mengetahui faktor-faktor yang berhubungan dengan plasenta previa di RSUP H. Adam Malik Medan Periode Tahun 2016-2017. Metode: Jenis penelitian ini bersifat survei analitik dengan desain cross sectional. Populasi penelitian ini sebanyak 54 ibu hamil yang mengalami plasenta previa. Pengambilan sampel menggunakan total population. Variabel independen adalah riwayat persalinan, riwayat abortus dan usia ibu, variabel dependen adalah plasenta previa dengan alat ukur yang digunakan adalah rekam medik status, riwayat persalinan, riwayat abortus, plasenta previa dan di analisis Chi-square. Hasil: dari hasil uji chi-square, untuk variabel riwayat persalinan didapatkan nilai p-value=0,041 (p<0,05), dan variabel riwayat abortus di dapatkan nilai p-value=0,032 (p<0,05), dan variabel usia ibu didapatkan nilai p-value = 0,004 (p<0,05). Kesimpulan: ada hubungan faktor riwayat persalinan dengan plasenta previa, ada hubungan faktor riwayat abortus dengan plasenta previa, ada hubungan faktor riwayat usia ibu dengan plasenta previa. Introduction: Antepartum hemorrhage is bleeding that occurs after 28 weeks of pregnancy. Bleeding especially due to placenta previa 15-20% causes maternal death. The 2014 World Health Organization (WHO) states that the maternal mortality rate is estimated to be more than 585 thousand worldwide dead each year during pregnancy or childbirth. Based on the percentage of research in H. Adam Malik General Hospital Medan in 2016-2017, it was found that 42.1% had placenta previa. The purpose of theresearch was to determine the correlated factors with placenta previa at  H. Adam Malik General Hospital Medan in 2016-2017. Method: The type of the research was analytic survey with cross sectional design. The population was 54 pregnant women who had placenta previa. The sampling technique used total population. The independent variable was the history of labor, history of abortion, and maternal age. The dependent variable was placenta previa with the measuring instruments used were medical status records, history of labor, history of abortion, placenta previa and Chi-square analysis. Results: The results showed that the variables of childbirth history obtained p-value = 0.041 (p <0.05), and the history of abortion was p-value = 0.032 (p <0.05), and the maternal age variables obtained p-value = 0.004 (p <0.05). Conclusion: there was a correlation between the history of birth factors and placenta previa,  the history of abortion and placenta previa, and the history of maternal age and placenta previa.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Tahereh Poordast ◽  
Zahra Naghmehsanj ◽  
Razie Vahdani ◽  
Shaghayegh Moradi Alamdarloo ◽  
Mohammad Ali Ashraf ◽  
...  

Abstract Background Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. Methods This cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period. Results There was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%). Conclusions Our results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.


Author(s):  
Maram Osman Elawad Mabyoue

Background: Postpartum depression is a mood disorder that can affect women after childbirth; it can occur at any time during the first year after delivery. Mothers experience depressive symptoms that may make it difficult for them to complete daily care activities. The aim of this study was to find out the prevalence of postpartum depression among Sudanese women as well as determining the association between postpartum depression (PPD), socio-demographic, and obstetric characteristics. Method:  In this cross-sectional study, 129 women selected through convenient sampling technique were interviewed; the participants were recruited from the postnatal and child welfare clinics at the Saad Abueleella and the Dream International Hospitals. To assess any possible depression, information was collected at six weeks postpartum using a structured questionnaire in addition to a screening tool. Results: At a cutoff score of ≥12, the prevalence of PPD was found to be 10.9% (Confidence Interval 6.5–17.3%); while 79.1% of mothers revealed no signs of PPD and scored <9 points, 10.1% scored 9–11, indicating a need for extra visits. Interestingly, 59.7% of the respondents were aged between 25 and 35 years, 76% were university graduates, 64.3% housewives, 20.9% had obstetric complications, 3.1% reported a history of PPD, and almost 97.7% breastfed their babies. Moreover, PPD was found to be associated with occupational status (p = 0.01) and a previous history of PPD (p = 0.01). Conclusion: The prevalence of postpartum depression was 10.9% among the studied sample. Interventions to address its risk factors should be implemented, physicians and health personnel should be qualified on screening and referring depressed mothers for further clinical assessment.  Keywords: Postpartum depression, Prevalence, Screening, Sudanese


2009 ◽  
Vol 194 (5) ◽  
pp. 456-463 ◽  
Author(s):  
Sonia Johnson ◽  
Helen Gilburt ◽  
Brynmor Lloyd-Evans ◽  
David P. J. Osborn ◽  
Jed Boardman ◽  
...  

BackgroundAcute psychiatric wards have been the focus of widespread dissatisfaction. Residential alternatives have attracted much interest, but little research, over the past 50 years.AimsOur aims were to identify all in-patient and residential alternatives to standard acute psychiatric wards in England, to develop a typology of such services and to describe their distribution and clinical populations.MethodNational cross-sectional survey of alternatives to standard acute in-patient care.ResultsWe found 131 services intended as alternatives. Most were hospital-based and situated in deprived areas, and about half were established after 2000. Several clusters with distinctive characteristics were identified, ranging from general acute wards applying innovative therapeutic models, through clinical crisis houses that are highly integrated with local health systems, to more radical voluntary sector alternatives. Most people using the alternatives had a previous history of admission, but only a few community-based services accepted compulsory admissions.ConclusionsAlternatives to standard acute psychiatric wards represent an important, but previously undocumented and unevaluated, sector of the mental health economy. Further evidence is needed to assess whether they can improve the quality of acute in-patient care.


2018 ◽  
Vol 1 (1) ◽  
pp. 43-50
Author(s):  
Juliana Widyastuti Wahyuningsih

Childbirthis a processLabor of opening and depleting the cervix and the fetus down into the birth canal. Birth is a process in which the fetus and amniotic are pushed out through the birth canal. (Sarwono, 2008). According to the World Health Organization (WHO) estimates more than 585,000 mothers annually die during pregnancy or childbirth. Indonesia Health Demographic Survey (SDKI) Survey in 2012, Maternal Mortality Rate in Indonesia is still high at 359 per 100,000 live births. The purpose of this study is the knowledge of maternal knowledge, maternal age, and maternal parity associated with normal birth events at Palembang Bari Hospital 2017. This study used analytical survey method with cross sectional approach. The population in this study were all maternal mothers at the Palembang Bari Hospital in 2017. Sampling in the study was conducted non-randomly with the technique of "Accidental Sampling". Data analysis was done univariat and bivariate with Chi-Square statistical test with significance level α = 0,05. The result of this research shows that there is correlation between mother's knowledge with normal delivery incidence with p value 0,001, there is correlation between mother age with normal delivery incidence with p value 0,009, there is relation between mother parity with normal delivery incidence with p value 0,001. From result of this research hopes healthcare workers can improve normal delivery care services and more often to carry out maternal safety counseling.


Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.


2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697349
Author(s):  
Anna Lalonde ◽  
Emma Teasdale ◽  
Ingrid Muller ◽  
Joanne Chalmers ◽  
Peter Smart ◽  
...  

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.


Author(s):  
Yuni Kurniati Yuni Kurniati

ABSTRACT   According to the World Health Organization (WHO), every two minutes a woman dies of cervical cancer in develoving countries. In Indonesia, new cases of cervical cancer is 40-45 cases of day. It is estimated every hour, a women died of cervical center. At the general hospital center Dr. Mohammad Hoesin Palembang, the incidence of women who had cervical cancer incidence year 2011 women who had cervical cancer incidence are 34 people (48,2%). The following factors increase the chance of cervical cancer in women is infection of Human Papilloma Virus (HPV), sexsual behavior, family history of cervical cancer, age, mechanism of how oral contraceptives, smoking, income or socioeconomic status, race , unhealthy diet, the cell abnormal, parity, use of the drug DES (Dietilsbestrol), and birth control pills. The purpose of this study is known of adolescents about cervical cancer in SMA Tebing Tinggi Empat Lawang year 2016. This study used Analytic Survey with Cross Sectional approach. The population in this study were all young women students in SMA Tebing Tinggi Empat Lawang with the number of 171 respondents. The results showed there were 171 respondents (37.5%) of respondents were knowledgeable, and (62.52%) of respondents who are knowledgeable unfavorable. These results indicate that knowledgeable either less than those less knowledgeable in both the SMA Tebing Tinggi Empat Lawang Year 2016. From these results, it is expected that more teens can know about cervical cancer so that it can add a lot of insight and knowledge.     ABSTRAK   Menurut data World Health Organization (WHO), setiap dua menit wanita meninggal dunia karena kanker serviks dinegara berkembang. Di Indonesia, kasus baru kanker serviks 40-45 kasus perhari. Di perkirakan setiap satu jam, seorang perempuan meninggal dunia karena kanker serviks. Di rumah sakit umum pusat Dr. Mohammad Hoesin Palembang, angka kejadian ibu yang mengalami kanker serviks pada tahun 2011 ibu yang mengalami kejadian kanker serviks terdapat 34 orang (48,2%). Faktor-faktor berikut meningkat kan peluang kanker serviks pada wanita yaitu infeksi Human Papiloma virus (HPV), perilaku seks, riwayat keluarga kanker serviks, umur ,mekanisme bagaimana kontrasepsi peroral, merokok, pendapatan atau status social ekonomi, ras, diet tidak sehat, adanya sel abnormal, paritas, menggunakan obat DES (Dietilsbestrol),dan pil KB. Tujuan penelitian ini adalah Diketahuinya pengetahuan remaja tentang Ca Cerviks di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Penelitian ini menggunakan metode survey  analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah semua siswi remaja putri di SMA Negeri Tebing Tinggi Empat Lawang dengan jumlah 171 responden.Hasil penelitian menunjukkan dari 171 responden terdapat(37.5 %) responden yang berpengetahuan baik, dan (62.52  %) responden yang berpengetahuan kurang baik. Hasil penelitian ini menunjukan bahwa yang berpengetahuan baik lebih sedikit dibandingkan dengan  yang berpengetahuan kurang baik di SMA Negeri Tebing Tinggi Empat Lawang Tahun 2016. Dari hasil penelitian ini, Diharapkan remaja bisa lebih banyak mengetahui tentang caserviks sehingga dapat menambah banyak wawasan dan pengetahuan.    


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