Beliefs and practices of young women on utilization of prevention of mother to child transmission of HIV services in Malawi

This study explored beliefs and actual practices of young women on utilization of Prevention of Mother to Child Transmission (PMTCT) of HIV services in Balaka district of Southern Malawi. The study design wascross sectional which utilized qualitative data collection and analysis methods. In-depth interviews were conducted on 12 young mothers of 15 to 24 years old. The respondents were drawn from 6 health centres in the district during their visits to either the under-five clinic, HIV and AIDS support groups or HIV follow up clinics. Data were analyzed using thematic analysis approach. Overall the respondents had positive beliefs on utilization of PMTCT services. They believed that adherence to PMTCT guidelines such as condom use, taking of Nevirapine (NVP) and exclusive breastfeeding protected the baby from contracting the virus. Nevertheless, all respondents believed that HIV testing was mandatory and that early weaning caused malnutrition and death of babies. Actual practice was very low. Very few young mothers breastfed exclusively, weaned their babies abruptly and took NVP as recommended. Not all positive beliefs translated into positive behavior. Lack of male support, inability of the midwives to provide comprehensive care to HIV infected mothers and their infants, and fear of stigma and discrimination were other factors that hindered utilization of PMTCT services. Culture was also a major barrier because traditionally babies are expected to be breastfed and supplements are fed to babies too. Therefore, there is a need to mobilize communities on PMTCT of HIV. Education programmes in HIV should emphasize behavior change interventions and should focus on both men and women and significant others. There is also need to intensify monitoring and evaluation of health workers’ activities to ensure that beliefs translate into positive behavior.

Assessment of Child Labour Practices among Market Women and Food Sellers in Ife Central Local Government Area of Osun State,Nigeria

The study examined the forms of child labour practices common among market women and food sellers in Ife Central local government area of Osun State.It also determined the awareness level of market women and food sellers on the existing child labour law in Nigeria and finally examined factors contributing to child labour practices among market women and food sellers.The study employed the descriptive research of the survey type.The study population consisted of market women and food sellers in Ife Central local government in Osun State.The sample consisted of 170 market women and 80 food sellers in conveniently selected five markets in the study area.The researchers developed three research instruments for this study,namely:Knowledge of Child Labour Questionnaire(KCLQ),Forms of Child Labour Practices Questionnaire(FCLPQ),and Factors Contributing to Child Labour Questionnaire(FCCLQ).The three instruments were validated by the investigators,using Cronbach alpha which yielded 0.79,0.77,and 0.78 values for KCLQ,FCLPQ,and FCCLQ respectively.Data collected were analyzed by using simple percentage and Relative Importance Index.The results among others showed that domesticlabour ranked the first significantly influential forms of child labour practiced among market women and food sellers in Ife Central local government,Osun State with RII analysis of 0.810 and 0.850 respectively.The study therefore concluded that majority of the respondents have low awareness level on the existing child labour law hence government should intensify the creation of awareness of the child labour law among market women and food sellers in Ife Central local government,Osun State.

Attention Model for Chronic Conditions:Blind Women and Their Sons

It aimed to analyze the assistance to the blind woman during prenatal care, childbirth, and child-care in light of the Model of Attention to Chronic Conditions. This is a descriptive, qualitative study. A collection was done through semi-structured interview and analysis of the speeches, conducted by content technique proposed by Bardin, emerging from the screening process. Ten mothers aged between 21 and 42 years old participated in the study. Three categories were identified: prescriptive and focused attention on the disease;for collaborative and focused attention on the person;uniprofessional attention to the multidisciplinary attention;establishment of relationship between the family health strategy and the specialized outpatient care. The women experienced chronic conditions according to the Model in addition to blindness. Study results show that for blind women, attention in the health service has weaknesses in service, both in the prenatal period and childbirth, and in childcare. It deems necessary transformation in assisting the blind woman.

Efficiency of HAART in the prevention of mother to children HIV-1 transmission at Saint Camille medical centre in Burkina Faso,West Africa

Objective:To evaluate efficiency of HAART in the prevention of mother to child HIV transmission.Methods:A longitudinal study was conducted on 1 300 women attending the antenatal service at Saint Camille Medical Centre from September 2010 to July 2011.The HIV status of mothers was determined by rapid tests and EUSA.Discordant results were confirmed by real-time PCR.PCR was used to determine HIV status of children born from HIV-positive mothers.Results:Among 1 300 pregnant women tested for HIV,378 were seropositive.Mothers were predominantly housewives(69.7%),and their mean age was(28.32±0.15) years.The overall prevalence of HIV transmission from mother to child was 4.8%(18/378).This prevalence differed significantly from 0.0%(0/114) to 6.8%(18/264) in children born from mothers under HAART and those with mothers under New Prophylactic Protocol(ACT + 3TC + NVP),respectively(P【 0.01).Children’s mortality rate during the medical follow up was 1.3%(5/378).Among 16 women with HIV dubious status by ELISA,the Real Time PCR confirmed 2/16(12.5%) as HIV positive. Conclusions:The protocol of prevention of mother to children HIV transmission(PMTCT) is effective.The rate of HIV vertical transmission is significantly reduced.Early diagnosis determined by PCR of children born from HIV- positive mother is necessary and recommended in the context of PMTCT in Burkina Faso.We also found that PCR is an effective tool to confirm HIV status in pregnant women.

Retrospective Analysis of Clinical Characteristics and Neonatal Outcomes of Pregnant Women with SARS-COV-2 Infection

This retrospective study aimed to investigate the clinical characteristics and neonatal outcomes of pregnant women with SARS-COV-2 in Wuhan Children's Hospital and further suggested a possible management strategy for infected pregnant women under epidemic situation.In this study,8 pregnant women with SARS-COV-2 who were admitted into Wuhan Children's Hospital,China from February 1,2020 to March 30,2020 and the clinical features,laboratory data,maternal and neonatal outcomes were analyzed.The mean age of the women at the time of admission was 30.6 years.The mean gestational age of the women was 37 weeks±4 days,and one woman presented with dichorionic diamniotic(DCDA)twin pregnancy.Except for one woman who was febrile,others had no typical clinical symptoms.For all pregnant women,the count of white blood cells and lymphocytes appeared normal,but 6 had a lower percentage of lymphocytes.C-reactive protein(CRP)levels were normal for all the women.One neonate was tested positive for the coronavirus IgG and IgM antibodies.The clinical symptoms of the pregnant women with SARS-COV-2 were mild,and the laboratory data showed similar characteristics to those of non-infected pregnant women.Since one neonate was tested positive for coronavirus,there is a possibility of vertical transmission of SARS-CoV-2.Prompt and efficient screening,triage,and isolation of pregnant women are ffective management strategies to reduce nosocomial infection during the SARS-COV-2 epidemic.

Research Progress of Related Laboratory Testing Indexes before and after Mother-Infant Blocking in HIV/AIDS Pregnant Women

More than 90% of HIV-positive children come from mother-to-child transmission, so mother-to-child interdiction is the main measure to prevent AIDS in children. Relevant data show that the incidence of mother-to-child transmission of HIV usually fluctuates between 15% and 50% without intervention. Standardized and effective comprehensive intervention can reduce the transmission rate of mother to child to less than 1%. At present, it is believed that mother-to-child transmission of AIDS can be blocked by comprehensive intervention, and its mechanism has been clearly studied. Combined with highly effective antiviral treatment, safe labor and artificial feeding, the mother to child transmission rate can be reduced to less than 1%. However, due to the effect of drugs on mother-to-child transmission of AIDS may lead to some changes in the main biochemical indicators of mother-to-child, there is no systematic analysis of the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-to-child transmission. In this study, the viral load, T lymphocyte subsets and major biochemical indicators of HIV/AIDS pregnant women before and after maternal-infant blockade were dynamically analyzed. It is hoped that this study will help to observe the basic physical fitness and disease development of pregnant women with HIV/AIDS during pregnancy, to provide a strong basis for the treatment and evaluation of maternal-infant blockade of HIV/AIDS pregnant women, and to establish a complete set of laboratory indicators to understand the body status of pregnant women at all stages to minimize the probability of fetal transmission, which will make good economic and social benefits.

Patient-Reported Factors Facilitating Participation in Prevention of Mother to Child Transmission of HIV Programs in Kara, Togo, West Africa

Background: Despite efforts to expand prevention of mother-to-child transmission (PMTCT) of HIV in resource-limited settings, only 53% of women in sub-Saharan Africa receive adequate PMTCT services. Understanding factors that enable successful program completion are crucial to improving adherence rates to PMTCT programs in these settings. Using a positive deviance approach, we explored patient and provider’s perspectives on factors enabling women to successfully access and adhere to PMTCT services to identify areas of program improvement and further reduce HIV transmission. Methods: Semi-structured interviews were conducted with 11 health care workers (HCWs) at two health centers in Kara, Togo and 34 women who had successfully completed the PMTCT program at those facilities. Women were identified using purposive sampling and content theme analysis was used to analyze the data. Results: Knowledge and belief in the potential to give birth to an HIV-negative child, supported by facilitating factors on the individual and community levels, was the cornerstone to women’s PMTCT program success. Effective program education and peer-to-peer interactions fostered the participants’ knowledge and belief in PMTCT, with the resulting internal motivation driving continued participation and adherence. The welcoming environment, availability of peer support groups and financial assistance from the health facility, further facilitated success, with women using this facility-based community to seek advice and support from HCWs and peers. Financial, physical, and emotional support from relatives was also important in ensuring unhindered access. Finally, the faith-based communities’ acceptance and support for HIV-positive women further encouraged participants to adhere to the program. Conclusion: Understanding and believing in the ability to have an HIV-negative baby was the most important facilitator for PMTCT program adherence. This led to internal motivation that was continually reinforced through facility and community supportive environments focused on addressing barriers. Efforts to improve PMTCT success should focus on all of these factors through a patient-centered approach.

论弥尔顿对荷马史诗传统中女性之“他者”定位的改写——以《伊利亚特》和《失乐园》为例

荷马在其被视为“西方最古老的史诗”《伊利亚特》里将女性人物定位为“他者”,由此开启西方史诗对女性的“自我”之探索。在西方史诗史上,随着史诗从“原始史诗”向“文学史诗”发展,史诗里的女性形象慢慢脱离“他者”而向“自我”演进。本文在分析“原始史诗”之代表《伊利亚特》中女性人物的基础上,进一步阐明:弥尔顿在“文学史诗之冠”《失乐园》中改写了荷马史诗传统中女性之“他者”定位。首先,《失乐园》的史诗英雄虽名为亚当夏娃之整体,但很大程度上乃史诗中唯一的女性夏娃之个体,弥尔顿在塑造史诗英雄的过程中将其主要关注锁定在夏娃身上。其次,诗人始终突显夏娃的“自我”,不仅展示了夏娃因“原初自我”中的“自恋”“自傲”而堕落的经过,而且呈现了夏娃通过“自省”“自知”“自赎”而将“自我”重构为“生态自我”并获得精神再生的过程。女性人物在史诗中的重新定位是弥尔顿对史诗传统的重要贡献之一。

无酬劳动对女性心理健康的影响

心理健康是衡量人力资本的重要指标,也是备受国家和政府关注的民生和社会问题。而长期以来,女性作为家庭中家务劳动和儿童照料的主要承担者,参与家庭无酬劳动的时间远高于男性,这可能会影响她们的心理健康水平。基于Grossman健康需求理论,使用中国家庭追踪调查(CFPS)2020年调查数据,实证检验了无酬劳动对女性心理健康的影响及传导机制。研究发现,家务劳动时间的增加会对女性心理健康水平产生显著的负向影响,而照顾孩子时间的增加虽然对女性心理健康水平有负向影响,却并不显著。异质性分析表明,家务劳动时间对农村女性、青年女性和受教育程度较高的女性群体心理健康水平的负向影响更明显,而照顾孩子时间对老年女性和未受过教育的女性群体心理健康水平的负向影响会更明显。稳健性分析表明,在控制内生性后,家务劳动和照顾孩子时间对女性心理健康水平的负向影响显著增强。传导机制分析表明,无酬劳动主要通过影响女性劳动力市场表现来影响其心理健康。随着无酬劳动时间的增加,女性倾向选择非正规就业,工资收入也随之降低,这对其心理健康水平产生了不利影响。因此,重视无酬劳动的价值、在工作场所引入家庭友好措施和倡导男女共同承担家庭劳动是提升我国女性心理健康水平的重要措施。

失独家庭养老服务困境及应对策略--基于社会性别视角

社会对失独家庭的关注越来越多,失独群体的养老保障和服务问题也越来越引起政府部门的关注。独生子女去世后,对父母亲心灵和精神产生严重创伤,对其养老生活也会产生较大影响。研究失独家庭的养老服务问题,探索失独家庭养老服务的“急难愁盼”需求,对维护社会和谐具有重要现实意义。论文以失独家庭面临的养老服务困境为调查内容,探析失独家庭面临的生活照顾、精神孤寂、失能护理等诸多困境,通过失独家庭养老服务需求现状分析,从政府责任、社会救助制度、心理精神关爱服务、养老服务保障四个维度提出应对策略。

妇幼健康信息化在高危孕产妇管理工作中的应用效果

目的探讨妇幼健康信息化在高危孕产妇管理工作中的应用效果。方法选取2019年1—12月深圳市南山区妇幼保健院实施常规管理的100例高危孕产妇作为对照组,选取2020年1—12月深圳市南山区妇幼保健院实施妇幼健康信息化管理的100例高危孕产妇中作为研究组。对比2组管理效果。结果研究组登记建档率、产检次数高于对照组,胎儿宫内窘迫、新生儿窒息发生率低于对照组(P<0.05)。研究组产妇急性事件总发生率为4.00%,低于对照组的15.00%(P<0.05)。管理后,研究组遵医嘱依从性(遵医嘱服药、科学运动、合理饮食、规律作息、自我管理)评分高于对照组,焦虑自评量表评分(self-rating anxiety scale,SAS)低于对照组(P<0.05)。出院时,研究组满意度(主动服务、健康宣教、交流能力、操作水平、环境评估)评分高于对照组(P<0.05)。管理后,研究组健康调查简表(the MOS item short fromhealth survey,SF-36)评分高于对照组(P<0.05)。结论高危孕产妇管理中使用妇幼健康信息化技术有利于提高管理效果,预防产妇急性事件的发生,改善产妇不良情绪,提高其遵医嘱依从性和生活质量,提高产妇对护理服务的满意度。

HBV高载量孕妇孕期抗病毒治疗结合标准阻断措施阻断母婴传播效果

目的:探究乙型肝炎病毒(HBV)高载量孕妇孕期HBV-DNA水平和乙型肝炎病毒e抗原(HBeAg)阳性情况,分析孕期抗病毒治疗结合标准阻断措施对HBV高载量孕妇母婴传播阻断效果。方法:回顾性收集2021年1月-2023年1月本院住院分娩的120例HBV高载量孕妇临床资料,分析孕妇妊娠期、分娩前HBV-DNA水平和HBeAg阳性率,多因素logistic回归分析HBeAg状态影响因素,分析孕期抗病毒治疗对新生儿乙肝母婴传播阻断效果及母婴安全性。结果:120例HBV高载量孕妇中,孕期接受抗病毒治疗93例(治疗组),抗病毒药物分别为替诺福韦占56.6%、拉米夫定占20.8%;未接受治疗27例(未治疗组)。妊娠期,抗病毒治疗组和未治疗组HBV-DNA载量、HBeAg阳性率无差异(P>0.05);分娩前,抗病毒治疗组HBV-DNA载量≥10^(6)IU/ml占比(7.5%)低于未治疗组(92.6%)(P<0.05),而两组HBeAg阳性率(90.3%、92.6%)无差异(P>0.05)。多因素logistic分析,年龄低、HBVDNA载量高影响HBeAg状态的独立危险因素(P<0.05)。新生儿乙肝母婴传播阻断率抗病毒治疗组(100.0%)高于未治疗组(2例,92.6%)(P<0.05)。两组新生儿体质量、早产、剖宫产、妊娠合并症、产时并发症比较无差异(P>0.05)。结论:HBV高载量孕妇HBV-DNA水平较高,HBeAg阳性率与孕妇年龄低、HBV-DNA载量高有关;孕期抗病毒治疗可降低孕妇分娩前HBV-DNA水平,结合标准阻断措施后可提高HBV母婴传播阻断率,且安全性较好。

妊娠期妇女和儿童丙型肝炎的管理

HCV感染是全球性的公共卫生问题,直接抗病毒药物的出现为丙型肝炎患者的治疗带来了革命性的突破。尽管直接抗病毒药物在成人患者中的治疗效果显著,但对于孕妇、婴幼儿、青少年这一特殊人群的治疗仍存在诸多挑战。本文旨在探讨这些特殊丙型肝炎人群在抗病毒治疗方面的现状及尚需解决的问题,以期为临床工作者提供参考与借鉴。

2018-2022年淄博市预防艾滋病、梅毒和乙肝母婴传播实施效果研究

目的研究2018—2022年淄博市预防艾滋病、梅毒和乙肝母婴传播工作实施效果。方法提取2018-2022年淄博市工作月报表及个案卡信息,分析艾滋病、梅毒和乙肝检测率、阳性检出率、治疗率及干预效果等。结果淄博市分娩产妇均在孕产期接受艾梅乙检测,孕期检测率呈上升趋势,差异有统计学意义(P<0.001);梅毒孕产妇阳性检出率2.03‰,呈上升趋势;乙型病毒性肝炎(Viral Hepatitis Type B,HBV)阳性检出率2.55%,呈下降趋势;艾滋病病毒(Human Immunodeficiency Virus,HIV)感染孕产妇及所生儿童抗HIV用药率均为100%;梅毒感染孕产妇治疗率及所生儿童预防性治疗率呈上升趋势,差异有统计学意义(P<0.001);HIV母婴传播率为0,先天梅毒报告发病率为1.56/10万活产;乙肝母婴传播率为0.68%。结论全市预防母婴传播工作成效明显,但仍需继续努力,为消除母婴传播工作奠定基础。

HIV暴露儿童血清逆转影响因素分析

目的研究HIV暴露儿童血清逆转相关影响因素。方法收集2019年1月至2021年12月期间深圳市第三人民医院管理的49例HIV感染孕产妇及所生HIV暴露儿童的一般情况、临床资料及血清结果等。结果49例HIV暴露儿童在出生后48 h、6周、3月龄HIV核酸检测均为阴性。在12、18、21月龄时血清逆转率分别为59.18%、93.87%和100.00%。HIV暴露儿童在12月龄血清是否逆转与母亲分娩方式、抗反转录病毒开始时间、孕期核酸检测结果、CD4^(+)T淋巴细胞计数无关;与HIV暴露儿童的性别、出生胎龄与体重、阻断药物使用种类等也无关。结论未发现12月龄HIV暴露儿童血清逆转的明确影响因素,其3月龄核酸检测与最终血清逆转结果一致性为100%。为尽早排除HIV感染,减少家属顾虑,未来可考虑HIV暴露儿童3月龄前3次核酸阴性结果代替血清逆转。

失独父母的精神困境与干预策略——基于对20名城市失独父母的扎根理论分析

由于失去独生子女,失独父母身陷多重困境,这些困境相互交织并进一步加重了其精神困境。文章采用质性研究方法,通过访谈法收集资料,使用扎根理论深入考察城市失独父母精神困境的表现与成因。研究发现,失独父母在遭遇失去独生子女的人生困境之后,个人精神支柱坍塌,生活的无意义感、“无儿防老”的养老焦虑和社会融入障碍无时无刻不在影响其精神状况,失独父母陷入严重的精神困境之中。因此,需要采取重塑失独父母人生意义、完善我国居家养老服务机制、促进失独父母社会融入等干预策略,帮助他们脱离精神困境。

基于潜在狄利克雷分布主题模型的初产妇产后健康信息需求研究

目的运用潜在狄利克雷分布(Latent Dirichlet Allocation,LDA)主题模型深入挖掘即时社交平台产后母婴保健信息需求。方法2023年1—6月提取产后延续性护理微信群内文本数据,通过数据清洗、分词和LDA主题模型构建,分析文本数据所蕴含的需求主题。结果LDA主题模型将所提取的23531条文本数据划分为8个主题:婴儿健康状况、婴儿喂养状况、婴儿日常护理、生长发育、母婴健康体检、疫苗接种、产后恢复、社会支持和同伴经验分享。结论基于自然语言的信息需求分析能获取客观全面的产后母婴健康信息需求,为医疗机构开展全面、精细化的产后健康指导提供参考。

农村妇女的儿童教育观念及影响因素研究

农村妇女作为家庭教育的主要承担者,她们对儿童教育的看法对儿童未来发展起着重要作用,本文采用问卷调查法及访谈法收集资料,用定性和定量结合的方法分析资料。从其对儿童发展、儿童教育及儿童期望的看法三方面系统分析农村妇女的儿童教育观念及存在的问题,对可能存在的影响农村妇女儿童教育观念的因素进行探讨。研究发现农村妇女这一群体的儿童教育观存在教育策略不够合理、教育认知存在性别差异、对孩子长远发展不够重视等问题,整体来说对儿童的教育观念仍然不够科学,这是受家庭条件、子女状况、妇女素质及婚姻状态等多因素影响的,需要采取综合性手段促进农村妇女儿童教育观念的全面发展。

共同养育理念下家庭协同护理对初产妇喂养行为及心理弹性的影响

【目的】探讨共同养育理念下家庭协同护理对初产妇喂养行为及心理弹性的影响。【方法】选取2020年12月至2023年12月在本院分娩的206例初产妇,按照随机数字表法分成对照组(采用常规护理,n=103)和观察组(在对照组基础上加用共同养育理念下家庭协同护理,n=103)。比较两组母乳喂养知识得分、自我效能[母乳喂养自我效能自评量表(BSES-SF)评分]、母乳喂养依从性率、共同养育质量[中文版简易共同养育量表(Brief-CRS)评分]及心理弹性水平[心理弹性量表(CD-RISC)评分]。【结果】产后3个月,两组母乳喂养知识得分、BSES-SF评分、Brief-CRS评分、CD-RISC评分均高于干预前(P<0.05),且观察组上述指标均高于对照组(P<0.05)。产后3个月,观察组母乳喂养依从率为94.06%,显著高于对照组的82.83%(P<0.05)。【结论】实施共同养育理念下家庭协同护理可有效提高初产妇母乳喂养知识水平及自我效能,明显改善共同养育质量,提高母乳喂养依从率,且可提升初产妇心理弹性水平,值得临床借鉴。