Effective Antenatal Education: Strategies Recommended by Expectant and New Parents

Antenatal education is a crucial component of antenatal care, yet practice and research demonstrate that women and men now seek far more than the traditional approach of a birth and parenting program attended in the final weeks of pregnancy. Indeed, women and men participating in this study recommended a range of strategies to be provided during the childbearing year, comparable to a “menu in a restaurant.” Their strategies included three program types: “Hearing Detail and Asking Questions,” “Learning and Discussing,” and “Sharing and Supporting Each Other.” The characteristics of each type of program are identified in this article. The actual learning methods the study participants recommended to be incorporated into the programs were “Time to Catch Up and Focus,” “Seeing and Hearing the Real Experience,” “Practicing,” and “Discovering.”     

促排卵后的不同步双侧异位妊娠(英文)

研究目的:报道一例不同步双侧异位妊娠,并回顾相关文献,总结规律。创新要点:第一次报道了不同步的双侧异位妊娠。研究方法:对促排卵后行宫腔内人工授精病人发生非同步双侧输卵管妊娠的病例进行报告,辅以人绒毛膜促性腺激素(hCG)值波动曲线、超声图像以及病理切片加以阐述;同时回顾2008年以来关于双侧异位妊娠的文献,并分析病例特征。重要结论:促排卵后可能会提高双侧异位妊娠风险,一侧异位妊娠发生后,需要注意对侧是否也存在异位妊娠。     

Romantic relationships: an important context for HIV/STI and pregnancy prevention programmes with young people

Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use. Self-report survey data were collected using electronic handheld devices for a school-based randomised trial. The survey sample includes 911 young people (mean age = 12.4 years) representative of their schools. Logistic regressions explored associations between selected sexual behaviours and relationship characteristics. For all participants, having more boy/girlfriends, dating alone, ever touching and ever having had oral sex were associated with an increased likelihood of having vaginal sex. Among young people with current partners, having a partner three or more years older, length of relationship and ever having oral sex were associated with an increased likelihood of having vaginal sex. The study data confirm the importance of accounting for relationships in sexual risk reduction programmes, and provide avenues for enhancing the relevancy of typical school-based prevention programmes.     

Mediation analysis of an adolescent HIV/STI/pregnancy prevention intervention

Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable X (e.g. intervention indicator) influences an outcome variable Y (e.g. unprotected sex) by first influencing an intermediate variable M (e.g. self-efficacy to use a condom) and provides a way for empirically validating theoretical hypothesised mediators. In this way, mediation analysis is a critical tool for suggesting which components of complex interventions should be the focus of more efficient and effective interventions in the future. The present study applied multilevel mediation analysis to outcome data from the All4You2! study to begin to examine the relationships between a theory-based HIV/STI/pregnancy prevention curriculum for students attending alternative high schools who were at risk of educational failure. The study targeted psychosocial mediating variables and the primary outcome unprotected sex in the past three months. Results suggest helping young people attending alternative schools identify and avoid exposure to risky situations and improving their self-efficacy to refuse sex should be focal points of future interventions.     

Outercourse: Exploring Nonpenetrative Forms of Pleasurable Safer Sex

Best practices in comprehensive sexuality education call for rights-based, factual lessons that provide healthy options and are sensitive to the varied contextual factors affecting participants. Further, lessons are to better balance positive and negative outcomes of sexual expression that reflect the sexual realities of (young) men and women. This lesson plan contributes to such aims through the facilitation of nuanced activities and discussions to critically assess a wide range of sexual practices with and without a partner and beyond penetrative or procreative acts. The main outcome is to broaden options for healthy sexual expression and consider the potential reconciliation of pleasure and safer sex.     

"Going Beyond the Call of Doula": A Grounded Theory Analysis of the Diverse Roles Community-Based Doulas Play in the Lives of Pregnant and Parenting Adolescent Mothers

This article presents some of the most salient qualitative results from a larger program evaluation of pregnant and parenting adolescents who participated in a community-based doula program. Using grounded theory analysis, seven problem-solving strategies emerged that doulas apply in helping pregnant and parenting adolescents navigate multiple social and health settings that often serve as barriers to positive maternal- and child-health outcomes. The ethnographic findings of this study suggest that the doulas provide valuable assistance to pregnant and parenting adolescents by addressing social-psychological issues and socio-economic disparities. "Diverse role-taking" results in doulas helping pregnant adolescents navigate more successfully through fragmented social and health service systems that are less supportive of low-income adolescents, who are often perceived to be draining scarce resources. The findings have implications for the roles of community-based doulas assigned to low-income adolescents of color seeking to overcome obstacles and attain better educational and economic opportunities.