Identify and examine modifiable risk factors that may differentially drive poor birth outcomes in such highly disparate environments

No description available.

No description available.

Objective: Rates of pregnancy smoking in the rural South are twice national averages and contribute to poor birth and long term outcomes for affected women and children. Efforts to intervene during prenatal care with pregnant women have been hampered by lack of knowledge, skill, comfort, and commitment from prenatal providers and their nursing staff. Regional community providers and staff have been reluctant to participate in available trainings, and even those who do seldom exhibit attitude and practice change long term. Therefore, efforts to educate health care professionals on the dangers of pregnancy smoking, and to provide necessary skills for intervention efforts, may need to occur before they ever enter practice. Thus, the goal of the current project was to implement and evaluate a pregnancy smoking-related training session for baccalaureate nursing students in rural Southern Appalachia. Design: Nursing students attended training on pregnancy smoking dangers/intervention techniques. Sample: Third year students beginning clinical rotations in obstetrics. Methods: 1.5-hour training including pre- and post-tests. Implementation Strategies: Four months later, follow-up survey assessed gains in knowledge, skill, comfort, and willingness to address smoking. Results: Over seven semesters, 659 nursing students were trained. Substantial gains in knowledge of pregnancy smoking issues were seen from pre- to post-testing, with knowledge retained at four- month follow-up. The percentage of students who felt they lacked skills to intervene with pregnant smokers dropped from 39% at pre-test to 6% at same day post-test. In addition, the percentage who reported they would be uncomfortable talking with pregnant women about smoking dropped from 10% to 1%, while the percentage who indicated they would always make time to address smoking with pregnant women increased from 54% to 87%. While most students did address smoking with multiple pregnant patients encountered during clinicals, and over half felt the patients benefited from their actions, only 58% were confident in their intervention skills at four month follow-up. Finally, 83% felt the training had been beneficial, and over 90% committed to addressing smoking with pregnant patients once they graduated. Conclusion/Implications for nursing practice: Training can increase nursing student knowledge, skill, comfort, and willingness to address smoking with pregnant women. However, it appears ongoing education may be needed to promote skills and confidence long term. In the rural South, where smoking rates are high and provider efforts to address pregnancy smoking are inconsistent, educating future nurses could have substantial impact on pregnancy smoking rates and birth outcomes into the future.

Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

No description available.

No description available.

No description available.

No description available.