Integration of home and nonhome roles: Women's conflict and coping behavior.

Investigated the conflict that women experience between their home and nonhome roles. 115 women (mean age 38.1 yrs) who (a) were married and living with their husbands, (b) had at least 1 child, and (c) were attending college completed questionnaires; their husbands completed similar questionnaires. It was found that the time demands of the student role were more strongly associated with conflict for women whose husbands held relatively traditional sex-role attitudes than for women whose husbands held relatively nontraditional attitudes. In addition, traditionally oriented women tended to use reactive coping strategies to deal with intense conflicts. Furthermore, reactive coping strategies were perceived to be less successful than more active strategies. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Compliance, counseling and satisfaction with oral contraceptives: a prospective evaluation

CONTEXT: Oral contraceptive users' risk of accidental pregnancy may be higher than it should be, because of inconsistent pill-taking. However, few reliable data are available on pill users' everyday experiences with their method, especially characteristics that may affect consistency of use. METHODS: Two months after initiating or resuming oral contraceptive use, a nationwide sample of 943 women completed questionnaires examining their compliance with instructions for proper use, the quality of their interactions with their provider, their satisfaction with the method, and the frequency and costs of visits or calls to their providers because of pill-related side effects. Regression analyses were used to determine the factors associated with compliance difficulties and method dissatisfaction. RESULTS: In all, 47% of users missed one or more pills per cycle, and 22% missed two or more. Women who lacked an established pill-taking routine, who did not read and understand all of the informational material accompanying the pill package, or who experienced spotting or heavy bleeding had increased odds of missing two or more pills per cycle. Method satisfaction was most likely among women who were aware of the pill's noncontraceptive benefits, were satisfied with their relationship with their provider, had used the pill in the past and experienced few side effects. Some 22% of users called their provider at least once about pill-related side effects, and 9% made at least one visit for this reason; these women spent $25 and $62, respectively, to treat side effects. CONCLUSIONS: Improving pill use is a shared responsibility of the provider, the patient and, to a lesser degree, pill manufacturers. Awareness of potential difficulties such as inadequate counseling is a key step in helping women use oral contraceptives effectively.     

Early experience with the contraceptive use of depot medroxyprogesterone acetate in an inner-city clinic population

There are few data on the experience of American women with the injectable depot medroxyprogesterone acetate (DMPA) since its recent approval by the Food and Drug Administration for contraceptive use in the United States. An exploratory study was conducted using chart reviews and telephone interviews of 261 women who initiated DMPA use between December 1992 and June 1994 at either a hospital-based (48%) or community-based (49%) clinic in New York City. Most DMPA users were single (70%), had had at least one birth (88%), had had at least one abortion (67%) and had ever practiced contraception (75% of those with available data). Life-table DMPA continuation rates were 63% at six months and 42% at 12 months and were not affected by the users' age, marital status, pregnancy history, clinic site or proximity of residence to the clinic. Among adults, the risk of DMPA discontinuation was highest during the three-month period following the second injection, while among adolescents, this risk increased throughout the duration of use. The most commonly reported reasons for method discontinuation were side effects, primarily menstrual irregularities (30%) and weight gain (24%).     

Depot medroxyprogesterone acetate pioneers. A retrospective study at a North Carolina Health Department

This article examines the characteristics of the first group of depot medroxyprogesterone acetate (DMPA) acceptors after US Food and Drug Administration (FDA) approval of the method and evaluates their continuation rates and factors associated with discontinuation. This was a population based retrospective study based on 12 months of clinic data for 510 women who began using DMPA in 1993 at a large county health department. Cumulative 12 month life table rates were calculated for the entire group and were then stratified by selected characteristics. The 4, 8, and 12 month continuation rates were 67%, 46%, and 35%, respectively. More than half of these women discontinued because of bleeding and nonbleeding side effects (25% and 28%, respectively). Almost 20% of these women were considered discontinuers because they waited longer than 16 weeks to return for an injection. As measured in this study, continuation rates for this first group of DMPA acceptors were low. The next step is to determine if the characteristics and patterns of use of these "pioneer" acceptors are representative of more recent acceptors, and if lessons learned from this group will lead to higher continuation rates.     

Effects of long-term treatment with depot medroxy progesterone acetate for contraception on estrogenic activity

The aims of this study were to evaluate the serum estradiol level and the estrogenic activity in long-term DMPA users. From 1st January 1996 to 31st December 1996, fifty healthy women receiving DMPA for contraception for more than 36 months were recruited to the study. From the study, it was found that the mean duration of DMPA use was 59.1 +/- 30.7 months, the mean serum estradiol was 52.7 +/- 15.1 pg/ml and these women did not have problems of estrogen deficiency. This study revealed that long-term treatment with DMPA should not have any adverse effects on estrogenic activity.     

Differentiation of Veillonella atypica, Veillonella dispar and Veillonella parvula using restricted fragment-length polymorphism analysis of 16S rDNA amplified by polymerase chain reaction

OBJECTIVE: To investigate the effect of pre-treatment counseling on discontinuation rates of 150 mg depo-medroxyprogesterone acetate (DMPA), given for contraception. METHODS: A total of 421 women participated, 204 receiving intensive structured pre-treatment and on going counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling. All participants were followed up at every 3 months for 1 year. The primary endpoint was termination rate, secondary endpoints were frequency of medical events and reasons for termination. RESULTS: The most common reasons for terminating DMPA were menstrual changes. Although women in the intensive structured counseling group reported more menstrual irregularity (39.7%) than did women in the routine counseling group (26.3%), study termination rates were significantly lower in the intensively structured counseling group than in the routine counseling group. At one year, the total cumulative termination rates were 11.3% (23/204) and 42.4% (92/217), respectively (P < 0.0001). No pregnancy and serious medical events were reported. CONCLUSION: Pre-treatment counseling on expected side effects increases the acceptability of DMPA.     

In vitro application of testosterone potentiates gonadotropin-releasing hormone-stimulated gonadotropin-II secretion from cultured goldfish pituitary cells

This report describes the methods used in conducting a long-term follow-up study and the factors associated with the successful location of subjects. In 1987-91, we selected, from among the women who were born in 1959-66 as members of the Philadelphia and Providence cohorts of the Collaborative Perinatal Project (CPP), 391 who were preterm at birth, 413 who were small-for-gestational age (SGA) and 978 who were term and appropriately grown; 1314 were from Philadelphia and 468 from Providence. Tracing was accomplished using original CPP records, telephone directories, voter registration and driver's licence records, birth certificate files and credit bureaux. A total of 61% of the women were located, 55% at Philadelphia and 77% at Providence. After adjustment, the odds ratio for ease of location, compared with women who were term and appropriately grown, was 0.85 [95% CI 0.66-1.11] for women who were preterm and 1.02 [0.78-1.34] for women who were SGA. In Philadelphia, African-American women were more likely than white women to be located, but in Providence, African-American women were less likely than white women to be located. Women whose own mothers were older at the time of their birth were more likely to be located, as were those who had more siblings followed in the CPP. Compared with women who did not complete their original CPP examinations at ages 4 and 7 years, those whose original CPP follow-up was more complete were more likely to be located. These findings demonstrate that long-term follow up in a US urban setting can be accomplished, and that successful location was not associated with birth status.     

The nature of the relationship between remarried individuals and former spouses and its impact on marital satisfaction.

The relationship with a former spouse and its impact on marital satisfaction were examined in a sample of 290 remarried individuals. There was little continued attachment and friendship with the former spouse; although infrequent, feelings of hostility were still more common than either friendship or continued attachment. The relationship with the former spouse was more positive among the more highly educated and among those who did not have children from the former marriage. Continued attachment to the former spouse was especially negatively related to current marital satisfaction. Wives' marital satisfaction was negatively related to their husbands' attachment, and wives had more objections to this type of attachment. Particularly among women, friendship with a former spouse was dependent on their husband's positive attitude toward this type of friendship. Women were likewise more dissatisfied with marriage the more problems their husbands had with the way they related to the former spouses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Test-retest characteristics of a group of attempted suicide patients.

15 male and 36 female patients who had been psychologically tested after having made a suicide attempt were retested in a postal follow-up to ascertain whether significant changes had occurred in their scores on the Neuroticism Scale Questionnaire (NSQ) and Symptom Sign Inventory. Men and women differed significantly in their response to postal retest. It is concluded that while women who responded to retest were representative of all women in the group, men who responded could not be so considered due to the disproportionate number of repeat-prone individuals in this group. These men showed no change in their test scores. Women, overall, did not change on any NSQ variables, although those who were retested quite soon after the original testing showed an increase in tendermindedness. They did show a significant reduction in psychiatric symptomatology, especially where the test-retest interval was longer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Division of Labor and Working-Class Women's Well-Being Across the Transition to Parenthood.

This study examines the degree to which the division of household and child-care tasks predicts working-class women's well-being across the transition to parenthood. Women completed questionnaires about the division of labor and their well-being before the birth of their first child and upon returning to work. Results showed that violated expectations regarding the division of child care were associated with increased distress postnatally, and there was some evidence that this relationship was moderated by gender ideology. Traditional women whose husbands did more child care than they expected them to do were more distressed. Work status also moderated the relationship between violated expectations and distress. The results suggest that the division of child care is more salient in predicting distress than the division of housework, for working-class women, at this time point. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smokeless tobacco: an addicting drug

OBJECTIVE: To describe the sexual behaviour of postnatal women, including time of restarting intercourse, problems encountered, use of contraception and related use of available services. DESIGN: Longitudinal survey using postal questionnaires following discharge from hospital, and at eight weeks and twelve to eighteen months postnatally. SETTING: The questionnaires referred to postnatal care received in a teaching hospital and general practitioner delivery units, and in the community. POPULATION: Randomly selected one in five sample of women who were delivered in the Grampian Region of Scotland over a 12-month period. MAIN OUTCOME MEASURES: Times to restarting intercourse and contraception; problems related to intercourse and their relation to perineal pain, tiredness and method of infant feeding; and perceived need for and adequacy of help. RESULTS: The median times to restarting intercourse and contraception were each six weeks. Problems with intercourse were reported by 569/1075 (53%, 95% CI 50-56) of women in the first eight weeks after delivery, and by 215/435 (49%, 95% CI 45-54) in the subsequent year. Women who reported perineal pain, depression or tiredness experienced problems related to intercourse more often than those who did not. Women who breastfed their infants were significantly less interested in intercourse than those who bottlefed, irrespective of tiredness or depression, but this effect did not persist in the long term. The need for help with problems was expressed by 7% to 13% of women, but a quarter of these had not sought it. CONCLUSIONS: Postnatal sexual problems are common. Health professionals ought to educate and prepare patients antenatally; be trained to identify problems; and be competent to deal with them openly and sympathetically.     

Psychophysiological responses to an infant cry: Comparison of groups of women in different phases of the maternal cycle.

Psychophysiological reactions of 60 women to an infant's cry and to a control sound were investigated. The 30-s cry stimulus evoked greater cardiac and electrodermal activity than did the control stimulus, although selected groups varied in the nature and extent of their reactions. Women who had given birth recently showed cardiac acceleration to the initial cry bursts, then decelerated during a pause in stimulation, and accelerated again during the final cry segment. Similar reactions were shown by pregnant women who heard the cry after the control stimulus, whereas those pregnant women who heard the cry first (and who as a group had a somewhat higher basal heart rate) showed deceleration to the cry. Women who were not pregnant responded with deceleration, followed by a return to baseline level. Within the pregnant and nonpregnant groups, women who had child-rearing experience showed greater arousal during the last 15 s of cry stimulation than did those without such experience. Thus, both maternal state and experience with infants affected women's reactions to an infant cry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of couple illness perception congruence on psychological adjustment in women with rheumatoid arthritis.

Objective: To characterize similarities and differences in illness perceptions between women with rheumatoid arthritis (RA) and their husbands, and examine whether illness perception congruence predicted wives' subsequent psychological adjustment. Design: Women with RA and their husbands (N = 190 couples) recruited from community and clinical settings completed mailed surveys at baseline and 4-month follow-up. Main Outcome Measures: Data for this investigation included illness perceptions in partners and illness severity, marital variables, and psychological adjustment in wives. Results: In general, wives and husbands had similar views of RA. Couple congruence concerning women's personal control over RA and its cyclic nature predicted better psychological adjustment in women 4 months later. Post hoc tests showed better psychological adjustment in wives from couples with similar optimistic beliefs about personal control, illness coherence, and RA consequences, when compared to those in couples with similar pessimistic beliefs. Furthermore, when partners disagreed about RA's consequences, wives fared better when husbands overestimated rather than underestimated their beliefs. In contrast, couple congruence about the emotions and timeline of RA was unrelated to adjustment. Conclusion: It may be important for husbands to understand wives' views on their control over RA and its cyclic nature. Furthermore, wives may benefit when they share optimistic views with their husbands about RA, and when their husbands avoid underestimating RA's consequences. Developing interventions to enhance partners' illness understanding may be beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aerobic and anaerobic microbiology of retroperitoneal abscesses

OBJECTIVE: This study examined the effects of order of previous modes of delivery on the rate of cesarean delivery and duration of a trial of labor among women with a history of 1 previous cesarean delivery and 1 previous vaginal delivery. STUDY DESIGN: The medical records of 4393 women at our institution who were seen June 1984-July 1996 for a trial of labor after a previous cesarean delivery were abstracted. The 800 women with a history of 1 previous cesarean and 1 previous vaginal delivery were included in this analysis. They were split into 2 groups by obstetric history: (1) 1 cesarean delivery followed by 1 vaginal delivery (vaginal last) and (2) 1 vaginal delivery followed by 1 cesarean delivery (cesarean last). Patient characteristics, durations of labor, and rates of cesarean delivery were compared with chi2 analysis, the Student t test, and the Wilcoxon rank sum test. Possible confounding variables were controlled for with multivariate logistic regression. RESULTS: The rates of cesarean delivery for the vaginal last and cesarean last groups were 7.2% and 14.7%, respectively (P = .002). The median durations of labor for the vaginal last and cesarean last groups were 5.6 and 7.0 hours, respectively (P = .01). The differences in cesarean rates and durations of labor were seen regardless of the indication for the previous cesarean delivery. CONCLUSIONS: Among women with 1 previous cesarean and 1 previous vaginal delivery, those whose most recent delivery was vaginal had a lower rate of cesarean delivery and shorter duration of labor than did those whose most recent delivery was cesarean.     

Oral contraceptive use and hemodynamic, lipid, and fibrinogen responses to smoking and stress in women.

The effects of acute smoking and oral contraceptive (OC) use on cardiovascular, lipid, and fibrinogen stress responses were examined in 52 female smokers and nonsmokers, half of whom were using OCs. Women smoked or sham-smoked a cigarette and then performed 2 stressful tasks. Stress elicited increases in total and low-density lipoprotein cholesterol, and in triglycerides among women who smoked, and in fibrinogen among all women. Smokers who used OCs had greater blood pressure increases to smoking and to stress than did smokers who did not use OCs. OC use was also associated with enhanced total peripheral resistance stress responses among women who smoked and cardiac output stress responses among women who sham-smoked. Results suggest that OC use moderates cardiovascular reactivity in smokers but not nonsmokers, enhancing vascular responsivity to smoking combined with stress and myocardial responsivity to stress alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status, marital satisfaction, and support processes among women at high risk for breast cancer.

This study explored marital status, social support processes, and psychological distress among women at high risk for breast and ovarian cancer who were anticipating genetic testing. In addition to substantive findings, it presents a means of using nonsense coding (J. Cohen & P. Cohen, 1983) to include unmarried persons in regression analyses examining the importance of marital support. These women had mobilized high levels of social support. Married and unmarried women did not differ in distress, but women had to have more satisfying marriages than average to be equivalent to unmarried women. For the married women, husbands were more involved and more influential in decision making than female relatives, even in distressed marriages. Negativity from close relationships, particularly the spouse, had more influence on these women's well-being than did positive involvement. The authors' findings suggest that counseling and education programs need to accommodate the key role that husbands have in decision making concerning genetic testing for risk of breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation

The contraceptive efficacy of oral contraceptives (OCs) depends on their proper and continued use, particularly with lower estrogen preparations. However, few studies have examined why women miss pills or discontinue OCs, and those that do tend to be small and to focus on adolescents. To address the issues of poor OC compliance and early OC discontinuation, we analyzed OC use in a convenience sample of 6,676 women between the ages of 16 and 30 from Denmark, France, Italy, Portugal, and the United Kingdom. Logistic regression was used to examine the independent effect of each factor. Poor compliance was associated with a lack of established routine for pill-taking (relative risk [RR] = 3.3), failure to read and understand written materials that came with the OC package (RR = 2.2), not receiving adequate information or help about OCs from their health care provider (RR = 1.5), and occurrence of certain side effects, including hirsutism (RR = 2.1), nausea (RR = 1.4), bleeding irregularities (RR = 1.3), and breast tenderness (RR = 1.2). Women who were inconsistent OC users, missing one or more pills per cycle, were almost three times as likely to experience an unintended pregnancy while using OCs than were women who took their OCs consistently. Factors that predicted early discontinuation (women who wished to continue contraceptive protection but discontinued OC use) were primarily side effects, including nausea (RR = 2.1), bleeding (RR = 1.9), breast tenderness (RR = 1.8), mood changes (RR = 1.8), and weight gain (RR = 1.4).(ABSTRACT TRUNCATED AT 250 WORDS)     

Patterns and correlates of hormone replacement therapy use among middle-aged Australian women

In this study, we examine the patterns of use of hormone replacement therapy (HRT) among women age 51 to 60 years and describe the characteristics of women who currently use HRT, previously used HRT, and have never used HRT. A brief postal survey of 800 women in this age range was used to determine HRT status. Telephone interviews were then conducted with 258 women (111 currently using HRT, 47 who previously used HRT, and 100 who had never used HRT) to determine characteristics of women who currently or previously used HRT or never used HRT, type of HRT used, duration of use, and reasons for use and nonuse. Nearly 40% of women were currently using HRT, 14% had previously used HRT, and 47% had never used HRT. Women currently using HRT were more likely than those not using HRT to have had a hysterectomy, attribute a greater number of symptoms to the climacteric, be in paid employment, and report a greater number of visits to the doctor over the past 12 months. HRT use among Australian women in their 50s is high and rising. Hysterectomy status, the attribution of symptoms to menopause, paid employment, and health care use were the most important correlates of HRT use. Few women specified long-term prevention of osteoporosis or heart disease as a reason for taking HRT.     

Disruptions of social relationships accentuate the association between emotional distress and menstrual pain in young women.

This study examined the effects of social support on dysmenorrhea and whether social support moderates the relationship between negative emotions and painful symptoms. Women (N?=?184) completed questionnaires on menstrual symptoms, depression, anxiety, and social networks. Depression and anxiety were strongly associated with menstrual pain. Women who no longer had access to their prior support providers manifested more symptoms than did women with stable social relations. In addition, this disruption in their social networks moderated the relationship between distress and menstrual pain. Results indicate that loss of social support is a significant contributor to menstrual symptoms and point to the importance of considering specific aspects of social support in studying its effect on health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)