The Sense of Stigmatization in Patients with Plaque Psoriasis.

BACKGROUND: Psoriasis is a systemic inflammatory disease capable of creating stigmatization in the form of social exclusion and decrement of psychological conditions. AIM: The aim of the study was to determine the level of stigmatization in patients with plaque psoriasis. METHODS: The study included 166 patients with plaque psoriasis (55.6% women and 44.3% men) with Psoriasis Area and Severity Index scores ≤10. The age of the study patients ranged between 18 and 72 years (arithmetic mean = 37.4; median = 38; standard deviation [SD] = 11.0). The mean age at the diagnosis of psoriasis was 21.5 years (median = 20; SD = 9.1) and disease duration varied from 2 to 59 years (arithmetic mean = 15.8; median = 15; SD = 11.3). The study patients completed the Polish version of the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire and a survey developed by the authors of this study, containing questions about the participants' sociodemographic characteristics (sex, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis). RESULTS: The mean score for the 6-item Stigmatization Scale for the whole study group was 7.6 out of 18 points (median = 7; SD = 3.8; minimum = 0; maximum = 17). The average score for the 33-item Stigma Feelings Questionnaire in our series was 84.5 out of 165 points (median = 88; SD = 20.9; minimum = 30; maximum = 136). A statistically significant sex-related difference was observed in the 6-item Stigmatization Scale scores, with higher stigmatization levels found in men than in women (p = 0.0082). Moreover, significantly higher levels of stigmatization were observed in countryside dwellers (p = 0.0311) and unmarried persons (p = 0.0321). Patients with a longer history of the disease (≥15 years) scored significantly higher on the 6-item Stigmatization Scale (p = 0.0217) than those in whom psoriasis lasted less long, and presented with higher, at the threshold of statistical significance, scores for the 33-item Feelings of Stigmatization Questionnaire. CONCLUSIONS: Stigmatization awareness should be promoted among physicians and psoriatic patients to improve psoriasis management.

Experimental Evidence for Sex Differences in Sexual Variety Preferences: Support for the Coolidge Effect in Humans.

We examined sex differences in preferences for sexual variety and novelty to determine whether the Coolidge effect plays a role in human sexuality. In two experimental studies that employed different manipulations, we found converging evidence that men showed a greater preference for variety in potential short-term mates than did women. In the first study, men (n = 281) were more likely than women (n = 353) to select a variety of mates when given the opportunity to distribute chances to have sex with different individuals in hypothetical situations. This sex difference was evident regardless of the targets' attractiveness and age. Further, men found it more appealing if their committed romantic/sexual partners frequently changed their physical appearance, while women reported that they modified their physical appearance more frequently than did men, potentially appealing to male desires for novelty. In the second study, when participants were given a hypothetical dating task using photographs of potential short-term mates, men (n = 40) were more likely than women (n = 56) to select a novel person to date. Collectively, these findings lend support to the idea that sex differences in preferences for sexual variety and novelty are a salient sex-specific evolved component of the repertoire of human mating strategies.

Stress and coping among unmarried pregnant university students in South Africa.

BACKGROUND: The improvement of maternal and child health (MCH) outcomes is an important part of the sustainable development goals (SDGs). MCH remains an important issue globally as the SDGs have not yet been achieved in most countries. Young women in universities are likely to experience unintended pregnancy due to risky sexual behaviors in tertiary institutions which is characterized by lack of condom and/or contraceptive use and coercion. Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. However, very little is known about the stress and coping among young people in tertiary institutions who get pregnant during the course of their studies and choose to keep the pregnancy. METHODS: Participants were purposively selected among pregnant students and those in the puerperal period at the time of the study. Semi-structured qualitative interviews were undertaken to explore the experiences of pregnancy and early motherhood, with particular focus on the various stressors experienced and possible coping strategies employed by students. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. RESULTS: The findings show that pregnancy and early motherhood was an experience that came with a lot of stress emanating from fear of parents' reactions, academic pressure, financial constraints, relationship problems with male partners and experiences of social stigma. Participants used emotion-focused and problem-focused coping strategies to deal with the stressors confronting them during and after their pregnancy. CONCLUSION: The experiences of pregnant students are multifaceted and generally characterised by financial crisis, academic challenges, shame, strenuous relationships and transitioning into a new identity. A multipronged approach to healthcare for pregnant students that focus on comprehensive antenatal services, health education, health promotion, psychosocial interventions including academic counselling will have positive outcomes for young mothers and their children.

Modern contraceptive use among unmarried girls aged 15-19 years in South Western Nigeria: results from a cross-sectional baseline survey for the Adolescent 360 (A360) impact evaluation.

PURPOSE: Adolescents 360 (A360) is an initiative being rolled out across Nigeria with the aim of increasing voluntary modern contraception use among women aged 15 to 19 years. Using evaluation study baseline data, we identified sexuality, fertility and contraceptive use characteristics of young unmarried girls in South Western Nigeria. METHODS: A cross-sectional baseline survey of unmarried girls aged 15 to 19 years was conducted in Ogun state, Nigeria in August 2017. A clustered sampling design was used. We identified determinants of modern contraceptive use in this subpopulation using logistic regression. RESULTS: Of 12,024 women interviewed, 15.3% reported sexual intercourse in the past year. The majority of respondents (79.6%, 9525/11,967) had heard of contraception. 45.3% of sexually active respondents were using a modern contraceptive method. Of those using any method of contraception, male condoms (50.3%) were the most widely used modern method followed by the emergency contraceptive pill (16.7%). Following adjustment for socio-demographic characteristics, there was evidence that the use of modern contraception was positively associated with having never given birth, living in an urban area, current enrolment in education, high level of education, high socioeconomic status, exposure to information about contraception, perceived social support for contraception, and self-efficacy for contraception. CONCLUSIONS: In South Western Nigeria, unmarried sexually active adolescent girls have relatively low levels of modern contraceptive use. Programmes should aim to increase access to modern contraception and to increase social support and acceptability of contraceptive use.

Putting reproductive rights into practice. The profile of the demand in a publicly sponsored ART program for single or female partner women in Catalonia.

PURPOSE: To evaluate the size and characteristics of the demand for a newly established, publicly sponsored, program of assisted reproduction for single women (SW) and women with a female partner (FP) in a European country. MATERIALS AND METHODS: We analysed the application forms received during the first two years and structured interviews with 300 successive non selected applicants. RESULTS: The mean sustained size of the demand was of 52.6 applications per month (sd 14) and corresponded to 0.06 % of the target population. Data from 237 applicants was evaluable. 119 (50.2 %) were SW and 118 (49.8 %) were FP. The median age was 36 years, 36.5 years for SW and 34 years for FP (p < 0.001, Mann-Whitney). Clinically 18.6 % of women presented irregular cycles, and 17.8 % of women had undergone hysterosalpingography (HSG), with a 14.3% prevalence of tubal dysfunction. CONCLUSIONS: A publicly sponsored program for Assisted Reproduction for SWFP should establish clear inclusion criteria, especially as regards to age, ovarian reserve, techniques offered, and the number of cycles to obtain the maximal efficiency. Further research specific for this group is required to ensure that they receive adequate care and ultimately to fulfil their reproductive rights.

Sexual behaviour and risk compensation among single women of reproductive age using hormonal contraception in Zambia.

OBJECTIVE: Developing countries have seen an increase in the use of hormonal contraception due to its high efficacy in preventing pregnancy. Our study assessed risk compensation among single women of reproductive age using hormonal contraception. METHODS: The study used data from a nationally representative, cross-sectional sample of the 2018 Zambia Demographic and Health Survey (DHS). Study participants (N = 2151) were single, sexually active women aged 15-49 years, of whom 595 were using hormonal contraception. RESULTS: Hormonal contraception was used by 26% of participants, 81% of whom reported they had not used a condom every time they had sexual intercourse (p < .001). Sexually transmitted infections (STIs) were reported in 4% of hormonal contraceptive users, compared with 2% of non-hormonal contraceptive users (p = .036). The odds of condom use at each occurrence of sexual intercourse were lower for: hormonal contraceptive users (adjusted odds ratio [OR] 0.62; 95% confidence interval [CI] 0.48, 0.80); women aged 15-19 years (adjusted OR 0.62; 95% CI 0.36, 1.08) and 20-24 years (adjusted OR 0.56; 95% CI 0.33, 0.95); women with no education (adjusted OR 0.33; 95% CI 0.16, 0.69) and primary education (adjusted OR 0.62; 95% CI 0.42, 0.94); women in the low wealth quintile (adjusted OR 0.46; 95% CI 0.36, 0.61); and women who had one or more children (adjusted OR 0.59; 95% CI 0.45, 0.77). CONCLUSION: Lack of knowledge about hormonal contraception predisposes women to sexual risk behaviour. As hormonal contraception is very effective in preventing unwanted pregnancy, and condoms are effective in reducing the risk of STI transmission, the use of both (dual protection) should be encouraged.

Single LBQ women of the baby boom planning for later life.

The aim of this study was to understand how sexual minority women of the baby boom cohort viewed their social connections and planned for their later years. Framed by feminist and life course perspectives, this study used semi-structured interviews and constructivist grounded theory. Thirteen single sexual minority baby boom women from across the U.S. were interviewed. The women were active in their communities and viewed their social connections with local community, family of origin and of choice. The women had formal and informal plans for their future, anticipating the possibilities of aging-related issues, related to housing and support.

How Bachelorhood and Migration Increase the HIV Transmission Risk Through Commercial Sex in China?

In China, the serious involuntary bachelorhood due to sex ratio imbalance in decades is expected to dramatically increase the spread of HIV through heterosexual contact. However, the higher HIV transmission risk and its correlates among never married men in rural China are not well understood. This study explored whether and how bachelorhood and migration increased the HIV transmission risk through commercial sex. By combining two cross-sectional survey data from never married men in rural areas and male migrants (including both married and unmarried men) in urban areas, a total of 1030 participants who were never married and age 28 and above or married male migrants were included in this study. The results show that both bachelorhood and migration put the never married male migrants at particularly higher HIV transmission risk by increasing both the possibility of engaging in commercial sex, and the frequency and inconsistency of condom use in commercial sex. Selection bias into marriage and neighborhood characteristics associated with exposure to commercial sexual risk may partly explain why male migrants that never married had a higher commercial sex related risk than that of married male migrants and never married non-migrant males.

Psychosocial Barriers and Enablers for Prostate Cancer Patients in Starting a Relationship.

Single prostate cancer (PCa) patients may face difficulties in starting a new relationship for various reasons. Here, we studied barriers and enablers to starting a relationship for PCa patients and characteristics of patients who were and were not in a relationship. PCa organizations distributed for us a 20-minute online survey, consisting of validated questionnaires (on treatment side effects, loneliness, social provision, and shyness) and questions on factors identified by patients as barriers and enablers to forming a new relationship. Participants were either single [n = 20] or had started a new relationship post-diagnosis [non-single, n = 15]. Three factors-confidence, sexual function, finding the right person-were perceived of as factors that can affect starting a relationship. Fourteen of twenty single patients were confident that they could find a partner and sixteen were comfortable in disclosing their cancer diagnosis to a potential partner. Non-single patients met their partners through various ways, including online dating and social events. They all revealed their cancer status prior to starting the relationship, and most partners reacted well to this disclosure. Single patients were lacking emotional support, more shy, and lonelier than non-single patients. Clinicians need to consider biopsychosocial factors when advising single patients who wish to start a new relationship.

Behavioral barriers to the use of modern methods of contraception among unmarried youth and adolescents in eastern Senegal: a qualitative study.

BACKGROUND: Many unmarried young people in low- and middle-income countries (LMIC) want to avoid pregnancy but do not use modern methods of contraception-as a result, half of teen births in these countries are unintended. Researchers have identified numerous barriers that prevent youth from using contraception. However, much of the research in West Africa is narrowly focused on married women, and relatively little research has been done to understand the needs, preferences, barriers, and solution set for sexually active unmarried young people who would like to avoid pregnancy. The purpose of this study was to gain insight into the behavioral barriers that prevent unmarried young people in eastern Senegal from using modern methods of contraception. METHODS: This qualitative study conducted in 2017 in the Tambacounda and Kedougou regions in Senegal explores attitudes and beliefs relating to sex and contraception among unmarried young women and men through 48 in-depth individual interviews with young people aged 15-24 and parents of youth and 5 sex-segregated focus groups with 6-9 young people per group. The research team conducted a thematic content analysis and synthesized the findings by major theme following the behavioral diagnosis methodology. RESULTS: Drawing insights from behavioral science, the analysis yields five key findings: (1) unmarried young people avoid making a decision about contraception because thinking about contraceptive use provokes uncomfortable associations with a negative identity (i.e., being sexually active before marriage); (2) unmarried young people see modern methods as inappropriate for people like them; (3) unmarried young people are overconfident in their ability to prevent pregnancy through traditional and folk methods; (4) unmarried young people overestimate the social and health risks of modern contraceptive methods; and (5) unmarried young people fail to plan ahead and are not prepared to use modern contraceptive methods before every sexual encounter. CONCLUSIONS: Interventions aimed at increasing uptake of contraceptives among unmarried young people in eastern Senegal must address several significant behavioral barriers in addition to structural, informational, and socio-cultural barriers in order to be successful.

A Retrospective Study to Identify Novel Factors Associated with Post-stroke Anxiety.

BACKGROUND AND PURPOSE: Post-stroke anxiety (PSA) is common and disabling. PSA should be considered as an important outcome in stroke. However, there is a lack of understanding of factors that may be linked to PSA. The purpose of this study was to determine the frequency of PSA and sociodemographic and clinical factors associated with PSA in a cohort of racially and ethnically diverse stroke patients. METHODS: We conducted a retrospective study of ischemic and hemorrhagic stroke patients seen in a stroke outpatient clinic from August 1, 2017 to June 30, 2018. Patients were eligible if a Generalized Anxiety Disorder 7-Item (GAD-7) instrument was available. GAD-7 scores greater than or equal to 10 indicated the presence of moderate to severe PSA. Multivariable logistic regression was used to identify independent sociodemographic and clinical factors associated with PSA. RESULTS: Records from 289 stroke patients with a GAD-7 instrument were analyzed. PSA was common (21%; GAD-7 ≥ 10). Fifty-seven percent of females had a GAD-7 greater than or equal to 10 compared to 41% of females who had a GAD-7 less than 10 (P = .03). Multivariable analysis found that self-reported nonmarried status (odds ratio, 3.27; 95% confidence interval, 1.44-7.44), excessive fatigue (odds ratio, 4.46; 95% confidence interval, 1.87-10.63), and depression (odds ratio, 1.24; 95% confidence interval, 1.16-1.33) were independently associated with PSA. CONCLUSIONS: PSA may occur more frequently in those who report non-married, excessive fatigue, or depression. Trials of PSA interventions should consider the potential impact of social support, depression, and comorbid conditions contributing to post-stroke fatigue, including sleep apnea.

Understanding condom use among unmarried female migrants: a psychological and personality factors modified information-motivation-behavioral skills model.

BACKGROUND: In China, unmarried female migrants are vulnerable to sexual and reproductive health risks. One effective protection strategy is promoting consistent condom use (CCU). METHODS: We conducted a cross-sectional study to apply the information-motivation-behavioral skills (IMB) model and modified it by addition of psychological and personal factors to examine the related factors of CCU and provide suggestions for intervention among unmarried female migrants. RESULTS: Of all 903 eligible participants, only 13.8% of participants reported CCU in the past six months. Both the IMB model and the modified IMB model provided acceptable fit to the data. In both models, information had no direct or indirect influence on CCU (p > 0.05). However, behavioral skills had a positive effect on CCU (ß = 0.344, p < 0.001 and ß = 0.330, p < 0.001). Moreover, motivation contributed to CCU indirectly by affecting behavioral skills (ß = 0.800, p < 0.001) and had no direct influence (p > 0.05). In the modified model, psychological and personality factors influenced CCU directly (ß = - 0.100, p = 0.005). CONCLUSIONS: Our results highlight the importance of conducting CCU promotion among unmarried female migrants. Future intervention strategies should focus on both the traditional IMB model constructs and the added psychological and personality factors.

Mental health status of unmarried youth living in single parent families: a case study from India.

Background: In South Asian countries like India, family system lays a strong foundation in societies and therefore, the context and consequences of single parent family structures are markedly different from that of the West. In these societies single parenthood is mainly an outcome of untimely death of any one of the parents. Aims: This study tried to examine the influence of parents' survival status on the mental health of youth in India. Methods: "Youth in India: situation and Needs (2006-2007)" survey data was used in the present study. We compared two groups of unmarried young population aged 15-24 y (n = 28 637): one having both parents alive and another having only one parent alive. Bivariate and multivariate techniques were applied to analyze the data. Results: Results revealed that around 11% of the unmarried youth belonged to single parent families. Findings underscored a significant association between parent's survival and mental health of youth; respondents from single parent families were more likely to report metal health problems Moreover, effects of parents' survival were significant on females' mental health rather than males'. Conclusion: Policies must focus on reducing stress of young people growing up in single parent families through enhanced educational and employment opportunities.

Factors Influencing Various Aspects of Patients' Knowledge of Oral Anticoagulation.

OBJECTIVES: To identify and examine individual characteristics and socioeconomic factors that contribute to the knowledge of patients who receive warfarin anticoagulation. METHODS: All patients treated using warfarin for anticoagulation were enrolled during a 6-month period at a university-affiliated cardiac clinic. All relevant demographic and clinical information were collected and the Anticoagulation Knowledge Assessment (AKA) questionnaire consisting of 29 questions was administered. After completion, the questionnaires were scored and the percent correct answers were analyzed for overall scores, as well as the following categories: drug/food interactions, pharmacological knowledge, recognition of complications, and patient compliance. Multiple linear regression analysis was used to identify the contributing factors to the knowledge level of the patients in each category. RESULTS: One hundred fifty patients (79 men and 71 women) with a median age of 61.5 years completed the AKA questionnaire. The average overall score was 29.3%. Living alone (P = 0.008), higher levels of education (P = 0.001), and durations of ≥3 years of warfarin therapy (P = 0.018) positively impacted overall AKA scores. CONCLUSIONS: Socioeconomic factors and level of general education remain the most important elements determining the patient awareness of therapeutic goals, possible drug/food interaction, recognition of adverse effects, and compliance of warfarin treatment.

Sexual compulsivity and its relationship with condomless sex among unmarried female migrant workers in Shanghai, China: a cross-sectional study.

BACKGROUND: Individuals with high sexual compulsivity are preoccupied with their sexual desire to such an extent that it interferes with their normal daily life and can inhibit self-control. Previous studies have found a close association between sexual compulsivity and condomless sex among different populations; however, no studies have investigated this among unmarried female migrant workers in China. This study aimed to validate the Sexual Compulsivity Scale (SCS) for appropriate use and examine the association between sexual compulsivity and condomless sex in this target population. METHODS: In 2015, we recruited 1325 unmarried female migrant workers in Shanghai, China. Information about sociodemographics, sexual compulsivity, and condomless sex were collected using a structured questionnaire. Exploratory factor analysis and reliability analysis were performed to validate the Chinese version of the SCS. Multiple logistic regression analyses were used to examine the association between sexual compulsivity and condomless sex. RESULTS: The prevalence of condomless sex in the previous 6 months was 66.8% among all participants. The SCS was proven internally consistent for the overall scale (Cronbach's α = 0.89), and two factors, Social Disruptiveness (Cronbach's α = 0.87) and Perceived Self-Control (Cronbach's α = 0.84), were extracted. With mean total score of 18.25 (standard deviation = 4.94) after adjusting for significant sociodemographic factors, the SCS total scores (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI] = 1.02-1.07) and two subscale scores (AOR = 1.07, 95% CI = 1.02-1.13; AOR = 1.06, 95% CI = 1.02-1.10) were all related to inconsistent condom use with partners in the previous 6 months. CONCLUSIONS: The Chinese version of the SCS was found to be well adaptable for use among unmarried Chinese female migrant workers and a potential predictor for condomless sex. In addition to safe sex interventions, counselling on managing sexually compulsivity should also be provided in this population.

Suicidal Ideation Among Medical Students: Prevalence and Predictors.

Suicide is one of the leading causes of death among medical students, second to car accidents. We investigated the prevalence and predictors of suicidal ideation (SI) among medical students in Brazil. This is a cross-sectional study with 475 medical students of a public university. The research protocol included data on sociodemographics and academic life, and structured instruments to assess social support and psychopathological symptoms, including the Beck Depression Inventory (BDI). The outcome was evaluated using the BDI suicide item. Bivariate analyses were followed by logistic regression. SI was present in 34 participants (7.2%). In the logistic regression, SI remained associated with living alone, thoughts of abandoning the course, moderate or severe depressive symptoms, and probable obsessive-compulsive disorder. SI is frequent among medical students and can be identified with a simple screening question. Special attention should be given to students living alone, with thoughts of abandoning the course, and relevant depressive or obsessive-compulsive symptoms.

Pain and self-rated health among middle-aged and older Canadians: an analysis of the Canadian community health survey-healthy aging.

BACKGROUND: Pain is an important health problem adversely affecting functionality and quality of life. Though self- rated health (SRH) is a major predictor of mortality, its relationship with pain is not well understood. We explore 1) how pain and age interact to influence SRH, and 2) provincial variations in SRH across Canada. METHODS: We analyzed cross-sectional data from Statistics Canada's Canadian Community Health Survey-Healthy Aging (n = 30,685), which targeted those 45 years and older and was conducted from 2008 to 12-01 to 2009-11-30. The response rate was 74.4%.The topics covered included socio-demographics, well-being and chronic diseases. We performed both bivariate and multivariate analyses between each predictor and SRH; unadjusted and adjusted odds ratios and 95% confidence intervals are reported. Two-level logistic regression mixed model was used to account for provincial differences. An intraclass correlation coefficient was also computed. RESULTS: Slightly more than half of respondents (56.40%) were female. In bivariate analyses, those experiencing pain had an odds ratio of 0.20. Which means that the odds of reporting good self-rated health are 4 to 5 times lower for those with pain, compare to the odds of reporting good self-rated health among those without pain (p < 0.001). In multivariate analyses the highly educated, female gender, the never married or single and households with high yearly income were predictors of good health (p < 0.001). Those who reported depressive symptoms, the lonely, the obese, daily smokers and/or the stressed were less likely to rate their health as good (p < 0.001). The influence of pain on SRH was stronger among younger age groups (45-54 years) compared to older age groups (75-84 years, with an odds ratio of 3.53 [p < 0.001] versus 3.14 [p < 0.001]). CONCLUSIONS: Pain, among other determinants, is associated with SRH. Individuals in rating their health may consider a variety of factors, some of which may not be apparent to health providers. We found that those who reported depressive symptoms, were daily smokers, the obese, the lonely, and/or having a stressful life were less likely to rate their health as good. No significant provincial variations in SRH in Canada was observed in this study.

Association between induced abortion and suicidal ideation among unmarried female migrant workers in three metropolitan cities in China: a cross-sectional study.

BACKGROUND: Despite reports of mental health issues, suicidality has not been closely examined among the migrant population. The association between induced abortion and suicidal ideation is unknown among unmarried female migrant workers of reproductive age in China. This study aims to examine induced abortion and suicidality among the Chinese migrant population. METHODS: We recruited 5115 unmarried female migrant workers during 2015 to 2016 from Shanghai, Beijing and Guangzhou, and collected demographic, psychosocial, reproductive and mental health information using structured questionnaires. We used logistic regression models to examine the association between lifetime induced abortion and suicidal ideation during the past year among the subjects. RESULTS: Overall, 8.2% of the subjects had suicidal ideation during the past year, and 15.5% of the subjects experienced induced abortion. Induced abortion was associated with nearly twice the odds of having past-year suicidal ideation (Odds ratio, OR = 1.89; 95% confidence interval, CI: 1.46, 2.44) after adjusting for age, education, years in the working place, tobacco use, alcohol consumption, daily internet use, attitude towards premarital pregnancy, multiple induced abortion, self-esteem, loneliness, depression, and anxiety disorders. The association was stronger in those aged > 25 (OR = 3.37, 95% CI = 2.16, 5.28), with > 5 years of stay in the working place (OR = 2.98, 95% CI = 2.02, 4.39), the non-anxiety group (OR = 2.28, 95% CI = 1.74, 3.00), and the non-depression group (OR = 2.94, 95% CI = 2.08, 4.15). CONCLUSIONS: Induced abortion was associated with increased odds for suicidal ideation among the unmarried female migrant workers in urban cities in China. More attention should be paid to the mental health of the population.

MEDIATION MODELS OF PREGNANCY DESIRES AND UNPLANNED PREGNANCY IN YOUNG, UNMARRIED WOMEN.

This paper examines the proposition that sexual and contraceptive behaviours mediate the relationship between the pregnancy desires of young, unmarried women and their having an unplanned pregnancy. The sample consisted of 854 18- to 19-year-old women living in Michigan, USA. First, the positive and negative pregnancy desires of these women were measured, as were the women's perceptions of the positive and negative desires of their sexual partners. Then the extent to which these four types of desires, as well as several types of interactions between them, prospectively predicted the occurrence of subsequent pregnancies were tested with logistic regression analyses, initially alone and then after the addition of several types of sexual and contraceptive mediator variables. The results demonstrated that four of the ten significant motivational predictors became non-significant following the introduction of the contraceptive mediator variables and that the predictive strength of the other six significant motivational predictors was substantially reduced by their introduction. A number of factors that may account for only a partial mediational effect in some models are discussed.

Gender difference in utilization willingness of institutional care among the single seniors: evidence from rural Shandong, China.

BACKGROUND: Institutional care has become an urgent issue in rural China. Rural single seniors, compared with their counterparts, have lower income and are more vulnerable. Gender is also a significant factor determining long-term institutional care. This study is designed to examine the gender difference towards utilization willingness of institutional care among rural single seniors. METHODS: A total of 505 rural single seniors were included in the analysis. Binary logistic regression model was used to examine the gender difference towards utilization willingness for institutional care, and also to identify the determinants of the utilization willingness for institutional care among rural single male and female seniors. RESULTS: Our study found that about 5.7% rural single seniors had willingness for institutional care in Shandong, China. Single females were found to be less willing for institutional care than single males in rural areas (OR = 0.19; 95 CI 0.06-0.57). It's also found that psychological stress was associated with institutionalization willingness in both single males (P = 0.045) and single females (P = 0.013) in rural China. The rural single seniors who lived alone were found to be more willing for institutional care both in males (P = 0.032) and females (P = 0.002) compared with those who lived with children or others. CONCLUSIONS: This study found that there was a gender difference towards utilization willingness for institutional care among single seniors in rural China. Factors including psychological stress and living arrangements were determinants of institutionalization willingness both in single males and females. Targeted policies should be made for rural single seniors of different gender.