Psychological Dimensions That Explain Integrity in Older Adults: Examination of a Structural Model.

OBJECTIVES: The aim of this research was to confirm whether internal coping strengths, depressive symptomatology and gratitude disposition are significant predictors of integrity in older adults. METHODS: Participated 394 Ecuadorian older adults with ages between 60 and 91 years old. Self-report were applied to assess the different variables under study. Specifically, integrity, coping, resilience, self-efficacy, mood and gratitude were assessed. RESULTS: A confirmatory model was estimated to predict ego-integrity. A personal adjustment factor composed of problem-focused coping strategies, resilience and self-efficacy, and gratitude showed positive and significant relationships with ego-integrity, whereas negative mood negatively predicted integrity. CONCLUSIONS: Integrity is a key variable to strengthen a coherent view of one's life history and highly relevant during ageing. Having personal strengths and dispositions that facilitate adaptation to ageing and maintaining a positive mood predicts the attainment of integrity. CLINICAL IMPLICATIONS: Integrity is an adjustment factor that facilitates adaptation to the stressors of ageing and to major life changes and loss of control indifferent areas of life.

Emotional intelligence predicting ego integrity in healthy older adults.

OBJECTIVES: A characteristic task in aging is the process of reevaluating and reflecting on one's life in order to give it meaning. The successful resolution of this task is defined as ego-integrity, and it is related to various psychological phenomena that foster the person's adaptation to change. The objective was to adapt an ego-integrity scale in a sample of older adults and study the relationships between emotional intelligence, coping strategies, and mood to find out whether they are predictors of ego-integrity. METHODS: The sample included 401 healthy older adults (241 women; ages 65-95, M = 73.69, SD = 6.83). Statistical analyses included structural equation models. Northwestern Ego-integrity Scale 9-item was tested showing that a structure with two unrelated factors fitted the data well. The internal consistency was satisfactory (.82 integrity and .72 despair). RESULTS: Emotional intelligence positively predicted problem-focused adaptive coping strategies (problem solving and positive reassessment) and negatively predicted state of mind (depression and hopelessness), whereas adaptive coping positively predicted integrity, and mood predicted it negatively. CONCLUSION: Emotional intelligence skills, adaptive coping strategies, and mood largely determine the successful resolution of the ego integrity conflict and are relevant resources in successful aging.

Coping and Life Satisfaction in Colombian Older Adults.

BACKGROUND: Effective coping strategies facilitate older adults' optimal adaptation and contribute to their well-being. Problem-focused strategies are associated with active styles and enhance well-being. This study analyzes the role of coping strategies in Colombian older adults' subjective well-being (SWB) using structural equation modelling. Additionally, Confirmatory Factor Analyses of the Life Satisfaction Scale and Coping Strategies Questionnaires are performed. METHOD: A cross-sectional study is conducted with 455 Colombian older adults, ranging from 65 to 92 years old. RESULTS: The results show that problem-focused coping has a positive effect on SWB, whereas emotion-focused coping has a negative effect on SWB. CONCLUSIONS: This article highlights the relationship between effective coping and life satisfaction by showing that problem-focused coping strategies are adaptative and enhance well-being during aging.

Factor structure, measurement invariance and psychometric properties of the Quality of Life Scale WHOQOL-BREF in the Ecuadorian context.

BACKGROUND: The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) is a popular instrument used to assess quality of life. The objective of this study was to evaluate the following psychometric properties: structural validity, convergent validity, internal consistency, and measurement invariance across sex of the WHOQOL-BREF in a sample of Ecuadorian adults. METHODS: We used a sample of undergraduates (n = 987) to assess the WHOQOL-BREF original four-factor structure, a model with correlated factors, a hierarchical model, and two models resulting from the exploratory factor analysis and exploratory graph analysis. All the models were evaluated using confirmatory factor analysis. RESULTS: The results of the exploratory factor analysis and exploratory graph analysis suggest that the items are organized into four factors, although differently from the original version and the orthogonality assumption is not maintained. The confirmatory factor analysis shows that the original WHOQOL-BREF structure with correlated factors presents adequate psychometric properties. However, we propose a four-factor structure that has the best psychometric properties and adequate internal consistency. The results of the measurement invariance show that strict and strong invariance is achieved between men and women. Convergent validity analysis reveals moderate correlations with self-esteem, resilience, and social support. CONCLUSIONS: Despite the original version of the WHOQOL-BREF with correlated factors has acceptable psychometric properties in the Ecuadorian context, we propose a version with a different organization of its items, which is consistent with the findings of other investigations.

Hemodynamic response after concurrent cross exercise in hypertensive women / Respostas hemodinâmicas pós-exercício concorrente cruzado em mulheres hipertensas / Respuestas hemodinámicas post ejercicio concurrente cruzado en mujeres hipertensas

ABSTRACT Introduction: Systemic arterial hypertension is a disease that mainly affects women. Objective: This study aimed to verify the hypotensive effect and blood pressure reactivity in women submitted to a concurrent cross exercise (CC) session. Methods: Fifteen volunteers (54±3) performed aerobic exercise alternated with a series of weights exercises, for the analysis of blood pressure variation (by the oscillometric method) and pressure reactivity (by the Cold pressure test) before and after exercise. Results: The results demonstrated the occurrence of post-exercise hypotension in the systolic phase in the comparison between CC and C post-exercise (−11.65 mmHg). CC led to attenuation of 7mmHg and 4mmHg for SBP and DBP, respectively, in the blood pressure reactivity after one session. Conclusion: It is concluded that concurrent cross exercise ensures hypotension and positive reactivity of systolic blood pressure. Level of evidence II; Therapeutic studies-Investigating the results of treatment.

RESUMO Introdução: A hipertensão arterial sistêmica é uma doença que acomete, principalmente, mulheres. Objetivo: O presente estudo teve como objetivo verificar o efeito hipotensor e a reatividade da pressão arterial em mulheres submetidas a uma sessão de exercício concorrente cruzado (CC). Métodos: Quinze voluntárias (54±3) realizaram exercício aeróbico alternado com uma série de exercícios com peso para a análise da variação da pressão arterial (através do método oscilométrico) e reatividade pressórica (através do Cold pressure test) pré- e pós-exercício. Resultados: Os resultados demonstraram a ocorrência da hipotensão pós-exercício na fase sistólica na comparação entre CC e C pós- exercício (−11,65mmHg). O CC provocou a atenuação de 7 mmHg e 4 mmHg para PAS e PAD, respectivamente, na reatividade pressórica após uma sessão. Conclusão: Conclui-se que o exercício concorrente cruzado garante hipotensão e reatividade positiva da pressão arterial sistólica. Nível de evidência II; Estudos terapêuticos-Investigação dos resultados do tratamento.

RESUMEN Introducción: La hipertensión arterial sistémica es una enfermedad que afecta principalmente a las mujeres. Objetivo: El presente estudio tuvo como objetivo verificar el efecto hipotensor y la reactividad de la presión arterial en mujeres sometidas a una sesión de ejercicio concurrente cruzado (CC). Métodos: Quince voluntarias (54 ± 3) realizaron ejercicio aeróbico alternando con una serie de ejercicios con peso para el análisis de la variación de la presión arterial (a través del método oscilométrico) y reactividad presórica (a través del Cold Pressure Test) pre y post ejercicio. Resultados: Los resultados demostraron la ocurrencia de hipotensión post ejercicio en la fase sistólica en comparación entre CC y C post ejercicio (−11,65mmHg). El CC provocó la atenuación de 7 mmHg y 4 mmHg para PAS y PAD, respectivamente, en la reactividad presórica después de una sesión. Conclusión: Se concluye que el ejercicio concurrente cruzado garantiza hipotensión y reactividad positiva de la presión arterial sistólica. Nivel de evidencia II; Estudios terapéuticos-Investigación de los resultados del tratamiento.

Adaptation and validation of the gratitude questionnaire GQ-6 for the Ecuadorian context / Adaptação e validação do questionário de gratidão GQ-6 para o contexto equatoriano / Adaptación y validación del cuestionario de gratitud GQ-6 para el contexto ecuatoriano

This paper evaluates the factor structure, reliability and validity of the gratitude scale (GQ-6) of McCullough, Emmons and Tsang (2002) and the five-item version proposed by Chen et al. (2009). Results of a sample of 1112 adults show that the fiveitem version has excellent internal consistency (α=.926; ω=.891; GLB=.913); high and significant factor loadings (greater than .8; p<.01), and excellent goodness of fit indexes (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). The criterion validity was evaluated applying subscales of the PERMA-Profiler: positive emotions (ρ=.5702, p=.021) and negative emotions (ρ=-.1786, p=.0316). Finally, we find psychometric equivalence between the sex of the participants. In conclusion, the five-item questionnaire is valid and reliable in the Ecuadorian context. (AU)

Este estudo avalia a estrutura fatorial, a confiabilidade e a validade da Escala de Gratidão (GQ-6) de McCullough, Emmons e Tsang (2002) e a versão de cinco itens proposta por Chen et al. (2009). Resultados de uma amostra de 1.112 adultos mostram que a versão de cinco itens tem excelente consistência interna (α=0,926; ω=0,891; GLB=0,913); cargas fatoriais altas e significativas (maior que 0,8; p<0,01), e excelentes índices de qualidade de ajuste (χ²(5)=23,837, p<0,001; CFI=0,997; TLI=0,995; RMSEA=0,082, p=0,045; SRMSR=0,035; WRMSR=0,837). A validade de critério foi avaliada aplicando-se subescalas do PERMA-Profiler: emoções positivas (ρ=0,5702, p=0,021) e emoções negativas (ρ=-0,1786, p=0,0316). Finalmente, encontra-se equivalência psicométrica entre o sexo dos participantes. Em conclusão, o questionário de cinco itens é válido e confiável no contexto equatoriano. (AU)

Este estudio evalúa la estructura factorial, la confiabilidad y la validez de la escala de gratitud (GQ-6) de McCullough, Emmons y Tsang (2002) y la versión de cinco ítems propuesta por Chen et al. (2009). Resultados de una muestra de 1112 adultos indican que la versión de cinco ítems tiene excelente consistencia interna (α=.926; ω=.891; GLB=.913); cargas factoriales altas y significativas (mayores a .8; p < .01), y excelentes índices de calidad de ajuste (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). La validez de criterio se evaluó aplicando subescalas del PERMA-Profiler: emociones positivas (ρ=.5702, p=.021) y emociones negativas (ρ=-.1786, p=.0316). Finalmente, se ha encontrado equivalencia psicométrica entre el sexo de los participantes. En conclusión, el cuestionario de cinco ítems es válido y fiable en el contexto ecuatoriano. (AU)

Fetal heart rate variability mediates prenatal depression effects on neonatal neurobehavioral maturity.

This study analyzed the mediating role of fetal heart rate variability (FHR) on prenatal depression and neonatal neurobehavioral maturity. A sample of 104 pregnant women was recruited and divided into two groups according to their Edinburgh Postnatal Depression Scale (EPDS) scores (depressed/non-depressed). FHR variability in response to speech stimuli was assessed at term (between 37 and 39 weeks gestation). The neonates were then assessed on the Neonatal Behavioral Assessment Scale (NBAS) during the first 5days after birth. The fetuses of non-depressed pregnant women showed higher HR variability than the fetuses of depressed pregnant women in response to speech stimuli, and later as neonates they performed more optimally on the NBAS (on autonomic stability and total scores). FHR variability mediated the relationship between the mother's prenatal depression and the neonatés NBAS performance. Prenatal depression effects on neonatal behavior may be partially explained by its adverse effects on fetal neurobehavioral maturity.

A cross-sectional triangulation analysis of the knowledge, attitudes and practices of patients from the endocrinology clinic of the Philippine General Hospital on the use of herbal dietary supplements

OBJECTIVE: This study aimed to determine the knowledge, attitudes and practices (KAP) of a selected population of patients on herbal dietary supplements (HDS).METHOD: Methodological triangulation was used to generate a conceptual framework on HDS KAP. A survey of 175 patients was performed to measure knowledge and attitudes regarding HDS and SPSS was used for data analysis. Inverviews and focus group discussions (FGDs) were conducted to further explore the attitudes and practices, and constant comparison method was used for analysis of responses.RESULTS: Respondents were generally aware of HDS. Majority of survey respondents believed that HDS are different from conventional drugs (52.0%, pThe attitude toward HDS was generally positive. Majority (64.0%, pAmong the survey respondents, only 22% were HDS users. Family was shown to promote use while cost deterred their use.CONCLUSION: Individual knowledge and attitudes on HDS exert significant influence toward HDS practices. Factors that promote use are poor knowledge and positive attitudes toward HDS. Good knowledge seems to lead to judicious use or non-use.

Mother's depression at childbirth does not contribute to the effects of antenatal depression on neonate's behavioral development.

BACKGROUND: Maternal depression is a worldwide phenomenon that has been linked to adverse developmental outcomes in neonates. AIMS: To study the effect of antenatal depression (during the third trimester of pregnancy) on neonate behavior, preference, and habituation to both the mother and a stranger's face/voice. To analyze mother's depression at childbirth as a potential mediator or moderator of the relationship between antenatal depression and neonate behavioral development. METHOD: A sample of 110 pregnant women was divided in 2 groups according to their scores on the Edinburgh Postnatal Depression Scale during pregnancy (EPDS; ≥ 10, depressed; <10, non-depressed). In the first 5 days after birth, neonatal performance on the Neonatal Behavioral Assessment Scale (NBAS) and in the 'Preference and habituation to the mother's face/voice versus stranger' paradigm was assessed; each mother filled out an EPDS. RESULTS: Neonates of depressed pregnant women, achieved lower scores on the NBASs (regulation of state, range of state, and habituation); did not show a visual/auditory preference for the mother's face/voice; required more trials to become habituated to the mother's face/voice; and showed a higher visual/auditory preference for the stranger's face/voice after habituation compared to neonates of non-depressed pregnant women. Depression at childbirth does not contribute to the effect of antenatal depression on neonatal behavioral development. CONCLUSION: Depression even before childbirth compromises the neonatal behavioral development. Depression is a relevant issue and should be addressed as a routine part of prenatal health care.

Brazelton Neonatal Behavioral Assessment Scale: a psychometric study in a Portuguese sample.

BACKGROUND: The Neonatal Behavioral Assessment Scale (NBAS, Brazelton & Nugent, 1995) is an instrument conceived to observe the neonatal neurobehavior. Data analysis is usually performed by organizing items into groups. The most widely used data reduction for the NBAS was developed by Lester, Als, and Brazelton (1982). OBJECTIVE: Examine the psychometric properties of the NBAS items in a sample of 213 Portuguese infants. METHOD: The NBAS was performed in the first week of infant life (3 days±2) and in the seventh week of life (52 days±5). RESULTS: Principal component analyses yielded a solution of four components explaining 55.13% of total variance. Construct validity was supported by better neurobehavioral performance of 7-week-old infants compared with 1-week-old infants. CONCLUSION: Changes in the NBAS structure for the Portuguese sample are suggested compared to Lester factors in order to reach better internal consistency of the scale.

Mother's anxiety and depression during the third pregnancy trimester and neonate's mother versus stranger's face/voice visual preference.

BACKGROUND: Neonates show visual preference for their mother's face/voice and shift their attention from their mother to a stranger's face/voice after habituation. AIM: To assess neonate's mother versus stranger's face/voice visual preference, namely mother's anxiety and depression during the third pregnancy trimester and neonate's: 1) visual preference for the mother versus the stranger's face/voice (pretest visual preference), 2) habituation to the mother's face/voice and 3) visual preference for the stranger versus the mother's face/voice (posttest visual preference). METHOD: Mothers (N=100) filled out the Edinburgh Postnatal Depression Scale (EPDS) and the State Anxiety Inventory (STAI) both at the third pregnancy trimester and childbirth, and the "preference and habituation to the mother's face/voice versus stranger" paradigm was administered to their newborn 1 to 5 days after childbirth. RESULTS: Neonates of anxious/depressed mothers during the third pregnancy trimester contrarily to neonates of non-anxious/non-depressed mothers did not look 1) longer at their mother's than at the stranger's face/voice at the pretest visual preference (showing no visual preference for the mother), nor 2) longer at the stranger's face/voice in the posttest than in the pretest visual preference (not improving their attention to the stranger's after habituation). CONCLUSION: Infants exposed to mother's anxiety/depression at the third gestational trimester exhibit less perceptual/social competencies at birth.

Mother's anxiety and depression and associated risk factors during early pregnancy: effects on fetal growth and activity at 20-22 weeks of gestation.

To examine effects of mother's anxiety and depression and associated risk factors during early pregnancy on fetal growth and activity. Repeated measures of mother's anxiety (State-Anxiety Inventory (STAI-S)) and depression (Edinburgh Postnatal Depression Scale (EPDS)) and related socio demographics and substance consumption were obtained at the 1st and 2nd pregnancy trimesters, and fetus' (N = 147) biometric data and behavior was recorded during ultrasound examination at 20-22 weeks of gestation. Higher anxiety symptoms were associated to both lower fetal growth and higher fetal activity. While lower education, primiparity, adolescent motherhood, and tobacco consumption predicted lower fetal growth, coffee intake predicted lower fetal activity. Vulnerability of fetal development to mother's psychological symptoms as well as to other sociodemographic and substance consumption risk factors during early and mid pregnancy is suggested.

Qualidade do relacionamento com pessoas significativas: comparação entre grávidas adolescentes e adultas / Quality of the relationship with significant persons: comparison between adolescent and adult pregnant women / Calidad de la relación con personas significativas: comparación entre embarazadas adolescentes y adultas

Na gravidez, a mulher experiencia mudanças desenvolvimentais ao nível dos seus relacionamentos significativos. Este estudo compara a qualidade do relacionamento com o companheiro e com outra figura significativa em grávidas adolescentes e adultas, e analisa preditores sócio-demográficos para a qualidade destes relacionamentos. Uma amostra de 130 grávidas (66 adolescentes e 64 adultas) foi avaliada no terceiro trimestre de gestação quanto às características sociais e demográficas e à qualidade do relacionamento com figuras significativas. Os resultados mostram que as adolescentes referem menor confiança (X² = 3.365, p = 0,055) e maior discórdia (X² = 3.842, p = 0,041) no relacionamento com o companheiro e maior sentimento de ligação (X² = 19.126, p = 0,000) e apatia (X² = 8.568, p = 0,004) no relacionamento com a outra figura significativa, comparativamente com as adultas. Verifica-se ainda que a gravidez na adolescência associa-se a relacionamentos de menor qualidade, especialmente devido a situações sócio-demográficas mais desfavoráveis e não tanto à condição de ser ou não adolescente.

During pregnancy, the woman experiences developmental changes in terms of her significant relationships. This study aimed to compare the quality of the relationship with the partner and with other significant figure in adolescents and adult mothers, and examining socio-demographic predictors for the quality of these relationships. A sample of 130 pregnant women (66 adolescents and 64 adults) was assessed at the 3rd trimester of gestation in terms of socio-demographic characteristics and relationships’ quality with significant persons. The results showed that adolescents relate lower confidence (X² = 3,365, p = 0.055) and higher disagreement (X² = 3,842, p = 0.041) in the relationship with the partner; and higher feeling of attachment (X² = 19,126, p = 0.000) and apathy (X² = 8,568, p = 0.004) in the relationship with the other significant figure, compared with adults. We also verify that teen pregnancy is associated to poor relationships, especially because of less favorable sociodemographic situations and not due to being or not an adolescent.

En el embarazo, la mujer vivencia cambios evolutivos en los relacionamientos afectivos significativos. Este estudio compara la calidad de la relación con el compañero y com otras figuras significativas en embarazadas adolescentes y adultas y analiza predictores sociodemográficos para la calidad de estas relaciones. Una muestra de 130 embarazadas (66 adolescentes y 64 adultas) fue evaluada en el 3º trimestre del embarazo en relación a características sociales y demográficas y a la calidad de la relación con figuras significativas. Los resultados muestran que las adolescentes refieren menor confianza (X² = 3.365, p = 0,055) y mayor discordia (X² = 3.842, p = 0,041) en la relación con el compañero y mayor sentimiento de intimidad (X² = 19.126, p = 0,000) y apatía (X² = 8.568, p = 0,004) en la relación con la otra figura significativa, comparativamente con las adultas. Se verificó también que El embarazo en la adolescencia se asocia a relacionamientos de menor calidad, debido especialmente a situaciones sociodemográficas más desfavorables y no tanto a la condición de ser o no adolescente.

Anxiety and depression during pregnancy in women and men.

BACKGROUND: High-anxiety and depression rates have been reported in women during pregnancy; however men and parity effects have not been studied as extensively. The purpose of this study was to analyze anxiety and depression in women and their partners during pregnancy, namely differences between the 1st, 2nd and 3rd pregnancy trimesters, between women and men, and between primiparous and multiparous. METHODS: A sample of 300 women and their partners (n=560) were recruited during the 1st pregnancy trimester and have completed the STAI-S (State Anxiety Inventory) and the EPDS (Edinburgh Postnatal Depression Scale) in the 1st, 2nd and 3rd pregnancy trimesters. RESULTS: Anxiety symptoms follow a U pattern in pregnancy, while depression symptoms decrease throughout pregnancy. Women show higher anxiety and depression values than men, although patterns of time variation are similar. Primiparous women and men display higher anxiety levels in the 1st than in the 3rd trimester, while multiparous register higher values in the 3rd than in the 1st pregnancy trimester. CONCLUSION: Different time variation in pregnancy was found for anxiety and depression symptoms; however anxiety and depression symptoms are particularly high during the 1st trimester. Intervention needs will be analyzed according to the results.

Mother-to-infant emotional involvement at birth.

OBJECTIVES: To study mother-to-infant emotional involvement at birth, namely factors (socio-demographics, previous life events, type of delivery, pain at childbirth, support from partner, infant characteristics, early experiences with the newborn, and mother's mood) that interfere with the mother's positive, negative and not clear emotions toward the newborn. METHODS: The Bonding Scale (an extended Portuguese version of the 'New Mother-to-Infant Bonding Scale') and the Edinburgh Postnatal Depression Scale were administrated during the first after delivery days to 315 mothers recruited at Júlio Dinis Maternity Hospital (MJD, Porto, Portugal). RESULTS: A worse emotional involvement with the newborn was observed when the mother was unemployed, unmarried, had less than grade 9, previous obstetrical/psychological problems or was depressed, as well as when the infant was female, had neonatal problems or was admitted in the intensive care unit. Lower total bonding results were significantly predicted when the mother was depressed and had a lower educational level; being depressed, unemployed and single predicted more negative emotions toward the infant as well. No significant differences in the mother-to-infant emotional involvement were obtained for events related to childbirth, such as type of delivery, pain and partner support, or early experiences with the newborn; these events do not predict mother's bonding results either. CONCLUSION: The study results support the need for screening and supporting depressed, unemployed and single mothers, in order to prevent bonding difficulties with the newborn at birth.

Prevalência e preditores de sintomatologia depressiva após o parto / Prevalence and predictors of depressive symptoms after childbirth

CONTEXTO: A depressão pós-parto é uma patologia que ocorre nas primeiras semanas após o parto com conseqüências negativas não só para a mãe, como também para o bebê e para a família. OBJETIVO: Examinar a prevalência de depressão após o parto, bem como as circunstâncias suscetíveis de predizer a sintomatologia depressiva 1 semana e 3 meses após o parto. MÉTODOS: 197 grávidas preencheram o Questionário de Antecipação do Parto (QAP) (Costa et al., 2005a) no segundo trimestre de gestação. Na primeira semana após o parto, responderam ao Questionário de Experiência e Satisfação com o Parto (QESP) (Costa et al., 2005b) e à Edinburgh Postnatal Depression Scale (EPDS) (Augusto et al., 1996), esta última aplicada novamente no terceiro mês do puerpério. RESULTADOS: Uma percentagem significativa de mulheres encontra-se clinicamente deprimida (EPDS 13) na primeira semana e 3 meses após o parto (12,4 por cento e 13,7 por cento, respectivamente). Das que têm EPDS > 13 na primeira semana, 25 por cento estão ainda deprimidas 3 meses após o parto. Circunstâncias relativas à saúde física, à experiência emocional de parto e ao primeiro contato com o bebê predizem a sintomatologia depressiva na primeira semana do puerpério. A sintomatologia depressiva na primeira semana após o parto e a experiência emocional negativa de parto predizem a sintomatologia depressiva 3 meses após o parto. CONCLUSÕES: Constata-se a importância da experiência emocional de parto e do primeiro contato com o bebê, enfatizando a necessidade de atender às necessidades psicológicas da mulher.

BACKGROUND: Postnatal depression is a pathology occurring in the first weeks after childbirth with negative consequence not only for mothers, but also for theirs babies and families. OBJECTIVE: To examine the prevalence of postnatal depression and factors that might predict depressive symptoms one week and three months after childbirth. METHODS: 197 pregnant women filled out the Anticipation of Childbirth Questionnaire (QAP) (Costa et al., 2005a) in the 2nd trimester of pregnancy. In the first week after childbirth participants filled out the Experience and Satisfaction with the Childbirth Questionnaire (QESP) (Costa et al., 2005b) and the Edinburgh Postnatal Depression Scale (EPDS) (Augusto et al., 1996). Three months after childbirth, EPDS questionnaire was filled out again. RESULTS: A significant number of women is clinically depressed (EPDS > 13) in the first week and three months after childbirth (12.4 percent and 13.7 percent, respectively). Of those with EPDS > 13 in the first week, 25 percent are still clinically depressed 3 months after childbirth. Physical health condition, childbirth emotional experience and the first contact with the infant predict depressive symptoms one week after childbirth. Mother's depressive symptoms one week after childbirth and childbirth negative experience predict depressive symptoms 3 month after delivery. CONCLUSIONS: We conclude about the importance of the emotional experience of childbirth and of the first contact with the infant, enhancing the need of taking care of mothers' psychological needs.

Teenage pregnancy, attachment style, and depression: a comparison of teenage and adult pregnant women in a Portuguese series.

The aim of this Portuguese study is to compare the experience of pregnancy in teenage years and later adulthood and to examine insecure attachment style as a risk factor for depression during pregnancy. The Attachment Style Interview (ASI) and the Edinburgh Postnatal Depression Scale (EPDS) were administered to 66 pregnant adolescents and 64 adult women. Pregnant teenagers were found to be nearly three times more likely to have an insecure attachment style of Enmeshed, Angry-Dismissive, or Fearful style than adults, all at high levels of impairment (54% vs.19%, p < .02). Logistic regression showed, when all risk factors were entered, highly Enmeshed style and poor partner support provided the best model for depression with age at pregnancy no longer adding. Insecure attachment style should be addressed in prevention and intervention strategies with teenage mothers.

[Adolescent and adult pregnant women: different risk circumstances?]. / Grávidas adolescentes e grávidas adultas: diferentes circunstâncias de risco?

The aim of the present study is to characterize the circumstance under which the pregnancy occurs in adolescence and adulthood, and to analyse differences in terms of social-demographics, adverse childhood experiences and current pregnancy conditions. A sample of 130 outpatients of the Julio Dinis Maternity (Porto, Portugal) (66 pregnant adolescent and 64 pregnant adult women) was interview in the last trimester of pregnancy. The results show that several less favourable conditions, that may negatively interfered with the gestation and the care of the baby, are significantly associated with adolescent pregnancy, as for example: unemployment, single parenthood, tobacco use, previous adverse conditions of existence and unwanted pregnancy. Although, other adverse circumstances are associated with pregnancy in adulthood, as: a history of infertility or of psychological problems with treatment or internment, and the absence of a least one parent in reason of death. We conclude that a considerable number of pregnant adolescent women are living under unfavourable conditions; thus, even attending to the variability of, the group as a whole can be considered at risk, when compared with the group of adult pregnant women. We also conclude that adolescent and adult pregnant women are pregnant under specific conditions, as we observe different risk circumstances in these two groups, that should be attended by the health providers in order to adequate their help to the real needs of the mothers.

Predominance of vanA genotype among vancomycin-resistant Enterococcus isolates from poultry and swine in Costa Rica.

The use of avoparcin as a growth promoter is considered to have selected for vancomycin-resistant enterococci (VRE). In Costa Rica, the use of avoparcin for poultry and swine was intensive until the product was withdrawn from the market in 2000. We evaluated the presence of VRE in poultry, swine, and cattle fecal samples obtained during 1998 and 1999. A total of 185 VRE isolates were recovered from 116 out of 893 samples. Enterococcus faecium was the most frequently isolated species (50.8%), being predominant among poultry (71.6%) and swine (37.7%) isolates, but it was not recovered from the bovine samples. The second-most-frequently-isolated species from poultry and swine, respectively, were E. durans (23.2%) and E. faecalis (21.7%). E. casseliflavus was the only species obtained from bovine samples, but it was not found among the avian isolates. An evident predominance of the vanA determinant among vancomycin-resistant enterococcal species from poultry and swine, but not from cattle, was observed and was similar to the situation in European countries before avoparcin was forbidden. The diversity of the vanA determinant in the isolates was assessed by detection of the IS1251 insertion in the vanSH intergenic region and of the IS1476 insertion in the vanXY intergenic region. However, in none of the 154 vanA+ isolates recovered in this study were those insertions detected.