Background And Aims: Between 2007 and 2016, pregnancy-associated mortality resulting from overdose more than doubled in the United States. This study explored the circumstances surrounding maternal opioid-related morbidity and mortality, using the life-course theory as a sensitizing framework to examine how each participant's life-course contributed to her substance use, relapse, recovery or overdose.
Design: A mixed-methods study using semi-structured, in-depth face-to-face interviews and focus groups were conducted.
Setting: Texas, United States.
Participants: Women who had relapsed into opioid use or experienced a 'near-miss' overdose and family members of women who had died during the maternal period due to opioid overdose were interviewed (n = 99).
Measurements: A socio-demographic questionnaire captured participants' ethnicity, age, marital status, medical and mental health history and employment status. The Stressful Life Events Screening Questionnaire-revised (SLESQ-R) assessed life-time exposure to trauma.
Findings: Women reported histories of abuse and loss of a loved one through homicide or suicide. Participants indicated that limited social support, interpersonal conflict with their partner and unaddressed mental illness made recovery more challenging. Additionally, losing their children through the child welfare system was described as punitive and placed them at greater risk for relapse and overdose.
Conclusions: A life-course theory approach to examining maternal opioid-related morbidity and mortality in Texas, United States reveals the complex needs of women at risk for opioid use relapse and overdose and the significant role of previous traumatic experiences.
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http://dx.doi.org/10.1111/add.15054 | DOI Listing |
Nurs Crit Care
January 2025
Departament d'Infermeria, Universitat Rovira i Virgili, Campus Catalunya, Tarragona, Spain.
Background: The process of discharging the critical patient to the ward (discharge from critical care to the general ward-DCCW) is often described as an experience involving uncertainty which may affect the patient's quality of life and ability to cope. Coping with uncertainty is an individual response not related to the course of the illness that is dependent on external and internal resources and the ability to utilize them. Mishel's theory of uncertainty identifies aspects of care that can shape the experience of uncertainty associated with the illness.
View Article and Find Full Text PDFThis study examines an inconsistency between an attitude and a behaviour: non-use of contraception among people who are trying to get pregnant. More than one in four people in that situation report using contraception 'sometimes' or 'always' and consequently face the risk of pregnancy. We test three potential explanations: acceptability of having (further) children; perceived low pregnancy risk; and perceived social pressure.
View Article and Find Full Text PDFAm J Hum Biol
January 2025
Department of Anthropology, Baylor University, Waco, Texas, USA.
Oxidative stress (OS) is a key biological challenge and selective pressure for organisms with aerobic metabolism. The result of the imbalance between reactive oxygen species production and antioxidant defense, OS can damage proteins, lipids, and nucleic acids and plays an important role in driving variation in biological aging and health. Among humans, OS research has focused overwhelmingly on adults, with demonstrated connections between OS, inflammation, and metabolic and neurodegenerative conditions.
View Article and Find Full Text PDFAnnu Rev Public Health
January 2025
3Department of Sociology, Florida State University, Tallahassee, Florida, USA.
This article provides a guide for rigorous, theory-driven measurement approaches, proposing best practices for the scientific study of systemic racism in health research. We argue that the analytical crux of measuring systemic racism-a complex, interconnected, and dynamic system-lies in operationalizing the collective logics, properties, and mechanisms that undergird racial inequities. Misalignment between measurement tools and these foundational features undermines research validity, as incongruent measures distort findings and obscure systemic racism's true impacts.
View Article and Find Full Text PDFSoc Sci Med
January 2025
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
Persistent racial disparities in low birth weight (LBW) in the United States may be better understood through the adoption of a life course perspective that considers differential exposure and vulnerability of Black and White women to socioeconomic position across generations. Using a multigenerational dataset of singleton birth certificates from South Carolina from 1989 to 2020 linked along the maternal line, we constructed intergenerational social mobility trajectories of grandmaternal and maternal education and compared unadjusted and adjusted associations between trajectories and LBW among Black and White women. We found that White women were more likely to be upwardly mobile, and Black women to be downwardly mobile.
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