ABSTRACT
Prior to January 2023, women living with HIV (WLWH) in the United States (US) were discouraged from breastfeeding due to the potential risk of mother-to-child HIV transmission through breastfeeding. Lack of breastfeeding decision-making and experience among WLWH may negatively affect maternal mental health. We implemented a quality improvement initiative to screen WLWH for postpartum depression (PPD), evaluate their attitudes toward breastfeeding, and assess their experience with breastfeeding decision-making. We collected quantitative data from WLWH using a voluntary, self-administered 6-item breastfeeding decision-making and experience survey (administered 1 month postpartum) and a 10-item Edinburgh Postnatal Depression Scale (EPDS, negative = 0-9; administered 1 and 4 months postpartum) tool. We conducted descriptive statistics and cross tabulation analysis. We analyzed 106 WLWH (93.4% non-Hispanic Black/African American; mean age 33.1 years; 82.1% HIV RNA < 200 copies/mL). One in five (19.1%) WLWH had a positive baseline EPDS screen, with the mean EPDS scores decreasing from 5.3 ± 5.4 (baseline) to 4.6 ± 4.8 (follow-up). Among 55 WLWH who provided baseline and follow-up EPDS scores, only 3/13 with a positive baseline EPDS screen had resolved depressive symptoms at follow-up. Over one-third (37.7%) of WLWH indicated feeling "sadness" when asked whether lack of breastfeeding negatively affected their feelings or emotions. Over half of WLWH (51.9%) were aware of the US breastfeeding recommendations, but the majority (60.4%) had never discussed breastfeeding options with a medical provider. Improved provider-patient discussions on infant feeding options among WLWH is needed to increase awareness of breastfeeding choices and promote informed, autonomous breastfeeding decision-making among WLWH.
Subject(s)
Depression, Postpartum , HIV Infections , Infant , Female , Humans , Adult , Breast Feeding , Mental Health , HIV Infections/psychology , Infectious Disease Transmission, Vertical , Postpartum Period , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Depression, Postpartum/psychologyABSTRACT
Summary discovery is one of the major components of knowledge discovery in databases, which provides the user with comprehensive information for grasping the essence from a large amount of information in a database. We propose an interactive top down summary discovery process which utilizes fuzzy ISA hierarchies as domain knowledge. We define a generalized tuple as a representational form of a database summary including fuzzy concepts. By virtue of fuzzy ISA hierarchies where fuzzy ISA relationships common in actual domains are naturally expressed, the discovery process comes up with more accurate database summaries. We also present an informativeness measure for distinguishing generalized tuples that delivers much information to users, based on C. Shannon's (1948) information theory.
ABSTRACT
Summary discovery is one of the major components of knowledge discovery in databases, which provides the user with comprehensive information for grasping the essence from a large amount of information in a database. In this paper, we propose an interactive top-down summary discovery process which utilizes fuzzy ISA hierarchies as domain knowledge. We define a generalized tuple as a representational form of a database summary including fuzzy concepts. By virtue of fuzzy ISA hierarchies where fuzzy ISA relationships common in actual domains are naturally expressed, the discovery process comes up with more accurate database summaries. We also present an informativeness measure for distinguishing generalized tuples that delivers much information to users, based on Shannon's information theory.
