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3.
Clin Obstet Gynecol ; 51(2): 371-84, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18463467

ABSTRACT

Access to perinatal healthcare services for women living in poverty is complicated by many barriers and directly affects rates of premature births, low birthweight infants, and maternal and infant deaths. Health and social services delivered in the home can help improve pregnancy outcomes. Home visiting programs need sustainable funding and support from physicians and other healthcare providers. Ongoing research is needed to develop, refine, and evaluate systems of care that integrate home visiting components and different service delivery models that address pregnancies complicated by various psychosocial and medical complications.


Subject(s)
Delivery of Health Care , Health Services Accessibility , Home Care Services , Perinatal Care/methods , Pregnancy Complications/prevention & control , Female , House Calls , Humans , Infant Mortality , Infant, Newborn , Male , Patient Acceptance of Health Care , Perinatal Care/standards , Perinatal Care/statistics & numerical data , Poverty , Pregnancy , Pregnancy Outcome
4.
Child Psychiatry Hum Dev ; 37(1): 65-72, 2006.
Article in English | MEDLINE | ID: mdl-16804751

ABSTRACT

Insecure mental representations of attachment, a nearly invariant feature of cluster B personality disorders, have never previously been studied in twins. We conducted the Adult Attachment Interview (AAI) on 33 pairs of monozygotic (MZ) female twins reared together as an initial exploration of causal influences on mental representations of attachment. As predicted by attachment theory, we observed substantial twin-twin concordance for attachment security (odds ratio 13.8; P = 0.001), a similar level of concordance between twins and their non-twin siblings, and an inverse relationship between attachment security and current level of aggression (P = 0.01). These data indicate that there are minimal effects of non-shared environmental influences (or measurement error) on attachment classifications derived from the AAI. In this sample of twins with and without histories of Conduct Disorder, mental representations of attachment appear to be highly familial, i.e., strongly influenced by either shared environmental factors, genetic factors, or both.


Subject(s)
Cognition , Conduct Disorder/epidemiology , Conduct Disorder/psychology , Object Attachment , Twins, Monozygotic/psychology , Adolescent , Adult , Demography , Female , Humans , Observer Variation , Prevalence
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