Pub Date : 2017-03-16DOI: 10.4172/2325-9795.1000257
B. Buening, S. Hendrickson, Christopher Smith
Research has shown that autoimmune diseases have a significant prevalence within the female population, and a considerable portion of women who are mothers. According to Khashan et al., 44.3% of women who develop an autoimmune disease have onset after the first year of pregnancy. During pregnancy, the fetus develops a separate circulatory system, however the fetus’s and mother’s blood often mix. This fetomaternal trafficking is known as microchimerism. Fetal components, such as DNA, may remain in the mother’s system for decades after childbirth, while maternal components remain in the offspring as well. There are certain conditions causing a higher percentage of blood mixing, such as hypertension or preeclampsia. The literature shows that complications during pregnancy can also progress into the development of postpartum autoimmune diseases. When the fetus’s blood mixes with maternal circulation, an autoimmune response is initiated. The mother’s immune system reacts to this blood as a foreign substance, releasing autoantibodies. For example; according to research, scleroderma is one of autoimmune diseases that follows this pattern of development after pregnancy. The review of literature supports a correlation of parity and the development of autoimmune disease. Recognition of this development may provide information of risk factors, development of screening tools, or lead to new evidenced based practices.
{"title":"Relationship between Pregnancy and Development of Autoimmune Diseases","authors":"B. Buening, S. Hendrickson, Christopher Smith","doi":"10.4172/2325-9795.1000257","DOIUrl":"https://doi.org/10.4172/2325-9795.1000257","url":null,"abstract":"Research has shown that autoimmune diseases have a significant prevalence within the female population, and a considerable portion of women who are mothers. According to Khashan et al., 44.3% of women who develop an autoimmune disease have onset after the first year of pregnancy. During pregnancy, the fetus develops a separate circulatory system, however the fetus’s and mother’s blood often mix. This fetomaternal trafficking is known as microchimerism. Fetal components, such as DNA, may remain in the mother’s system for decades after childbirth, while maternal components remain in the offspring as well. There are certain conditions causing a higher percentage of blood mixing, such as hypertension or preeclampsia. The literature shows that complications during pregnancy can also progress into the development of postpartum autoimmune diseases. When the fetus’s blood mixes with maternal circulation, an autoimmune response is initiated. The mother’s immune system reacts to this blood as a foreign substance, releasing autoantibodies. For example; according to research, scleroderma is one of autoimmune diseases that follows this pattern of development after pregnancy. The review of literature supports a correlation of parity and the development of autoimmune disease. Recognition of this development may provide information of risk factors, development of screening tools, or lead to new evidenced based practices.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125395447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-16DOI: 10.4172/2325-9795.1000262
M. Davidson, S. Armstrong, McClain Sampson
Objective: The objective of this study is to explore the childbearing beliefs and to describe the perspectives of pregnancy in women living on Smith Island, a geographically isolated community that lacks on-site obstetrical care services. Design: A qualitative exploratory, longitudinal focus group model consisting of two focus groups, conducted 6 years apart, that included 12 female participants was used. The focus group used open-ended questions regarding their childbirth experiences and the impact of geographic isolation and lack of healthcare access impacted them during the childbearing period. During the initial focus group, 60%multiparous and participated in a 70 minute interview. The second focus group contained only multiparous women and lasted 110 minutes. The timing interval represented the interval when another group of women had given birth. The study included 100% of women who were pregnant and subsequently gave birth who were living on the Island during the study period. Data collection and analysis were performed simultaneously and included: audio recordings with verbatim transcription, and subsequent coding using direct quotes from the participants. Findings: The majority of women identified acceptance of pregnancy as a safe, normal biological process and identified strong religious beliefs as the underlining factor for their perceptions. All women identified themselves as Methodist religion and “to be religious”. All of the women also identified anxiety, separation strain, and financial strain as normal components associated with pregnancy and childbearing in this remote island community. Of the women who had never given birth, all of them, and the majority of the multiparous women feared their family members, especially their husbands, would miss the actual birth due to geographic separation and feared being alone in labor and at the time of birth. Conclusions: The strong religious presence provided a foundation of acceptance of normalcy of childbearing. Women perceived their religious beliefs as a source of protection. They viewed childbirth as a rite of passage, but reported spending a great deal of time and financial resources on obtaining prenatal care. Separation strain occurred when the women were forced to be away from family and friends at the end of the pregnancy. Multiparous women with older children expressed a greater degree of stress in being separated from children and having to manage childcare and school issues. All of the women in the study had a fear that their husbands, working watermen, would missthe birth itself and that they would be alone at the time of birth.
{"title":"Childbearing in Geographically Isolated Communities: The Smith Island Experience","authors":"M. Davidson, S. Armstrong, McClain Sampson","doi":"10.4172/2325-9795.1000262","DOIUrl":"https://doi.org/10.4172/2325-9795.1000262","url":null,"abstract":"Objective: The objective of this study is to explore the childbearing beliefs and to describe the perspectives of pregnancy in women living on Smith Island, a geographically isolated community that lacks on-site obstetrical care services. Design: A qualitative exploratory, longitudinal focus group model consisting of two focus groups, conducted 6 years apart, that included 12 female participants was used. The focus group used open-ended questions regarding their childbirth experiences and the impact of geographic isolation and lack of healthcare access impacted them during the childbearing period. During the initial focus group, 60%multiparous and participated in a 70 minute interview. The second focus group contained only multiparous women and lasted 110 minutes. The timing interval represented the interval when another group of women had given birth. The study included 100% of women who were pregnant and subsequently gave birth who were living on the Island during the study period. Data collection and analysis were performed simultaneously and included: audio recordings with verbatim transcription, and subsequent coding using direct quotes from the participants. Findings: The majority of women identified acceptance of pregnancy as a safe, normal biological process and identified strong religious beliefs as the underlining factor for their perceptions. All women identified themselves as Methodist religion and “to be religious”. All of the women also identified anxiety, separation strain, and financial strain as normal components associated with pregnancy and childbearing in this remote island community. Of the women who had never given birth, all of them, and the majority of the multiparous women feared their family members, especially their husbands, would miss the actual birth due to geographic separation and feared being alone in labor and at the time of birth. Conclusions: The strong religious presence provided a foundation of acceptance of normalcy of childbearing. Women perceived their religious beliefs as a source of protection. They viewed childbirth as a rite of passage, but reported spending a great deal of time and financial resources on obtaining prenatal care. Separation strain occurred when the women were forced to be away from family and friends at the end of the pregnancy. Multiparous women with older children expressed a greater degree of stress in being separated from children and having to manage childcare and school issues. All of the women in the study had a fear that their husbands, working watermen, would missthe birth itself and that they would be alone at the time of birth.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133815229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-28DOI: 10.4172/2325-9795.1000255
Nur Shahida Abdul Aziz, N. Zaki, Noor Safiza Mohamad Nor, R. Ambak, Cheong Siew Man
Introduction: The World Health Organization has declared obesity a global epidemic. In Malaysia the prevalence of obesity has reached an upward trend. Findings from the National Health and Morbidity Survey 2011 indicated that obesity among women was higher as compared to men and mean Body Mass Index among housewives was highest compared to other job categories. The aim of this qualitative study was to explore perspective on obesity problems and to gain a better understanding on barriers and facilitators to reduce weight among housewives in order to develop a weight loss intervention package. Methodology: This qualitative survey is part of the “My Body is Fit and Fabulous at Home” (MyBFF@Home) which involved in-depth interviews with 28 overweight and obese housewives in low cost flats around Klang Valley. Housewives were sampled purposively and data were analysed using thematic analysis. Themes and subthemes were also coded, explored and refined using the NVIVO software. Results: Five main themes associated with obesity problems emerge from the analysis that included ‘personal feelings, beliefs, lifestyles, life issues and effort to reduce weight’. Housewives perceived that their body size were big or too big and felt dissatisfied with their weight. Six main barriers were identified which included support, attitude, safety, environment, time and life issues such as finance and health problems. Self motivation, lifestyle, mindset, appealing figure, family and peer support were identified as facilitators to motivate housewives to reduce weight. Conclusion: These findings provided tools useful to develop strategies to empower housewives to reduce and to sustain their weight loss over a period of time.
{"title":"Perspective on Obesity Problems and Associated Factors to Reduce Weightamong Overweight and Obese Housewives: A Qualitative Study","authors":"Nur Shahida Abdul Aziz, N. Zaki, Noor Safiza Mohamad Nor, R. Ambak, Cheong Siew Man","doi":"10.4172/2325-9795.1000255","DOIUrl":"https://doi.org/10.4172/2325-9795.1000255","url":null,"abstract":"Introduction: The World Health Organization has declared obesity a global epidemic. In Malaysia the prevalence of obesity has reached an upward trend. Findings from the National Health and Morbidity Survey 2011 indicated that obesity among women was higher as compared to men and mean Body Mass Index among housewives was highest compared to other job categories. The aim of this qualitative study was to explore perspective on obesity problems and to gain a better understanding on barriers and facilitators to reduce weight among housewives in order to develop a weight loss intervention package. Methodology: This qualitative survey is part of the “My Body is Fit and Fabulous at Home” (MyBFF@Home) which involved in-depth interviews with 28 overweight and obese housewives in low cost flats around Klang Valley. Housewives were sampled purposively and data were analysed using thematic analysis. Themes and subthemes were also coded, explored and refined using the NVIVO software. Results: Five main themes associated with obesity problems emerge from the analysis that included ‘personal feelings, beliefs, lifestyles, life issues and effort to reduce weight’. Housewives perceived that their body size were big or too big and felt dissatisfied with their weight. Six main barriers were identified which included support, attitude, safety, environment, time and life issues such as finance and health problems. Self motivation, lifestyle, mindset, appealing figure, family and peer support were identified as facilitators to motivate housewives to reduce weight. Conclusion: These findings provided tools useful to develop strategies to empower housewives to reduce and to sustain their weight loss over a period of time.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121867740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-28DOI: 10.4172/2325-9795.1000251
R. Ragusa, S. Rametta, A. Lombardo
Objective: The HTA Committee of University Hospital “G. Rodolico” of Catania received the form with the purchase request of four hysteroscopes. HTA report was developed to answer the following questions: Policy question: What is the optimal use for mini hysteroscope for gynecological problems in terms of effectiveness, safety and economic costs compared to the alternatives? Research question: Are the mini hysteroscope for all gynecological problems safe, painless, effective and cost-effective? Methods: We have identified and described some different types of hysteroscopes available on the Italian market and performed a context analysis to show their impact in terms of spending and consumption. We performed a systematic review of literature in order to synthesize the evidence on comparative efficacy, safety, and pain relating to the use of technology in question. The evaluation was conducted using a multidisciplinary approach and has provided an analysis of the seven following domains: Health problem and current use of the technology Description and technical characteristic of technology Clinical effectiveness Safety Costs, economic evaluation Organizational aspects Ethical aspects Results: We have reported a summary for each domain analyzed and conclusions of HTA Committee. Research questions domains were ranked using a 5-point scale. For clinical effectiveness, economic and safety evaluation, rigid hysteroscopes have the best results. The trophyscope has a very small caliber and is particularly painless. There are no big differences in the organizational aspects; all these tools are used for outpatient basis. Conclusions: with even smaller diameters but primarily used for diagnostics. The purchase of these has not been considered necessary and there is no evidence in the literature on the conversion times from diagnosis to operation. Evidence is still limited for the trophyscope. We recommend decision makers to consider carefully the effectiveness and safety aspect related to the use of the technology in each contest.
{"title":"Hysteroscope or Mini-Hysteroscope: HTA in a University Hospital in Italy","authors":"R. Ragusa, S. Rametta, A. Lombardo","doi":"10.4172/2325-9795.1000251","DOIUrl":"https://doi.org/10.4172/2325-9795.1000251","url":null,"abstract":"Objective: The HTA Committee of University Hospital “G. Rodolico” of Catania received the form with the purchase request of four hysteroscopes. HTA report was developed to answer the following questions: Policy question: What is the optimal use for mini hysteroscope for gynecological problems in terms of effectiveness, safety and economic costs compared to the alternatives? Research question: Are the mini hysteroscope for all gynecological problems safe, painless, effective and cost-effective? Methods: We have identified and described some different types of hysteroscopes available on the Italian market and performed a context analysis to show their impact in terms of spending and consumption. We performed a systematic review of literature in order to synthesize the evidence on comparative efficacy, safety, and pain relating to the use of technology in question. The evaluation was conducted using a multidisciplinary approach and has provided an analysis of the seven following domains: Health problem and current use of the technology Description and technical characteristic of technology Clinical effectiveness Safety Costs, economic evaluation Organizational aspects Ethical aspects Results: We have reported a summary for each domain analyzed and conclusions of HTA Committee. Research questions domains were ranked using a 5-point scale. For clinical effectiveness, economic and safety evaluation, rigid hysteroscopes have the best results. The trophyscope has a very small caliber and is particularly painless. There are no big differences in the organizational aspects; all these tools are used for outpatient basis. Conclusions: with even smaller diameters but primarily used for diagnostics. The purchase of these has not been considered necessary and there is no evidence in the literature on the conversion times from diagnosis to operation. Evidence is still limited for the trophyscope. We recommend decision makers to consider carefully the effectiveness and safety aspect related to the use of the technology in each contest.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132732238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-28DOI: 10.4172/2325-9795.1000254
Montanelli Aless, Ro, Bianchi Paolo, Brambilla Simona, Ass, ri Roberto, Maura Federica, M. Lucia, Levi Setti Paolo, Monari Marta
Toxoplasmosis is a common zoonosis in humans and is still a serious problem for pregnant women also in western industrialized countries. The infection may be acquired or congenital and in pregnant women, may be transferred to the fetus causing miscarriage or congenital malformations. In Italy, a nationwide epidemiological surveillance system for Toxoplasmosis is still lacking. Aim of the present study is an assessment of the prevalence of anti-Toxoplasma gondii antibodies IgG in a Northern Italian region. We have performed a retrospective study in which we analyzed 16937 samples (16.118 female, 819 male all in fertile period). All samples were analyzed using Toxo IgG Architect®, for the quantitative determination of IgG antibodies in human serum or plasma. The data were classified following manufacturer’s guide (<1.6 IU/mL negative; ≥ 1.6 <6 IU/mL as doubt immunity; and ≥ 6.0 IU/mL immunity). Using these cut-offs we reported 14967 women (93%) and 455 men (55.6%) susceptible to Toxoplasma gondii infection for a total of 15422 persons (90.2%). Our data showed that the level of attention for the possible infection in pregnant women should not be lowered, to avoid possible malformations of the foetus. An active screening for Toxoplasma gondii during pregnancy should be introduced, but we also suggest introducing pre-pregnancy controls to closely assess the susceptibility and to exclude the immune women in further retest.
{"title":"The Prevalence of Toxoplasma IgG Antibody in a Selected Population of Northern Italian Region","authors":"Montanelli Aless, Ro, Bianchi Paolo, Brambilla Simona, Ass, ri Roberto, Maura Federica, M. Lucia, Levi Setti Paolo, Monari Marta","doi":"10.4172/2325-9795.1000254","DOIUrl":"https://doi.org/10.4172/2325-9795.1000254","url":null,"abstract":"Toxoplasmosis is a common zoonosis in humans and is still a serious problem for pregnant women also in western industrialized countries. The infection may be acquired or congenital and in pregnant women, may be transferred to the fetus causing miscarriage or congenital malformations. In Italy, a nationwide epidemiological surveillance system for Toxoplasmosis is still lacking. Aim of the present study is an assessment of the prevalence of anti-Toxoplasma gondii antibodies IgG in a Northern Italian region. We have performed a retrospective study in which we analyzed 16937 samples (16.118 female, 819 male all in fertile period). All samples were analyzed using Toxo IgG Architect®, for the quantitative determination of IgG antibodies in human serum or plasma. The data were classified following manufacturer’s guide (<1.6 IU/mL negative; ≥ 1.6 <6 IU/mL as doubt immunity; and ≥ 6.0 IU/mL immunity). Using these cut-offs we reported 14967 women (93%) and 455 men (55.6%) susceptible to Toxoplasma gondii infection for a total of 15422 persons (90.2%). Our data showed that the level of attention for the possible infection in pregnant women should not be lowered, to avoid possible malformations of the foetus. An active screening for Toxoplasma gondii during pregnancy should be introduced, but we also suggest introducing pre-pregnancy controls to closely assess the susceptibility and to exclude the immune women in further retest.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117052847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-27DOI: 10.4172/2325-9795.1000250
Brent Reider
There are many important outcomes from the responsive muscle contractions in the female orgasm. A number of these outcomes are structural and these structural outcomes have a direct positive effect on the well-being of the woman. Though these direct physiological outcomes may or may not have an adaptive history, they affect the well-being of the woman and include structural load management, continence, and sexual function. These benefits of orgasm for adult women last a lifetime; positive outcomes do not end at menopause—female urinary incontinence and pain in the lower back, hip(s), and knee(s) are not a de facto consequence of aging. So although the conveyance of sperm helps the act of reproduction and is considered the major function of the orgasm, this reading is limited; glossing the appreciation of the female orgasm in maintaining pelvic floor muscle tone and missing the function of the clitoral gland in maintaining pelvic floor muscle tone. The point of this paper is to suggest that the role of the pelvic floor muscles in female orgasmic response has much more immediate and more wide-ranging physiological outcomes for the human female than the reproductive primacy perspectives suggested in many studies to date. Clearly defining the broad structural importance of the pelvic floor muscles in female orgasmic response would have positive epidemiological outcomes for all women. While pelvic floor muscle performance has psychological outcomes that synergistically affect the woman’s well-being, the psychological outcomes are not within the scope of this paper.
{"title":"Role of Pelvic Floor Muscles in Female Orgasmic Response","authors":"Brent Reider","doi":"10.4172/2325-9795.1000250","DOIUrl":"https://doi.org/10.4172/2325-9795.1000250","url":null,"abstract":"There are many important outcomes from the responsive muscle contractions in the female orgasm. A number of these outcomes are structural and these structural outcomes have a direct positive effect on the well-being of the woman. Though these direct physiological outcomes may or may not have an adaptive history, they affect the well-being of the woman and include structural load management, continence, and sexual function. These benefits of orgasm for adult women last a lifetime; positive outcomes do not end at menopause—female urinary incontinence and pain in the lower back, hip(s), and knee(s) are not a de facto consequence of aging. So although the conveyance of sperm helps the act of reproduction and is considered the major function of the orgasm, this reading is limited; glossing the appreciation of the female orgasm in maintaining pelvic floor muscle tone and missing the function of the clitoral gland in maintaining pelvic floor muscle tone. \u0000The point of this paper is to suggest that the role of the pelvic floor muscles in female orgasmic response has much more immediate and more wide-ranging physiological outcomes for the human female than the reproductive primacy perspectives suggested in many studies to date. \u0000Clearly defining the broad structural importance of the pelvic floor muscles in female orgasmic response would have positive epidemiological outcomes for all women. \u0000While pelvic floor muscle performance has psychological outcomes that synergistically affect the woman’s well-being, the psychological outcomes are not within the scope of this paper.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125621753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-27DOI: 10.4172/2325-9795.1000249
A. Marshall, Xin Zhang, B. Lewis, Sun, A. Kane, R. Go
Background: Iron deficiency is a common cause of anemia, and etiologies differ by sex. Endoscopic procedures are often utilized to search for a source of gastrointestinal blood loss in patients with iron deficiency, but sex-based differences in patterns of workup have not been well characterized. Methods: We performed a retrospective review of all patients at Mayo Clinic who underwent esophagogastroduodenoscopy (EGD), colonoscopy, or both between July 1, 2014 and June 30, 2015 for an indication of “anemia” or “iron deficiency anemia” and analyzed the data for evidence of sex-based differences in procedure outcomes. Results: 999 procedures were performed; 455 (46%) procedures were performed on men and 544 (54%) on women. Median age was 68 years in men (range 19-94) and 64 years in women (range 18-94), P<0.01. 365 (37%) procedures identified a probable benign source of bleeding, 54 (5%) identified a probable malignant source, and 580 (58%) had no findings consistent with a bleeding source. Procedures performed on men were more likely to identify a source of bleeding (48% versus 37%, P<0.01), primarily EGDs which were significantly more likely to identify a bleeding source in men (59% versus 37%, P<0.01). Conclusion: There are sex-based variations in the utilization and findings of EGD and colonoscopy used for workup of anemia. A source of bleeding is more likely to be identified in men, particularly in the case of EGD. Clinicians should be made aware of these variations and quality improvement programs may be helpful to reduce non-clinically indicated practice variations.
{"title":"Sex-Based Disparities in the Use and Results of Gastrointestinal Procedures for Workup of Anemia","authors":"A. Marshall, Xin Zhang, B. Lewis, Sun, A. Kane, R. Go","doi":"10.4172/2325-9795.1000249","DOIUrl":"https://doi.org/10.4172/2325-9795.1000249","url":null,"abstract":"Background: Iron deficiency is a common cause of anemia, and etiologies differ by sex. Endoscopic procedures are often utilized to search for a source of gastrointestinal blood loss in patients with iron deficiency, but sex-based differences in patterns of workup have not been well characterized. \u0000Methods: We performed a retrospective review of all patients at Mayo Clinic who underwent esophagogastroduodenoscopy (EGD), colonoscopy, or both between July 1, 2014 and June 30, 2015 for an indication of “anemia” or “iron deficiency anemia” and analyzed the data for evidence of sex-based differences in procedure outcomes. \u0000Results: 999 procedures were performed; 455 (46%) procedures were performed on men and 544 (54%) on women. Median age was 68 years in men (range 19-94) and 64 years in women (range 18-94), P<0.01. 365 (37%) procedures identified a probable benign source of bleeding, 54 (5%) identified a probable malignant source, and 580 (58%) had no findings consistent with a bleeding source. Procedures performed on men were more likely to identify a source of bleeding (48% versus 37%, P<0.01), primarily EGDs which were significantly more likely to identify a bleeding source in men (59% versus 37%, P<0.01). \u0000Conclusion: There are sex-based variations in the utilization and findings of EGD and colonoscopy used for workup of anemia. A source of bleeding is more likely to be identified in men, particularly in the case of EGD. Clinicians should be made aware of these variations and quality improvement programs may be helpful to reduce non-clinically indicated practice variations.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123468000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-27DOI: 10.4172/2325-9795.1000253
M. T. Alghabashi, Tiffany Kim, Neenah Estrella-Luna, B. Guthrie
Background: Although the Kingdom of Saudi Arabia (KSA) began surveillance for human immunodeficiency virus (HIV) transmission in 1984, STI-related incidence and prevalence rates are unavailable for the larger Saudi population, and more specifically, for married Saudi Arabian women. Studies show that married Saudi Arabian women are at risk of contracting STIs from their husbands, but studies regarding married Saudi Arabian Women’s STI-related knowledge and attitudes are lacking because there is no valid and reliable quantitative measurement instrument available. The aims of this qualitative study were to explore the perceptions of married Saudi Arabian women’s knowledge and attitudes about the risk of becoming infected with STIs, and to generate themes needed to guide the development of a valid and reliable quantitative instrument that is culturally appropriate and gender-specific for married Saudi Arabian women. Methods: A grounded theory (GT) approach was used for data collection, guided by Bronfenbrenner’s Ecological Model. Married Saudi Arabian women over age 18 who had been living in the United States (US) for less than 18 months underwent private interviews about STI-related knowledge and attitudes. Themes resulting from the GT analysis were assembled into a framework. Results: Twelve participants were interviewed before saturation of themes was reached. The 153 codes identified were categorized and assembled into a hierarchical thematic framework. Eight themes pertinent to STI-related knowledge and attitudes were uncovered. Discussion: The results revealed that Saudi Arabian married women are aware that they are lacking knowledge about STIs, and would like more education and resources to provide this information. In addition, these women were concerned about prevention and treatment of STIs, not only personally, but in the community at large. The results of this study will be used as a basis to develop a quantitative instrument that focus on measuring the STI-related knowledge and attitudes of married Saudi Arabian women.
{"title":"Married Saudi Arabian Women’s Attitudes and Knowledge Concerning SexuallyTransmitted Infections","authors":"M. T. Alghabashi, Tiffany Kim, Neenah Estrella-Luna, B. Guthrie","doi":"10.4172/2325-9795.1000253","DOIUrl":"https://doi.org/10.4172/2325-9795.1000253","url":null,"abstract":"Background: Although the Kingdom of Saudi Arabia (KSA) began surveillance for human immunodeficiency virus (HIV) transmission in 1984, STI-related incidence and prevalence rates are unavailable for the larger Saudi population, and more specifically, for married Saudi Arabian women. Studies show that married Saudi Arabian women are at risk of contracting STIs from their husbands, but studies regarding married Saudi Arabian Women’s STI-related knowledge and attitudes are lacking because there is no valid and reliable quantitative measurement instrument available. The aims of this qualitative study were to explore the perceptions of married Saudi Arabian women’s knowledge and attitudes about the risk of becoming infected with STIs, and to generate themes needed to guide the development of a valid and reliable quantitative instrument that is culturally appropriate and gender-specific for married Saudi Arabian women. \u0000Methods: A grounded theory (GT) approach was used for data collection, guided by Bronfenbrenner’s Ecological Model. Married Saudi Arabian women over age 18 who had been living in the United States (US) for less than 18 months underwent private interviews about STI-related knowledge and attitudes. Themes resulting from the GT analysis were assembled into a framework. \u0000Results: Twelve participants were interviewed before saturation of themes was reached. The 153 codes identified were categorized and assembled into a hierarchical thematic framework. Eight themes pertinent to STI-related knowledge and attitudes were uncovered. \u0000Discussion: The results revealed that Saudi Arabian married women are aware that they are lacking knowledge about STIs, and would like more education and resources to provide this information. In addition, these women were concerned about prevention and treatment of STIs, not only personally, but in the community at large. The results of this study will be used as a basis to develop a quantitative instrument that focus on measuring the STI-related knowledge and attitudes of married Saudi Arabian women.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121736187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-05DOI: 10.4172/2325-9795.1000239
S. Puchalski, T. Tortorella
Postpartum depression (PPD) is a serious mental health disorder, characterized by severe feelings of sadness that occurs in a significant number of women with symptoms generally appearing in the first 2 months to one-year postpartum. As with many mental health disorders PPD is multifactorial, including such influential factors as race, ethnicity, gender, age, social constructs and community. Women in lower socioeconomic strata experience depression in higher numbers than their counterparts in upper socioeconomic groups. Additionally, women with lower levels of education are more prone to develop PPD. It is critical to understand how healthcare providers can intervene to address PPD. The Centers for Disease Control (CDC) (2016) reported postpartum depressive symptoms in 1 out of 10 women. Although New Jersey led the nation as the first state to enact a law addressing postpartum depression in 2006, there is little empirical evidence that significant changes have occurred in relation to the diagnosis and treatment of PPD. The law provides funding for education, screening, and the program “Speak Up When You’re Down”. There needs to be an increased commitment to addressing this issue to improve the health of women. In addition to the mandated screening for PPD, advanced practice nurses (APNs) and other health care providers need to provide follow-up for those women identified as being at high risk in order to provide the appropriate support as dictated by the situation.
{"title":"Strategies to Improve Identification of Postpartum Depression, Follow up andContinuity of Care among Women","authors":"S. Puchalski, T. Tortorella","doi":"10.4172/2325-9795.1000239","DOIUrl":"https://doi.org/10.4172/2325-9795.1000239","url":null,"abstract":"Postpartum depression (PPD) is a serious mental health disorder, characterized by severe feelings of sadness that occurs in a significant number of women with symptoms generally appearing in the first 2 months to one-year postpartum. As with many mental health disorders PPD is multifactorial, including such influential factors as race, ethnicity, gender, age, social constructs and community. Women in lower socioeconomic strata experience depression in higher numbers than their counterparts in upper socioeconomic groups. Additionally, women with lower levels of education are more prone to develop PPD. It is critical to understand how healthcare providers can intervene to address PPD. The Centers for Disease Control (CDC) (2016) reported postpartum depressive symptoms in 1 out of 10 women. \u0000Although New Jersey led the nation as the first state to enact a law addressing postpartum depression in 2006, there is little empirical evidence that significant changes have occurred in relation to the diagnosis and treatment of PPD. The law provides funding for education, screening, and the program “Speak Up When You’re Down”. There needs to be an increased commitment to addressing this issue to improve the health of women. In addition to the mandated screening for PPD, advanced practice nurses (APNs) and other health care providers need to provide follow-up for those women identified as being at high risk in order to provide the appropriate support as dictated by the situation.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131289662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-12-05DOI: 10.4172/2325-9795.1000225
B. Sharma, E. Small
Objective: The current trends continue to show a disproportionate increase of HIV infections among women mostly in sub-Sahara Africa. This study focuses on multi-dimensional factors such as social elements, cultural beliefs, cognitive and psychosocial norms, and self-efficacy that influence sexual health communication among Kenyan women in preventing HIV/AIDS. Methods: This exploratory study uses cross-sectional KDHS dataset (2008/2009). It utilizes chi-square significance test to propose for a parsimonious and fit model to determine the odds of respondents’ sexual health communication behavior using multistage hierarchical logistic regression. Results: Self-efficacy and HIV testing was significant predictor of sexual health communication implying that women who have autonomy and who are likely to make individual decision in HIV testing are also more likely to communicate with their husband or sexual partner about ways to prevent getting the HIV/AIDS virus. Education and regional factors are also predictors of sexual health communication among women of Kenya. Conclusion: Sexual health communication is key in sustaining and supporting prevention efforts of HIV/AIDS in Kenya where cultural beliefs and preset cognitive and psychosocial norms overpower self-efficacy in women’s decision making for sexual health.
{"title":"Let us talk about AIDS: Sexual Health Communication among Kenyan Women about HIV/AIDS Risk Prevention","authors":"B. Sharma, E. Small","doi":"10.4172/2325-9795.1000225","DOIUrl":"https://doi.org/10.4172/2325-9795.1000225","url":null,"abstract":"Objective: The current trends continue to show a disproportionate increase of HIV infections among women mostly in sub-Sahara Africa. This study focuses on multi-dimensional factors such as social elements, cultural beliefs, cognitive and psychosocial norms, and self-efficacy that influence sexual health communication among Kenyan women in preventing HIV/AIDS. \u0000Methods: This exploratory study uses cross-sectional KDHS dataset (2008/2009). It utilizes chi-square significance test to propose for a parsimonious and fit model to determine the odds of respondents’ sexual health communication behavior using multistage hierarchical logistic regression. \u0000Results: Self-efficacy and HIV testing was significant predictor of sexual health communication implying that women who have autonomy and who are likely to make individual decision in HIV testing are also more likely to communicate with their husband or sexual partner about ways to prevent getting the HIV/AIDS virus. Education and regional factors are also predictors of sexual health communication among women of Kenya. \u0000Conclusion: Sexual health communication is key in sustaining and supporting prevention efforts of HIV/AIDS in Kenya where cultural beliefs and preset cognitive and psychosocial norms overpower self-efficacy in women’s decision making for sexual health.","PeriodicalId":218923,"journal":{"name":"Journal of Womens Health, Issues and Care","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133317544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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