Women & Health最新文献

The risk of cervical dysplastic changes, re-surgery, and abnormal Pap smear for patients after LLETZ due to high-grade squamous intraepithelial lesions is highest within patients with endocervical positive (surgical resection) margins of precancerous lesions and with cells of HSIL in the endocervical curettage in their primary LLETZ. This research aimed to determine whether performing endocone resection during LLETZ procedure with routine ECC reduces the risk of recurrent/persistent cervical dysplastic changes and to assess the significance of the Pap smear and high-risk human papillomavirus test in follow-up care. A retrospective analysis of 404 patients at the University of Wuerzburg was conducted. The risk of recurrent dysplastic changes was similar between patients with or without endocone resection when HSIL was present in the ECC (OR 19.66 vs OR 19.11). Abnormal Pap smears occurred in 21.4% patients without endocone resection and 27.3% with resection, both showing HSIL in the ECC. Regardless of endocone status, 50% patients with HSIL in the ECC required further surgery. HR-HPV positivity after surgery is correlated with higher rates of re-surgery (SR = 1.3) and recurrent dysplastic changes (SR = 4.0). This study indicates that performing an endocone resection is redundant, as ECC results sufficiently predict clinical outcomes.

A significant number of Malaysian women are diagnosed with breast and cervical cancers at advanced stages, highlighting the need for early symptom recognition to improve treatment outcomes and reduce mortality. This study aimed to assess knowledge of breast and cervical cancer symptoms among underserved women and identify the barriers preventing them from seeking treatment. A cross-sectional survey involving 401 women at a public health clinic was conducted using validated questionnaires and convenience sampling. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Over half of the women demonstrated poor knowledge of both breast (55 percent) and cervical (69 percent) cancer symptoms, while only a smaller proportion exhibited good knowledge, 12 percent for breast cancer and 6 percent for cervical symptoms, respectively. Commonly recognized symptoms included a "lump or thickening in the breast' and 'persistent, unpleasant-smelling vaginal discharge." The most reported barrier to seeking treatment was fear of diagnosis, reported by 49 percent of women. Logistic regression identified being married and having higher level of education were significantly associated with greater perceived barriers to seeking treatment. The research highlights the need for personalized health education to address individual concerns and barriers, ensuring content is relevant and effective.

Ovarian cancer ranks as the fifth leading cause of cancer deaths among Canadian women. This study aims to investigate trends in socioeconomic inequalities in ovarian cancer mortality over the past three decades, from 1990 to 2019. A dataset was construed at Census Division (n = 280) level in Canada using information from the Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey. Socioeconomic inequalities in ovarian cancer mortality were assessed using the age-standardized Concentration Index (C), based on average/median equivalized household income, and educational attainment (bachelor's degree or higher). The average crude mortality rate for ovarian cancer in Canada was 9.7 per 100,000, with the highest rates in British Columbia and the Atlantic region. The negative values of age-standardized C based on average income and educational attainment - indicating higher ovarian cancer mortality rates among low socioeconomic groups - reached statistical significance in certain years, particularly in the more recent period. Trend analysis revealed a notable pattern of increasing income inequality in ovarian cancer mortality over time based on average income. The observed socioeconomic inequalities in ovarian cancer mortality warrant further investigation to identify the underlying factors contributing to this pattern in Canada.

The objective of the current systematic review and meta analysis was to assess workplace sexual violence among women, aiming to provide a comprehensive understanding of the issue's magnitude and implications across various professional sectors and geographical locations. A systematic search of six electronic databases was conducted following PRISMA guidelines, including studies published up to April 15, 2023. The JBI Critical Appraisal Tool was used for quality assessment, and a random-effects model calculated the pooled prevalence. Heterogeneity was assessed using I² statistics, with outliers identified through diagnostic and Baujat plots, followed by a leave-one-out meta-analysis. Publication bias was examined using the Doi plot and LFK index, and subgroup analyses explored variations in geographical location, occupational domain, and time period. A total of 912 studies were screened, with 129 meeting inclusion criteria, comprising 333,649 female participants. The pooled prevalence of workplace sexual violence was 26 percent (95 percent CI: 1-32 percent), with substantial variability observed across regions and occupational groups; prevalence was highest in Africa (38 percent, 95 percent CI: 29-47 percent), followed by North America (34 percent, 95 percent CI: 25-43 percent), and Asia (30 percent, 95 percent CI: 17-47 percent). Among occupational groups, security personnel experienced the highest prevalence (44 percent, 95 percent CI: 22-68 percent), while health-care workers were also highly affected (30 percent, 95 percent CI: 24-38 percent). Workplace sexual violence remains a global issue, affecting over a quarter of female workers, with its prevalence influenced by cultural, occupational, and temporal factors. These findings underscore the necessity for tailored interventions, comprehensive workplace policies, and supportive reporting mechanisms, while ongoing monitoring and evidence-based strategies are essential to mitigate risks, protect employees, and foster safer workplace environments worldwide.

Brazilian Cohort Study of Preeclampsia: latent risks after pregnancy (PERLA-Brazil) are a retrospective cohort study including women with and without preeclampsia history, 6-15 years after pregnancy, aiming to evaluate lipid profile, clinical parameters and the frequency of metabolic syndrome. A total of 188 women from Belo Horizonte (Brazil), who became pregnant between 2008 and 2017, were included: 86 with PE history and 102 with normotensive pregnancy. The participants underwent an interview and had blood samples collected between 2022 and 2023. The following data were collected, using standard equipment and techniques: blood pressure, body weight, height, body fat percentage, waist and hip circumference and lipid profile. For variable comparisons, T-test, Mann-Whitney, and chi-square test were used. A linear regression model assessed the isolated effect of a positive history of PE on cardiovascular risk indicators. PE group had higher body mass index compared to normotensive pregnancy, as well as fat percentage, systolic blood pressure, diastolic blood and low-density lipoprotein. Finally, a higher frequency of metabolic syndrome was detected in PE history group. These results suggested that women who had PE showed a combination of cardiovascular risk markers and increased frequency of metabolic syndrome. To mitigate the risk of subsequent chronic diseases, lifestyle modifications are recommended, along with more frequent follow-ups with a health-care team.

Physical Activity (PA) promotion is an essential component of the comprehensive management of Gestational Diabetes Mellitus (GDM). Even though the literature is available regarding the importance of PA, limited access to reliable sources of information hinders involvement in recommended PA during pregnancy. The present study aims to develop, validate, and pilot test the Physical Activity Promotion Program (PAPP) booklet for women with GDM. The booklet was developed based on the previous literature, validated by seven experts, and administered to 38 participants for 8 weeks. The level of PA was evaluated with the Global Physical Activity Questionnaire before and after the intervention. The Scale Content Validity Index of the booklet was 0.98. The Flesch readability ease score and Flesch Kincaid grade level were 62 and 6.9, respectively. The validation scores showed that the booklet is appropriate and the readability score indicated a "standard" description style. There was a significant increase in the level of PA (MD = -320, 95% CI = -360, -250, d = -0.96, p < .001) and reduced Sedentary Behavior (MD = 45, 95% CI = 37.5, 60, d = 1, p < .001) post-intervention. The PAPP booklet was found to be a valid and reliable source of information and improves the level of PA among women with GDM.

Maternal mortality is a critically significant issue in developing countries, where the lifetime risk for a woman in pregnancy or childbirth is approximately one in six. This elevated risk is often linked to delays in accessing and utilizing maternal health care services. Therefore, the study aims to provide a comprehensive understanding of the delaying factors influencing the maternal health care disparities in developing countries using Thaddeus and Maine's Three Delays Model. Researchers searched Science Direct, Pub Med, Pub Med Central, Embase, Medline, Simantic Scholar and Scopus to extract 69 case study articles published between 2015 and 2023 for this scoping review. The search reveals that among the three primary delay factors (Delay 1- patient, Delay 2- en-route or geographical, and Delay 3- service factors), patient-related factors contribute most to adverse outcomes across Asia, which is often deeply rooted in socio-economic and cultural discrepancy. All three delays significantly hinder maternal health care access in Africa with Delay 2 remaining a persistent challenge. Along with en-route causalities and security risks, many African countries face an acute shortage of emergency obstetric care infrastructure. While, increasing awareness and addressing cultural barriers are essential for achieving better health outcomes across Asia, expanding free maternal health care policies, reducing indirect costs and improving community engagement found to be more significant for African regions. In Latin American countries, Delay 3 is the primary challenge, driven by persistent disparities in health care quality, understaffing, and inconsistent service delivery. The study therefore concludes that bringing structural changes is utmost necessary by framing policies from grass root level understanding to reduce the prevailing maternal health care disparities in developing part of the world.

Pelvic health is an understudied area for female military personnel. This study aimed to explore the pelvic health concerns, prevalence rates, and co-existence of a wide range of pelvic health issues in Australian servicewomen. An online questionnaire was offered to adult females (sex-assigned at birth) who had completed a minimum of 6-month active-duty service in the Australian Defence Force (ADF). Data analyses were focused on calculating prevalence for the included female pelvic health issues and identifying trends within the data (frequencies, 95% CI). Of the 987 survey responses, 496 were excluded, leaving 491 responses (49.7%) to inform this study. Over two-thirds of servicewomen reported pelvic health concerns (n = 350, 71%, 95% CI 67-75%), including sexual dysfunction (41%), gynecological surgery (34%), menstrual cycle manipulation (32%), frequent pelvic pain (20%), endometriosis (18%), irregular menstrual cycles (17%), pelvic organ prolapse (12%), pelvic injury (10%), and frequent episodes of fecal incontinence (2%). Coexistence of pelvic health issues were also reported by 24%. Pelvic health concerns, beyond lower urinary tract symptoms, are common and can co-exist in Australian servicewomen. Consideration of sex-responsive health services within military organizations may help to mitigate potential risks, enhancing wellbeing, operational readiness, and mission outcomes.

This study examined potential disparities in Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores of patient care experiences among racial/ethnic minority survivors and breast cancer-specific mortality. Female breast cancer survivors who completed a CAHPS survey between 2000 and 2019 after being diagnosed with first primary invasive breast cancer were selected from the Surveillance, Epidemiology, and End Results (SEER)-CAHPS data linkage. Adjusted Fine-Gray subdistribution hazards models were used to determine associations of CAHPS scores of patient care experiences with breast cancer-specific mortality, overall and stratified by race/ethnicity. Most survivors were NHW women (80.4 percent). Adjusted associations between CAHPS scores and breast cancer mortality were not significant. However, Hispanic survivors reporting higher Physician Rating scores were less likely to experience breast cancer death (HR = 0.985, 95 percent CI = 0.970-1.000, p = .046). The only interaction found to be significant was observed among other/multi-racial groups and Getting Care Quickly (p = .044). Patient care experience scores were not associated with breast cancer-specific mortality among older breast cancer survivors; some associations were found to be significant among certain racial/ethnic groups. Future research should capture care experiences from historically underrepresented populations.