Background Cervical cancer is preventable with regular PAP tests and the human papillomavirus (HPV) vaccine. Objective Identify factors influencing initiation into regular sexual health examinations within a group of undergraduate health science students who have high parental SES. Methods After reviewing the literature, a survey of knowledge, attitudes and behaviors about HPV exposure and cervical cancer prevention through vaccination and cervical cancer screening was developed. The survey was circulated using a web-based survey tool to undergraduate Faculty of Health Sciences student. Results Two hundred and three students at McMaster University completed the survey. The sample included 72% women and 28% men. The mean age was 19.4 years. This sample represents a population of young adults who the previous literature would suggest are most likely to have regular health care since they are affluent (FAS greater than 6.7 ∓ 1.4). This group is also motivated in health education as 83.3% knew about the HPV vaccine and 76.4% could define the purpose of a PAP smear. Both male and female students were more likely to consult their family doctor about sexual health than their family. More than half of sexually active females have a family doctor, 82.1% of which visit them regularly. Sexually active women visit more regularly than sexually inactive women (p ≤ 0.01). The majority (66%) are comfortable discussing sexual health with their family doctor, yet only 62.5% of women have had this discussion. 57% of sexually active women and less that 1% of non-sexually active women had had a PAP smear or a pelvic exam. Conclusion These affluent and well educated students do not appear to be able to apply their knowledge of HPV and PAP smears to their own sexual health. Thus they require access to tools that help motivate university students to personalize information and make important health decisions.
{"title":"The Knowledge and Attitudes of University Students concerning HPV Vaccine and Cervical Screening","authors":"L. Elit, K. Trim, R. Mohan, S. Nastos, D. Harnish","doi":"10.4137/CMRH.S2973","DOIUrl":"https://doi.org/10.4137/CMRH.S2973","url":null,"abstract":"Background Cervical cancer is preventable with regular PAP tests and the human papillomavirus (HPV) vaccine. Objective Identify factors influencing initiation into regular sexual health examinations within a group of undergraduate health science students who have high parental SES. Methods After reviewing the literature, a survey of knowledge, attitudes and behaviors about HPV exposure and cervical cancer prevention through vaccination and cervical cancer screening was developed. The survey was circulated using a web-based survey tool to undergraduate Faculty of Health Sciences student. Results Two hundred and three students at McMaster University completed the survey. The sample included 72% women and 28% men. The mean age was 19.4 years. This sample represents a population of young adults who the previous literature would suggest are most likely to have regular health care since they are affluent (FAS greater than 6.7 ∓ 1.4). This group is also motivated in health education as 83.3% knew about the HPV vaccine and 76.4% could define the purpose of a PAP smear. Both male and female students were more likely to consult their family doctor about sexual health than their family. More than half of sexually active females have a family doctor, 82.1% of which visit them regularly. Sexually active women visit more regularly than sexually inactive women (p ≤ 0.01). The majority (66%) are comfortable discussing sexual health with their family doctor, yet only 62.5% of women have had this discussion. 57% of sexually active women and less that 1% of non-sexually active women had had a PAP smear or a pelvic exam. Conclusion These affluent and well educated students do not appear to be able to apply their knowledge of HPV and PAP smears to their own sexual health. Thus they require access to tools that help motivate university students to personalize information and make important health decisions.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S2973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697641","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}
Objective To explore the relationship between coping mechanisms and suicidal ideations among women who experience symptoms of postpartum depression. Design This exploratory descriptive study used secondary data from a study of women who experienced symptoms of postpartum depression. Participants Convenience and purposive sampling were used to obtain the community sample of 40 women who experienced symptoms of postpartum depression. Methods Binary logistic regression was employed to explore emotion-focused coping, avoidance-focused coping, problem-focused coping, and religious coping as predictors of suicidal ideations. Results Approximately 27% of the sample reported suicidal ideations within the past seven days. The results showed that lower levels of emotion-focused coping and higher levels of avoidance-focused and religious coping predicted suicidal ideations in participants. Problem-focused coping did not predict suicidal ideations. Conclusion Overall, our findings provide support for the importance of coping mechanisms as predictors of suicidal ideations among women who experience symptoms of postpartum depression. The results illustrate the need for health professionals to conduct routine assessments on coping strategies and thoughts of suicide when caring for postpartum women, as well as the need to integrate coping approaches in the prevention and treatment of suicidal ideations.
{"title":"Coping and Suicidal Ideations in Women with Symptoms of Postpartum Depression","authors":"S. Doucet, N. Letourneau","doi":"10.4137/CMRH.S3801","DOIUrl":"https://doi.org/10.4137/CMRH.S3801","url":null,"abstract":"Objective To explore the relationship between coping mechanisms and suicidal ideations among women who experience symptoms of postpartum depression. Design This exploratory descriptive study used secondary data from a study of women who experienced symptoms of postpartum depression. Participants Convenience and purposive sampling were used to obtain the community sample of 40 women who experienced symptoms of postpartum depression. Methods Binary logistic regression was employed to explore emotion-focused coping, avoidance-focused coping, problem-focused coping, and religious coping as predictors of suicidal ideations. Results Approximately 27% of the sample reported suicidal ideations within the past seven days. The results showed that lower levels of emotion-focused coping and higher levels of avoidance-focused and religious coping predicted suicidal ideations in participants. Problem-focused coping did not predict suicidal ideations. Conclusion Overall, our findings provide support for the importance of coping mechanisms as predictors of suicidal ideations among women who experience symptoms of postpartum depression. The results illustrate the need for health professionals to conduct routine assessments on coping strategies and thoughts of suicide when caring for postpartum women, as well as the need to integrate coping approaches in the prevention and treatment of suicidal ideations.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S3801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697735","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}
Objective To examine the association between body mass index and time to conception. Methods Secondary data analysis of The Asthma in Pregnancy Study, a Prospective cohort of 2205 women assembled from April 1997-June 2000. Results Time to conception in women not on contraception, by BMI category, did not show a significant difference among the groups, p = 0.81 for test of equality over the strata. Conclusions No association between time to conception and BMI was demonstrated in these data.
{"title":"Obesity and Time to Conception","authors":"S. Richman","doi":"10.4137/CMRH.S869","DOIUrl":"https://doi.org/10.4137/CMRH.S869","url":null,"abstract":"Objective To examine the association between body mass index and time to conception. Methods Secondary data analysis of The Asthma in Pregnancy Study, a Prospective cohort of 2205 women assembled from April 1997-June 2000. Results Time to conception in women not on contraception, by BMI category, did not show a significant difference among the groups, p = 0.81 for test of equality over the strata. Conclusions No association between time to conception and BMI was demonstrated in these data.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697817","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}
Introduction Despite an increasing number of available contraceptive options, about 49% of the annual U.S. pregnancies remain unintended.1 Surprisingly, over a third of all pregnancies in women in their forties are unintended. Perhaps due to safety considerations and co-existing medical conditions, these patients may be directed toward less effective, compliance dependent methods. In addition to reliable contraception, perimenopausal women may need to stabilize hormonal fl uctuations and minimize irregular heavy menstrual fl ow. The ideal contraceptive for the perimenopausal woman would be compliance independent and provide non-contraceptive benefi ts. With the perimenopausal woman’s needs in mind , we will discuss all contraceptive options currently available in the United States, review the risks and benefi ts of each and describe the transition from contraception to postmenopausal hormone therapy. We include a summary of the effi cacy of various contraceptives in Table 1. As women enter their perimenopausal years, they are often faced with contraceptive decisions along with the onset of new medical conditions. These conditions include cardiovascular risk factors such as hyperlipidemia, hypertension, diabetes and obesity. Cardiovascular disease increases dramatically with age and is the leading cause of death among adult women in the U.S. Cardiovascular risk factor management is therefore a critical component in the care of perimenopausal women. It is prudent to educate women seeking contraceptive counseling about the importance of a healthy diet, exercise and avoidance of smoking. It is known that coronary artery disease in women who undergo natural menopause occurs about 10 years later than men. However, women who undergo early natural menopause or bilateral oophorectomy develop coronary artery disease at a younger age. The decline in ovarian function is related to changes in the lipid profi le and subsequent risk for developing coronary artery disease.2 Studies have not shown an increased risk of myocardial infarction or stroke in women who are current users of oral contraceptives containing less than 50 ug of EE.3 However, women older than 35 years of age who smoke and have a history of hypertension are at increased risk for myocardial infarction and stroke.4 Women with a history of diabetes but no other risk factors such as hypertension or vascular disease including nephropathy are candidates for combination oral contraceptives. Those who have diabetes in addition to multiple other cardiac risk factors should be offered progestin only or nonhormonal contraceptives. In short, from the standpoint of medical eligibility, combination estrogen-progestin contraception is most appropriate for lean, healthy, non-smoking women without signifi cant cardiovascular risk factors. Women with multiple cardiovascular risk factors are ineligible for combination estrogen-progestin contraceptives. These women need to be counseled regarding a healthy lifestyl
{"title":"Contraceptive Options for the Perimenopausal Woman","authors":"Petra M. Casey, M. Marnach, S. Pruthi","doi":"10.4137/CMRH.S886","DOIUrl":"https://doi.org/10.4137/CMRH.S886","url":null,"abstract":"Introduction Despite an increasing number of available contraceptive options, about 49% of the annual U.S. pregnancies remain unintended.1 Surprisingly, over a third of all pregnancies in women in their forties are unintended. Perhaps due to safety considerations and co-existing medical conditions, these patients may be directed toward less effective, compliance dependent methods. In addition to reliable contraception, perimenopausal women may need to stabilize hormonal fl uctuations and minimize irregular heavy menstrual fl ow. The ideal contraceptive for the perimenopausal woman would be compliance independent and provide non-contraceptive benefi ts. With the perimenopausal woman’s needs in mind , we will discuss all contraceptive options currently available in the United States, review the risks and benefi ts of each and describe the transition from contraception to postmenopausal hormone therapy. We include a summary of the effi cacy of various contraceptives in Table 1. As women enter their perimenopausal years, they are often faced with contraceptive decisions along with the onset of new medical conditions. These conditions include cardiovascular risk factors such as hyperlipidemia, hypertension, diabetes and obesity. Cardiovascular disease increases dramatically with age and is the leading cause of death among adult women in the U.S. Cardiovascular risk factor management is therefore a critical component in the care of perimenopausal women. It is prudent to educate women seeking contraceptive counseling about the importance of a healthy diet, exercise and avoidance of smoking. It is known that coronary artery disease in women who undergo natural menopause occurs about 10 years later than men. However, women who undergo early natural menopause or bilateral oophorectomy develop coronary artery disease at a younger age. The decline in ovarian function is related to changes in the lipid profi le and subsequent risk for developing coronary artery disease.2 Studies have not shown an increased risk of myocardial infarction or stroke in women who are current users of oral contraceptives containing less than 50 ug of EE.3 However, women older than 35 years of age who smoke and have a history of hypertension are at increased risk for myocardial infarction and stroke.4 Women with a history of diabetes but no other risk factors such as hypertension or vascular disease including nephropathy are candidates for combination oral contraceptives. Those who have diabetes in addition to multiple other cardiac risk factors should be offered progestin only or nonhormonal contraceptives. In short, from the standpoint of medical eligibility, combination estrogen-progestin contraception is most appropriate for lean, healthy, non-smoking women without signifi cant cardiovascular risk factors. Women with multiple cardiovascular risk factors are ineligible for combination estrogen-progestin contraceptives. These women need to be counseled regarding a healthy lifestyl","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697826","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}
Background Medical termination of pregnancy [TOP] during the early first trimester is commonly used. However, treatment failure which warrants surgical intervention occurs in small proportion of patients. Our objective was to examine the effectiveness and predictive value of sonographic measurement of endometrial thickness during a follow up visit after medical abortion as an accurate predictor of the necessity of curettage for completion of pregnancy termination. Methods Women who opted for medical TOP where treated by single dose of RU486 followed by a single dose of misoprostol. Endometrial thickness was evaluated by transvaginal U.S. at 14 days after misoprostol tretament. The data was collected prospectively for this cohort study which includes all the women undergoing medical abortion in the first seven weeks of gestation. Results In 34.7% of the patients the endometrial width was > 11 mm on the follow-up visit. Surgical intervention was performed in 18% of these patients, for a failure rate of the medical termination of pregnancy [TOP] of 6.25%, as compared with no failure rate in those with endometrium < 11 mm, P < 0.001. In the patients where the endometrium was 11-12 mm on follow-up, the failure rate was 5%, and if > 12 mm the failure was 5.9%. In cases where the endometrium was 12-13 mm the failure rate was 27.3%, and if >13 mm the failure was 18.9%. When the endometrium was 13-14 mm the failure rate was 10%, and when >14 mm the failure was 23.7%. Half of the 18 patients who had undergone dilatation and curettage [D&C] for completion of the TOP, had endometrium > 14 mm, one to two weeks after the medical abortion. Conclusion Measurement of endometrial width after medical TOP is beneficial in segregating patient to low or high risk for surgical treatment of retained product of conception [POC]. Using a cutoff of 11 mm during the follow-up visit after medical TOP, 18% of the patients may need dilatation and curettage to complete the pregnancy termination, and if it is >14 mm, half of them may need surgical intervention. There is no difference between 11 and 14 mm regarding the risk of surgical intervention after medical TOP.
{"title":"Endometrial Thickness- a Practical Prospective Marker for the Risk of Surgical Intervention after RU486 Induced Abortion","authors":"Z. Blumenfeld, W. Abdallah, D. Kaplan, O. Nevo","doi":"10.4137/CMRH.S994","DOIUrl":"https://doi.org/10.4137/CMRH.S994","url":null,"abstract":"Background Medical termination of pregnancy [TOP] during the early first trimester is commonly used. However, treatment failure which warrants surgical intervention occurs in small proportion of patients. Our objective was to examine the effectiveness and predictive value of sonographic measurement of endometrial thickness during a follow up visit after medical abortion as an accurate predictor of the necessity of curettage for completion of pregnancy termination. Methods Women who opted for medical TOP where treated by single dose of RU486 followed by a single dose of misoprostol. Endometrial thickness was evaluated by transvaginal U.S. at 14 days after misoprostol tretament. The data was collected prospectively for this cohort study which includes all the women undergoing medical abortion in the first seven weeks of gestation. Results In 34.7% of the patients the endometrial width was > 11 mm on the follow-up visit. Surgical intervention was performed in 18% of these patients, for a failure rate of the medical termination of pregnancy [TOP] of 6.25%, as compared with no failure rate in those with endometrium < 11 mm, P < 0.001. In the patients where the endometrium was 11-12 mm on follow-up, the failure rate was 5%, and if > 12 mm the failure was 5.9%. In cases where the endometrium was 12-13 mm the failure rate was 27.3%, and if >13 mm the failure was 18.9%. When the endometrium was 13-14 mm the failure rate was 10%, and when >14 mm the failure was 23.7%. Half of the 18 patients who had undergone dilatation and curettage [D&C] for completion of the TOP, had endometrium > 14 mm, one to two weeks after the medical abortion. Conclusion Measurement of endometrial width after medical TOP is beneficial in segregating patient to low or high risk for surgical treatment of retained product of conception [POC]. Using a cutoff of 11 mm during the follow-up visit after medical TOP, 18% of the patients may need dilatation and curettage to complete the pregnancy termination, and if it is >14 mm, half of them may need surgical intervention. There is no difference between 11 and 14 mm regarding the risk of surgical intervention after medical TOP.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S994","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70698312","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}
Over the recent years there has been a gradual rise in the use of pharmaceuticals during pregnancy. Knowledge on placental drug transfer and metabolism has increased during the past decades as well. Investigation of the transplacental transfer of any therapeutically useful drug is essential to the understanding of its metabolic processes and is a prerequisite for its use during pregnancy. The purpose of this review is to give insight on the various techniques that have been developed to evaluate transplacental transfer of drugs and xenobiotics.
{"title":"In Vitro Models Using the Human Placenta to Study Fetal Exposure to Drugs","authors":"M. Kovo, A. Golan","doi":"10.4137/CMRH.S974","DOIUrl":"https://doi.org/10.4137/CMRH.S974","url":null,"abstract":"Over the recent years there has been a gradual rise in the use of pharmaceuticals during pregnancy. Knowledge on placental drug transfer and metabolism has increased during the past decades as well. Investigation of the transplacental transfer of any therapeutically useful drug is essential to the understanding of its metabolic processes and is a prerequisite for its use during pregnancy. The purpose of this review is to give insight on the various techniques that have been developed to evaluate transplacental transfer of drugs and xenobiotics.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697879","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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