Women's health (London, England)最新文献

Background: Approximately 15%-25% of clinical pregnancies end in miscarriage, with more than 15,000 miscarriages occurring annually in British Columbia, Canada. Despite the significant rates of loss, research and health care services for pregnancy loss remain scarce in British Columbia.

Objectives: This study aimed to (1) aid miscarriage recovery through the identification and sharing of equitable pregnancy loss care practices and supports and (2) present policy recommendations to improve prenatal care guidelines and employment standards for pregnancy loss.

Design: This research took a patient-oriented methodological approach alongside people with lived/living experience(s) of miscarriage recovery in British Columbia to evaluate access to health care during pregnancy loss, societal understanding of miscarriage, and treatment options that foreground dignity.

Methods: The mixed-methods design of this research included policy research on prenatal care guidelines, policy research on provincial and territorial employment legislation for bereavement leave, semi-structured interviews (n = 27), and a discovery action dialogue (n = 4).

Results: The findings of this research demonstrate the need for improved prenatal care guidelines for early pregnancy loss, follow-up care after a miscarriage, mental health screening and supports, and bereavement leave legislation.

Conclusion: This article includes recommendations to improve equitable access to pregnancy loss care, bereavement leave legislation, and future research in this area.

Confidential medical care for adolescent patients is essential as they are likely to forgo needed care if privacy cannot be maintained. The use of telemedicine for adolescent health has rapidly expanded due to the COVID-19 pandemic and can increase access to important services like reproductive care; however, it has raised challenges for providers, patients, and their parents/guardians related to confidentiality and privacy. Health care providers are often uncertain about the laws and regulations that govern confidential services including the 21st Century Cures Act. Through a narrative review of studies on confidentiality and telemedicine, this article seeks to summarize the available evidence and provide recommendations on maintaining privacy during virtual encounters and identify current best practices for prescribing contraception via telemedicine.

Endometriosis, a chronic condition characterized by the growth of endometrial-like tissue outside of the uterus, poses substantial challenges in terms of diagnosis and treatment. Artificial intelligence (AI) has emerged as a promising tool in the field of medicine, offering opportunities to address the complexities of endometriosis. This review explores the current landscape of endometriosis diagnosis and treatment, highlighting the potential of AI to alleviate some of the associated burdens and underscoring common pitfalls and challenges when employing AI algorithms in this context. Women's health research in endometriosis has suffered from underfunding, leading to limitations in diagnosis, classification, and treatment approaches. The heterogeneity of symptoms in patients with endometriosis has further complicated efforts to address this condition. New, powerful methods of analysis have the potential to uncover previously unidentified patterns in data relating to endometriosis. AI, a collection of algorithms replicating human decision-making in data analysis, has been increasingly adopted in medical research, including endometriosis studies. While AI offers the ability to identify novel patterns in data and analyze large datasets, its effectiveness hinges on data quality and quantity and the expertise of those implementing the algorithms. Current applications of AI in endometriosis range from diagnostic tools for ultrasound imaging to predicting treatment success. These applications show promise in reducing diagnostic delays, healthcare costs, and providing patients with more treatment options, improving their quality of life. AI holds significant potential in advancing the diagnosis and treatment of endometriosis, but it must be applied carefully and transparently to avoid pitfalls and ensure reproducibility. This review calls for increased scrutiny and accountability in AI research. Addressing these challenges can lead to more effective AI-driven solutions for endometriosis and other complex medical conditions.

Despite decades of faculty professional development programs created to prepare women for leadership, gender inequities persist in salary, promotion, and leadership roles. Indeed, men still earn more than women, are more likely than women to hold the rank of professor, and hold the vast majority of positions of power in academic medicine. Institutions demonstrate commitment to their faculty's growth by investing resources, including creating faculty development programs. These programs are essential to help prepare women to lead and navigate the highly matrixed, complex systems of academic medicine. However, data still show that women persistently lag behind men in their career advancement and salary. Clearly, training women to adapt to existing structures and norms alone is not sufficient. To effectively generate organizational change, leaders with power and resources must commit to gender equity. This article describes several efforts by the Office of Faculty in the Johns Hopkins University School of Medicine to broaden inclusivity in collaborative work for gender equity. The authors are women and men leaders in the Office of Faculty, which is within the Johns Hopkins University School of Medicine dean's office and includes Women in Science and Medicine. Here, we discuss potential methods to advance gender equity using inclusivity based on our institutional experience and on the findings of other studies. Ongoing data collection to evaluate programmatic outcomes in the Johns Hopkins University School of Medicine will be reported in the future.

Background: Models of abortion care have changed significantly in the last decade, most markedly during the COVID-19 pandemic, when home management of early medical abortion with telemedical support was approved in Britain.

Objective: Our study aimed to examine women's satisfaction with abortion care and their suggestions for improvements.

Design: Qualitative, in-depth, semi-structured interviews.

Methods: A purposive sample of 48 women with recent experience of abortion was recruited between July 2021 and August 2022 from independent sector and National Health Service abortion services in Scotland, Wales and England. Interviews were conducted by phone or via video call. Women were asked about their abortion experience and for suggestions for any improvements that could be made along their patient journey - from help-seeking, the initial consultation, referral, treatment, to aftercare. Data were analyzed using the Framework Method.

Results: Participants were aged 16-43 years; 39 had had a medical abortion, 8 a surgical abortion, and 1 both. The majority were satisfied with their clinical care. The supportive, kind and non-judgmental attitudes of abortion providers were highly valued, as was the convenience afforded by remotely supported home management of medical abortion. Suggestions for improvement across the patient journey centred around the need for timely care; greater correspondence between expectations and reality; the importance of choice; and the need for greater personal and emotional support.

Conclusion: Recent changes in models of care present both opportunities and challenges for quality of care. The perspectives of patients highlight further opportunities for improving care and support. The principles of timely care, choice, management of expectations, and emotional support should inform further service configuration.

The special collection on Maternal Health Considerations offers a comprehensive exploration of critical issues surrounding maternal well-being across diverse contexts and disciplines. Recognising that maternal health extends beyond the physiological realm, this collection delves into the multifaceted dimensions of maternal well-being, including physical, mental, and socio-ecological factors. The collection comprises a series of interdisciplinary studies that investigate various facets of maternal health, from conception to postpartum stages. It addresses the complex interplay between biological, psychological, and socio-cultural determinants that influence maternal health outcomes. By adopting a holistic approach, the contributors shed light on the interconnectedness of maternal well-being. Key themes explored within this collection include the impact of prenatal care on maternal and neonatal health outcomes, as well as the role of mental health in shaping maternal experiences. In addition, the collection presents innovative recommendations to enhancing maternal well-being, such as community-based interventions, technological advancements, and future policy considerations. Furthermore, the special collection emphasises the significance of culturally sensitive care in promoting maternal health. It highlights the need for tailored interventions that respect the diversity of maternal experiences across different ethnic, racial, and socioeconomic groups. Contributors to this collection employ a range of methodologies, including qualitative and quantitative research case studies, which provide an intricate overview of the current state of maternal health research. The collection also offers valuable insights for policymakers, healthcare practitioners, researchers, and advocates working towards improving maternal health outcomes worldwide. It serves as a vital resource for contributing to our understanding of the complexities surrounding maternal well-being. It offers a platform for critical dialogue and collaborative efforts aimed at promoting holistic maternal health.

Background: Lifestyle in Western countries has significantly changed during recent decades. These and other factors have increased the prevalence of overweight and obesity, leading to a higher risk of noncommunicable diseases such as cardiovascular disease and cancer. A balanced diet has been shown to predict better health, so several public healthcare strategies aim to encourage "healthy" food choices.

Objectives: To assess self-concept of knowledge about nutrition compared to factual knowledge and knowledge implementation in daily life.

Design: Cross-sectional cohort study with a total of 524 Swiss women recruited, of which 447 women met the inclusion criteria for the final analysis.

Methods: Main outcome measure: a self-constructed questionnaire was used to evaluate subjective and objective knowledge about healthy nutrition and its practical application. Subgroup analyses utilized Fisher's test for categorical and Mann-Whitney-U test for metric/ordinal.

Results: Most participants sourced their nutritional information predominantly from nonexperts. While the majority believed they were well-educated about nutrition, this self-assessment was only partially accurate. The "nutrition pyramid" concept was widely recognized, and correct assignment of food items to dominant macronutrient components was generally accurate. However, understanding of food category ranking by optimal daily intake and composing a healthy diet was lacking. Higher education levels correlated with better objective nutrition knowledge (p < 0.001), and normal-weight women were more likely than overweight/obese women to implement nutritional knowledge daily (p = 0.021). Apart from body mass index other bio-psycho-social factors were observed.

Conclusion: Recent insights show that although women perceive themselves as knowledgeable about nutrition, there are significant gaps in their objective understanding. Higher education levels improve nutritional knowledge, and normal-weight women apply this knowledge more effectively. Thus, providing accessible, high-quality expert information on nutrition is essential.

Trial registration: The study has been approved by the Cantonal Ethics Committee (registration number: 2018-00358).

Background: Researchers and participants who are members of minoritized populations experience negative psychosocial and wellness outcomes like burnout. Burnout may manifest uniquely for Black women in academia conducting research with Black women participants navigating similar sociocultural contexts.

Objectives: This article qualitatively interprets our experiences as 15 Black women scholar-practitioners at a midwestern university conducting community-engaged research. We discuss our experiences of care and burnout while working to reduce opioid use disparities among Black women community members as we simultaneously navigate multilevel challenges in academia.

Design: We employ collaborative autoethnography, an autobiographical writing method, using a Black feminist framework and intersectionality methodology.

Methods: We are 15 Black women researcher-subjects on the REFOCUS study-a mixed-methods National Institute on Health-funded project examining nonmedical prescription opioid misuse among Black Kentuckians. We examined a series of multigenerational sista circles and individual journal entries we completed to understand the multilevel power dynamics impacting our individual and collective work, burnout, and care.

Results: Themes were: (1) "I see me in you": Research with Black Women, (2) "Pervasive, cellular, and epigenetic": Burnout Experiences; (3) "Taxing but rewarding": The Price We Pay to See an Outcome, and (4) "Thank God for the collective": Complexities of Caring Through the Process.

Conclusion: We highlight the importance of continued efforts to address workload inequities among Black women in academia, particularly for those working to combat health disparities among Black women or within Black communities. We make recommendations for structural, institutional, and interpersonal steps to improve the support of Black women across career stages.

Background: Previous studies quantified that women who experienced intimate partner violence (IPV) had a higher risk of spontaneous abortion than women who did not experience IPV. However, there is limited evidence documenting the experiences of women in Northern Ethiopia who have been subjected to partner violence and who had spontaneous abortions. This evidence is critical for policymakers looking to improve women's access to maternity care.

Objectives: This study aimed to explore the lived experiences of IPV survivors during pregnancy who had spontaneous abortions in Northern Ethiopia.

Design: A phenomenological qualitative study design was used to explore the lived experiences of survivors of IPV who had spontaneous abortions.

Methods: A total of 16 interviews were conducted between April 23 and June 5, 2020. Eight in-depth interviews and eight key informant interviews were conducted with eligible mothers who received the required service, Adigrat General Hospital service providers, zonal women's affairs experts, and legal professionals. The purposive sampling technique was used to select study participants, and the sample size was determined using the information saturation principle. The data were analyzed through open coding and thematic content analysis.

Result: The themes that emerged in this study included opinions toward IPV, mothers' and experts' experiences of partner support during pregnancy, attitudes toward IPV, and understanding of spontaneous abortion. Physical, emotional, sexual, and economic pressure were identified as the most common forms of IPV. Participants in the study believed that physical violence and stress were associated with spontaneous abortion. They also mentioned various strategies for preventing IPV, such as providing job opportunities for women, punishing perpetrators, and encouraging mutual tolerance.

Conclusion: This study found that spontaneous abortion is linked to any type of IPV, including physical IPV during pregnancy. IPV is a community-supported event that necessitates strategies and legal frameworks to prevent and mitigate its effects.

Background: Social media negatively affects body image, but few have investigated its impact on pregnancy-related body image. Pregnancy represents a vulnerable period for body image, and poor body image has negative implications for health.

Objectives: We aimed to (1) understand relations of social media and pregnancy-related body image variables, (2) examine differences in social media use and body image based on demographic characteristics, and (3) evaluate whether type of social media use (i.e., active versus passive) was differentially related with body image based on time spent on social media.

Design: This was a cross-sectional study.

Methods: We recruited an online sample of women (N = 154) experiencing early motherhood, as defined by giving birth within the past 5 years. We examined social media use (e.g., amount of time, type of use) on Facebook, Instagram, and Twitter in relation to pregnancy-related body image questionnaires.

Results: Passive use (e.g., viewing others' content rather than creating original content) and greater time on Facebook were independently related to lower positive body image. Those who passively used Facebook for the longest amount of time had the lowest positive body image. No significant effects were found for Instagram or Twitter.

Conclusion: Spending more time passively viewing others' content may facilitate social comparison, reducing positive feelings about one's own body. Social media may constitute a source of pressure and scrutiny for women, resulting in lowered pregnancy-related body image.