Women's health reports (New Rochelle, N.Y.)最新文献

Background: Despite the widespread prevalence of obesity and its potential adverse impacts on health, the majority of interventions aimed at weight loss stay ineffective. This study aimed to assess illness perception in people with overweight/obesity and its impact on bio-functional age (BFA) and cognitive patterns governing eating and movement behavior.

Methods: A total of 40 subjects from the original overweight/obesity subcohort of the Bern Cohort Study 2014 (BeCS14) were included and assessed for a follow-up from 2019-11-29 to 2020-07-14. The subjects completed a validated "bio-functional status" test battery with calculation of BFA, as well as validated questionnaires for eating and movement behavior and illness perception.

Results: Participants were overall bio-functionally younger than their chronological age (mean 4.3 ± 6.9 year equivalents) but aging was more pronounced than anticipated. Mental occupation with illness cause was moderate to high with psychosocial (PS) factors being more pronounced than naturalistic (NT) factors. There was a shift from defined theory with focus clearly on PS theories to diffuse theory with consideration of both PS and NT theories. Participants with good sense of coherence (SOC) were less likely to be mentally preoccupied with illness cause (p < 0.05, r_s = -0.404), especially with PS factors. PS theories on illness cause correlated with pathological eating behavior (emotional eating: p > 0.05, r_s = 0.378; temptation: p < 0.01, r_s = 0.486).

Conclusions: Illness perception does affect cognitive patterns and integrating it into therapeutic management for people with obesity can enhance outcomes. Strengthening of SOC is important to decrease PS stress and achieve better subjective health, less mental preoccupation, and less dysfunctional eating behavior.

Introduction: High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital. We focused on assessing midwives' confidence in midwifery core competencies.

Methods: The study was conducted in a prospective, non-controlled intervention design. As a quality improvement tool, the Plan, Do, Check, Act cycle was implemented. SOPs for standard obstetric care were developed and trained in online meetings. Qualitative and quantitative data were collected through a questionnaire completed pre- and post-intervention by participating midwives, evaluations, minutes and video recordings of each case training, and annual analytical reports from Mutolere Hospital containing morbidity and mortality data.

Results: The online intervention was successfully implemented. Nine SOPs on basic obstetric care were developed, trained in online case training, and integrated into clinical practice at Mutolere Hospital. An increase in midwives' confidence regarding all surveyed core competencies was observed. There were no significant changes in the hospital's morbidity and mortality rates. The quality management system was implemented to optimize the follow-up projects further.

Conclusion: This pilot study shows the potential of web-based interventions as a quality improvement tool in developing countries. The developed SOPs and video database are being used in subsequent studies and extended to further health centers in the Kisoro region.

Background: Societal attitude toward spousal physical abuse plays a crucial role in preventing violence against women. Yet, this public health issue has been insufficiently addressed. This study examines the relationship between the societal attitude toward spousal physical abuse and various social determinants.

Methods: We used data from the 2022 Philippines' National Demographic and Health Survey. The outcome variable was attitude toward spousal physical abuse. Covariates included women's sociodemographic characteristics, experiences of witnessing their father's abusive behavior, intimate partner violence (IPV), and controlling behavior. Partner-related variables (age, educational level, employment status, and alcohol consumption behavior) were also considered. Descriptive and logistic regression analyses were performed to examine the associated factors of spousal physical abuse by using Stata 18.0.

Results: Overall, 1,920 (9%) of 19,228 women reported that spousal physical abuse is justifiable in at least one of the presented scenarios. Women IPV survivors (adjusted Odds Ratio [aOR] = 1.35, 95% confidence interval [95% CI] = 1.06-1.73) and those who experienced controlling behavior by their partners (aOR = 1.77, 95% CI = 1.45-2.15) were more likely to accept spousal physical abuse than their counterparts. Conversely, women with a higher decision-making score were less likely to accept spousal physical abuse than those who had a lower score (aOR = 0.74, 95% CI = 0.56-0.98).

Conclusions: Finding suggests that women's attitudes toward spousal physical abuse are significantly influenced by their experience of IPV. Future health research, programs, and policies should address individual, interpersonal, and systemic-level risk factors that profoundly impact women's health.

Background: About 25% of pregnancies end in early miscarriage or abortion annually in the United States. While mifepristone is part of the most effective medication regimen for miscarriage and abortion, regulatory burdens and legal restrictions limit its provision in obstetric-gynecological practice. The extent of geographic disparities in mifepristone use is unknown.

Objectives: We sought to ascertain whether regional "deserts" for mifepristone-based miscarriage and abortion care exist in Massachusetts using geographic regions specified by the Commonwealth's Executive Office of Health and Human Services.

Methods: We fielded a cross-sectional survey of obstetrician-gynecologists practicing in Massachusetts. We weighted survey data to account for differential nonresponse by provider sex, region, and years in independent practice.

Results: Among obstetrician-gynecologists in independent practice with region data (n = 148), 51.0% reported using mifepristone for miscarriage and 43.5% for abortion. Significant differences in reported use were observed across regions (p < 0.001 for both indications). Barriers to using mifepristone for miscarriage management also varied across regions. Respondents outside of Boston and Western Massachusetts were more likely to report gaps in knowledge about regulations and prescribing and had less prior experience using mifepristone. In a multivariable model adjusting for provider sex and practice type, obstetrician-gynecologists outside of Boston had significantly lower odds of using mifepristone for miscarriage (adjusted odds ratio [aOR] = 0.14, 95% confidence interval [95% CI] = 0.08-0.25) and abortion (aOR = 0.46, 95% CI = 0.26-0.82), compared to Boston-based obstetrician-gynecologists.

Conclusion: Mifepristone provision varies significantly by Massachusetts region. This may lead to spatial disparities in reproductive health outcomes.

Introduction: Cervical cancer disproportionally affects Black and Latinx women in Chicago. Black and Latinx women have a higher incidence of cervical cancer diagnosis and lower rates of cervical cancer screening than non-Latinx White women. Self-collected high-risk human papillomavirus (HPV) testing has been proposed as a method to address these barriers to screening and prevent cervical cancer.

Objective: This study aimed to understand the feasibility and acceptability of self-collected HPV testing as a novel approach to address barriers to cervical cancer screening for Black and Latinx women in Chicago.

Methods: Semistructured interviews with 17 Black and Latinx community members of the greater Chicago area were conducted. Thematic analysis using inductive and deductive coding was completed.

Results: Findings from qualitative interviews indicate strong support for self-collected HPV testing among community members. They expressed a preference for self-collected HPV testing due to the comfort, control, and reduced anxiety it offers. Financial constraints, prioritization of other life demands, and past trauma were identified as substantial barriers to traditional cervical screening.

Conclusion: Self-collected HPV testing could address barriers to cervical cancer screening by providing a less-invasive, patient-centered alternative to traditional methods. Self-collected HPV testing should be made accessible, be integrated into existing cervical cancer screening programs, and be covered by health insurance.

Background: This study examines the relationship between premenstrual syndrome (PMS) and the attitude toward seeking professional psychological help among Omani college students.

Method: This study used a cross-sectional design with a convenience sampling approach. The date was issued between January and March 2024. A sample of 601 undergraduate female students completed the study questionnaires, including (1) a sociodemographic questionnaire, (2) the Premenstrual Syndrome Scale and (3) the attitude toward seeking professional psychological distress scale.

Results: The study included 601 eligible participants of age 18-29 years who were mostly single (83.7%) and living on campus (68.6%). PMS prevalence was high at 87.9%, with a mean score of 109.4, indicating low severity for most (62.1%). Participants generally had positive attitudes toward seeking psychological help (41.6% high willingness). A linear regression showed a positive link between PMS severity and help-seeking attitudes.

Conclusion: This study highlights a significant association between the experiences of PMS and attitudes toward seeking professional psychological help among Omani female undergraduate students. With a high prevalence of PMS reported, the findings suggest that cultural factors and support systems play crucial roles in shaping these attitudes. The positive inclination toward seeking help indicates a growing awareness of mental health issues within this demographic. Enhancing mental health services and fostering supportive environments in educational settings can further empower students to address PMS-related challenges.

Background: There is a growing body of research highlighting that Black women have more adverse maternal health events. Instead of only focusing on severe maternal morbidity and mortality events, patient safety events (PSEs) and feedback reports are data sources that can offer insights into a broader spectrum of maternal safety, including near misses, and unsafe conditions. In this work, we explore the racial differences in the representation of mothers and birthing individuals' (MBIs) voices in PSE and feedback reports.

Materials and methods: We analyze patient experience themes, dissatisfaction, and disrespect in PSE and patient feedback reports from two large birthing hospitals. We compare racial differences in how the voices of MBIs are represented in these reports. Reports were manually coded for the presence of MBIs' voices, patient experience themes, dissatisfaction, and disrespect by staff.

Results: In total, 866 reports were reviewed, of which 271 had explicit mentions of MBIs' voices. A statistically significant association (p < 0.001) was observed between patient experience themes and report type, driven by clinical safety event themes in PSE reports. A statistically significant association (p = 0.030) was observed between race and report type in 190 reports explicitly mentioning dissatisfaction.

Discussion: Delays with handoff and transfer, pain management, patient staff violence, and procedural harm were proportionally more commonly reported among Black MBIs, supporting prior research in pain management and procedural harm disparities. We also identified themes of positive feedback and good catches by patients, which are key components to patient-centered care and promoting resilience in the care process.

Conclusions: PSE reports tended to capture predominantly clinical themes from Black MBIs, while feedback reports captured predominantly administrative themes from White MBIs. Important perspectives of the safety narrative can be missed when only PSE reports or feedback reports are considered.

Background: Decreasing primary care access and increasing emergency department (ED) usage is a potential contributor to declining cancer screening prevalences in those facing barriers to health care access. The ED is a non-traditional yet potentially high-yield setting for implementation of interventions to monitor and increase cancer screening.

Methods: An ED-administered survey in July 2022 gathered data on breast, cervical, and colorectal cancer screening, as well as human papillomavirus (HPV) vaccination status of females presenting to the ED for care. This was compared with electronic health record (EHR) data extraction of all ED patients during the same timeframe. Primary outcome was proportion of cancer screening and HPV vaccination not up to date in each group.

Results: ED survey was administered to 101 individuals; EHR data was extracted on 2934 patients. Survey versus EHR, respectively, found cervical cancer screening was not up to date in 6.2% vs. 77.6%, breast cancer screening in 14.3% vs. 73.4%, colorectal cancer screening in 22.9% vs. 56.5%, and HPV vaccination in 33.3% vs. 57.8%. p value was < 0.001 for all screening category comparisons between survey and EHR.

Discussion: Our data indicate significant discrepancies between self-reported screening history and EHR data. ED survey results were more in line with the observed screening rates in various surveillance systems and published in the literature. This suggests that point-of-care ED survey administration may be more effective in identifying those needing preventative cancer screening, especially in individuals with less access to routine health care.

Pregnancy is a hypercoagulable state. There is a lack of strong evidence-based guidance regarding management when anticoagulation is required to prevent or treat venous thromboembolism during pregnancy. In practice, some patients are prescribed enoxaparin and transitioned to heparin due to the shorter half-life in the setting of an unpredictable delivery despite less predictable pharmacokinetics of heparin compared with enoxaparin, while others are continued on enoxaparin with a scheduled delivery. This work retrospectively evaluates obstetrical and neonatal outcomes between these two practices for 194 live singleton deliveries from 179 patients in a single institution January 2017 through May 2022. A Bayesian regression was used to control for confounders including dosing regimens. This work found no statistically significant differences in blood loss at time of delivery or availability of neuraxial anesthesia. This suggests continuing enoxaparin is noninferior to transitioning to heparin when anticoagulation is indicated in pregnancy.

Purpose: In this study, we examined the relationship between health-related social needs (HRSNs) and screening mammography.

Methods: We gathered data from April 2020 to February 2021 among women ages 52-74 years at a federally qualified community health center network in the Chicago region. We measured HRSNs using a one-item screener, and among those screening positive, with an eight-item questionnaire. Screening mammography was measured as (1) ever having mammography and (2) mammography completed in the past 2 years. We examined the relationship between HRSNs in the one-item and multi-item questionnaires and both measures of screening mammography using logistic regression.

Results: Among 3711 women, mean age was 60 years, 68% were Hispanic/Latino, 62% were best served in Spanish, 39% had no insurance, and 71% had incomes <100% federal poverty level. In total, 32% reported an HRSN in the one-item screener. Of these, 74% completed the multi-item questionnaire; changes in income (60%) and inadequate access to food (46%) were the most common HRSNs reported. Overall, 65% reported prior mammography and 47% reported mammography in the past 2 years. There was an association between prior mammography and the one-item screener (odds ratio = 0.83, 95% confidence intervals = 0.70, 0.98), but no association between recent mammography and HRSNs reported in the one-item, specific HRSNs, or number of HRSNs.

Conclusions: We found an association between ever having a mammogram and a positive one-item screener, but not in relation to specific HRSNs. The findings of this study may inform future assessments of HRSNs and understanding their relationships with preventive health care.