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

Objective: To measure and assess the relationship of patient safety culture to reducing cesarean overuse.

Study setting: Maternity care hospitals in Michigan.

Study design: Cross-sectional observational design, combining individual survey data with hospital characteristics using existing databases. Multivariate Poisson regression assessed the associations between survey scores and hospital nulliparous term singleton vertex cesarean rates. Factor analysis determined the scalability of survey items.

Data collection methods: Electronic survey distributed at the hospital site level.

Principal findings: A total of 3091 clinicians from 54 out of 57 eligible hospitals completed the survey. Confirmatory factor analysis demonstrated best fit with a univariate model with two local factors. The new scale encompassing both local factors, including vaginal birth microculture and safety culture, is entitled "Unit Norms." The safety culture subdomain demonstrated an association with a reduction in hospital cesarean rate [-0.15; 95% CI: -0.27 to -0.04; incident rate ratio (IRR) 0.86], parallel to but lower in magnitude to vaginal birth microculture (-0.18; 95% CI: -0.35 to -0.02; IRR 0.84).

Conclusions: Vaginal birth microculture remains the strongest predictor of cesarean delivery overuse; however, safety culture characteristics, including teamwork, psychological safety, and communication, correlate with lower cesarean delivery rates. Measuring these aspects of hospitals' culture may be important for other areas of quality improvement initiatives focused on quality and safety.

In 2022, the US Supreme Court decision in Dobbs v. Jackson Women's Health Organization to overturn federal law safeguarding abortion rights led to considerable national debate on abortion and reproductive rights. We report the findings of a survey of academic scientists' perspectives regarding abortion rights, state policies, and the impact of the 2022 Supreme Court decision in Dobbs v. Jackson. Furthermore, we look at how academic scientists' institutions acted to address the Dobbs decision. Using a 2023 cross-sectional survey, we address the following research questions: (i) What are scientists' views of abortion rights? (ii) How have scientists responded to the 2022 Supreme Court decision in Dobbs v. Jackson Women's Health Organization? and (iii) How are their views different from that of the general public with regard to Dobbs v. Jackson and abortion rights in general? Findings show that abortion was a key factor influencing scientists' voting decisions. We also highlight substantial differences between scientists' perspectives and those of the general population and reveal gender differences of opinions within the scientific community. We conclude by presenting the actions implemented by universities and scholars in response to the Dobbs decision and discuss the implications our results have for both policy and practice.

Introduction: Parental leave yields significant health benefits for parents and children. While many medical associations endorse parental leave, it is unknown what parental leave they provide for their employees.

Objective: To assess parental leave policies of national physician societies for their employees including paid versus unpaid and parity between birth mothers and non-birthing parents.

Methods and materials: A cross-sectional analysis in 2023 examined parental leave policies of national physician societies, including the American Medical Association (AMA), American Osteopathic Association (AOA), and six specialty societies: American College of Obstetricians and Gynecologists (ACOG), American College of Osteopathic Obstetricians and Gynecologists (ACOOG), American Academy of Pediatrics (AAP), American College of Osteopathic Pediatricians (ACOP), American Academy of Family Physicians (AAFP), and American College of Osteopathic Family Physicians (ACOFP). Examination of policies included: duration, whether paid or unpaid; qualifications before receiving benefit; and whether non-birthing, adoptive, and foster parents were covered.

Results: Among the eight societies surveyed, two (25%) did not disclose their policies (ACOG, ACOP), and one (12.5%) lacked a policy (ACOOG). Of the remaining five, two (40%) offered paid leave (AMA, AAP), while three (60%) provided unpaid leave in line with legal requirements (AOA, AAFP, ACOFP). Benefits for non-birthing parents mirrored those for birth mothers, although the AMA offered birth mothers enhanced benefits.

Conclusions: Only a minority of surveyed physician societies provide paid parental leave. Physician societies should consider providing paid parental leave for their employees and making their policies publicly available to promote and model the benefit of paid parental leave.

Background: Polycystic ovary syndrome (PCOS) is one of the most common gynecological endocrinopathies in women of reproductive age in the Middle Eastern countries, including Kuwait. This cross-sectional study assessed the prevalence of and examined the factors associated with PCOS status among female university students of health sciences in Kuwait.

Methods: During January 2023, a cross-sectional study was conducted among female students, enrolled in any of the five colleges (i.e., Medicine, Public Health, Dentistry, Pharmacy, and Allied Health Sciences) of Kuwait University. Data were collected using a structured e-questionnaire administered through social media platforms. The prevalence (%) of physician-diagnosed PCOS was computed. The multivariable logistic regression model was used to compute the adjusted odds ratios (aOR) and corresponding 95% confidence intervals (CI) for the factors significantly associated with PCOS status.

Results: Of the 588 participants, most were Kuwaiti (86.5%), single (95.6%), and 21-24 years old (59.3%). The prevalence of PCOS was 16.3% (96/588). The risk factors significantly associated with PCOS status were hyperprolactinemia (aOR = 7.67; 95% CI: 3.72-15.83), menstrual irregularities (aOR = 5.12; 95% CI: 2.32-11.31), family history of PCOS (aOR = 3.49; 95% CI: 1.93- 6.29), hirsutism (aOR = 3.58; 95% CI: 2.06-6.21), and male pattern baldness (aOR = 2.06; 95% CI: 1.19-3.58).

Conclusions: This study showed moderately high prevalence of PCOS. Hyperprolactinemia, menstrual irregularities, family history of PCOS, hirsutism and baldness were significantly associated with PCOS status in the study sample. Imparting awareness and early diagnosis may help minimize PCOS burden in this and other similar settings in the region. If implemented, future studies may look at the impact of such efforts.

Background: Monitoring of diabetes by measuring capillary blood glucose using a glucometer.

Objectives: To compare the three most used glucose meters in diabetic patients in a maternity and neonatal center in terms of repeatability, accuracy, and stability.

Methodology: A comparative study on 100 diabetic patients admitted to the various departments of a maternity and neonatal center. For each patient, a capillary measurement was made using each of the three glucometers to be tested (Accucheck^®, On Call^® and Bionime^®) as well as a blood glucose on venous blood, performed in the laboratory using the Siemens X brand plus^® PLC (reference method). The same sample was used to carry out all measurements.

Results and conclusions: The Accucheck^® brand reader and the On Call^® brand thus, show a better correlation for open and closed bottles of test strips'storage, compared with the Bionime^® brand reader. We found that the Accucheck^® and On Call^® readers are comparable in terms of reliability of results and are better than the Bionime^® brand reader. We have found that, first using closed vials give more accurate results for glycemia readers and also, On Call^® and Accucheck^® brand readers are more reliable and accurate than the Bionime^® brand reader.

Introduction: Postpartum period is a critical period for a woman, where the body of the woman is in healing stage. In this situation, there arises the risk for developing anemia, if proper diet is not maintained. So, it is necessary to routinely determine the hemoglobin levels during this period to avoid chances of developing anemia and assist in early diagnosis.

Methodology: A cross-sectional study was carried out at the maternity ward of Kalinga Institute of Medical Sciences Hospital, Bhubaneswar. The study was conducted for a period of 5-6 months by received approval from the concerned institutional committee. The study involved women participants having age above 18 years and who had recently undergone delivery. Written informed consent was taken from all the participants prior to their enrolment for this study.

Results: A total of 670 women were involved in this study and more than 50% of the women were found to be affected by anemia. A Pearson's correlation of 0.87 was observed with sensitivity of 95.69% and specificity of 67.06% between the hematology analyzer and non-invasive EzeCheck device in determining anemia.

Conclusion: Women often neglect their health situations and always prioritize their family's wellbeing and health over their own. This avoidance results in the development of a chronic disease which in the long run becomes difficult to be cured. So, in such situations, it is necessary to inculcate certain routine tests for the women during their healing period (such as postpartum stage) to keep an eye on their health status. Use of non-invasive devices can help in achieving this in a painless and much effective manner with instant reporting of the results.

Objective: This study assessed the diagnostic efficacy of combining 3.0T MRI and molybdenum target X-ray in triple-negative breast carcinoma (TNBC) and its association with the prognosis of sentinel lymph node biopsy (SLNB).

Methods: The retrospective analysis included 128 patients suspected of having TNBC, who underwent 3.0T MRI and molybdenum target X-ray. Sensitivity and specificity were calculated for each imaging technique, and their combined diagnosis was evaluated using the four-table method. Consistency between the imaging techniques and pathological examination was assessed using the consistency checking method. Additionally, changes in imaging indicators were compared among patients with different prognostic indicators.

Results: Among the 128 patients, 86 were diagnosed with TNBC through pathological examination. The sensitivity and specificity of 3.0T MRI for TNBC were 82.56% and 76.19%, respectively. Molybdenum target X-ray exhibited a sensitivity of 77.91% and specificity of 78.57%. The combined diagnosis of the two techniques showed a sensitivity of 90.70% and specificity of 86.36%. There was good agreement between both imaging techniques and pathological examination results. Significant differences were observed in imaging indicators based on tumor diameter, histological grade, and lymph node metastasis.

Conclusion: Both 3.0T MRI and molybdenum target X-ray are valuable in diagnosing TNBC. Additionally, these imaging techniques provide prognostic information and can aid in treatment decision-making. The findings highlight the importance of 3.0T MRI and molybdenum target X-ray in improving the outcomes of patients with TNBC.

Women veterans (WV) are a fast-growing population in the United States with concerning health disparities. Reports of increased risks of cardiovascular disease (CVD) and poorer health are evident in WV compared with their civilian counterparts. The transition from active duty to veteran poses additional life stressors, causing changes in health behaviors such as unhealthy alcohol consumption and decreased physical activity, which may explain health disparities in WV. The changes in these two health risk behaviors may be influenced by each other, and emerging evidence suggests that physical activity aids in managing alcohol consumption during alcohol use treatment. In this general narrative review, we summarized findings from studies involving WV on (1) the associations between alcohol consumption and physical activity and (2) the effect of physical activity on reducing alcohol use. We also discussed the clinical consideration of adding physical activity to alcohol use interventions for WV. Most of the literature included in this review has been based on predominantly veteran men populations. This knowledge gap highlights the importance of continued efforts and research studies targeting WV to eliminate health disparities among them.

Introduction: The aim of this study was to assess whether the choice between double embryo transfer (DET) and single embryo transfer (SET) in healthy women of advanced maternal age (AMA) was associated with an increased risk of adverse outcomes.

Materials and methods: Healthy women aged 39-40 years who achieved live birth after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment between 2009 and 2020 at Karolinska University Hospital, Stockholm in Sweden, were included in this prospective, single-center cohort study.

Results: A total of 310 women, who underwent IVF/ICSI treatments and achieved live births, were included in our analysis. Within this cohort, 78% of the women received SET, while 22% received DET. Nulliparity was common in both the SET (62.7%) and DET (85.3%) groups. Fresh embryo transfers were more prevalent in the DET group (91.2%) than in the SET group (31.1%). The rate of pregnancy-induced hypertension was higher in the SET group (8.3%) compared to the DET group (1.5%, p = 0.048). Furthermore, the DET group had a significantly higher rate of twin pregnancies (13.2%) compared to the SET group (0.4%). No statistically significant differences were observed in composite obstetric and perinatal complications between the SET and DET groups across all model estimates following different adjustments.Clinical Trial Registration number: ClinicalTrials.gov NTC04602962.

Conclusions: While DET was more common in nulliparous women and associated with a higher rate of twin pregnancies, our analysis did not reveal significant differences in adverse outcomes between the SET and DET groups after comprehensive adjustments. Our study suggests that in the absence of co-morbidities, meticulous patient selection coupled with comprehensive maternal care can potentially mitigate potential DET-associated risks in women of AMA.

Background: Anemia is associated with fatigue, low physical activity, and poor quality of life. The purpose of this study was to determine the effects of a field trial on 6-month change in anemia and physical activity among nonpregnant women living in rural India.

Methods: The Reduction in Anemia through Normative Innovations (RANI) Project is a cluster randomized controlled trial of a social norms-based intervention to reduce anemia among women (15-49 years). Participants (n = 292) performed a modified Queen's College Step Test (QCST) and wore an ActivPAL accelerometer for 3 days. Hemoglobin concentrations (g/dL) were determined using a HemoCue 301 photometer. Linear regression tested the effects of the intervention on 6-month change in hemoglobin and physical activity, while adjusting for age, body mass index, education, parity, and predicted VO_2max.

Results: We observed no differences in hemoglobin (11.8 ± 1.2 vs.11.6 ± 1.4 g/dL) or overall physical activity (36.6 ± 2.1 vs. 35.3 ± 5.8 metabolic equivalent of task-hours/day) at 6 months between the treatment and control groups, respectively. In contrast, steps/day was significantly higher in the treatment, compared with the control group (β = 1353.83; 95% confidence interval: 372.46, 2335.31), independent of other covariables.

Conclusions: The potential to modify walking and other health-seeking behaviors using a social norms approach is worthy of further investigation among women living in rural India.Clinical Trial Registry - India: CTRI/2018/10/016186.