Clinical medicine insights. Women's health最新文献

Background: Body mass index (BMI) has been used widely among clinicians to assess obesity in their patients due to its ease and availability. However, BMI has some diagnostic limitations and other measures related to health risks; in particular, body shape may be of greater relevance to health outcomes.

Objective: The objective of this study was to illustrate the importance of body shape assessments above and beyond BMI and its relationship to health risk among a sample of African-American and European American women.

Methods: African-American and European American women aged 19-78 years (n = 552) in Birmingham, Alabama, were recruited and stratified by menopausal status (ie, pre- or postmenopausal). Pictorial body shapes were derived from digital photographs, while body fat distribution defined by android-gynoid ratio (AGR) and body composition were obtained from dual-energy X-ray absorptiometry.

Results: Images of BMI and age-matched women illustrate variability in fat distribution. Among both menopausal status groups, more than 50% of women had a pear body shape (AGR < 1). An apple body shape was associated with higher odds of having diabetes (unadjusted odds ratio [OR]: 4.1, 95% confidence interval [CI]: 1.9-9.3), hypertension (unadjusted OR: 3.1, 95% CI: 2.0-4.7), and high cholesterol (unadjusted OR: 3.0, 95% CI: 1.8-5.1).

Conclusion: Use of visual cues alongside traditional methods of weight status assessment may help to facilitate weight management conversations between physicians and female patients. However, next steps should include the validation of visual assessments of body shape in women for use by physicians.

Analyzing the Latino community and focusing on the women that make up this fast-growing demographic create a better understanding of the needs and considerations for health-care professionals and social policies. It is important that national health and health-care data on the Latino ethnic group be presented by gender in order to determine areas specific to women. This review focuses on the existing health and health-care data of Latino women (Latinas). The ability to distinguish the health-care experiences of Latinas will increase the understanding of existing barriers to their health care, the initiatives needed to overcome them, and increase the overall quality of health among Latina women.

African-American women, a historically understudied and underserved group, have increased risk for triple-negative breast cancer and obesity-associated disease. Obesity-associated metabolic diseases share a common link of low grade chronic inflammation, but not all obese women have metabolic disturbances or are inflamed. One goal of our ongoing research is to identify blood biomarkers that can predict increased risk of breast cancer in women who have obesity or metabolic dysfunction. However, vulnerable populations that stand to benefit most from advances in biomedical research are also underrepresented in research studies. The development of effective, novel approaches for cancer prevention and treatment will require significant basic medical research effort to establish the necessary evidence base in multiple populations. Work with vulnerable human subjects at a safety net hospital enabled us to comment on potential obstacles to obtaining serological and tissue specimens from African-American women. Here, we report some unexpected barriers to participation in our ongoing research study that might inform future efforts.

This article reviews psychosocial influences on women's participation in physical activity as they differ from men and how associated activity differences impact women's risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women's health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male counterparts. These lower rates of physical activity are directly related to both incidence of and outcomes from cardiovascular disease, type 2 diabetes, and breast and gynecological cancers. The relationship between psychosocial factors that are understood to affect physical activity differs between men and women. Specifically, self-efficacy, social support, and motivation are empirically substantiated factors that found to impact physical activity participation among women differently than men. Understanding these relationships is integral to designing effective interventions to target physical activity participation in women so that the related health risks are adequately addressed.

Purpose: The purpose of this study is to compare the health of primary caregiving African American grandmothers with diabetes with African American women with diabetes who were not primary caregivers.

Design: Using a comparative, descriptive, cross-sectional design, 34 African American primary caregiving grandmothers were compared with 34 non-caregiving women with diabetes mellitus; women aged 55-75 years were recruited for this study throughout the central Arkansas.

Methods: To measure the overall health, data on blood pressure, body mass index measurements, HbA1c levels, total cholesterol, and urine protein and creatinine levels were collected from all the participants.

Results: Statistically significant differences between the caregivers and non-caregivers groups in systolic pressure (t = -3.42, P = 0.001) and diastolic pressure (t = -3.790, P = 0.000) and urine protein (W = 294.00, P = 0.000) were noted. Additionally, a clinically significant difference in HbA1c was noted between groups.

Conclusion: Differences in systolic and diastolic pressures, urine protein, and clinically significant differences in HbA1c suggest that African American primary caregiving grandmothers with diabetes mellitus may have more difficulty in maintaining their diabetic health than non-caregiving African American women.

Background: Strategies for identifying the most relevant psychosocial predictors in studies of racial/ethnic minority women's health are limited because they largely exclude cultural influences and they assume that psychosocial predictors are independent. This paper proposes and tests an empirical solution.

Methods: Hierarchical cluster analysis, conducted with data from 140,652 Women's Health Initiative participants, identified clusters among individual psychosocial predictors. Multivariable analyses tested associations between clusters and health outcomes.

Results: A Social Cluster and a Stress Cluster were identified. The Social Cluster was positively associated with well-being and inversely associated with chronic disease index, and the Stress Cluster was inversely associated with well-being and positively associated with chronic disease index. As hypothesized, the magnitude of association between clusters and outcomes differed by race/ethnicity.

Conclusions: By identifying psychosocial clusters and their associations with health, we have taken an important step toward understanding how individual psychosocial predictors interrelate and how empirically formed Stress and Social clusters relate to health outcomes. This study has also demonstrated important insight about differences in associations between these psychosocial clusters and health among racial/ethnic minorities. These differences could signal the best pathways for intervention modification and tailoring.

Although poor health-related behaviors that impact development of chronic diseases begin much earlier than when actual disease is evident, few studies have examined health behaviors in college students, who may be at an important transitional period where early intervention could prevent development of chronic diseases. The purpose of this study was to examine health-related factors in female college students (N = 61) by race/ethnicity and weight status. We found significant differences in health profiles between non-Hispanic White (White) and African American students, including greater physical fitness and healthier diets among White students. Overweight/obese students had worse health profiles than healthy BMI students. Furthermore, weight status was significantly associated with cardiovascular fitness. This supports a focus on PA promotion for interventions in the period of emerging adulthood, alongside the other healthy behaviors, to elicit improvements in weight status and potential reduction of chronic disease risks.

This study aims to establish a profile of teenage pregnancy (<20 years) at a hospital in Huambo, Angola. Subjects were categorized into two age groups, 10-16 and 17-19 years. We interviewed 381 mothers in the postpartum maternity ward of the Central Hospital of Huambo. Statistical analysis then followed two stages, a descriptive analysis of the study population and analysis through a bivariate 2 × 2 table, using a chi-squared test to evaluate the hypothesis of homogeneity of proportions with a significance level of 5%. Comparing the two groups revealed a more frequent occurrence of problems among mothers under 17 years of age, including a higher frequency of involvement with unemployed parents, more often not living with parents, and fewer prenatal consultations.

Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area.

Women from diverse ethnic/racial backgrounds have higher chronic disease mortality rates when compared to White non-Hispanic women. Community-based programs, such as beauty salons, have been used to reach diverse ethnic/racial women, yet little is known about diverse ethnic/racial women cosmetologists' involvement in health promotion and their health behaviors, which is the purpose of this review. The growing beauty salon health promotion literature indicates that their roles in these studies have been varied, not only as health promoters but also as recruiters, facilitators, and in general major catalysts for investigator-initiated studies. However, the review also identified a major void in the literature in that there were few studies on health behaviors of diverse ethnic/racial women cosmetologists, especially African American women cosmetologists. Recommendations include increasing the capacity of diverse ethnic/racial women cosmetologists as community health leaders and investigating their health status, knowledge, attitudes, and practices.