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Women who experience symptoms of an acute myocardial infarction (MI) are less likely than men to seekmedical attention after the onset of initial symptoms. The purpose of this study was to facilitate a better understanding of the treatment-seeking decisions of women who seek emergency evaluation for symptoms suggestive of MI. A qualitative, semi-structured, feminist, post structuralist interview approach was used to explore the treatment-seeking decisions of ten women hospitalized for a MI. The oral descriptions were tape-recorded, transcribed verbatim, and analyzed using the Morse and Field method. Content analysis revealed ten important issues that influenced women's treatment-seeking decisions: associating symptoms with non-cardiac causes, minimizing symptoms, experiencing non-classic symptoms, mass media portrayal, male family member experience, knowledge deficit, family insistence, experiencing increased pain, experiencing difficulty breathing, and having expectations different from realities. Based on their language and subjectivity, participants revealed the power of the meaning of heart disease on treatment-seeking decisions. PMID:16537300
Medical abortion offers a new option to womenseeking to terminate their pregnancies. In particular, the mifepristone-misoprostol regimen consists of simple pills, and is potentially suitable for self-administration. Yet access to and administration of this method of abortion remains tightly controlled. Is this strict control medically necessary? This paper identifies the seven steps women would need to accomplish in order
BACKGROUND: Labiaplasty is an increasingly popular surgical intervention but little is known about the characteristics and motivation of women who seek the procedure or the psychosexual outcome. Method A total of 55 womenseeking labiaplasty were compared with 70 women who did not desire labiaplasty. Various general measures of psychopathology as well as specific measures (Genital Appearance Satisfaction; Cosmetic Procedure Screening for labiaplasty) were used. Labia measurements of the womenseeking labiaplasty were also obtained. RESULTS: Womenseeking labiaplasty did not differ from controls on measures of depression or anxiety. They did, however, express increased dissatisfaction towards the appearance of their genitalia, with lower overall sexual satisfaction and a poorer quality of life in terms of body image. Womenseeking labiaplasty reported a significantly greater frequency of avoidance behaviours on all the domains assessed, and greater frequency of safety-seeking behaviours for most of the domains. Key motivations reported for labiaplasty were categorized as cosmetic, functional or sexual. Of the 55 womenseeking labiaplasty, 10 met diagnostic criteria for body dysmorphic disorder. CONCLUSIONS: This is the first controlled study to describe some of the characteristics and motivations of womenseeking labiaplasty. We identified a wide range of avoidance and safety-seeking behaviours, which occurred more frequently in the labiaplasty group than the control group. These could be used clinically as part of a psychological intervention for womenseeking labiaplasty. PMID:23659496
|Presents findings of a research study on how women in information technology (IT) professions seek information on the Web as part of their daily work. Develops a behavioral model of Web information seeking that identifies four complementary modes of information seeking: undirected viewing, conditioned viewing, informal search, and formal search.…
Presents findings of a research study on how women in information technology (IT) professions seek information on the Web as part of their daily work. Develops a behavioral model of Web information seeking that identifies four complementary modes of information seeking: undirected viewing, conditioned viewing, informal search, and formal search.…
OBJECTIVES To determine whether perceived medication use knowledge held and/or needed influenced intention to seek information from pharmacists, whether an information-intention relationship held after accounting for other variables, and whether asking medication use knowledge questions increased pharmacist information-seeking intention. DESIGN Cross-sectional study. SETTING United States during July 2012. PARTICIPANTS Qualtrics national panel members 21 years or older obtaining a new chronic medication within previous 30 days. INTERVENTION Internet-administered survey. MAIN OUTCOME MEASURES Medication information-seeking intention, medication knowledge held and needed, and pharmacist medication information-seeking intention. RESULTS Although knowledge held and needed were initially significant, they became nonsignificant after adding affective and evaluative attitudes, perceived control, and risk. The final best-fitting model explained 21% of variance in pharmacist information-seeking intention. Patient intentions to seek information from pharmacists increased significantly after being asked medication use knowledge questions. CONCLUSION Perceptions of medication risk, attitudes, and information-seeking control predict pharmacist information-seeking intention and offer pharmacists an opportunity to market information services. PMID:24030123
Although therapeutic itineraries have been studied in a variety of contexts, little research has investigated care-seekers’ quests for traditional medical treatments outside their own ethnic boundaries. The present study investigated 19 Igbo womenseeking traditional cures from Ibibio indigenous healers in Akwa Ibom State, Nigeria. Emerging data show that these Igbo women were uptaking Ibibio indigenous treatments primarily for health
C. Otutubikey Izugbara; I. Wilson Etukudoh; A. Sampson Brown
Objective: To determine the prevalence of self-reported abuse in a population of women aged 18 years or older seeking elective pregnancy termination, and to compare abused and nonabused women with respect to the primary reasons for pregnancy termination.Methods: A self-administered questionnaire was returned by 486 womenseeking outpatient abortion. The survey included demographic information, abuse screening, and items regarding partner
SusanS Glander; MaryLou Moore; Robert Michielutte; LinnH Parsons
|Research on the characteristics of women in non-traditional fields, e.g., medicine, has yielded complex information in terms of adherence to sex-role stereotypes. To determine whether students' attitudes toward helping and achieving followed sex-role typing and were different at various stages in medical school, 384 male and female oncology…
Research on the characteristics of women in non-traditional fields, e.g., medicine, has yielded complex information in terms of adherence to sex-role stereotypes. To determine whether students' attitudes toward helping and achieving followed sex-role typing and were different at various stages in medical school, 384 male and female oncology…
This study examined types of internal and external motivations for seeking treatment and the predictive utility of different types of motivation among 180 women with an alcohol use disorder (AUD) participating in a two-armed trial testing different individual and couple therapies for AUDs. Reasons for seeking treatment were coded for type of internal or external motivation. Most women (97%) cited internal reasons for seeking help, including: concern about progression of AUD (61.1%), health (43.3%), mental health (38.9%), and family (38.3%). Occupational concerns, an internal motivator cited by 6% of women, were associated with better drinking outcomes; interpersonal-family concerns were associated with poorer outcomes. Some motivators for seeking treatment may not be related to sustained changes in drinking, suggesting that understanding motivators for treatment may be inadequate to maintain change. Reasons for help-seeking may need to be addressed in treatment to produce long-lasting change. PMID:23501141
Grosso, Justine A; Epstein, Elizabeth E; McCrady, Barbara S; Gaba, Ayorkor; Cook, Sharon; Backer-Fulghum, Lindsey M; Graff, Fiona S
This study used data from a community-based survey to examine women's experiences of abortion in Nigeria. Fourteen percent of respondents reported that they had ever tried to terminate a pregnancy, and 10% had obtained an abortion. The majority of women who sought an abortion did so early in the pregnancy. Forty-two percent of women who obtained an abortion used the services of a non-professional provider, a quarter experienced complications and 9% sought treatment for complications from their abortions. Roughly half of the women who obtained an abortion used a method other than D&C or MVA. The abortion prevalence and conditions under which women sought abortions varied by women's socio-demographic characteristics. Because abortion is illegal in Nigeria except to save the woman's life, many women take significant risks to terminate unwanted pregnancies. Reducing the incidence of unwanted pregnancy and unsafe abortion can significantly impact the reproductive health of women in Nigeria. PMID:17711597
... Digg Google Bookmarks When should I seekmedical attention? Were you exposed to rabies? What materials can ... with soap and water. See your doctor for attention for any trauma due to an animal attack ...
A transient ischaemic attack (TIA) is a warning sign that a debilitating stroke could occur unless preventive action is taken. People with suspected TIAs should be seen urgently in a specialist service that provides rapid assessment, preventive care and treatment. This article highlights the importance of seekingmedical attention urgently for suspected TIAs. It examines how quickly a specialist TIA clinic investigates and treats TIAs. It also identifies factors that affect how quickly patients with TIAs seekmedical attention. PMID:23752453
...Documentation an eligible requester seekingmedical benefits must submit. 102.60 Section...Documentation an eligible requester seekingmedical benefits must submit. A requester...who seeks payment or reimbursement for medical services or items must submit the...
Delay in seeking stroke care costs women best treatment July 22, 2013 Study Highlights: In the Netherlands, women with strokes caused by blood ... Download file. Media playback is not available Ischemic Stroke Animation Download (20.3 MB) Related Links Stroke ...
Despite social and governmental responses to battering, many women continue to feel entrapped in abusive relationships. Using standpoint epistemology, this article examines the various aspects of help seeking, and the social and institutional responses to such efforts, through the narratives of 19 women in a domestic violence shelter. The findings are discussed with reference to Ptacek's social entrapment perspective and Gondolf and Fisher's survivor hypothesis, illustrating the socioeconomic and political context of the control tactics utilized by abusers and the structural impediments to battered women's successful help seeking. PMID:17600305
Background: Delay time from onset of symptoms of myocardial infarction to seekingmedical assistance can have life-threatening consequences. A number of factors have been associated with delay, but there is little evidence regarding the predictive value of these indices. Aim: To explore potential predictors of patient delay from onset of symptoms to time medical assistance was sought in a consecutive
The reasons why women choose medical abortion vary in different countries. In most countries, the most common reasons for choosing medical abortion are as follows: (a) avoidance of surgery or general anesthesia; (b) perception that it is safer; and (c) perception that it is more natural than a surgical procedure. In most studies, over 80% of women who chose medical
The purpose of this study was to compare sexual function between women of infertile couples (AR) and womenseeking tubal ligation (TL). Women who attended Setor de Infertilidade do Serviço de Ginecologia e Obstetrícia do Hospital de Clinicas de Porto Alegre (HCPA) or the Serviço de Orientação e Planejamento Familiar (SERPLAN) completed the Female Sexual Function Index, a questionnaire about
Heitor Hentschel; Daniele Lima Alberton; Robert John Sawdy; Edison Capp; José Roberto Goldim; Eduardo Pandolfi Passos
This article examines online women-seeking-women (WSW) personal ads that engage with tomboy identities and ideologies. This research demonstrates the importance of body and physicality among lesbian personal ads and the diversity of women using online personal ads. The meaning of “tomboy” in the language of WSW personal ads suggests major themes of use including: as an intermediate identity distinct within
Gender differences in pathological gambling disorder (PGD) have received little investigation. This study was constructed to detail the demographic and phenomenological differences in men and women with PGD. We assessed gender differences in 131 subjects with PGD who were evaluated in terms of demographic characteristics, clinical features of PGD, and treatment history. Seventy-eight (60%) subjects were women, and 53 (40%) were men. Men had an earlier age of onset of gambling behavior, while women progressed to pathological gambling sooner after beginning to gamble. In terms of gambling behavior, men were more likely to engage in blackjack, cards, sporting events, and the track, whereas women played slot machines and bingo. Women reported that loneliness was the major trigger to gambling, while men were more likely to gamble secondary to sensory stimuli. Although men were as likely as women to have filed bankruptcy because of gambling, women were more likely to have written bad checks and men were more likely to have lost significant savings. Both groups were equally likely to seek treatment, but Gamblers Anonymous (GA) and outpatient therapy were reported equally ineffective in reducing gambling symptoms. There appear to be some gender differences in the clinical features of PGD, and these differences may have treatment implications. PMID:11788920
Background: Individual disposition of goal orientation and situational factors of the working context, both generate and modulate motives to seek feedback. Aim: We looked for correlations between feedback-seeking and individual goal orientation, motives or concerns of feedback-seeking, working context of medical residents. We focussed on how promotion of feedback-seeking by supervisors and educational environment influenced motives and behaviours of feedback-seeking in residents. Methods: Web-based administration of a Likert-type composite questionnaire to residents of a tertiary care teaching hospital in Switzerland and mini-interviews. Results: Fifty-six (45%) of 125 residents completed the questionnaire. After multiple regression analysis promotion of feedback-seeking through supervisors remained the sole predictor correlating with feedback-seeking through inquiry (R(2?)=?16) and the motive of self-improvement (R(2?)=?0.30). This predictor was also associated with reduced concerns of ego-protection (R(2?)=?0.14) and impression-defence (R(2?)=?0.18). Performance-avoid goal orientation was associated with concerns of impression-defence (R(2?)=?0.36) and ego-protection (R(2?)=?0.48). Women had significantly more concerns of ego-protection, residents with more than three years of experience more concerns of impression-defence. Disillusion that PG-training would ever improve, seemed the main reason to refuse participation Conclusions: Promotion of feedback-seeking through supervisors combined with delivery of high quality feedback may guide residents towards seeking feedback for professional self-improvement. PMID:23808875
Background Women requesting abortion are at increased risk of developing RTI complications. However, RTI control in many resource-poor countries including Vietnam have been faced with logistical and methodological problems due to lack of standardized definitions of RTIs, lack of well-validated diagnostic criteria, lack of accurate laboratory tests, and lack of diagnostic equipment and skills. This article investigates the prevalence of RTIs among Vietnamese abortion-seekingwomen, to evaluate the available diagnostic techniques, and to assess antibiotic resistance among aetiological agents of RTI. Method The study was conducted in Phu-San hospital (PSH) from December 2003 through April 2004 among 748 abortion clients. A structured questionnaire was used to collect data on socio-economic and reproductive characteristics. Specimens were collected for laboratory analyses of chlamydia, gonorrhoea, trichomoniasis, vaginal candidiasis (VC), bacterial vaginosis (BV) and syphilis. To assess the validity of the obtained results, the study was repeated among 100 women and the duplicate samples were analysed at PSH and Copenhagen University Hospital (CUH). Results In all 54% of the women were diagnosed as having an RTI, including 3.3% with sexually transmitted infections. Endogenous infections were most prevalent (VC 34% and BV 12%) followed by chlamydia (1.3%) and trichomoniasis (0.7%). The sensitivity of culture for VC and BV was 30% and 88%, respectively, when tests in PSH were measured against tests in CUH. Antibiotic resistance was common among bacterial isolates. Conclusion RTIs are common among womenseeking abortion. The presence of RTIs is associated with an increased risk of developing iatrogenic infections, routine administration of prophylactic antibiotic to all women undergoing abortion should be considered. However, the choice of routine prophylactic antibiotics should be based on relevant surveillance data of antibiotic resistance. Moreover, since the accuracy of diagnosis is doubtful and to address the problem of under-diagnosed and treated RTIs new investment in diagnostic facilities with simple performed microscopy or improved rapid tests should also be taken into consideration.
Cancer patients in developing countries often delay seekingmedical advice. It can adversely influence the clinicopathological behavior and outcome of the disease process. This study was undertaken to obtain information about initial perceptions of patients presenting with breast lump, subsequent efforts to seekmedical advice, frequency and reasons for delay in seekingmedical advice and its possible impact on clinicopathological
This study explored experiences of women with large breasts who were considering or had had breast reduction surgery. Open-ended questionnaires were returned via email from 32 women, 13 of whom were seeking breast reduction and 19 who had already undergone breast reduction surgery. Transcripts were analyzed using Interpretative Phenomenological Analysis (IPA). Themes arising from this analysis included physical symptoms, information,
The study explored the association between temperament and character and medication adherence in 76 patients with schizophrenia. Patients were assessed with the Temperament and Character Inventory, the Beck Depression Inventory, and the Positive and Negative Syndrome Scale. First-degree relatives were used as informants on adherence. The patients differed in their adherence based on the effect of gender, as males were found to be less adherent than females. Adherence differed based on novelty seeking. The temperament of the patient should be considered during the assessment of adherence. PMID:20630601
The aim of this study was to profile the users of emergency contraception (EC) attending general practices and a general practice out-of-hours co-operative service using a pre-piloted questionnaire. Questionnaires were offered to 171 women and completed by 144 (84.2%). Mean age was 24.4 years (Standard Deviation = 6.7, range 14 to 51). Most were single, 116 (80.6%). Those who had no regular partner at the time of seeking EC were more likely to have > or =6 lifetime sexual partners than those in stable relationships (OR: 3.5; CI: 1.14-10.86, p < 0.03). At the time of seeking EC 121 (84.0%) were using some method of contraception. Ninety-three (64.6%) presented within 24 hours of sexual intercourse. Concerns about condoms were the commonest reason for seeking EC. For 55 (38.2%) this was their first time to use EC. Thirty-three (22.9%) were drunk at the time of intercourse. PMID:16548221
In the literature, uses of the internet by patients are interpreted either as a resource supporting their autonomy, or as a source of perturbation in the doctor-patient relationship. Analysing 50 interviews with pregnant women, this article aims at describing the different uses made during pregnancy. Some women mostly aim at sharing their experience in their use of internet. Others are looking for specialised information, by curiosity, to complement the information received in medical visits or, more rarely, as a result of a lack of information in their exchanges with professionals. Uses of internet by patients will develop in the future and it is important that professionals take into account these different forms of internet use in their practices. PMID:23697085
Background Existing questionnaires to assess barriers against consultation for urinary incontinence (UI) are not appropriate for use in the Middle East culture. The aim of this study was to explore barriers against seeking help for UI and introducing a questionnaire that assess these barriers among those women. This is important before proceeding to any educational programs or having interval clinical audits to help incontinent women. Methods 1- Screening for UI. Women - aged 20 years and older, attending the outpatient Urology and Gynaecology clinics were invited to participate and interviewed by a research nurse. The UDI-6 was administered to assess the presence and type of UI. Women with UI as their chief complaint were excluded. 2- Interviewing study subjects for possible barriers. Subjects who had UI - as determined by the UDI-6-were first asked an open question "what prevented you from seekingmedical consultation for urine leakage?"." They were then asked the proposed questions to assess possible barriers. We developed a preliminary questionnaire based on a review of reasons for not seeking incontinence care from the literature and the response of UI sufferers to the open question in this study. The questionnaire was modified many times to reach this final form. 3- Pilot Study to assess characteristics of the questionnaire. Validity and reliability of the final version of the questionnaire were assessed in a small pilot study including 36 women who completed questionnaire at initial visit and again after 2 weeks. Results Of the 1231 subjects who agreed to participate in the study, 348 reported having UI. About 80% of incontinent women have never sought medical advice. Factors significantly associated with seeking help were husband encouragement, prayer affection and having severe UI. Common barriers were embarrassment and assuming UI as a normal part of aging. A pilot study included 36 women to assess the psychometric properties of the questionnaire after modifying it. The number of missing or not interpretable responses per item ranged from 2.2% to 8.7%. Internal consistency of the items was good. The test-retest reliability of individual items of the questionnaire was variable, with weighted kappa statistics ranging from 0.32 to 0.94 (median, 0.76, p 0.000). Conclusions Preliminary data on our proposed questionnaire show that it is an easy to administer, stable and suits the Middle Eastern culture.
Background Though non-communicable diseases contribute to an increasing share of the disease burden in South Asia, health systems in most rural communities are ill-equipped to deal with chronic illness. This analysis seeks to describe care-seeking behavior among women of reproductive age who died from fatal non-communicable diseases as recorded in northwest rural Bangladesh between 2001 and 2007. Methods This analysis utilized data from a large population-based cohort trial in northwest rural Bangladesh. To conduct verbal autopsies of women who died while under study surveillance, physicians interviewed family members to elicit the biomedical symptoms that the women experienced as well as a narrative of the events leading to deaths. We performed qualitative textual analysis of verbal autopsy narratives for 250 women of reproductive age who died from non-communicable diseases between 2001 and 2007. Results The majority of women (94%) sought at least one provider for their illnesses. Approximately 71% of women first visited non-certified providers such as village doctors and traditional healers, while 23% first sought care from medically certified providers. After the first point of care, women appeared to switch to medically certified practitioners when treatment from non-certified providers failed to resolve their illness. Conclusions This study suggests that treatment seeking patterns for non-communicable diseases are affected by many of the sociocultural factors that influence care seeking for pregnancy-related illnesses. Families in northwest rural Bangladesh typically delayed seeking treatment from medically certified providers for NCDs due to the cost of services, distance to facilities, established relationships with non-certified providers, and lack of recognition of the severity of illnesses. Most women did not realize initially that they were suffering from a chronic illness. Since women typically reached medically certified providers in advanced stages of disease, they were usually told that treatment was not possible or were referred to higher-level facilities that they could not afford to visit. Women suffering from non-communicable disease in these rural communities need feasible and practical treatment options. Further research and investment in adequate, appropriate care seeking and referral is needed for women of reproductive age suffering from fatal non-communicable diseases in resource-poor settings.
Gender differences among a cohort of injured patients seeking emergency medical services were examined with respect to their experiences as perpetrators and/or victims of domestic violence. Contextual issues, including violence initiation, emotional and behavioral responses to partner-initiated violence, and injury frequency and severity were analyzed. Women reported male partner-initiated violence more frequently than men reported female partner-initiated violence. Behavioral responses to partner initiated violence varied. Women were more likely to report using force back and to involve law enforcement. Women were more likely to be injured in a domestic assault over their lifetime, within the last year, and at the time of recruitment. Comparison of injury severity revealed that women reported higher rates of injuries than men in all possible severity categories. Women also reported experiencing more fear than men during partner-initiated violence, as well as being subjected to larger numbers of dominating and controlling behaviors, and greater intimidation secondary to their partner's size. Understanding contextual differences in partner violence for women and men has significant implications for policy development, identification, treatment, and referral of patients identified as living in violent relationships. PMID:16075666
Phelan, Mary Beth; Hamberger, L Kevin; Guse, Clare E; Edwards, Shauna; Walczak, Suzanne; Zosel, Amy
Although therapeutic itineraries have been studied in a variety of contexts, little research has investigated care-seekers' quests for traditional medical treatments outside their own ethnic boundaries. The present study investigated 19 Igbo womenseeking traditional cures from Ibibio indigenous healers in Akwa Ibom State, Nigeria. Emerging data show that these Igbo women were uptaking Ibibio indigenous treatments primarily for health conditions that have failed to respond to initial treatments in their places of origin, were stigmatized at their own places of origin, or and were thought to have resulted from supernatural causes. Care-seeking outside patients' ethnic borders was thus both a quest for a more effective treatment and a strategy for concealing therapeutic progress or and the nature of illness from the patients' places of origin. Findings underscore the critical role of culture and place in health-seeking behaviour and the need for health care services to be responsive to the complex nature of cultural organization involving care-seekers' and the critical ways this plays out in, flows into, and is negotiated through particular places during therapeutic quests. PMID:15550352
Izugbara, C Otutubikey; Etukudoh, I Wilson; Brown, A Sampson
The new consumer?oriented literature on PMS both directly and indirectly suggests that the health care system, and in particular physicians, offer little acknowledgement, understanding or assistance to womenseeking care for perimenstrual distress. In fact clinical reports point to disrespectful, dismissing and antagonistic attitudes on the part of health care providers as an important stress for womenseeking help. Although
HEALTH ISSUE: Research has consistently shown that while women generally live longer than men, they report more illness and use of health care services (including medication). In the literature, the reasons for women's elevated medication use are not clear. This paper investigates the associations between over-the-counter (OTC) and prescription (Rx) medication use and selected social and demographic variables in men
Jennifer Payne; Ineke Neutel; Robert Cho; Marie DesMeules
This study examined information-seeking and its predictors (information needs and barriers) in low-income pregnant women. Eighty-four pregnant women from a prenatal clinic were interviewed using three scales that measured the frequency of information-seeking from eight different sources, information needs for 20 pregnancy health topics, and 15 barriers to seeking information, respectively. Most women were black, unmarried, between 20 and 29 years of age, high school educated or less, multigravidas, and in their third trimester of pregnancy. Information needs and barriers were significant predictors of information-seeking. Together, they explained 26% of the variance in the seeking outcome. High information needs and low barriers predicted more frequent information-seeking. First pregnancy and asthma during pregnancy were significant covariates for information-seeking. Information needs and barriers are related to information-seeking among low-income pregnant women. To facilitate pregnant women's information-seeking, health care providers may assess a woman's need for information and barriers that the woman experiences when seeking information, and factors such as first pregnancy and asthma. PMID:19720337
There has been relatively little research published to guide the field in identifying and addressing barriers to seeking help\\u000a for older women who experience domestic violence (DV). The current article focuses on findings related to external behaviors to help-seeking in the Domestic Violence Against Older Women (DVAOW) study. Data were collected in 21 focus groups with 134\\u000a women, 45 to
Richard L. Beaulaurier; Laura R. Seff; Frederick L. Newman; Burton Dunlop
This article examines online women-seeking-women (WSW) personal ads that engage with tomboy identities and ideologies. This research demonstrates the importance of body and physicality among lesbian personal ads and the diversity of women using online personal ads. The meaning of "tomboy" in the language of WSW personal ads suggests major themes of use including: as an intermediate identity distinct within a butch/femme dichotomy, as a tempering agent for traditional femininity, as a fluid construct of personality, physicality, and body, as an understood descriptor of a particular aesthetic or physicality, and as synonymous with butch. To be a tomboy is to be simultaneously understood as a social stereotype, but also as complex, fluid, and of multiple meanings. PMID:21973069
|Objective: The authors examined the incidence of stalking victimization and subsequent help-seeking behaviors among college women. Participants and Methods: A stratified random sample of college women (N = 391) completed an anonymous Internet-based questionnaire in spring 2006. Results: One-fifth of women reported stalking victimization while…
Buhi, Eric R.; Clayton, Heather; Surrency, Heather Hepler
This multimethod study explored women's information seeking behaviour and decision making regarding menopause, hormone replacement therapy (HRT), and use of complementary and alternative medicines (CAM) during menopause. This research was underway during the mass media release of the Women's Health Initiative (WHI) estrogen–progestin trial results, allowing an examination of the impact of this news on women's decisions. There were two
This paper examines the relative influence of social network norms on sexual risk-taking among womenseeking a new partner in Quebec (Canada). A survey was conducted among 430 women, 30 to 54 years of age, and living without a partner. Condom use is significantly influenced by the norms of women's different social networks: confidants, social circles through which they meet
To determine the images of women in picture advertisements, a stratified random sample of 32 medical journals, representing approximately 12% of medical journals published in the United States that are directed toward physicians in clinical practice, was subjected to content analysis. The sample consists of 209 different ads. The subjects of the ads included men, women, and children representing a
Do men base their self-worth on relationships less than do women? In an assessment of lay beliefs, men and women alike indicated that men are less reliant on relationships as a source of self-worth than are women (Study 1). Yet relationships may make a different important contribution to the self-esteem of men. Men reported basing their self-esteem on their own relationship status (whether or not they were in a relationship) more than did women, and this link was statistically mediated by the perceived importance of relationships as a source of social standing (Studies 1 and 2). Finally, when relationship status was threatened, men displayed increased social-standing concerns, whereas women displayed increased interdependence concerns (Study 3). Together, these findings demonstrate that both men and women rely on relationships for self-worth, but that they derive self-esteem from relationships in different ways. PMID:23658253
Kwang, Tracy; Crockett, Erin E; Sanchez, Diana T; Swann, William B
We examined male partners’ influence on the decision to seekmedical help for infertility using from the National Survey of Fertility Barriers. Building upon an existing help-seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we found an association between couple-level attitudes and medical help-seeking even when other predisposing and enabling conditions existed. Overall, the findings highlight that both partners contribute to the infertility help-seeking process, and that different factors may play a role in different stages of help-seeking. Studies of infertility help-seeking need to be more inclusive of the context that these decisions are embedded within to better understand service use.
Introduction Chronic constipation is significantly more prevalent in women than men in Singapore. We carried out a survey to study patient demographics, symptom prevalence, healthcare-seeking behavior, and patient satisfaction with available treatment options in women with chronic constipation. Methods Responses were collected predominantly via a web-based survey from a panel representative of Singapore’s women population. Eligibility was established using a nine-question screener. Results A total of 1006 invited females took part in an online screener survey, of which 911 respondents did not meet the eligibility requirements for the chronic constipation survey. Of the total panelists consenting to participate (via both online and face-to-face interviews), 100 women met eligibility requirements and took the 22-question survey. Eligible respondents were skewed to younger patients but well mixed in terms of marital status. The majority of them were not keen on doing exercise and were working women, especially white collar females. The majority complained of straining and hard stools as the most common constipation symptoms (88% and 80% respectively) and rated constipation symptoms as severe or moderate. On average, respondents experienced constipation symptoms for 6 to 7 months in the last year. In more than two-thirds of respondents, constipation symptoms were frequent (at least 1 in 3 times). Most of the patients had attempted to treat constipation themselves and 80% had tried laxatives before visiting the doctor. Satisfaction with fiber supplements and laxatives was average and many of the users were not satisfied with their effect. Ineffectiveness and prolonged time taken for the treatment to take effect were the most common reasons for dissatisfaction. Nearly all respondents (97%) were interested in considering alternative prescriptive medication that is proven more effective. Conclusion Chronic constipation symptoms in women are often severe and bothersome, and many patients are dissatisfied with available treatment options primarily because of lack of efficacy.
This research explores the problems that women professors encounter when combining the pursuit of tenure with having and raising children. In-depth interviews were conducted with 19 women academics at one Canadian university. These women believe that engaging in childbearing/childrearing practices prior to obtaining tenure is detrimental to their…
The importance of pets in families, especially during major life stressors, is well documented. Research suggests links between pet ownership and intimate partner violence (IPV). This study explored abused women's decisions about pets when seeking help from a shelter. Interviews were conducted with 19 women who were pet owners. Using grounded theory methods, two patterns emerged surrounding abusers' treatment of pets, bonds to pets, women's decisions about pets upon seeking shelter, and future plans for pets. The presence of coercive control was central to these patterns. Women also discussed their experiences with and needs from shelter professionals and veterinarians with implications for practice. PMID:23670287
Vaginal discharge (safed pani in Hindi, meaning “white water”) is one of the leading symptoms for which women in India seek care. Treatment-seeking for\\u000a safed pani is disproportionately high among poor women, representing a physical, emotional and financial burden for low-income families.\\u000a Safed pani is only rarely indicative of a reproductive tract or sexually transmitted infection. The discrepancy between symptom
Kristin M. KostickStephen; Stephen L. Schensul; Kalpita Jadhav; Rajendra Singh; Amruta Bavadekar; Niranjan Saggurti
Objective Abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seekingwomen in Tehran was the main objective of the present study. Method 278 women of reproductive age (15-49) interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. Results The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. Conclusion Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.
Objective: Body image dissatisfaction is common in treatment-seeking patients with obesity. We aimed to investigate the effects of obesity management on body image in patients with obesity attending Italian medical centers for weight loss programs.Research Methods and Procedures: A total of 473 obese patients seeking treatment in 13 Italian medical centers (80% females; age, 45.9 ± standard deviation 11.0 years;
In the breast cancer literature, "delayed presentation" is defined as a period of 3 months or more between the self-detection of a new breast symptom and the decision to seek help for it. Delay studies have overlooked the relevance of dominant medical discourses such as those concerning "proper" health. In this paper we use a critical discursive method to analyze interviews with 14 women about their symptom appraisal process to demonstrate how many inhabited a liminal space comprised of both "knowing and not knowing" about the symptom, and "acting and not acting" on it (interviews took place from January 2006 to April 2007). We describe three discursive themes that arose in the transcripts including "Doing the right thing", "Deliberate ignorance", and "Passive resistance." These women's narratives are juxtaposed with two commonly accepted medical discourses in relation to self-detected breast symptoms: That of the woman who was unaware of her symptom, or interpreted it as being insignificant, and therefore, not requiring medical attention; or that of the woman who noticed the symptom, interpreted it as threatening, and immediately sought medical attention. We suggest that such discourses are constricting and fail to account for the sizeable number of women who do not fit this mold (i.e., those who are both aware of the concerning change and delay presentation). We conclude that these constricting medical discourses effectively have a role to play in the contradictory reasoning or perceived irrationality of women's delay behavior when it occurs. PMID:22884943
Knowledge about where battered women present for services and the violence, biopsychosocial, and demographic factors associated with their help seeking can provide social workers with guidance in anticipating needs among this portion of their clientele. The authors examined the service contact patterns of a sample of battered women (N = 448)…
Macy, Rebecca J.; Nurius, Paula S.; Kernic, Mary A.; Holt, Victoria L.
BACKGROUND: Infertility is a major reproductive health problem in Africa. This paper presents the findings of two studies which focus on the knowledge that infertile women have about fertility and the causes of infertility, their treatment-seeking behaviour and their expectations of an infertility clinic. METHODS: A total of 150 infertile women from a culturally diverse, urban community in South Africa
S. J. Dyer; N. Abrahams; M. Hoffman; Z. M. van der Spuy
|The authors explored the extent to which Asian American college women's perceived stigma about counseling mediated the relationship between their adherence to Asian cultural values and intentions to seek counseling, Participants, 201 Asian American college women (age range = 18-24 years), completed measures of Asian cultural values, perceived…
BACKGROUND: Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of womenseeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation
Elisabeth Kurth; Fabienne N Jaeger; Elisabeth Zemp; Sibil Tschudin; Alexander Bischoff
Breast cancer is the most frequently occurring malignancy among women in India, however, the recorded stage distribution at presentation in India is less favorable than in Europe. Health beliefs are important in help-seeking for potential symptoms of disease, which may be particularly important among women who do not have access to breast screening programs. The purpose of this study was
The purpose of this study was to propose and test a model of attachment insecurity in a clinical sample of 268 eating disordered women. Structural relationships among attachment insecurity, BMI, perceived pressure to diet, body dissatisfaction, restrained eating, and negative affect were assessed. A heterogeneous sample of treatment seekingwomen with a diagnosed eating disorder completed psychometric tests prior to
Giorgio A. Tasca; John Kowal; Louise Balfour; Kerri Ritchie; Barbara Virley; Hany Bissada
Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help. PMID:23098462
Norsa'adah, Bachok; Rahmah, Mohd Amin; Rampal, Krishna Gopal; Knight, Aishah
Women who seekmedical care following sexual assault are usually evaluated and treated in an emergency department (ED). Therefore, EDs can be an important source of sexual assault surveillance data. The authors compared the incidence of sexual assault presenting for emergency care in a single county during July to November of 1974 and 1991. Participants included all female sexual assault
David J. Magid; Debra Houry; Thomas D. Koepsell; Andrew Ziller; Michael R. Soules; Carole Jenny
|This survey-based study examined the information-seeking behaviour of traditional medical practitioners using Taylor's information use model. Respondents comprised all 160 traditional medical practitioners that treat sickle cell anaemia. Data were collected using an interviewer-administered, structured questionnaire. Frequency and percentage…
Medical termination of pregnancy with mifepristone, a progesterone antagonist, is available to women in North America, the United Kingdom, much of Western Europe, Russia, China, Israel, New Zealand, Turkey and Tunisia, but not Australia. • Experience of mifepristone use in around two million abortions has shown that it is safe, effective, cheap to produce, and highly acceptable to women. •
This paper explores the magnitude of physical violence by husbands, the disclosure of it and the help-seeking behavior of abused women in urban and rural Bangladesh. The data come from a larger study on domestic violence against women conducted in Bangladesh during 2000–2004. All ever-married women covered by the population-based survey component (n=2702) conducted in 2001 were included in the
Ruchira Tabassum Naved; Safia Azim; Abbas Bhuiya; Lars Åke Persson
Objective: The authors examined the incidence of stalking victimization and subsequent help-seeking behaviors among college women. Participants and Methods: A stratified random sample of college women (N = 391) completed an anonymous Internet-based questionnaire in spring 2006. Results: One-fifth of women reported stalking victimization while enrolled at their current institution. Individuals known by victims, such as the following, were most
Eric R. Buhi; Heather Clayton; Heather Hepler Surrency
Abstract Background Epidemiological studies have consistently reported rates of posttraumatic stress disorder (PTSD) in women that are twice that of men. In men and women, PTSD has been associated with comorbid medical conditions, medical symptoms and lower self-rating of health. In low-income urban women, rates of PTSD are even more elevated than in suburban women and may be related to observed health disparities. Methods In this study, 250 womenseeking healthcare at an urban clinic were interviewed for a PTSD diagnosis, major depressive disorder (MDD), the experience of traumatic events, the experience of current and past common medical conditions and symptoms, and subjective rating of health. A chart review was used to assess healthcare use in the past year. Results More current (5.2 vs. 3.8, p?0.05) and past medical conditions (4.6 vs. 3.3, p?0.05) were reported by women with a lifetime history of PTSD than by women without this history, after controlling for demographics and current depression. Women with lifetime PTSD also had more annual clinic appointments (5.9 vs. 3.8 p?0.03) and were 2.4 times (p?0.05) more likely to report lower appraisal of their physical health. Conclusions These findings suggest that urban health-seekingwomen with PTSD experience health impairments that may cause increased morbidity and that healthcare providers should consider the health ramifications of PTSD when providing medical care to women.
As the number of women serving in the military continues to grow, it is increasingly important to explore the sequelae of military sexual trauma (MST) among female veterans. The current study included 232 female veterans who sought outpatient mental health treatment at an urban Veterans Affairs hospital. The study's aims were to (a) describe and compare the demographic characteristics, health
Erin L. Rowe; Jaimie L. Gradus; Suzanne L. Pineles; Sonja V. Batten; Eve H. Davison
Background: Delay in seeking care for sexually transmitted diseases (STDs) has adverse consequences for both the individual and population. We sought to identify factors associated with delay in seeking care for STDs. Methods: Subjects included 300 young men and women (aged 15-24) attending an urban STD clinic for a new STD-related problem due to symptoms or referral for an STD screening. Subjects completed a structured interview that evaluated STD history, attitudes and beliefs about STDs, depression, substance use, and other factors possibly associated with delay. Delay was defined as waiting > 7 days to seek and obtain care for STDs. Results: Nearly one-third of participants delayed seeking care for > 7 days. Significant predictors for delay included self-referral for symptoms as the reason for visit (OR 5.3, 95% CI: 2.58 – 10.98), and the beliefs “my partner would blame me if I had an STD” (OR 2.44, 95% CI: 1.30 – 4.60) and “it’s hard to find time to get checked for STDs” (OR 3.62, 95% CI: 1.95 – 6.69), after adjusting for age, race, sex, and other factors. Agreeing with the statement “would use a STD test at home if one were available” was associated with a decrease in delay (OR 0.24, 95% CI: 0.09 – 0.60). Conclusions: Many young persons delay seeking care for STDs for a number of reasons. Strategies to improve STD care-seeking include encouragement of symptomatic persons to seekmedical care more rapidly, reduction of social stigmas, and improved access to testing options.
Malek, Angela M.; Chang, Chung-Chou H.; Clark, Duncan B.; Cook, Robert L.
... place. Keep important personal papers, money and prescription medications handy so that you can take them with you on short notice. Know exactly where you'll go and how you'll get there. Protect your communication and location An abuser can use technology to ...
This study explored the ways in which urban, older, African American women obtain health information and some of the factors that influence such activity. Among the possible determinants examined were self-perceived literacy, access to health information, and mobility. The findings suggest that respondents receive health information from their physicians, the mass media, and members of their social networks. The results of this research also indicated that members of this population have a highly positive perception of the public library, although only a small segment use the library regularly, and that it may be in the interest of the library to investigate the role it could play in providing health information to older adults.
Studies suggest that the experiences of unmarried young womenseeking abortion in India differ from those of their married counterparts, but the evidence is limited. Research was undertaken among nulliparous young women aged 15–24 who had abortions at the clinics of a leading NGO in Bihar and Jharkhand. Over a 14-month period in 2007–08, 246 married and 549 unmarried young
Shireen J Jejeebhoy; Shveta Kalyanwala; AJ Francis Zavier; Rajesh Kumar; Nita Jha
Background: Illicit substance use and abuse may be an important contributor to behavioral health problems of lesbian and bisexual women. This paper describes the nature and extent of self-reported illicit and licit drug use, associated severity, and substance use-related help- seeking behaviors in an urban\\/metropolitan community sample of sexual minority women in California. Methods: Self-administered questionnaire data from 2011 lesbian
Heather L. Corliss; Christine E. Grella; Vickie M. Mays; Susan D. Cochran
The current study examined the influence of legal status and cultural variables (i.e., acculturation, gender role ideology\\u000a and religious coping) on the formal and informal help-seeking efforts of Latino women who experienced interpersonal victimization.\\u000a The sample was drawn from the Sexual Assault Among Latinas (SALAS) Study that surveyed 2,000 self-identified adult Latino\\u000a women. The random digit dial methodology employed in
Chiara Sabina; Carlos A. Cuevas; Jennifer L. Schally
To examine the influence of race/ethnicity on seeking health information from the Internet among women aged 16-24 years, the authors conducted a self-administered survey on 3,181 women regarding their Internet use and obtaining information on reproductive health (menstruation, contraception, pregnancy, sexually transmitted infections) and general health from the Internet. The authors performed multivariate logistic regression to examine the association between race/ethnicity and online health-related information seeking after adjusting for covariates. Racial/ethnic disparities were noted in overall Internet use and its use to locate health information. Overall, more White (92.7%) and Black (92.9%) women used the Internet than did Hispanics (67.5%). More White women (79.2%) used it to find health information than did Blacks and Hispanics (70.3% and 74.3%, respectively). Compared with White women, Blacks and Hispanics were less likely to seek information on contraception [(OR 0.73, 95% CI 0.58-0.91) and (OR 0.75, 95% CI 0.61-0.92)] and more likely to seek information on pregnancy tests [(OR 1.67, 95% CI 1.28-2.18) and (OR 1.40, 95% CI 1.09-1.81] and sexually transmitted infections [(OR 1.39, 95% CI 1.11-1.73) and (OR 1.25, 95% CI 1.01-1.54)], respectively. With regard to general health issues-such as how to quit smoking, how to lose weight, alcohol/drug use, mood disorders, and skin disorders-Blacks, but not Hispanics, were significantly less likely to seek online information than were Whites. Disparities in the way that women from different backgrounds use the Internet for health-related information could be associated with overall health awareness. PMID:23130608
|Research with refugees and asylum seekers tends to be divided into research with adults or research with children under the age of 18. This is despite relational approaches to studying age that contest such dichotomous and fixed understandings of "life-stages". This article seeks to provide an insight into the experiences of young women who in…
Couseling in legal abortions have previously focused only on the women who seek such abortions and has neglected their partners. A program of group counseling for these men was developed at an abortion clinic. The program was influenced by two major theoretical approaches: crisis intervention and group psychotherapy. The purpose of this paper is to propose a foundation for further
“Take Charge. Take the Test.” (TCTT), a media campaign promoting HIV testing among African American women, was piloted in Cleveland and Philadelphia from October 2006 to October 2007. This study assesses TCTT's effectiveness in promoting HIV testing information seeking among target audiences in each pilot city. The authors analyzed data on telephone hotlines promoted by the campaign and the www.hivtest.org
Kevin C. Davis; Jennifer Uhrig; Douglas Rupert; Jami Fraze; Joshua Goetz; Michael Slater
Even though the number of womenseeking reconstruction after mastectomy has risen during the last decade from 10% to 30%, this percentage remains low. Research suggests that quality of life improves after breast reconstruction. This raises the question as to why reconstructive surgery is not performed more often. Could it be that only those patients asking for reconstructive surgery experience
K. M. E. Wehrens; W. J. S. S. Cuypers; W. D. Boeckx; R. R. W. J. van der Hulst
OBJECTIVE: To better understand parental beliefs regarding the etiology and treatment of nocturnal enuresis (NE). METHODS: A self-administered survey queried parental NE beliefs including perceived etiologies and home behavioral treatments. We assessed for associations between demographic characteristics and propensity to seekmedical care for NE. RESULTS: Of 216 respondents, 78% were female. The most common causes for NE reported were: deep sleeper (56%), unknown (39%), and laziness (26%). Popular home behavioral therapies included: void prior to sleep (77%) and limiting fluid intake at night (71%). Few reported they would use a bedwetting alarm (6%). Fifty-five percent reported they would seekmedical care for NE and 28% reported awareness of effective treatments. On multivariable analysis, females (OR 2.3, 95% CI 1.04-5.0) and those with graduate level education (OR 4.8, 95% CI 1.5-15.7) were more likely to seekmedical care for their child with NE. CONCLUSIONS: General parental knowledge of the causes and effective treatments for NE is lacking. Only 55% reported they would seekmedical care for their child with NE and only 28% reported awareness of effective treatments. Counseling should focus on dispelling common misconceptions about causes and treatments of NE and focus on proven effective treatments. PMID:23608323
|Objective: To examine the factors that influenced African American men's medical help seeking. Method: Thematic analysis of 14 focus groups with 105 older, urban African American men. Results: African American men described normative expectations that they did not go to the doctor and that they were afraid to go, with little explanation. When…
Griffith, Derek M.; Allen, Julie Ober; Gunter, Katie
The number of migrants arriving in Canada from non-European countries has grown significantly over the past three decades. How best to assist these escalating numbers of immigrant and refugee women to adapt to their new environment and to cope with postpartum depression (PPD) is a pressing issue for healthcare providers. Evidence has shown that immigrant and refugee women experience difficulties in accessing care and treatment for PPD. This qualitative study was conducted with 30 immigrant and refugee women using in-depth interviews to obtain information about the women's PPD experiences. The primary aim was to explore how cultural, social, political, historical and economic factors intersect with race, gender and class to influence the ways in which immigrant and refugee womenseek help to manage PPD. Results reveal that immigrant and refugee women experience many complex gender-related challenges and facilitators in seeking equitable help for PPD treatment and prevention. We will demonstrate that (a) structural barriers and gender roles hinder women's ability to access necessary mental healthcare services and (b) insecure immigration status coupled with emotional and economic dependence may leave women vulnerable and disadvantaged in protecting themselves against PPD. PMID:22962942
Aims Objectives of this study are: 1) To examine the prevalence of healthcare seeking among black and white women with self-reported urinary incontinence (UI), 2) To investigate barriers to treatment for incontinence, and 3) To investigate commonly used therapeutic modalities for UI. Methods This is a planned secondary analysis of responses from 2812 black and white community-dwelling women living in southeastern Michigan, aged 35-64 years, who completed a telephone interview concerning UI, healthcare-seeking behaviors and management strategies. The study population was 571 subjects (278 black, 293 white) who self-identified as having urinary incontinence. Results Of these women with UI, 51% sought healthcare with no statistically significant difference between the two races (53% black, 50.6% white, p 0.64). In multivariate logistic regression analysis, a higher likelihood of seeking healthcare was associated with increased age, body mass index lower than 30 kg/m2, prior surgery for UI, having regular pelvic exams, having a doctor, and worsening severity of UI. There was no significant association between hypothesized barriers to care seeking and race. Almost 95% of the subjects identified lack of knowledge of available treatments as one barrier. Black and white women were similar in percentage use of medications and some self-care strategies, e.g., pad wearing and bathroom mapping, but black women were significantly more likely to restrict fluid intake than white women and marginally less likely to perform Kegels. Conclusions Black and white womenseek healthcare for UI at similar, low rates. Improved patient-doctor relationships and public education may foster healthcare seeking behavior.
Berger, MB; Patel, DA; Miller, JM; DeLancey, JO; Fenner, DE
The aim of this study was to describe the knowledge and health-seeking behaviour related to sexually transmitted infections (STIs) and abortion among women selling sex in Lahore, Pakistan. This was a cross-sectional, community-based, quantitative study. A total of 730 women selling sex were recruited by respondent-driven sampling. A pretested structured questionnaire was administered through face-to-face interviews. The median age of the participants was 30 years. Thirteen percent of the participants said it was common for them to have an abnormal vaginal discharge. Seventy-five percent of the participants recognized STIs as either leucorrhoea or AIDS. Sixty-five percent of the participants complained of having suffered from STI(s) in the six months preceding the survey, of whom 28% sought treatment. Women selling sex who reported consistent condom use were 1.5 times (95% confidence interval [CI]: 1.1-2.2) more likely to seek treatment than women who did not report consistent condom use. The level of knowledge about STIs remains low among women selling sex in Lahore, Pakistan, and health-seeking behaviour for the management of STIs and abortions is influenced by ability to pay and ease of access in the private sector. PMID:21729955
Khan, M S; Unemo, M; Zaman, S; Lundborg, C Stålsby
Maternal mortality remains one of the biggest public health challenges in Nepal. This paper explores the health seeking behavior, during pregnancy and child birth in certain ethnic group. The poverty, illiteracy, women's low status in the society, lack of access and difficult geographical terrain are major reasons for poor maternal health status in Nepal. Cross-sectional study was conducted among 200 Muslim women of ward # 7 of Biratnagar municipality. They were interviewed to understand their health seeking behavior during pregnancy and childbirth, factors associated with use of health services and their role in the family. Information's on usages of health services, education level, family stricture, and occupational status, information were collected using a pretested and structured questionnaire. The overall institutional delivery in study population was found 24.5%. Low socio-economic status, Illiteracy and poverty in women are the major challenging features of pregnancy and child birth. PMID:23671962
Pokhrel, B R; Sharma, P; Bhatta, B; Bhandari, B; Jha, N
The objective of this study was to investigate the health-seeking practices of pregnant women in a periurban area in Cape Town, South Africa. This qualitative study was based on 103 minimally structured in-depth interviews of 32 pregnant women. Most women were interviewed on several occasions, and a group discussion was held with women. The interviews were taped, transcribed, analyzed ethnographically,
Background HPV infection in women from developing countries is an important public health problem. Therefore, we sought to determine the prevalences of HPV infection and HPV genotypes in a female population of Durango City, Mexico. Also to determine whether any socio-demographic characteristic from the women associated with HPV infection exists. Methods Four hundred and ninety eight womenseeking cervical Papanicolaou examination in three public Health Centers were examined for HPV infection. All women were tested for HPV DNA PCR by using HPV universal primers. In addition, all positive HPV DNA PCR samples were further analyzed for genotyping of HPV genotype 16, 18 and 33. Socio-demographic characteristics from each participant were also obtained. Results Twenty-four out of four hundred and ninety-eight (4.8%) women were found infected by HPV. HPV genotype 16 was found in 18 out of the 24 (75%) infected women. Two of them were also coinfected by HPV genotype 18 (8.3%). In the rest 6 PCR positive women, genotyping for HPV genotypes 16, 18 and 33 were negative. Conclusion The prevalence of HPV in women of Durango City is low; however, most infected women have high risk HPV genotype. The women who were studied showed low frequency of risk factors for HPV infection and this may explain the low prevalence of HPV infection. The high frequency of high risk HPV genotypes observed might explain the high rate of mortality for cervical cancer in our region.
Sanchez-Anguiano, Luis Francisco; Alvarado-Esquivel, Cosme; Reyes-Romero, Miguel Arturo; Carrera-Rodriguez, Margarita
|In total, 123 battered Korean women who used domestic violence agencies were asked where they had turned for assistance in response to intimate partner violence. This study examined the factors related to use of formal and informal resources by these women. Formal resources included police, medical, legal, and shelter; informal were family or…
Background In the Dominican Republic, a Latin American country with filariasis-endemic areas, more than 63,000 people have lymphatic filariasis and more than 400,000 people are at risk of future infection. In this paper, we explore the health beliefs, health-seeking behaviors and self-care practices of women with lymphoedema in filariasis-endemic areas to better understand the needs of women when developing lymphoedema morbidity control programs. Methods Qualitative data were collected through semi-structured interviews of 28 women, 3 focus group discussions with 28 women, field notes and photographs. Results Women described exhaustive and expensive attempts at seeking a cure for their lymphoedema. Family members were influential in providing women with initial care seeking referrals to indigenous healers credited with influence over physical, mental, spiritual and supernatural properties of illness. When indigenous treatments proved to be ineffectual, the women sought care from trained healthcare providers. Most healthcare providers incorrectly diagnosed the edema, failed to adequately treat and meet the needs of women and were viewed as expensive. Most women resorted to self-prescribing injectable, oral, or topical antibiotics along with oral analgesics as a standard practice of self-care. Conclusion Healthcare providers must understand a woman's cultural perspectives of illness, her natural networks of support and referral, her behavioural practices of care-seeking and self-care and the financial burden of seeking care. In the culture of the Dominican Republic family members and traditional healthcare providers are influential advisors on initial health-seeking behaviors and self-care practices. For this reason family-oriented interventions, support groups for women and their families, community education and training on simple, low cost lymphoedema management techniques for indigenous healers are viable ways to influence the early detection, diagnosis and treatment of women with lymphoedema. The extensive use of injectable, oral and topical antibiotics by indigenous healers and women without medical supervision suggests a need for health education messages related to the risks of such practices.
Person, Bobbie; Addiss, David G; Bartholomew, L Kay; Meijer, Cecilia; Pou, Victor; van den Borne, Bart
Over the past three decades, international covenants have been signed and countries have implemented strategies and legislation to address violence against women. Concurrently, strong evidence on the magnitude and impact of violence against women has emerged from around the world. Despite a growing understanding of factors that may influence women's vulnerability to violence and its effects, key questions about intervention options persist. Using evidence from a WHO household survey on domestic violence, our paper discusses women's help-seeking patterns and considers these findings in relation to Brazil's policies and strategies on violence against women. For the WHO survey, data from a large urban center (the city of São Paulo) and from a rural region (Zona da Mata Pernambucana [ZMP]) was collected. Findings from this survey indicate that in São Paulo, only 33.8% of women who experienced intimate partner violence (IPV) sought help from a formal service provider, including health, legal, social, or women's support services; in the Forest Zone of the State of Pernambuco, an even smaller proportion (17.1%) sought formal assistance. The majority of women were likely to contact only informal sources of support, such as family, friends, and neighbors. Women who used formal services were primarily those who experienced more severe levels of violence, were severely injured, had children who witnessed the violence, or whose work was disrupted by the violence. Although Brazil adopted progressive laws and national and local strategies to address violence against women (VAW), messages about violence and equality need to reach informal networks and the wider community in order to national anti-violence policies to be successful in supporting women before violence becomes intolerable.. To translate international standards and national policies into actions that genuinely reach women experiencing violence, states must carefully consider evidence on women's options and decision making. PMID:22773099
Kiss, Ligia; d'Oliveira, Ana Flavia Lucas; Zimmerman, Cathy; Heise, Lori; Schraiber, Lilia Blima; Watts, Charlotte
Curiosity, composed of two factors: exploration and absorption, has been previously associated with life satisfaction, life meaningfulness, and enhanced positive affect. It also shares some overlap with sensation seeking, which has been linked to alcohol use and other addictive behaviors. The present research explored the association between curiosity and college women's problematic drinking in the context of sensation seeking. Participants (79 women) completed questionnaires measuring curiosity, sensation seeking, alcohol consumption, and consequences related to alcohol consumption. A zero-inflated negative binomial model indicated that curiosity and sensation seeking accounted for unique variance in alcohol-related problems after controlling for drinking. The curiosity factors had opposing relationships to alcohol-related problems: higher scores on absorption were associated with more alcohol-related problems whereas higher scores on exploration were associated with fewer alcohol-related problems. Should findings be replicated, the curiosity factors may represent additional prevention and intervention targets. Future directions for research about curiosity and drinking and for the inclusion of positive psychology constructs in addictive behaviors research are discussed. PMID:20080358
Lindgren, Kristen P; Mullins, Peter M; Neighbors, Clayton; Blayney, Jessica A
A case of congenital rubella syndrome has been the reason to seek damages but a Civil Court of Rome sentenced against this and in favor of sued doctors. We discussed the high level of social attention and the feeling present in our western culture behind the request for damages. Legal considerations above the Italian abortion Law is provided to understand the framework of the court decision. Ethical, medical, and public health issues are commented and compared with the Perruche's case. PMID:21231850
Verghini, Emanuele; Di Pietro, Maria Luisa; Virdis, Andrea; De Luca, Daniele
The purpose of this study was to propose and test a model of attachment insecurity in a clinical sample of 268 eating disordered women. Structural relationships among attachment insecurity, BMI, perceived pressure to diet, body dissatisfaction, restrained eating, and negative affect were assessed. A heterogeneous sample of treatment seekingwomen with a diagnosed eating disorder completed psychometric tests prior to receiving treatment. The data were analysed using structural equation modeling. Fit indices indicated that the hypothesized model fit adequately to the data. Although cross-sectional in nature, the data suggested that attachment insecurity may lead to negative affect. As well, attachment insecurity may lead to body dissatisfaction, which in turn may lead to restrained eating among women with eating disorders. Attachment insecurity could be a possible vulnerability factor for the development of eating disorder symptoms among women. PMID:16843228
Tasca, Giorgio A; Kowal, John; Balfour, Louise; Ritchie, Kerri; Virley, Barbara; Bissada, Hany
Physical injuries among battered women represent risks for both acute and long-term physical health functioning. The current study assessed the nature and extent of minor and severe injuries among a help-seeking sample of battered women. Hierarchical regression analyses were conducted to assess the unique roles of physical violence, sexual coercion, psychological abuse, and stalking to the prediction of minor and severe injuries in battered women. Not unexpectedly, length of relationship abuse and severity of physical aggression were the most robust predictors of minor and severe physical injuries. Consistent with other research findings, psychological abuse and stalking, as a block, contributed uniquely to the prediction of severe injuries. Results are discussed in terms of implications for future research and intervention with battered women.
Mechanic, Mindy B.; Weaver, Terri L.; Resick, Patricia A.
Predictors of body image dissatisfaction (BID) among obese people are poorly understood. In 79 obese womenseeking weight reduction, associations with BID of self-esteem, youth teasing, adult teasing, and internalization of sociocultural appearance standards (ISAS) were studied. Analyses revealed that only self- esteem, adult teasing, and ISAS predicted BID. Results highlight the importance of adulthood self-esteem and interpersonal-cultural context—rather than
Patty E. Matz; Gary D. Foster; Myles S. Faith; Thomas A. Wadden
Aims: This study aimed to determine the sociological characteristics of abortion seekers according to marital status and previous induced abortions in a major regional hospital in Nanjing, China. Methods: A cross-sectional survey was conducted through face-to-face interviews using a structured questionnaire in womenseeking abortion at Nanjing Maternal and Child Health Care Hospital in China in 2003. Results: The average
We randomized 332 women, 18–24 years old, who were not explicitly seeking treatment for their marijuana use to either a two-session motivationally focused intervention or an assessment-only condition. Assessed by timeline follow-back methodology, participants reported using marijuana 57% of days in the 3 months prior to study entry. Intervention effects on the likelihood of marijuana use were not statistically significant
Michael D. Stein; Claire E. Hagerty; Debra S. Herman; Maureen G. Phipps; Bradley J. Anderson
The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 womenseeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis were detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p less than 0.001). Compared with isolation, chlamydial antibodies at a titre of greater than or equal to 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of greater than or equal to 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening womenseeking abortion.
The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 womenseeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis were detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p less than 0.001). Compared with isolation, chlamydial antibodies at a titre of greater than or equal to 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of greater than or equal to 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening womenseeking abortion. PMID:3278017
|Efforts to understand and support the process of help seeking by victims of intimate partner violence are of considerable urgency if we are to design systems and responses that are capable of actively and appropriately meeting the needs of victims. Using data from the New Zealand Violence Against Women Study, which drew from a representative…
High levels of stress and depression in medical students is raising concern. In this study, we sought to identify coping strategies and other factors influencing academic stress in medical students. We enrolled 157 students from the University of Ulsan College of Medicine, Korea, in November, 2010. We used the Medical Stress Scale, Temperament and Character Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Coping Response Inventory to assess psychological parameters. We used Pearson's correlation and linear regression analyses to analyze the data. Novelty-seeking, self-directedness, cooperativeness, coping strategy, and depression scale scores all correlated significantly with stress level. Linear regression analysis indicated that students who are novelty-seeking, likely to use avoidant coping strategies, and unlikely to use active-cognitive and active-behavioral strategies tend to have higher stress levels. Reduction of stress in medical students may be achieved through evaluation of coping strategies and personality features and use of interventions to promote active coping strategies. PMID:22901439
An, Hoyoung; Chung, Seockhoon; Park, Jangho; Kim, Seong-Yoon; Kim, Kyung Mo; Kim, Ki-Soo
Background Reproductive morbidity has a huge impact on the health and quality of life of women. We aimed to determine the prevalence of reproductive morbidities and the health seeking behavior of a nationally representative sample of Iranian urban women. Methods A sample of 1252 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure. Data were collected through interviews and physical, gynecological and ultrasonographic examinations. Results Reproductive tract infection (RTIs), pelvic organ prolapse (POP) and menstrual dysfunction were the three main groups of morbidities with a prevalence of 37.6%, 41.4% and 30.1%., respectively. Our study demonstrated that 35.1, 34.5 and 9.6 percent of women experienced one, two or these reproductive organ disorders mentioned, respectively, while 20.6 percent of participants had none of these disorders. Findings also showed that the majority of women who suffered from reproductive morbidities (on average two out of three) had not sought appropriate care for these except for infertility. Conclusions Reproductive health morbidities impose a large burden among Iranian women and have negative impact on their reproductive health and wellbeing.
In this descriptive correlational study, 48 African American women were assessed for delay in care-seeking for breast cancer symptoms by examining: (a) relationships between selected psychosocial variables (fear, denial, utility, and social norm) and delay, (b) relationships between delay and having an identified health provider, affordable health care services, and accessible health-care services, (c) whether denial would mediate the effect of fear on delay, (d) whether utility would moderate the effects of social norm and facilitating conditions on delay, and (e) whether denial was related to escape-avoidance coping. Participants completed mailed questionnaires. Pearson correlation and separate regression analyses showed that denial was associated with increased delay. Confrontive coping, social support, and problem-solving strategies had no relationship with delay. Interventions focusing on denial could help enhance early care seeking. PMID:17893935
BackgroundMedication abortion has the potential to increase abortion availability, primarily through new provider networks; however, without a better understanding of how and why women make decisions regarding both their abortion method and their provider, expansion efforts may be misguided and valuable resources may be wasted.
The study's (n = 447) purposes were to (1) describe relationships of abuser behavior to elder women's perception of barriers to help-seeking; (2) compare fit of model to participants' levels of abuse, race-ethnicity, age, and gender and relationship of identified close other; and (3) determine extent to which the model differentiated relationship of abuser to participant and level of abuse. Analyses identified six factors contributing to the overall barrier score, accounting for 84% of total variance (?2/df = 1.527, CFI = .989, RMSEA = .034), including three internal and two external factors and a single abuser behavior factor that were invariant across participant characteristic; however, covariances did differ. PMID:23627428
Newman, Frederick L; Seff, Laura R; Beaulaurier, Richard L; Palmer, Richard C
Veterinary medical students at Iowa State University were surveyed in January of 1997 to determine their general use of the Veterinary Medical Library and how they sought information in an electronic environment. Comparisons were made between this study and one conducted a decade ago to determine the effect of the growth in electronic resources on student library use and information-seeking behavior. The basic patterns of student activities in the library, resources used to find current information, and resources anticipated for future education needs remained unchanged. The 1997 students used the library most frequently for photocopying, office supplies, and studying coursework; they preferred textbooks and handouts as sources of current information. However, when these students went beyond textbooks and handouts to seek current information, a major shift was seen from the use of print indexes and abstracts in 1987 towards the use of computerized indexes and other electronic resources in 1997. Almost 60% of the students reported using the Internet for locating current information. Overall use of electronic materials was highest among a group of students receiving the problem-based learning method of instruction. Most of the students surveyed in 1997 indicated that electronic resources would have some degree of importance to them for future education needs. The electronic environment has provided new opportunities for information professionals to help prepare future veterinarians, some of whom will be practicing in remote geographical locations, to access the wealth of information and services available on the Internet and Web.
BACKGROUND: 'Concordance' has been proposed as a new approach towards sub-optimal medication use; however, it is not clear how this may be achieved in practice. AIM: To develop a strategy for understanding sub-optimal medication use and seek concordance during primary care consultations. DESIGN: A developmental qualitative study using a modified action research design. SETTING: Three Scottish general practices. METHOD: Patients using treatment sub-optimally and having poor clinical control were offered extended consultations to explore their situation. Their authority to make treatment decisions was made explicit throughout. Clinicians refined a consultation model during ten 'Balint-style' meetings that ran in parallel with the analysis. The analysis included all material from the consultations, meetings, and discussion with patients after the intervention. RESULTS: Three practitioners recorded 59 consultations with 24 adult patients. A six-stage process was developed, first to understand and then to discuss existing medication use. Understanding of medication use was best established using a structured exploration of patients' beliefs about their illness and medication. Four problematic issues were identified: understanding, acceptance, level of personal control, and motivation. Pragmatic interventions were developed that were tailored to the issues identified. Of the 22 subjects usefully engaged in the process, 14 had improved clinical control or medication use three months after intervention ceased. CONCLUSIONS: A sensitive, structured exploration of patients' beliefs can elucidate useful insights that explain medication use and expose barriers to change. Identifying and discussing these barriers improved management for some. A model to assist such concordant prescribing is presented.
This study uses National Violence against Women Survey data to investigate the differential impact of concomitant forms of violence (sexual abuse, stalking, and psychological abuse) and ethnicity on help-seeking behaviors of women physically abused by an intimate partner (n = 1,756). Controlling for severity of the physical abuse, women who experienced concomitant sexual abuse are less likely to seek help, women who experienced concomitant stalking are more likely to seek help, whereas concomitant psychological abuse is not associated with help seeking. Ethnic differences are found in help seeking from friends, mental health professionals, police, and orders of protection. Implications for service outreach are discussed. PMID:21821618
Flicker, Sharon M; Cerulli, Catherine; Zhao, Xi; Tang, Wan; Watts, Arthur; Xia, Yinglin; Talbot, Nancy L
Background Reproductive tract infections (RTI's) are endemic in developing countries and entail a heavy toll on women. If untreated, RTI's can lead to adverse health outcomes such as infertility, ectopic pregnancy and increased vulnerability to transmission of the human immunodeficiency virus. It is also associated with adverse pregnancy outcomes. While RTI's and its sequelae abound in Nigeria, there is paucity of publications on the subject in the country. This study assessed the understandings and care seeking behavior with regards to RTI's among women of reproductive age in Lagos, Nigeria with the aim of improving awareness on the subject. Methods A descriptive cross sectional survey of women attending the gynaecological outpatient and family planning clinics of the Lagos State University Teaching Hospital was carried out between 1st June 2008 and 31st August 2008 using a pre-tested questionnaire. Data was analysed using the Epi-Info 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta U.S.A. Results Most of the respondents (77.2%) had heard of RTI's. Toilet was the most perceived mode of contracting RTI's (44.6%), followed by sexual intercourse and poor hygiene. Vaginal discharge was the commonest symptom of RTI's named while inability to get pregnant was the commonest named complication. Majority of the respondent's demonstrated poor overall knowledge of symptoms and complications of RTI"s. 37.4% of the respondents had experienced symptoms of RTI's in the preceding six months. Vaginal discharge was the commonest symptom reported (21.8%) and the majority of those who reported symptoms sought medical treatment. Government health centres were the most visited health facilities for treatment. Conclusion Even though most of the respondents have heard of RTI's and sought treatment when symptomatic, they demonstrated poor overall understanding of the subject. There is need to educate women on preventive strategies, as RTI's are often assymptomatic.
"Take Charge. Take the Test." (TCTT), a media campaign promoting HIV testing among African American women, was piloted in Cleveland and Philadelphia from October 2006 to October 2007. This study assesses TCTT's effectiveness in promoting HIV testing information seeking among target audiences in each pilot city. The authors analyzed data on telephone hotlines promoted by the campaign and the www.hivtest.org Web site to examine trends in hotline calls and testing location searches before, during, and after the campaign. Cleveland hotline data were available from October 1, 2005, through February 28, 2008, for a total of 29 months (N = 126 weeks). Philadelphia hotline data were available from May 1, 2006, through February 28, 2008, for a total of 22 months (N = 96 weeks). The authors assessed the relation between market-level measures of the campaign's advertising activities and trends in hotline call volume and testing location searches. They found a significant relation between measures of TCTT advertising and hotline calls. Specifically, they found that increases in advertising gross ratings points were associated with increases in call volume, controlling for caller demographics and geographic location. The campaign had similar effects on HIV testing location searches. Overall, it appears the campaign generated significant increases in HIV information seeking. Results are consistent with other studies that have evaluated the effects of media campaigns on similar forms of information seeking. This study illustrates useful methods for evaluating campaign effects on information seeking with data on media implementation, hotline calls, and zip code-based searches for testing locations. PMID:21707409
Davis, Kevin C; Uhrig, Jennifer; Rupert, Douglas; Fraze, Jami; Goetz, Joshua; Slater, Michael
This paper develops an analysis of women's perceptions of medical technology and the elements which shape them, and then draws out the implications for medicine and the medicalization thesis. In the first part of the paper we outline the macro-theoretical debates about medicalization and the role of medical technology in this process, and the consequences for those who use health
Purpose This qualitative study explored women’s experiences with counseling about medication-induced birth defects, as well as how and when they would like to receive information on medication-induced birth defects from their health care providers (HCPs). Methods We conducted 4 focus groups with 36 women of reproductive age (18–45 years) in Pittsburgh, PA. Twenty-one women were using medications to treat a chronic health condition, and two were pregnant. Content analysis was performed by 3 independent coders using a Grounded Theory Approach. Discrepancies were resolved by consensus. Results Women reported depending on their HCPs for information about the risks of teratogenic effects of medications on a pregnancy, but felt the information they had been provided was not always comprehensive. Women want HCPs to initiate discussions about potentially teratogenic medications at the time the medications are prescribed, regardless of whether the woman is sexually active or planning a pregnancy. Women want clear information about all potential outcomes for a fetus. Factors women reported as being critical to effective teratogenic risk counseling included privacy, sufficient time to discuss the topic, and a trusting relationship with their HCP. Conclusions Women of reproductive age feel provision of information about the possible teratogenic effects of medications could be improved by routine discussions of teratogenic risks at the time medications are prescribed.
The authors of the present study contribute to research on the role of sexist events in women’s mental health by examining the sexism–distress relation (a) with a sample of women who are seeking mental health services and (b) in the context of the additional roles of perceived social support in positive self-appraisal (i.e., empowerment and self-esteem) and psychological distress. A
Background This qualitative study sets to fill a gap in knowledge by exploring the health seeking behaviour of rural women living in the occupied Palestinian territories (oPt). The existing literature on the oPt has so far focused on unravelling the country’s epidemiological and health system profile, but has largely neglected the assessment of factors shaping people’s decisions on health care use. Methods Based on a conceptual framework rooted in the Anderson behavioural model, we conducted 30 semi-structured interviews with purposely selected women and seven key informant interviews in three purposely selected villages in Ramallah district. Results Our findings indicate that women delay seeking professional care, use self-prescribed medications and home treatment, and do not use preventive and educational health services. Their health seeking behaviour is the result of the interplay of several factors: their gendered socio-cultural role; their health beliefs; financial affordability and geographical accessibility; their perceptions of the quality of care; and their perceived health needs. Conclusions Findings are discussed in the light of their policy implications, suggesting that adequate health policy planning ought to take into considerations socio-cultural dimensions beyond those directly pertinent to the health care system.
Hidden agendas impacting women's health care are explored in the context of the intersecting effects of capitalism as the ideology of medical politics, and patriarchy as the ideology of sexual politics. The mutually enhancing forces of medical and sexual politics collide in scientific reductionism - biological determinism for her'. Women are valued according to their ability and willingness to bear
In India it is only a century since women were accepted as fully-fledged professionals on parallel lines to male doctors. Since Independence, governmental policies ensuring equal opportunities for women to work and health care for all have provided an impetus to women's involvement in the medical profession. The expansion in the facilities for professional knowledge and training as well as
Low rates of breast and cervical cancer screening among Hmong women have been documented. Mistrust of Western medicine and the health care system, as well as experiences of discrimination in health care, may be barriers to seeking health care for this population. In this study, we explored medical mistrust among Hmong women and men, their experiences with discrimination in health care, and how these factors may influence Hmong women’s breast and cervical cancer screening behavior. We conducted semi-structured, in-depth interviews with women and men who were members of the Hmong community in Oregon. Transcripts of 83 interviews were analyzed using content analysis. Despite personally trusting Western medicine and the health care system, participants shared reasons that some Hmong people feel mistrust including lack of understanding or familiarity, culture, and tradition. Although mistrust was thought to result in delaying or avoiding breast or cervical cancer screening, more frequently trust was described as positively influencing screening. In addition, few participants reported being treated differently during breast or cervical cancer screening because they were Hmong. When discussing health care more broadly, however, some participants described differential (e.g., disrespectful or rude) treatment. Such experiences led to feelings such as anger and sadness and affected behavior, including willingness to seek care and choice of provider. Medical mistrust and perceived discrimination were not major barriers to breast and cervical cancer screening in this study. Additional studies are needed to assess whether our findings reflect the experiences of other Hmong.
Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of womenseeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population), due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion Health policies for asylum seekers need to be designed to assure access to adequate contraception, and to provide psychological care for this vulnerable group of patients. Care for asylum seekers may be emotionally very challenging for health professionals.
Since the mid-1990s, the Israeli medical scene has witnessed a real boom in elective prenatal testing for inherited diseases that has spread beyond risk groups to the general Jewish population, especially of Ashkenazi (European) origin. This study tried to identify key social influences involved in the growing range and prevalence of prenatal genetic tests as they emerged from women's own perspective. Twenty-seven women having blood tests for genetic mutations were interviewed at two types of genetic clinics, and re-interviewed after getting test results. The names of 23 women who chose not to have elective tests were obtained from testers, and these non-testers were interviewed for comparison. Women's accounts suggest that elective genetic testing is more acceptable, if not normative, among educated middle class Ashkenazi women, and is more often questioned and refused by lower class Mizrahi women, as well as religious women of any ethnic origin. The key forces that drive women's choice of prenatal genetic diagnosis include the fear of having a sick and/or socially unfit child in an unsupportive environment; strong endorsement of testing by gynaecologists; popular and professional discourse on the common Ashkenazi mutations causing genetic anxiety in this ethnic group (i.e. apprehension of multiple known and unknown dangers hidden in its genetic makeup); and the emerging social pressure for comprehensive prenatal screening as an indispensable part of good motherhood. Many women described the experience of testing as frustrating because of the long wait for results and difficulty of their interpretation and subsequent decision-making. Women who rejected elective tests explained their decision by moral/religious objections to abortion and/or eugenic aspects of prenatal screening, as well as by prohibitive costs and poor understanding of the tests' meaning and implications. Yet, few informants voiced objections to the excessive medicalisation of pregnancy as such; ethno-national motives of reproductive decisions were also uncommon in this group. More critical reflection is clearly needed from both providers and users of elective genetic screening before the more widespread uptake of this practice. PMID:16509941
|Purpose. A purpose of this study was to describe the career (extrinsic) and personal (intrinsic) factors perceived by K-12 minority women central office administrators (Directors, Assistant Superintendents, Associate Superintendents, Deputy Superintendents in California) who facilitated or inhibited their promotion for (or desire to pursue) the…
Background Meeting the medical and sexual health care needs of young people is crucial for sustainable development. In Uganda, youth are faced with a number of challenges related to accessing medical care and sexual health counselling services. This study sought to investigate the barriers faced by Ugandan university students in seekingmedical care and sexual health counselling. Methods This study is part of a cross-sectional survey conducted in 2005 among 980 students at Mbarara University of Science and Technology. Data was collected by means of a self-administered 11-page questionnaire. The barriers encountered by respondents in seekingmedical care and sexual health counselling were classified into three categories reflecting the acceptability, accessibility, or availability of services. Results Two out of five students reported unmet medical care needs, and one out of five reported unmet sexual health counselling needs. Acceptability of services was the main barrier faced by students for seekingmedical care (70.4%) as well as for student in need of sexual health counselling (72.2%), regardless of age, gender, self-rated health, and rural/peri-urban or urban residence status. However, barriers differed within the various strata. There was a significant difference (p-value 0.01) in barriers faced by students originally from rural versus peri-urban/urban areas in seekingmedical care (acceptability: 64.8%/74.5%, accessibility: 22.0% /12.6%, availability 13.2%/12.9%, respectively). Students who reported poor self-rated health encountered barriers in seeking both medical care and sexual health counselling that were significantly different from their other counterparts (p-value 0.001 and 0.007 respectively). Conclusions Barriers faced by students in seekingmedical and sexual health care should be reduced by interventions aimed at boosting confidence in health care services, encouraging young people to seek early treatment, and increasing awareness of where they can turn for services. The availability of medical services should be increased and waiting times and cost reduced for vulnerable groups.
Background Although direct medical costs for constipation related medical visits are thought to be high, to date there have been no studies examining longitudinal resource utilization in adults with constipation. Aim To estimate the incremental direct medical costs associated with constipation in women. Methods This is a nested case-control study. The study population consisted of all mothers of 5,718 children in the population-based birth cohort born during 1976-1982 in a community. The cases presented to the medical facilities with constipation. The controls were randomly selected and matched to cases in a 2:1 ratio. Direct medical costs for constipated women and controls were collected for the years 1987-2002. Results We identified 168 women with a diagnosis of constipation. The total direct medical costs over a 15-year period for constipated subjects were more than double those of controls ($63,591 [95%CI: 49,786- 81,396]) vs. $24,529 [95%CI: 20,667-29,260]). The overall outpatient costs for constipated women were $38,897 (95% CI: 31,381-48,253) compared to $15,110 (95% CI: 12,904-17,781) for controls. The median annual outpatient visits for constipated women was 0.16 compared to 0.11 for controls. Conclusion Women with constipation have significantly higher medical care utilization and expenditures compared to women without constipation.
Choung, Rok Seon; Branda, Megan E.; Chitkara, Denesh; Shah, Nilay; Katusic, Slavica K.; Locke, G. Richard; Talley, Nicholas J.
This study examined characteristics of binge eating among overweight women in the community seeking treatment for binge eating or weight loss. Five hundred and ninety-two women completed a telephone interview in which binge eating was thoroughly assessed. A large percentage of the sample (84.4%) reported features of binge eating consistent with the Diagnostic and Statistical Manual of Mental Disorders (4th
Lisa A. P Johnsen; Amy Gorin; Arthur A Stone; Daniel le Grange
Few with eating disorders (EDs) access evidence-based treatments. We conducted a prospective exploration of help-seeking by 57 community women with bulimic-type EDs using the Framework approach of familiarization, identifying themes, indexing, charting and mapping and interpretation. The mean age of the sample was 33 years. Results found women sought help for concerns regarding perceived (over) weight rather than for eating,
Elizabeth J. Evans; Phillipa J. Hay; Jonathan Mond; Susan J. Paxton; Frances Quirk; Bryan Rodgers; Atiranjan K. Jhajj; Marta A. Sawoniewska
This study examined two aspects of body checking and avoidance, and their relations to the core psychopathology of eating disorders (EDs), in severely obese men and womenseeking bariatric surgery. A consecutive series of 260 (44 male and 216 female) gastric bypass candidates were administered measures to assess body checking and avoidance, binge eating, restraint, and overevaluation of weight and
Carlos M. Grilo; Deborah L. Reas; Michelle L. Brody; Carolyn H. Burke-Martindale; Bruce S. Rothschild; Robin M. Masheb
OBJECTIVE Diabetic women are at increased risk for adverse pregnancy outcomes that can be improved by preconception care. Our goal was to evaluate the quality of medical care in diabetic women who undergo fertility treatment and compare it with the quality of medical care in diabetic women with spontaneous pregnancies. RESEARCH DESIGN AND METHODS This retrospective study on reproductive-age women undergoing fertility treatment in Clalit Health Services (CHS) used data on fertility treatments, prescription fillings, HbA1c levels, and demographics extracted from CHS computerized systems. The control group comprised women with spontaneous pregnancy. Three quality measures in the periconception period were evaluated: folic acid prescription fillings, evaluation and level of HbA1c, and use of potentially hazardous drugs. RESULTS There were 230 fertility treatment cycles in 83 diabetic women, and 30 diabetic women had spontaneous pregnancy. Women in the fertility group were older and had fewer children. There were no significant differences in marital status or ethnicity. Regular folic acid use, HbA1c recording, and the percentage of women with HbA1c <7% was similar between women in fertility treatment and those with spontaneous pregnancy (23.9, 57.8, and 31.3% vs. 20.0, 73.3, and 40.0%, respectively). Several women in both groups continued the use of potentially hazardous medication. CONCLUSIONS The periconception medical care of diabetic women who undergo fertility treatment is suboptimal and no better than that of diabetic women with spontaneous pregnancies. More intensive and targeted counseling regarding the importance of folic acid and glycemic control is needed to optimize periconception care of these diabetic patients.
The relationship between partner violence and physical health symptoms is well-established. Although some researchers have theorized that the physical health effects of partner violence may be worse for ethnic minority women, there is little research addressing this topic. The current study examined whether African American women demonstrate a differential association in this relationship than Caucasian women. This study included 323 women (232 African American, 91 Caucasian) who participated in a larger investigation of the psychological and psychophysiological correlates of recent partner violence among womenseeking help for the abuse. Race was examined as a moderator of the relationship between partner violence frequency and physical health symptoms. Although mean levels of partner violence frequency and physical health symptoms did not significantly differ between African American and Caucasian women, linear regression analyses demonstrated a significant positive relationship between partner violence frequency and physical health symptoms for African American women; whereas there was no association observed between these variables for Caucasian women. Post hoc analyses revealed that posttraumatic stress disorder symptoms partially mediated the association between partner violence frequency and physical health symptoms for the African American women. The current findings underscore the importance of considering race when studying the effect of partner violence on women’s health.
Iverson, Katherine M.; Bauer, Margret R.; Shipherd, Jillian C.; Pineles, Suzanne L.; Harrington, Ellen F.; Resick, Patricia A.
Abstract Background Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES. Methods We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999–2000. We studied the 730 women with at least one genitourinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured by income (tertile group) and education (?primary school, junior high school, senior high school, college or above). Bivariate tests and logistic regressions were applied. Results There was a significantly positive relationship among income, education, and treatment. Odds ratios (ORs) of medium and high income were 2.01 (p?=?0.04) and 1.39 (p?=?0.46), respectively, after controlling demographics. ORs of middle school, high school, and college or above were 1.81 (p?=?0.05), 2.27 (p?=?0.03), and 1.27 (p?=?0.64), respectively. The relationship between income and formal treatment was also positive, and the relationship between education and formal treatment was negative. Additional adjustment for STI knowledge and experience reduced the HCS disparity across education. Conclusions Income and education have different effects on HCS behavior among Chinese women with GU symptoms. Income may affect HCS via affordability, and education is a complicated proxy for sex education, STI knowledge, and experience that will affect the socioeconomic disparity in HCS.
Lauderdale, Diane; Mou, Shanshan; Parish, William I.; Laumann, Edward O.; Schneider, John
We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical
B. Ganatra; S. Kalyanwala; B. Elul; K. Coyaji; S. Tewari
Unipolar depression occurs twice as frequently among women as among men, and the pharmacological industry maintains a massive advertising campaign that encourages psychiatric professionals to rely on antidepressant medication as the solution to this problem. The pictorial content of drug advertisements shows women as victims of depression. The social problems and situational stresses associated with unipolar depression are never shown,
This study utilized data from the National Survey of American Life to investigate the use of professional services and informal support among Black women with a lifetime mood, anxiety, or substance use disorder. Forty-seven percent combined professional services and informal support, 14% relied on professional services only, 2% used informal support only, and 16% did not seek help. Co-occurring disorders, recent episodes, social networks, marital status, age, and level of education were significantly related to help seeking from professional and informal helpers, demonstrating the importance of both. Targeting interventions in these areas will likely increase treatment effectiveness. PMID:24074130
Intimate partner violence (IPV) has a detrimental effect on the wellbeing of victims and their children. Situational as well\\u000a as individual factors shape victims’ responses to the experiences of IPV in many ways. This study uses a quantitative approach\\u000a to examine the factors that influence victims’ decisions on whether and where to seek help. The role of (unborn) children\\u000a has
Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA) refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used.Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades.This article summarizes the findings of a literature review on women's experiences with medical abortion in Latin American countries where voluntary abortion is illegal.Women's personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1) a medically supervised abortion in a clandestine clinic or 2) complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support.Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it might not be effective, and the fact that some women eventually need to seekmedical care at a hospital where they might be sanctioned for having an abortion and even reported to the police. PMID:23259660
Research on the health of trafficked men and on the health problems associated with trafficking for labor exploitation are extremely limited. This study analysed data from a case series of anonymised case records of a consecutive sample of 35 men and women who had been trafficked for labor exploitation in the UK and who were receiving support from a non-governmental service between June 2009 and July 2010. Over three-quarters of our sample was male (77 %) and two-thirds aged between 18 and 35 years (mean 32.9 years, SD 10.2). Forty percent reported experiencing physical violence while they were trafficked. Eighty-one percent (25/31) reported one or more physical health symptoms. Fifty-seven percent (17/30) reported one or more post-traumatic stress symptoms. A substantial proportion of men and women who are trafficked for labor exploitation may experience violence and abuse, and have physical and mental health symptoms. People who have been trafficked for forced labor need access to medical assessment and treatment. PMID:23649665
Turner-Moss, Eleanor; Zimmerman, Cathy; Howard, Louise M; Oram, Siân
Abstract Background Medical pluralism can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness. American women use a variety of health services and practices for women's health conditions, yet no national study has specifically characterized women's medical pluralism. Our objective was to describe medical pluralism among American women. Methods A nationally representative telephone survey of 808 women ?18 years of age was conducted in 2001. Cross-sectional observations of the use of 11 CAM domains and the use of an additional domain—spirituality, religion, or prayer for health—during the past year are reported. Women's health conditions, treatments used, reasons for use, and disclosure to conventional physicians are described, along with predictors of CAM use. Results Over half (53%) of respondents used CAM for health conditions, especially for those involving chronic pain. The majority of women disclosed such practices at clinical encounters with conventional providers. Biologically based CAM therapies, such as nutritional supplements and herbs, were commonly used with prescription and over-the-counter (OTC) pharmaceuticals for health conditions. Conclusions Medical pluralism is common among women and should be accepted as a cultural norm. Although disclosure rates of CAM use to conventional providers were higher than in previous population-based studies, disclosure should be increased, especially for women who are pregnant and those with heart disease and cancer. The health risks and benefits of polypharmacy should be addressed at multiple levels of the public health system.
The library facilities, resource materials, training of librarians and so on are described at first. The library collection is that of middle sized medical library. However, since the facilities are not enough to handle it, it is necessary for the library to be supplemented by information services. Then primary information services such as reading of materials, interlibrary loan and journal acquisition system of the recent issues for each laboratory is outlined. Secondary information services centered around on-line information retrieval service, contents sheet service and preparation of index cards are also described. What a medical library should be is considered in terms of its relation to information services.
The prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, group B streptococcus, herpes simplex virus, and Neisseria gonorrhoeae from cervical cultures obtained from 210 womenseeking abortion in Pittsburgh, Pennsylvania, United States of America was 9.3%, 72.9%, 25.2%, 4.3%, 0.9%, and 0.9% respectively. Cultures from 40\\/203 (19.7%) patients failed to produce any of these organisms. C trachomatis isolation was not
This article reports a study of the possible impact of sociodemographic and interactional aspects of intimate partner violence\\u000a (IPV) on help-seeking behavior. Do different sociodemographic groups of IPV survivors use different professional supports\\u000a and treatments? Do different professional support and treatment agencies come predominantly in contact with women who have\\u000a been subjected to different characteristics of IPV? Do different interactional
The purpose of this study was to examine the breast cancer prevention information seeking behaviors among rural women, the prevalence of Internet, cell, and text use, and interest to receive breast cancer prevention information cell and text messages. While growing literature for breast cancer information sources supports the use of the Internet, little is known about breast cancer prevention information seeking behaviors among rural women and mobile technology. Using a cross-sectional study design, data were collected using a survey. McGuire's Input-Ouput Model was used as the framework. Self-reported data were obtained from a convenience sample of 157 women with a mean age of 60 (SD = 12.12) at a rural New Mexico imaging center. Common interpersonal information sources were doctors, nurses, and friends and common channel information sources were television, magazines, and Internet. Overall, 87% used cell phones, 20% had an interest to receive cell phone breast cancer prevention messages, 47% used text messaging, 36% had an interest to receive text breast cancer prevention messages, and 37% had an interest to receive mammogram reminder text messages. Bivariate analysis revealed significant differences between age, income, and race/ethnicity and use of cell phones or text messaging. There were no differences between age and receiving text messages or text mammogram reminders. Assessment of health information seeking behaviors is important for community health educators to target populations for program development. Future research may identify additional socio-cultural differences. PMID:22706805
Women more and more frequently refer to medical doctors for treating weight excess. Even if the primum movens is usually a pure esthetic concern, medical aspects should not be neglected. Indeed, if obesity with gynoid adipose tissue distribution is less deleterious than android obesity from a metabolic point of view, severe obesity is frequently associated with cardiovascular risk factors which may hinder the prognosis of these female patients. Other complications are common in obese women, such as oestrogen-related cancers, osteoarticular problems and psychological disturbances. Various therapeutic approaches are available which permit an encouraging weight loss and a rapid improvement of risk factors. Unfortunately, long-term results are often disappointing, essentially because of the difficulty to follow on the long term a strict diet regimen and practice physical exercise and because of the usual unrealistic expectations of the obese women who consult medical doctors. PMID:10389468
This paper provides a brief account of events leading to the establishment of the constitutional right to privacy in the case known as Griswold vs. State of Connecticut. It also discusses changes in the training of residents in the Department of Obstetrics and Gynecology at Yale University School of Medicine and the evolving role of women in the residency program. It concludes with reflections and speculations about new directions in medical care for women.
We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedica- lisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in- depth interview guide. While women appreciated the non-invasiveness
Little is known about the cancer information seeking experiences of Chinese immigrants despite reported disparities in cancer burden and use of cancer screening. This research used semi-structured interviews to the explore cancer information seeking preferences and experiences of 50 English-as-a-second-language older Chinese immigrant women to Canada with different levels of health literacy. Directed content analysis was used to identify three main themes: sources of cancer information, barriers to cancer information seeking, and strategies used during information seeking. Health literacy did not distinguish the women on any of the major themes. The women expressed strong preferences for interpersonal and interactive cancer information from their physician and trusted others, such as friends and family. Barriers to cancer information seeking included language difficulties and limited time with physicians. The results emphasize the need for cancer information that reinforces cultural norms, language familiarity, and other values specific to cultural identities, such as interpersonally oriented values. PMID:20978955
Adherence to highly active antiretroviral therapy (HAART) is essential to improving the quality of life of people living with HIV/AIDS; however, it still remains a challenge especially for young African women. The purpose of the study was to explore how young women with HIV/AIDS in Uganda experience the influence of their everyday life occupations on adherence to HAART after more than 1 year on the medication. Narratives of six participants were elicited using two semistructured interviews within a period of 1 month. Narrative analysis was used to develop themes reflecting the participants' stories of coping with everyday activities. The participants described their adherence to HAART in relation to everyday life occupations as a "tug of war", which describes the struggles they had taking medication because they were afraid of being discriminated by peers and the general society. They also expressed fear of not being included in many activities if people knew they have HIV/AIDS because there are many beliefs associated with the illness especially for young women in which they are branded promiscuous. However, in the Ugandan culture, women are considered to be home makers, which restricted their activities mostly around domestic work making it hard for them to prioritize their medication, and when they young women prioritized, it was all about fun activities that seemed to consume much time, hence contributing to the poor adherence. It is therefore important to assess the everyday occupations of young women before they start taking medication, so that HAART is scheduled in accordance with their everyday life occupation to reduce poor adherence. The implications of the study on practice is that it will enable occupational therapists working with persons with HIV/AIDS develop age-specific activities taking into consideration HAART as an everyday life activity rather than one that needs to be incorporated into their already existing activities, hence improving their adherence and reducing on stigma associated to the medication. PMID:22740312
Matovu, Sarah Natalia; La cour, Karen; Hemmingsson, Helena
Eighteen women who served in Operation Iraqi Freedom\\/Operation Enduring Freedom (OIF\\/OEF) sought mental health services at a Veterans' Affairs (VA) medical center. Ten of the 18 women (56%) reported military sexual trauma (MST) while serving in OIF\\/OEF. All 10 with MST reported sexual harassment, 6 of the 10 (33% of the sample) reported unwanted physical advances, and 3 (17%) reported
Lori S. Katz; Lindsey E. Bloor; Geta Cojucar; Taylor Draper
Objective: To analyze the follow-up of a cohort of women who requested reversal of surgical sterilization. Methods: This retrospective study was carried out at the State University of Campinas, Brazil. A cohort of 394 women who requested sterilization reversal was followed up for one year after reversal surgery. The analysis includes the percentage of women who completed the steps between
C. A. Petta; L. Bahamondes; M. Hidalgo; A. Faúndes; A. J. Bedone; D. Faundes
Introduction: The policy goal of shifting nonurgent visits from the emergency department to nonemergency health care settings is commonly devised, planned, and implemented without considering patients’ perspectives. The purpose of this study was to gain an understanding of the context in which patients choose to seek health care in an emergency department. Human science provided the framework for this exploratory
Jane Koziol-McLain; David W. Price; Barbara Weiss; Benjamin Honigman
Women and girls are especially vulnerable to HIV infection in sub-Saharan Africa, and in some of those countries, prevalence among young women can be up to 3 times higher than among men of the same age. Effective HIV prevention options for women are clearly needed in this setting. Several ARV-based vaginal microbicides are currently in development for prevention of HIV transmission to women and are discussed here. The concept of pre-exposure prophylaxis for the prevention of HIV transmission to women is introduced. PMID:21345763
Women and girls are especially vulnerable to HIV infection in sub-Saharan Africa, and in some of those countries, prevalence among young women can be up to 3 times higher than among men of the same age. Effective HIV prevention options for women are clearly needed in this setting. Several ARV-based vaginal microbicides are currently in development for prevention of HIV transmission to women and are discussed here. The concept of pre-exposure prophylaxis for the prevention of HIV transmission to women is introduced.
This study examined the records of 252 admissions to an impatient drug rehabilitation program for African American women between July 1989 and July 1991 to determine the prevalence and treatability of the medical conditions found on screening evaluation. All but 0.7% of subjects were on General Relief, Medicare, Medicaid, or had no payment source. The results showed a high prevalence
Mary Anne Curtiss; Kellene M. Lenz; Nicole R. Frei
A middle-aged woman in a Newfoundland outport fishing village visits the doctor at a local medical clinic and complains of a case of bad nerves. Because he neither adequately understands the subtleties of the village concept of nerves nor the local etiquette of disease disclosure, the physician misinterprets the women's complaint and treats her for an ailment she does not
The authors studied state anxiety in women awaiting three different medical examinations: abdominal ultrasonography, mammography, and hysterosalpingography. These procedures differ in degree of intrusiveness and cause, respectively, low, intermediate, and high levels of pain and discomfort. The evidence supported the hypothesis that the degree of anxiety will correspond to the level of invasiveness. In addition, the study examined the impact
|This study analyzed the impact of a medical amnesty policy and an online alcohol poisoning video on college students' intentions to seek help when witnessing alcohol poisoning symptoms. Students were randomly assigned to receive an amnesty policy, alcohol poisoning video, or both. The group that received both treatments was most likely to seek…
Social psychological correlates of two main aspects of the process of cancer detection, viz. passive detection (i.e., paying attention to cancer symptoms) and help-seeking intention, were studied among a-symptomatic Dutch adults. Two written questionnaires, with a six-week interval, identified correlates of both variables, using a determinant model based on the theory of planned behavior. Knowledge, advantages, self-efficacy, being female and
This study explores how women’s functional limitations resulting from domestic violence lead to police involvement. Examining\\u000a functionality is a broader approach to exploring domestic violence outcomes than looking at injuries or impairments, and in\\u000a this study we look at the social participation aspects of social functioning. One hundred eleven battered women in four metropolitan\\u000a cities in the U.S. participated in
This study explores the severity and frequency of physical violence from an intimate partner experienced by 15- to 59-year-old women and their help-seeking behavior by using data from the "National Research on Domestic Violence Against Women in Turkey." Chi-square tests and logistic regression analyses were conducted to compare the relationship between severity and frequency of violence and women's characteristics. Of all ever-partnered women, 36% have been exposed to partner violence; almost half of these experienced severe types of violence. Women used informal strategies to manage the violence instead of seeking help from formal institutions. Help-seeking behavior increases with increased severity and frequency of violence. PMID:24142955
Ergöçmen, Banu Akadli; Yüksel-Kaptanoglu, Ilknur; Jansen, Henrica A F M Henriette
A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks
Jennifer L. Strauss; Christine E. Marx; Julie C. Weitlauf; Karen M. Stechuchak; Kristy Straits-Tröster; Ayaba W. Worjoloh; Christina B. Sherrod; Maren K. Olsen; Marian I. Butterfield; Patrick S. Calhoun
OBJECTIVES. This study identified factors predicting adherence to medical recommendations in maternal phenylketonuria, which can result in severe fetal damage. METHODS. Sixty-nine women with phenylketonuria, 68 of their acquaintances, and 69 women with diabetes mellitus were interviewed annually for 5 years. A model in which each stage in the maternal phenylketonuria life cycle represented a treatment-related goal provided a means to assess adherence. RESULTS. At the stages of prevention of unplanned pregnancy, treatment initiation, and diet continuation throughout pregnancy, attitudes and social support were associated with adherence to medical recommendations. No specific variables were associated with outcome at reproductive decision making, but women with phenylketonuria were more likely to delay making a decision, resulting in unplanned and, hence, untreated or late-treated pregnancy. CONCLUSIONS. Women with phenylketonuria differed from their acquaintances and diabetic women in many respects, suggesting that special programs are needed. Greater emphasis on reproductive decision making is especially needed. Interventions that focus on improving social support networks and attitudes about treatment may increase adherence to recommendations.
Waisbren, S E; Hamilton, B D; St James, P J; Shiloh, S; Levy, H L
Prior research on the relations among eating behaviors and thought suppression is limited to a measure of general thought suppression, the White Bear Suppression Inventory. To address this limitation, researchers recently validated the Food Thought Suppression Inventory (FTSI). Analyses using this measure suggest that food thought suppression is distinct from and is more predictive of eating disorder psychopathology than is general thought suppression. The FTSI, however, has not yet been validated in clinical samples. The purpose of the current study is to examine the factor structure and clinical correlates of the FTSI within treatment seeking obese women with binge eating disorder (BED; N = 128). Analyses revealed a valid and reliable one-factor measure of food thought suppression that was related to higher levels of eating and general psychopathology. The findings provide evidence for the use of the FTSI with obese women with BED. Future research should examine the psychometric properties of the FTSI within larger and more diverse samples.
Barnes, Rachel D.; Sawaoka, Takuya; White, Marney A.; Masheb, Robin M.; Grilo, Carlos M.
Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.
The objective of the present study is to assess the use of medication by pregnant women; classify them regarding therapy group and its risk category; and identify the cost of these drugs. The sample is formed by 47 pregnant women, in the 20 to 29 year-old age group, from July 2001 to June 2003, in the city of São Paulo. A specific instrument was used for data collection in family charts and others from the Sistema de Informação da Atenção Básica (Primary Care System Information). Average of medications used by pregnant woman was 3.63. Iron sulfate was the most commonly used, followed by antibiotics (78.7%). Regarding risk category, 34.1% of medications belonged to category B and 16.5% to category C. In the calculation of total costs of care, expenses with medication accounted for 11.13%. We have seen the need for assessing further the criteria for use, especially of medications of category C. The higher costs were related to antimicrobials for the treatment of infections. PMID:18506346
... doctors and other health care providers, said Rosemary Fama, senior research scientist and senior research neuropsychologist at ... release. She was not involved in the study. Fama suggested that women may attach less social stigma ...
ABSTRACT. Outside traditional risk-oriented public health campaigns, few sexuality education opportunities exist for adult women, particularly those in partnered relationships, that address issues related to sexual desire and pleasure. Data were collected from 677 women attending in-home sex toy parties to assess whether they sought sexuality-related information at a recent party they attended. Participants reported asking 765 questions at parties.
Kristen N. Jozkowski; Vanessa Schick; Debby Herbenick; Michael Reece
The aim of this cross-sectional study was to report risk factors for painful bladder syndrome in women. We surveyed 645 women presenting for care to general gynecology clinics and a vulvar specialty clinic using a standardized questionnaire and validated outcome measures. We used two definitions for painful bladder syndrome, based on the O‘Leary–Sant interstitial cystitis symptom and problem indices. Of
Colleen M. Kennedy; Catherine S. Bradley; Rudolph P. Galask; Ingrid E. Nygaard
Background: Although women make up nearly half of medical school classes in the United States, just over 20% of residents in surgery are women (excluding obstetrics\\/gynecology). The objective of this study was to identify whether the proportion of women surgeons on the faculty who have frequent encounters with medical students during their surgery rotation influences the student’s perceptions about women
Leigh Neumayer; Susan Kaiser; Kimberly Anderson; Linda Barney; Myriam Curet; Donald Jacobs; Thomas Lynch; Christine Gazak
Objective: To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case–control study of NHL in Connecticut women.
Yawei Zhang; Theodore R. Holford; Brian Leaderer; Shelia Hoar Zahm; Peter Boyle; Lindsay McOmber Morton; Bing Zhang; Kaiyong Zou; Stuart Flynn; Giovanni Tallini; Patricia H. Owens; Tongzhang Zheng
Context: The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality. Objective: To identify and describe patient views of medical confidentiality and to assess provisionally the range of these views. Design: Qualitative study using indepth, open ended face-to-face interviews. Setting: Southeastern Pennsylvania and southern New Jersey, USA. Participants: A total of 85 women interviewed at two clinical sites and three community/research centres. Main outcome measures: Subjects' understanding of medical confidentiality, beliefs about the handling of confidential information and concerns influencing disclosure of information to doctors. Results: The subjects defined medical confidentiality as the expectation that something done or said would be kept "private" but differed on what information was confidential and the basis and methods for protecting information. Some considered all medical information as confidential and thought confidentiality protections functioned to limit its circulation to medical uses and reimbursement needs. Others defined only sensitive or potentially stigmatising information as confidential. Many of these also defined medical confidentiality as a strict limit prohibiting information release, although some noted that specific permission or urgent need could override this limit. Conclusions: Patients share a basic understanding of confidentiality as protection of information, but some might have expectations that are likely not met by current practice nor anticipated by doctors. Doctors should recognise that patients might have their own medical confidentiality models. They should address divergences from current practice and provide support to those who face emotional or practical obstacles to self-revelation.
The emergency hostel of Tokyo Metropolitan Women's Counseling Center, established in 1957, provides protection and care for about 600 Japanese or foreign women per year. The women housed there need social support for various reasons such as prostitution, poverty, somatic or mental diseases, or domestic violence (DV). We investigated the sociodemographic characteristics, psychiatric diagnoses and social prognoses of 2667 women who consulted the psychiatric clinic in the emergency hostel between 1961 and 1997. Seventy-four women consulted the psychiatric clinic per year, on average. Most were aged between 20 and 49. During the study period, there was a gradual decline in the number referred through the prostitution prevention law. Psychiatric diagnoses at the first visit varied widely. Annual comparison showed a gradual decrease in schizophrenia and manic-depressive illness, but an increase in substance abuse, psychogenic reaction, and personality disorder. Sociodemographically, most subjects appeared to have been children from underprivileged backgrounds. The social prognoses of 930 cases judged in March 1998 were good in 25%, moderate in 23% and poor in 48%. The poor prognosis group contained significantly more women with schizophrenia and personality disorder than the other two groups. The poor prognosis group tended to include more cases of substance abuse, while the good prognosis group contained more cases of depression and mental retardation. Women in the DV group tended to have more children than those in the non-DV group, and to have a higher prevalence of psychogenic reaction and a lower prevalence of schizophrenia. The DV group also tended to include more subjects with a moderate social prognosis and fewer subjects with a poor social prognosis. Specialized treatment should be provided for women after emergency admission to the hostel and this treatment needs to be aimed at improving social adaptation of the hostel residents, especially those with schizophrenia, personality disorders and substance abuse. Victims of DV should receive more conscious attention. In particular, prevention of mental disorders should be aimed not only at the residents but also their children. PMID:12078106
Although ED can impair sexual satisfaction as well as the quality of partnership and life, men affected often avoid seeking treatment. There is growing evidence that women have an influence on their partner's help-seeking behavior. This qualitative study examined men with ED and their female partners in order to detect motivational factors for men to seek treatment and motivational actions of the women to support their partners. Twelve couples took part in a semi-structured telephone interview, which was performed separately in men and women. Analysis was on the basis of the Grounded Theory. The identified motivational factors could be divided into extrinsic (for example, media, female partner) and intrinsic (for example, desire to clarify the cause of the ED, hope for improvement) factors. Women can support their partners in treatment-seeking through various motivational actions such as talking with each other, showing interest and dealing actively with the problem, appealing to the male self-esteem, supporting the doctor's visit, forcing the treatment, active cooperation and participation in the treatment or initiating sexual intercourse. On the basis of these findings, recommendations for women were developed to support their partners and increase the probability of help-seeking behavior. PMID:23051681
Gerster, S; Günzler, C; Roesler, C; Leiber, C; Berner, M M
This paper provides an analysis of the potential impact of changes in recruitment and hiring processes in Portuguese higher education institutions – under the New Public Management framework – on the representation of women in academia. Based on official data from the Portuguese Ministry of Science, Technology and Higher Education, two major conclusions emerge. First, Portuguese higher education institutions reproduce
Little is known about the cancer information seeking experiences of Chinese immigrants despite reported disparities in cancer\\u000a burden and use of cancer screening. This research used semi-structured interviews to the explore cancer information seeking\\u000a preferences and experiences of 50 English-as-a-second-language older Chinese immigrant women to Canada with different levels\\u000a of health literacy. Directed content analysis was used to identify three
The current research is a pilot study that included 87 single women who responded to an announcement placed in one of the national newspapers and then filled out interview questionnaires. The study hypothesized three groups of variables for predicting elderly single women's appeals for help from health and welfare services: (a) demographic variables, (b) intrapersonal variables, and (c) interpersonal variables. The research tools were (a) a demographics questionnaire constructed specifically for this study; (b) a personal assessment of single life: chosen or unchosen, including a question regarding what single people think about bachelorhood/spinsterhood; (c) an approach to the institution of bachelorhood/spinsterhood; (d) self-evaluation questionnaire; (e) a sense of mastery over life questionnaire; (f) informal support networks questionnaire; and (g) an assessment of the appeal to health and welfare services for help. A special questionnaire was constructed, which included a list of health and welfare services. The research findings indicate connections among all the research variables. All the research hypotheses were confirmed. Special attention should be given to this one tenth and more of the elder population. It might improve the lives of those women and save Western governments a lot of money. PMID:20183153
Objective The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women. Methods A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis. Results Correlates to positive breast cancer screening included demographics (ethnicity), cultural factors (living in the United States for 15 years or more, speaking English well), enabling factors (having a regular physician to visit, health insurance covering the screening), and family/social support factors (those who had a family/friend receiving a mammogram). Conclusions The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.
Ma, Grace X; Gao, Wanzhen; Lee, Sunmin; Wang, MinQi; Tan, Yin; Shive, Steven E
This study examined two aspects of body checking and avoidance, and their relations to the core psychopathology of eating disorders (EDs), in severely obese men and womenseeking bariatric surgery. A consecutive series of 260 (44 male and 216 female) gastric bypass candidates were administered measures to assess body checking and avoidance, binge eating, restraint, and overevaluation of weight and shape. The majority of patients reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations were observed between checking and restraint, and between avoidance and binge eating. Both checking and avoidance behaviors were significantly associated with overevaluation of weight and shape. The positive associations between each of the two behaviors (body checking and avoidance) with overevaluation of weight/shape remained significant even after controlling for the effects of avoidance on body checking and vice versa. Stepwise multiple regression analyses revealed that binge eating, body checking, and avoidance behaviors made significant unique contributions and jointly accounted for 22-25% of the variance in overevaluation of weight and shape, respectively. This study documents the presence of eating disorder psychopathology among severely obese patients seeking bariatric surgery. The findings support the view that body checking and avoidance behaviors are manifestations of overevaluation of weight and shape and disordered eating. PMID:15865917
Grilo, Carlos M; Reas, Deborah L; Brody, Michelle L; Burke-Martindale, Carolyn H; Rothschild, Bruce S; Masheb, Robin M
As it has grappled with issues of population policy, the international community has emphasized that women's reproductive rights are human rights. Scholars have also acknowledged that the right to reproductive health care exists within the scope of international human rights treaties and conventions and that gender equality, nondiscrimination, and freedom from government interference in marriage and family life are also guaranteed. Further protections extend to counseling and health information and referral. The Programme of Action of the 1994 International Conference on Population and Development continues this trend by emphasizing the importance of human rights for attaining population and development objectives, calling on governments to focus their efforts on improving the quality of life for individuals, and endorsing the notion that reproductive rights are universal human rights. Reproductive health care options are also influenced by sovereign laws that restrict availability of contraception, sterilization, or abortion. However, universal rights and unrestricted access must be complemented by other factors controlled by domestic laws to guarantee reproductive choice. Such laws cover issues like marriage age, divorce, marital property, child support, maternity benefits, day care, sex discrimination, eligibility for insurance, confidentiality, spousal consent, rape, and sexual abuse. Countries must modify restrictive national laws and promote laws protecting women's rights. PMID:12320714
In this study I explore Canadian women's use of midwifery to examine whether their choice represents a resistance to the medicalization of pregnancy\\/childbirth. Through my analysis of the data I identified eight ways the women's deliberate decision to pursue midwifery care represented resistance to medicalization. In so doing, I demonstrate how women actively assert their agency over reproduction thus shaping
The prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, group B streptococcus, herpes simplex virus, and Neisseria gonorrhoeae from cervical cultures obtained from 210 womenseeking abortion in Pittsburgh, Pennsylvania, United States of America was 9.3%, 72.9%, 25.2%, 4.3%, 0.9%, and 0.9% respectively. Cultures from 40/203 (19.7%) patients failed to produce any of these organisms. C trachomatis isolation was not associated with age, race, marital status, average family income, number of sexual partners, history of gonorrhoea or syphilis, or previous pregnancies, live births, or abortions, and 82.4% of women with chlamydial infections had had no urogenital symptoms in the preceding six months. The highest concentration of U urealyticum was 10(5) colour changing units (ccu)/ml, and about half of the positive ureaplasma cultures produced less than 10(3) ccu/ml of this organism. Screening for C trachomatis, is encouraged to prevent neonatal morbidity and the common complication of pelvic inflammatory disease after abortion.
|Medical-career aspirations prior to college are examined in longitudinal data (N=27,065; 59.1% female). Men and women aspire to medical careers at roughly the same rate and for mostly the same reasons, but the strength of influence varies significantly for certain factors. Fewer women maintain medical-career aspirations during college.…
We investigated health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. The Short Test of Functional Health Literacy in Adults (STOFHLA) was used to measure health literacy in 143 English-speaking low-income pregnant women. About 15% of the participants demonstrated low health literacy. Participants with low health literacy were
Carol Shieh; Rose Mays; Anna McDaniel; Jennifer Yu
This article reports a study of women victimized by intimate partner violence (IPV). We describe three interactional aspects\\u000a of IPV: (1) responses and conduct before, during, and after IPV episodes, (2) impact of alcohol and drug intoxication, and\\u000a (3) Predictors of risk for IPV victimization in more than one partnership. A representative sample of 157 help-seekingwomen,\\u000a recruited from family
BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese womenseeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether
Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton
|This article reports a study of the possible impact of immigration on interactional aspects of intimate partner violence (IPV) among help-seekingwomen. Are there differences concerning (a) IPV categories, (b) IPV severity, frequency, duration, regularity, and predictability, (c) guilt and shame, (d) partners' ethnicity, and (e) children being…
Background When measuring neighbourhood effects on health, it is both incorrect to treat individuals as if they were static and tied to their residential neighbourhood and to consider neighbourhoods rigid places whose geographical scales can be delineated a priori. We propose here to investigate the effects of residential medical density on health-seeking behaviours, taking into account the mono/polycentric structure of individual activity space (i.e., the space within which people move in the course of their daily activities) and exploring various neighbourhood units based on administrative delineations and regular grids. Methods We used data collected in the SIRS cohort study, which was carried out over a 5-year period (2005–2010) among a representative population living in 50 census blocks in the Paris metropolitan area. In the 662 women who lived in the same census blocks during the follow-up period and who had reported a recent cervical screening at baseline, we studied the association between residential medical density and individual activity space and the incidence of delayed cervical screening (> 3 years) in multilevel logistic regression models after adjustment for potential confounders. Results Among the 662 women studied, there were 94 instances of delayed cervical screening in 2010 (14%). The women who indicated that their activity space was concentrated within their neighbourhood of residence were significantly more at risk for an incident delayed cervical screening. No significant association was found between residential medical density and the incidence of delayed cervical screening. However, we observed a significant interaction between individual activity space and residential medical density. Indeed, women living in neighbourhoods with a low medical density had a significantly higher risk of delayed screening, but only if they reported that their daily activities were centred within their neighbourhood of residence. Lastly, a sensitivity analysis exploring various neighbourhood spatial units revealed that the incidence of delayed screening was better modelled when residential medical densities were calculated from a 1400 × 1400 metre grid or from adjacent census blocks. Conclusion This analysis underscores the view that people and neighbourhoods should be considered interacting entities. Using unsuitable neighbourhood units or neglecting the mono/polycentric structure of activity space would result in downplaying the importance of access to local health resources when addressing inequalities in health-seeking behaviours.
Health behavior plays an important role in the development, detection and course of cancer of the head and neck. Relevant health behavior includes prompt medical care seeking, and smoking and drinking cessation after diagnosis. This study examines the relationship between these health behaviors and health value and control beliefs, as well as psychological distress. Two hundred and sixty-four recently diagnosed
D. M. Tromp; X. D. R. Brouha; G. J. Hordijk; J. A. M. Winnubst; W. A. Gebhardt; M. P. van der Doef; J. R. J. De Leeuw
The oral hormonal agent anastrozole improves clinical outcomes for women with breast cancer, but women have difficulty taking it for the five-year course. The unique medication-taking experiences related to self-management of anastrozole therapy for women with early stage breast cancer are not known. Our purpose was to describe the medication-taking experiences for postmenopausal women with early stage breast cancer who were prescribed a course of anastrozole therapy. Twelve women aged 58 to 67 years, midway through therapy, participated in audio-recorded interviews. Women's medication-taking experiences involved a belief in their importance and an imperative to take anastrozole. We found that women's side effect experiences, particularly menopausal symptoms, were significant, but only one woman stopped anastrozole due to side effects. Medication-taking included routinization interconnected with remembering/forgetting and a storage strategy. Some women noted a mutual medication-taking experience with their spouse, but most felt taking anastrozole was something they had to do alone. Our results provide insight into the way some women with early stage breast cancer manage their hormonal therapy at approximately the midpoint of treatment. Next steps should include examinations of patient-provider communication, potential medication-taking differences between pre- and postmenopausal women, and the effects of medication-taking on clinical outcomes.
Wickersham, Karen; Happ, Mary Beth; Bender, Catherine M.
Fertile women may be exposed to ionizing radiation as human subjects in medical research studies. If the woman is pregnant, such exposures may result in risk to an embryo/fetus. Fertile women may be screened for pregnancy before exposure to ionizing radiation by interview, general examination, or pregnancy test. Use of the sensitive serum pregnancy test has become common because it offers concrete evidence that the woman is not pregnant (more specifically, that an embryo is not implanted). Evidence suggests that risk to the embryo from radiation exposure before organogenesis is extremely low or nonexistent. Further, demonstrated effects on organogenesis are rare or inconclusive at fetal doses below 50 mSv (5 rem). Therefore, there may be some level of radiation exposure below which risk to the fetus may be considered essentially zero, and a serum pregnancy test is unnecessary. This paper reviews the fetal risks and suggests that consideration be given to establishing a limit to the fetus of 0.5 mSv (50 mrem), below which pregnancy screening need not include the use of a serum pregnancy test.
Baseline characteristics, including body composition measures by bioelectrical impedance, medication profiles, and reported symptoms were recorded in an observational database for 1624 HIV+ men and 315 HIV+ women. Mean values for body cell mass (BCM) were slightly higher in both men and women taking anabolic medications including injection testosterone, oral anabolic steroids, subcutaneous injected growth hormone, and combinations of the
This study evaluated whether or not medication usage among young adult women differed across three countries. An additional aim was to evaluate the association between medication use and sociodemographic factors and exercise habits. A sample of 1098 young adult women were selected in Sweden, the USA, and Greece. Consistent medication usage by young adult women in the three countries related to oral contraceptives and vitamins; nevertheless, there were differences. The main differences were found in the use of laxatives, iron supplements, analgesics, antidepressants, and antacid medication. The most outstanding differences were the frequent use of laxatives in Sweden and vitamins in the USA. Different association patterns were found between medication use and culture, sociodemographic factors, and exercise. The assessment of medication use among young adult women can be performed very easily and provides an immediate indication of their well-being and needs for preventative care. PMID:18257825
Current research and policy on maternal and child health-care in Eritrea and Ethiopia focus primarily on female education and employment, while little attention is placed on women’s decision-making autonomy. However, the role of women’s decision-making in reproductive health cannot be overemphasized. In this paper, different dimensions of women’s decision-making autonomy and their relationship to maternal and child health-care utilization are
The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions. PMID:21528795
Mass media health communication has enormous potential to drastically alter how health-related information is disseminated and obtained by different populations. However, there is little evidence regarding the influence of media channels on health decision-making and medical advice-seeking behaviors among the Hispanic population. The Pew 2007 Hispanic Healthcare Survey was used to test the hypothesis that the amount of mass media
Background—The risk of cardiovascular mortality is higher among black women than white women, and the reasons for this disparity are largely unexplored. We sought to evaluate differences in medical care and clinical outcomes among black and white women with established coronary artery disease. Methods and Results—Among the 2699 women enrolled in the Heart and Estrogen\\/progestin Replacement Study (HERS), we used
Ashish K. Jha; Paul D. Varosy; Alka M. Kanaya; Donald B. Hunninghake; Mark A. Hlatky; David D. Waters; Curt D. Furberg; Michael G. Shlipak
Background Several common medical conditions are associated with altered hormone levels, and may thus plausibly influence breast cancer risk. Few studies have examined such relationships, and we utilized a population-based case-control study of young women in the US to examine breast cancer risk following a history of various medical conditions. Relationships between breast cancer and each medical con- dition examined
Helen A Weiss; Louise A Brinton; Nancy A Potischman; Donna Brogan; Ralph J Coates; Marilie D Gammon; Kathleen E Malonee; Janet B Schoenbergf
|Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…
Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger
The Women's Health Interschool Curriculum Committee of Ontario has developed goals and objectives for medical education based on a definition of women's health that includes emotional, social, cultural, spiritual and physical well-being. The author presents background information on how women have been treated as "other" and sex-role stereotypes have been reinforced by some of the assumptions, terminology and attitudes used in medical practice and research. The objectives address the biologic and social context of women's health, the effect of power differentials (particularly the imbalance in power between physicians and patients), sex-role stereotyping in medical practice and teaching, and the effect of individual physicians' attitudes toward women on the care they provide. These objectives are the first published effort to define what physicians should know about the social context of women's health. The committee encourages readers to debate, discuss and use these objectives. PMID:7859198
Background Infertility affects about 15% of couples in Western-societies with most progressing to fertility clinics for treatment. Despite being common, infertility is often experienced as a lonely road for affected couples. In this paper we expand on our previously published findings of women’s experiences with infertility or difficulty of viable pregnancy who had sought Traditional Chinese Medicine (TCM) therapy in Australia, and focus on women’s quality of life, coping strategies, and support needs. Methods We applied mixed methods using the Tuebingen Quality of Life and the COPE questionnaires and in-depth interviews with 25 women with primary or secondary infertility, recurrent miscarriages or unexplained stillbirth, and who had consulted a TCM practitioner. We used a thematic approach to analyse the interviews, and descriptive statistics to evaluate questionnaire responses. Results Women reported through both questionnaires and interviews compromised quality of life due to the high level of distress, guilt, grief, and frustration caused by infertility. However, our women represented a highly motivated sample, actively seeking alternative support. While the TCM approach to infertility management increased women’s sense of personal agency and control through education and continuity of care, the need for greater understanding and support on a societal level remains. Conclusions In infertility, ongoing emotional and instrumental support is pivotal to the wellbeing and quality of life of the affected. Traditional Chinese Medicine addresses some support needs in infertility not routinely available in the Western model of care. More peer-led and professional-led support groups are greatly needed for women experiencing infertility to help break isolation and raise awareness of integrative approaches to fertility management.
Breastfeeding women may be prescribed a psychotropic medication to treat a pre-existing illness such as bipolar disorder or schizophrenia, or to treat an illness that develops as a direct result of pregnancy and childbirth, such as depression. Mental health nurses are often not aware that many psychotropic medications are considered relatively safe for the infant as well as the breastfeeding woman. This paper provides the clinician with an overview of the major psychotropic medications for breastfeeding women and outlines their potential impact on the infant. Guidelines for the use of these medications are also provided for mental health nurses based on the available evidence. PMID:16594886
OBJECTIVES: This study assessed use and dosage of analgesic medications in relation to severity of osteoarticular pain. METHODS: The type and dose of analgesic medication and the severity of pain in the lower back, hips, knees, or feet of 1002 older disabled women were assessed. RESULTS: Severe pain and the use of analgesic medications were reported by 48.5% and 78.8% of women, respectively. Among those who had severe pain, 41.2% were using less than 20% of the maximum analgesic dose. Overall, 6.6% of women were using more than 100% of the maximum dose. CONCLUSIONS: Severe pain is common. Additional, more effective, and safe analgesic treatments are needed for controlling pain in older persons.
Pahor, M; Guralnik, J M; Wan, J Y; Ferrucci, L; Penninx, B W; Lyles, A; Ling, S; Fried, L P
The purpose of this HBCU/MI Partnership Training Award is to train Meharry Medical College faculty to conduct independent breast cancer research by collaborating with faculty from Vanderbilt University Medical Center. Year 1 is a training year and during ...
OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING--Teaching hospital in Scotland. PATIENTS--363 women undergoing legal induced abortion at
We investigated the perception of nocturia and possible explanatory factors for medical consultation among community-dwelling\\u000a women. Between October 2004 and February 2005, women aged ?40 years living in Matsu, Taiwan, who were identified as having\\u000a nocturia in a previous epidemiological survey, were interviewed with a questionnaire eliciting information about nocturia-specific\\u000a quality of life impact (N-QOL), perceptions of nocturia, and medical-consultation behavior.
OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause.
de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.
Dietary supplements are becoming increasingly popular as therapies for symptom relief among menopause-age women in the United States. However, a large gap exists between research in the concomitant use of prescription medications and dietary supplements and provider preparedness to guide patient decision making. Many menopausal women take prescription medications, over the counter medications, and herbs and dietary supplements for climactic symptoms or other health conditions. With any drug, there is the potential for interactions. Women taking medications with a narrow therapeutic index, such as anticoagulants, anticonvulsants, and drugs for the treatment of chronic diseases, are at particular risk. Patients should be queried regarding their use of dietary supplements when starting or stopping a prescription drug, or if unexpected reactions occur. When counseling patients, one must carefully consider the risks and benefits of each supplement and medication being taken by each individual.
From November 2000 to July 2001, 321 consenting women were enrolled at four sites across the country in an effort to demonstrate that mifepristone medical abortion could safely be used by providers throughout Tunisia. Women who met the study's inclusion criteria were given 200 mg oral mifepristone and offered the choice of taking 400 ?g oral misoprostol 2 days later
Selma Hajri; Jennifer Blum; Nabiha Gueddana; Habib Saadi; Leila Maazoun; Hela Chélli; Rasha Dabash; Beverly Winikoff
Four pregnant, HIV seropositive, African American women and their families were interviewed to explore the influence of family and extended-kinship networks on health care use and medical adherence. The major factors that emerged as relevant to health care in the lives of all four women were: 1) transportation, 2) child care, 3) the pregnancy and concern for the unborn child’s
Darlene Shelton; Katherine Marconi; Moses B. Pounds; Mercedes Scopetta; Mary Jo O’Sullivan; Jose Szapocznik
Objective: The overall objective of the project was to determine whether the current MD undergraduate curriculum at the University of British Columbia (UBC) met the minimum competencies in women's health according to available guidelines. Methods: Ovid and MEDLINE were searched for information on women's health topics in medical undergraduate curricula. The Association of Professors of Obstetrics and Gynaecology (APOG) and
Background Preventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce. Methods Data from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT), and medical-care seeking. Results More than 48 million individuals (38%) in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12?months or had at least one visit to a health care provider during the previous 12?months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors. Conclusions Lack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.
Women with current posttraumatic stress disorder (PTSD) comprise 30–59% of substance abuse treatment samples and experience a more severe course than women with either disorder alone. As yet, no effective treatment for this population has been identified. This paper reports outcome results on 17 women who completed a new manual-based 24-session cognitive behavioral group therapy protocol treatment, based on assessments
Lisa M. Najavits; Roger D. Weiss; Sarah R. Shaw; Larry R. Muenz
Background Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design Description of prescriptions filled in 2001. Setting A large health maintenance organization in northern California in 2001. Patients 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements Medications dispensed, contraceptive counseling, and pregnancy testing. Results A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling.
Schwarz, Eleanor Bimla; Postlethwaite, Debbie A.; Hung, Yun-Yi; Armstrong, Mary Anne
This investigation examined the relationship of abuse-specific coping strategies and perceived responses to abuse disclosure to symptoms of depression and posttraumatic stress among 131 womenseeking a protection order against an intimate partner. Disengagement, denial, and self-blame coping strategies, as well as blaming of the participant by others, were associated with greater depressive and posttraumatic symptoms. None of the strategies of coping or responses to abuse disclosure were negatively related to depressive or posttraumatic stress symptoms. Findings suggest that mental health providers may find it useful to address these negative styles of coping while public education campaigns should target victim blaming. PMID:22735315
Flicker, Sharon M; Cerulli, Catherine; Swogger, Marc T; Talbot, Nancy L
Today's research explaining women's usage of alcohol is inaccurate. Researchers have failed to include the powerful variable of race. African-American females are increasing their use of alcohol, yet the literature fails to tell why. To understand alcoholism among African-American women, it is necessary to conceive their culture, values, and role in society. This article highlights the biopsychosocial issues impacting female African Americans, and the need for unbiased research and treatment. Women who have the dual status of addiction and are members of a racial minority face a special range of stressors. Therefore, clinicians who serve them must possess more than generalized clinical skills.
Supervised injection facilities are a form of micro-environmental intervention that aim to address various harms associated with injection drug use. Given the numerous threats faced by women who inject drugs and are street-involved, including heightened risks for violence, we sought to elucidate how North America's first supervised injection facility (SIF) mediates the impact of violence among women during the injection
Nadia Fairbairn; Will Small; Kate Shannon; Evan Wood; Thomas Kerr
Outside traditional risk-oriented public health campaigns, few sexuality education opportunities exist for adult women, particularly those in partnered relationships, that address issues related to sexual desire and pleasure. Data were collected from 677 women attending in-home sex toy parties to assess whether they sought sexuality-related information at a recent party they attended. Participants reported asking 765 questions at parties. The
Kristen N. Jozkowski; Vanessa Schick; Debby Herbenick; Michael Reece
Introduction Cardiovascular disease is the largest single cause of death among women in the US. The American Heart Association guidelines\\u000a recommend aspirin use in women ?65 years of age if blood pressure is controlled and the benefits of cardiovascular risk reduction\\u000a likely outweigh the risk of bleeding. The objective of this study is to determine the prevalence of aspirin use in
Helen Y. Lee; Yvette P. Tong; Shan Xing; Catherine E. Cooke
BackgroundInformation on women with domestic violence (DV) suggests increased healthcare utilization across all levels of care and many diagnoses. In the present ancillary study (1997–2002), derived from a large, group-randomized intervention trial we conducted in a staff-model health maintenance organization (HMO) (1995–1998), we examined total and incremental utilization rates, costs, and patterns for women aged ?18 years with DV identified
Yvonne C Ulrich; Kevin C Cain; Nancy K Sugg; Frederick P Rivara; David M Rubanowice; Robert S Thompson
This study provides national prevalence estimates for complementary and alternative (CAM) use, visits to doctors for health\\u000a problems, and the effects of acculturation on health practices in Chinese women living in the United States. A national telephone\\u000a survey of 3,172 women on their use of complementary and alternative medicine was conducted in 2001. This study focuses on\\u000a a subsample of
This study examines how medical knowledge of women is socially informed in historically specific contexts. The case of obstetric and gynecologic knowledge of the 1950s is the focus of this investigation of the social character of medical knowledge.\\u000aThere is a prevalent notion that error results when medical knowledge is socially influenced. However, in the present work, social influence is
Objectives This study aims to explore the attitudes and beliefs of Omani women attending primary health care and Omani general practitioners regarding help seeking behaviour for emotional distress. The study also intends to clarify the understanding of help seeking from both lay and professional perspectives in the context of Omani culture exploring factors related to doctors’ training and health care services. Methods A qualitative phenomenological study using semi-structured interviews was conducted at the Family Medicine Health Care Centre at Sultan Qaboos University Hospital. 20 lay informants (Omani women) and 10 professional informants (Omani family physicians) were interviewed. Results Two main sets of themes are presented in this study; 1). the original themes, which are presented in the results section and represent the descriptive level of analysis, and 2). the emergent themes are presented in the discussion section and represent the interpretive level of analysis. The original themes are: a) self help, with subthemes including the role of faith, talking and distraction. b) Health care and doctors, with subthemes including: reasons for seeing a doctor, reasons for not seeing a doctor, continuity of care, doctor-patient relationship and time. c) Traditional (folk) medicine. The emergent themes are: a) Talking b) Religious faith c) Cultural beliefs and d) The doctor’s role. Cultural and religious beliefs were found to shape the experience of help seeking in the study group. In addition, factors associated with doctor-patient relationship were found to play a major role in determining the help seeking behaviour of women experiencing symptoms related to psychological distress. Professional informants emphasized the role of their training, availability of supporting services, time and continuity of care. The study showed discrepancy between lay and professional informants’ beliefs regarding the role of family physicians in managing mental problems. Conclusion This study recommends paying more attention to factors related to cultural beliefs, doctor-patient relationship and family physicians’ role when planning health services and residency programs, and when planning research on aspects related to mental health in non-Western cultures.
Objective: This study compared the psychosocial status and weight loss expectations of women with extreme (class III) obesity who sought bariatric surgery with those of women with class I–II obesity who enrolled in a research study on behavioral weight control.Research Methods and Procedures: Before treatment, all participants completed the Beck Depression Inventory-II and the Weight and Lifestyle Inventory. This latter
Thomas A. Wadden; Meghan L. Butryn; David B. Sarwer; Anthony N. Fabricatore; Canice E. Crerand; Patti E. Lipschutz; Lucy Faulconbridge; Steven E. Raper; Noel N. Williams
Although maternal morbidity is increased, reported perinatal outcomes from peri- and postmenopausal pregnancy are generally good. Ethical considerations, in particular those relating to long term wellbeing of the child, constitute the primary reason to restrict the use of donated eggs in postmenopausal women.
Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of 80,431 patients attending federally funded prenatal care clinics in California from 1984 through 1989. The fetal death rate per 1,000 live births and fetal deaths was 7.8 for Hispanic, 8.4 for white non-Hispanic and 20.5 for black non-Hispanic women. These rates indicated favorable reproductive outcomes for Mexican Americans despite their social risk profile. An analysis of stillbirths by gestational age showed that Hispanic women stood a significantly lower risk of short-gestational stillbirths than non-Hispanics. In contrast, Hispanic women had a higher proportion of term stillbirths. Hispanic acculturation was a significant predictor of short-term gestation fetal deaths only. The inability to pay for health care was a strong predictor of fetal deaths for all ethnic groups, underscoring the need to ensure adequate access to maternity care for low-income women. PMID:7836554
Women account for 15 percent of the total admissions in medicine and present overall better examinations than men. Obstetrics and gynecology is the most common speciality selected by women, and job satisfaction is found in 87 percent. Sixty-six percent are married to other doctors, and 39 percent emigrate. (Author/LBH)
Three hundred women presenting to a sexually transmitted infection (STI) clinic in Mumbai, India were surveyed and HIV tested. Thirty-nine percent were HIV infected; 80% were current sex workers, and HIV infection was not significantly associated with past-year sex work. Only 44% always used condoms with their noncommercial sex partners. Most believed that condom preparation is a male responsibility (58%); that condom use is a sign that partner trust is lacking (84%); and that if a woman asks her partner to use a condom, he will lose respect for her (65%). All women at STI clinics in India need HIV testing and culturally sensitive risk interventions. PMID:23659311
Objective To (1) describe the frequency of spontaneous preterm birth (SPTB) and medically indicated preterm birth (PTB) among women with chronic hypertension (CHTN) and (2) to evaluate differences in neonatal outcomes according to SPTB or medically indicated PTB.Study Design Retrospective analysis of a previously conducted multicenter randomized trial. Deliveries were categorized as SPTB or medically indicated and stratified by gestational ages (<37 weeks, 34 to 366/7 weeks, 30 to 336/7 weeks, < 30 weeks). Rates of neonatal intensive care unit admission, composite respiratory morbidity, perinatal mortality, and small for gestational age (SGA) were evaluated.Results Of 765 women, 32.2% (n = 246) delivered at < 37 weeks, of which 10.5% (n = 80) were SPTB and 21.6% (n = 166) were medically indicated. Fifty-nine percent of PTBs occurred in the late preterm period (n = 146). SGA was significantly more frequent among those with medically indicated PTB at < 30 weeks (p = 0.03). There were no other differences in adverse neonatal outcomes between medically indicated versus SPTB at any gestational age (p > 0.05).Conclusion Nearly one-third of women with CHTN delivered preterm. The majority of PTBs were medically indicated and late preterm, but approximately one-third were due to SPTB. PMID:23359232
Kase, Benjamin A; Carreno, Carlos A; Blackwell, Sean C; Sibai, Baha M
Establishing successful vaccine programs for pregnant women would be the quintessence of preventive medicine when you realize the preventive potential for reproductive problems of many of the new and old vaccines. The development of vaccines to prevent maternal, fetal and newborn disease is actually in its infancy. The risks and benefits are discussed in detail as well as the most appropriate and inappropriate time to immunize women of reproductive age and pregnant women. The great majority of risks are theoretical, but the problem is that birth defects and other developmental and reproductive problems are in the group of "diseases of affliction" which means that there are tremendous emotional upheavals in families affected with serious reproductive problems. The failures in reproduction are so common that immunization of a pregnant women has potential deleterious consequences. A consortium of government, academia and industry must work together and an appeal to the more responsible members of the law profession to solve the problem of non-meritorious litigation has be in place before manufacturers of vaccines will be willing to initiate the development of new vaccines. The potential for reducing the incidence of birth defects, prematurity and neonatal infectious disease exists, but it will be difficult to initiate these programs because vaccine makers may be unwilling to assume an additional burden of negligence litigation. Certainly, it is clear that we could provide a safe vaccine for Group B streptococcus and infant botulism that would be of immediate benefit and the potential for reducing other diseases is realistic. This is not going to be an easy task. PMID:12850350
|Objective: We examined 4 separate dimensions of functional social support (tangible, appraisal, self-esteem, and belonging) as predictors of change in depression over 4.5 years in a sample of women reporting intimate partner violence. Method: Participants were recruited as they sought help for violence perpetrated by a current or former male…
Suvak, Michael K.; Taft, Casey T.; Goodman, Lisa A.; Dutton, Mary Ann
|Presents preliminary results from a survey of how women in information technology professions use information sources. Investigates the effects of perceived source accessibility and perceived source quality on the selection and use of information sources. Discusses results of correlation analysis and regression analysis that also examined…
Many breastfeeding women require and regularly take medicines, especially those available over-the-counter, and the safe use of these is dependent on the advice provided by health professionals such as general practitioners and pharmacists. The primary aim of this review therefore, was to investigate the literature relating to health professionals' and women's knowledge, attitudes and practices towards medication use and safety in breastfeeding. The limited literature that was uncovered identified that general practitioners and pharmacists have poor knowledge, but positive attitudes, and variable practices that are mostly guided by personal experience. They tend to make decisions about the use of a medicine whilst breastfeeding based on the potential 'risk' that it poses to the infant in terms of possible adverse reactions, rather than its 'compatibility' with breast milk. The decision-making process between health professionals and women is usually not a negotiated process, and women are often asked to stop breastfeeding whilst taking a medicine. Women, in turn, are left dissatisfied with the advice received, many choosing not to initiate therapy or not to continue breastfeeding. Some directions for future research have been suggested to address the issues identified in this critical area. This review is important from a societal perspective because many breastfeeding women require and regularly take medications, especially those available without prescription, and the safe use of these is dependent on the advice provided by health professionals, which is ultimately influenced by their knowledge, attitudes and practices. However, there is an absence of high quality evidence from randomised controlled trials on the safety of medications taken during breastfeeding, which naturally would hinder health professionals from appropriately advising women. It is equally important to know about women's experiences of advice received from health professionals, and whether there is consistency between recommendations made across resources on medication safety in breastfeeding, in order to gain a full understanding of the issues prevalent in this area of practice.
The objective of this study was to evaluate the effects of exercise on physical functions (activities of daily living, physical fitness) and medical examination parameters as risk factors for lifestyle-related diseases in 65- to 75-year-old women living independently at home. The women were provided instruction on aerobic exercises and resistance training for 20 weeks. This was followed by a voluntary
This study aimed to identify the prevalence and types of complementary and alternative medications (CAMs) used by women during menopause and explore potential associations between CAM use and menopausal symptoms. Analysis was undertaken with 886 randomly selected menopausal women aged 47-67 years who participated in a postal questionnaire on the menopause experience. The prevalence of CAM use was relatively high (82.5%), with nutrition most commonly cited (67%), followed by phytoestrogens (56%), herbal therapies (41%), and CAM medications (25%). Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17-23% more likely to report anxiety (p = .019) or vasomotor symptoms (p = .013). Women who used herbal therapies (p = .009) or phytoestrogens (p = .030) were 13-16% more likely to experience vasomotor symptoms. Women who used nutrition were 18% more likely to experience anxiety (p = .049). These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices. PMID:15482967
In the second half of the 19th century, with a wave of emancipation, women started to overcome discrimination and obtained access to the medical departments of universities. The first woman to obtain doctor's diploma was the American, Dr Elisabeth Blackwell (1821-1910) in 1851. In 1864 Switzerland was the first country in Europe to allow women to undertake medical studies. It was there that the first Polish woman - Dr Anna Tomaszewicz-Dobrska (1854-1918) obtained the doctor's diploma in 1878. In Poland, the official opening of university gates of medical faculties for women took place in 1900. In the 20s and 30s of the XXth century, the number of female doctors increased by 15%. It was then that counter-feminism began in the medical profession. The process of turning the medical profession into a feminine occupation went on in spite of the counter-action which took place at that time. Nowadays it is predominantly a feminine occupation with over 50% of doctors in Poland being women. PMID:11768365
This paper presents results from a qualitative analysis of the perceptions Australian young women cigarette smokers have of the medical health messages espoused through anti-smoking campaigns. The study aims to show that the deployment of medico-scientific knowledges in the most recent series of anti-smoking campaigns disseminated in New South Wales Australia (those which emerged in the 1990s under the auspices
Abstract Background Although there has been much research examining the relationship between pregnancy and abuse, this study is one of the few to investigate whether perinatal status (defined as pregnancy or early postpartum) impacts the help seeking of abused women. Methods We retrospectively reviewed 3 years of prosecutor administrative records, police incident reports, and hospital medical records for a countywide population of adult females (n?=?964) assaulted by an intimate partner in 2000. Perinatal and nonperinatal victims were compared using chi-square and a series of logistic regression models, controlling for all demographic and incident-related factors. Results Compared with women across the county, abused women were twice as likely to become pregnant (p?0.001). Perinatal status did not change the rate of help seeking from police (OR 1.1, p?=?0.67) or emergency departments (ED) (OR 1.1, p?=?0.94), but it did change the pattern of help seeking with higher ED use in the 6 months prior to the assault (p?0.01) and a trend toward seeking help with fewer injuries (p?=?0.10). Conclusions Abused women are more likely to become pregnant. Perinatal status impacts how victims seek help from criminal justice agencies and EDs.
Cerulli, Catherine; Marcus, Steven; Rhodes, Karin V.
Use of antidepressant medications has been associated with increased risk of fracture, but prior studies have been limited\\u000a by incomplete control of confounders or a limited number of fractures. Use of antidepressant medications by 8,217 community-dwelling\\u000a women aged 69 and older from a population-based prospective cohort study at four US clinical centers was assessed by interview\\u000a at four examinations over
Susan J. Diem; Terri L. Blackwell; Katie L. Stone; Jane A. Cauley; Teresa A. Hillier; Elizabeth M. Haney; Kristine E. Ensrud
OBJECTIVES: The purpose of this study was to determine the prevalence of, and sociodemographic factors associated with, adult domestic violence within a Native American community. METHODS: Adult women in the community were surveyed. RESULTS: Of 371 eligible women, 341 (92%) were surveyed. Among respondents, 179 reported a history of at least 1 episode of domestic violence. Fifty-six (16.4%) reported violence within the previous 12 months. Age under 40 years and living in a household receiving governmental financial assistance were independently associated with 1-year prevalence of adult domestic violence. CONCLUSIONS: Adult domestic violence is prevalent within this Native American community. Additional research is required to characterize further the relationship between domestic violence and socioeconomic status.
Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of
Sylvia Guendelman; Gilberto Chavez; Roberta Christianson
Aims. To seek high risk population for diabetes and to improve their health care by investigating the characteristics and outcome of hospitalization in hospitals with predominant Arab patients in Northern Israel. Methods. Retrospective analysis of the prevalence of diabetes and the outcome of diabetic in comparison to nondiabetic patients hospitalized in the internal medicine and intensive cardiac units in two major hospitals with one-year postdischarge data between 1.1.2009 and 31.12.2009. Results. Thirty-nine percent of the patients were diagnosed with diabetes. The preponderance of women in the diabetes group was noted. Diabetic patients had an increase in the duration of hospitalization (P = 0.0008), with one hospital having a high readmission rate for the diabetic patients. The average glycemia during hospitalization exceeded the recommended threshold of 180?mg% without major changes in the therapeutic regimens in comparison to preadmission regimens. Conclusions. Arab populations, women in particular, in westernizing societies are at high risk for diabetes which exemplifies as high rate of patients with diabetes among hospitalized patients. Areas for intervention during hospitalization and at predischarge have been identified to improve health outcomes and prevent readmissions.
... children. You should seek treatment whenever changes in your bowel or bladder habits keep you from going and doing what you want to do. Ten Warning Signs of Bladder Control Problems: Leakage of urine which ...
|Studied behavior problems, social competence, internalizing/externalizing behaviors, academic performance, and school behavior of 96 children (ages 8-16) of unipolar depressed, bipolar, medically ill, and psychiatrically normal women over 2 years. Children of unipolar mothers showed significantly poorer functioning on all measures; greater…
The aim of this study was to estimate the hospitalization incidence and the total number of hospital days related to all fractures and osteoporotic fractures in the year 2000 in Switzerland and to compare these with data from other frequent disorders in men and women. The official administrative and medical statistics database of the Swiss Federal Office of Statistics (SFOS)
Describes a collaboration to analyze and integrate elements of women's health into the core curriculum in internal medicine for a medical school's third year clerkship. Illustrates the new curriculum by describing the new module in pulmonary medicine and discusses the use of the process to integrate curricula in other interdisciplinary fields.…
Objective Eating disorders are a common clinical problem among young women in Asian countries. The aim of this study is to determine the medical effects of anorexia nervosa (AN) in the Korean population. Methods We comprehensively investigated medical complications including haemodynamic, haematologic, endocrine, and bone density abnormalities in 67 Korean women with AN, together with 194 healthy Korean women of comparable age with a cross-sectional design. Results In AN, 36.9% were anaemic, 50.8% were leukopenic, 35.5% were hypoproteinemic, 7.9% were hypokalemic, 9.5% had increased alanine aminotransferase, 6.3% were hyperbilirubinemia, 14.5% were hypercholesterolemia, 14.8% had decreased triiodothyronine. Osteopenia at any one site was identified in 43.3% and an additional 13.4% had osteoporosis. The lowest-ever body mass index was the main determinant of bone mineral density. Conclusion Our data in Korean patients with AN show high frequencies of laboratory abnormalities for medical complications. This study emphasizes the importance of recognizing AN as a medical risk in young Korean women.
This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM +…
Denton, Wayne H.; Wittenborn, Andrea K.; Golden, Robert N.
|This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM +…
Denton, Wayne H.; Wittenborn, Andrea K.; Golden, Robert N.
BACKGROUND: Health care workers are important in the promotion, protection and support of breast feeding. Their ability to do this may be influenced by their knowledge, personal experiences and work. PATIENTS AND METHOD: The breast feeding experience of 36 female medical doctors who had babies within the preceding two years and had resumed work was evaluated using a semi-structured self administered questionnaire. RESULT: All respondents knew that babies should be exclusively breast fed for the first six months of life but only 60% knew that breast feeding should continue until two years. The exclusive breast feeding rate for the studied doctors was 11.1%. Before their babies were six months old, about 75% of respondents had resumed work whilst over 50% had started taking calls. Most could not breast feed during working or call hours. Alternative feeds during working or call hours included expressed breast milk in 34.4% and infant formula in 21.9%. Feeding bottle was the major method (77.4%) for feeding these alternatives. Work schedule was rearranged to allow breast feeding in only 27.3% of respondents. CONCLUSION: Failure to carry out exclusive breast feeding, the use of infant formula and feeding bottles (rather than cup feeding) are practices that may be inimical to the practice of breast feeding in society in general. The suboptimal breast feeding experience in these doctors and the identified knowledge deficits may limit their effectiveness in promoting and supporting breast feeding among their patients and communities. Female medical personnel should be empowered to carry out optimal feeding of their own infants. PMID:21968706
OBJECTIVE: To show why women are still seeking anorexiant medications despite current concerns over their use. DESIGN: In-depth interviews using grounded theory methodology. SETTING: Participants chose where they were to be interviewed. PARTICIPANTS: Women older than 18 years who had previously taken or were currently taking anorexiant medications for the purpose of losing weight. METHOD: Nine women completed two semistructured in-depth interviews during which they described their experiences from the time they began pharmacologic therapy for obesity until they discontinued the medications. Interview data were compiled and analyzed until saturation was reached. MAIN OUTCOME FINDINGS: Control was an important factor for the women. Their previous lack of control was due to frustration with failed dieting attempts and feeling pressure from others to lose weight. Prescription medications controlled physiologic hunger while the women sought to lose weight. Increased control over hunger and a decrease in weight gave participants confidence to continue their weight-loss efforts without the medications. Once the medications were discontinued, the women were able to maintain weight control through various lifestyle modifications. CONCLUSIONS: Anorexiant medications provide some women with a perception of control that helps them lose weight and not regain it. Health care professionals should be aware of their patients' struggles with weight loss and understand the importance of these medications for some patients.
Prolactin (PRL) and thyroid stimulating hormone (TSH) serve important roles in the reproductive and other systems. Active smoking is associated with changes in PRL and TSH secretion, but the relationship between secondhand tobacco smoke (STS) exposure and these hormones is unclear. We measured PRL and TSH in serum as well as cotinine in follicular fluid (to estimate STS exposure) among 314 nonsmoking women undergoing in vitro fertilization treatment. We observed a significant increase in PRL concentrations (p=0.03) among STS-exposed nonsmokers compared to unexposed nonsmokers. There was no significant difference in TSH concentration (p>0.4) among those exposed to STS compared to those who were unexposed. STS exposure is associated with an increase in circulating PRL but not TSH levels. Future studies are needed to confirm our results, identify biological mechanisms involved, and better understand the potential clinical and public health implications. PMID:23046534
Benedict, Merle D; Missmer, Stacey A; Ferguson, Kelly K; Vitonis, Allison F; Cramer, Daniel W; Meeker, John D
Objective: The purpose of this study was to evaluate the impact of substance use and psychotherapeutic medications on menstrual characteristics in women who are human immunodeficiency virus seropositive and seronegative. Study Design: Menstrual calendars were prospectively collected for 1075 women who were human immunodeficiency virus seropositive and seronegative and who were enrolled in the Women's Interagency Human Immunodeficiency Virus Study
Siobán D. Harlow; Mardge Cohen; Suzanne E. Ohmit; Paula Schuman; Susan Cu-Uvin; Xihong Lin; Ruth Greenblatt; Alejandra Gurtman; Ann Khalsa; Howard Minkoff; Mary A. Young; Robert S. Klein
Due to cultural and religious reasons, Pakistani women can be reluctant to seekmedical attention for disorders affecting their genitals or breasts. As a result, in the case of cervical and breast cancers, oncological treatment is often not received until the diseases are in the late stages. Once a cancer is classified and the tumor marked, the role of the medical physicist begins. Medical physicists' responsibilities include treatment planning, supervising treatment through radiation, dosimetry, contouring, training, equipment selection, education, research, and supervising radiotherapy facilities. In brachytherapy, isotopes are placed at the tumor site in the form of wires or seeds. There are very few female medical physicists in Pakistan. This leads to further hesitation on the part of many women to seek treatment. To help female patients obtain needed medical care, female physics students should be encouraged to pursue the emerging field of medical physics. This would provide a new professional opportunity for female physics students and give comfort to female patients.
Naqvi, Syed Mansoor [Department of Radiology, Aga Khan University Hospital, Karachi (Pakistan); Hasnain, Aziz Fatima [Center for Physics Education, Karachi (Pakistan)
Empirical data indicative of the health conditions and medical needs of homeless persons are scarce in Japan. In this study, with the aim of contributing to the formulation of future healthcare strategies for the homeless, we conducted a self-administered questionnaire survey and interviews at a park in Shinjuku Ward, Tokyo, to clarify the living conditions of homeless persons and their health conditions and awareness about the availability of medical treatment. Responses from 55 homeless men were recorded (response rate: 36.7%). With the exception of one person, none of them possessed a health insurance certificate. Half of the respondents reported having a current income source, although their modal monthly income was 30,000 yen($1 was approximately 90 yen). The number of individuals who responded "yes" to the questions regarding "Consulting a doctor on the basis of someone's recommendation" and "Being aware of the location of the nearest hospital or clinic" was significantly higher among those who had someone to consult when they were ill than among those who did not (the odds ratios [95% confidence intervals] were 15.00 [3.05-93.57] and 11.45 [1.42-510.68], respectively). This showed that whether or not a homeless person had a person to consult might influence his healthcare-seeking behavior. When queried about the entity they consulted (multiple responses acceptable), respondents mentioned "life support organizations" (61.1%) and "public offices" (33.3%). Overall, 94.5% of the respondents were aware of swine flu (novel influenza A (H1N1)). Their main sources of information were newspapers and magazines. On the basis of these findings, with regard to the aim of formulating healthcare strategies for homeless persons, while life support organizations and public offices play significant roles as conduits to medical institutions, print media should be considered useful for communicating messages to homeless persons. PMID:22189479
Medicine maintains a distinction between the medical symptom--the patient's "subjective" experience and expression, and the privileged medical sign--the "objective" findings observable by the doctor. Although the distinction is not consistently applied, it becomes clearly visible in the "undefined," medically unexplained disorders of women patients. Potential impacts of genderized interaction on the interpretation of medical signs are addressed by re-reading the diagnostic process as a matter of social construction, where diagnosis results from human interpretation within a sociopolitical context. The discussion is illustrated by a case story and empirical evidence of the gendering in the doctor-patient relationship. The theoretical analysis is supported by semiotic perspectives of bodily signs, feminist theory on experience, and Foucault's ideas about medical perception and gaze, and concludes that a medical diagnosis is seldom a biological fact, but the outcome of a process where biological, cultural and social elements are interwoven. Further deconstruction of the chain of signs from a feminist perspective, assigning validity to the voice of the woman patient, might broaden the understanding of women's health, illness and disease. PMID:10474313
Women are an important audience for voluntary medical male circumcision (VMMC) communication messages so that they know that VMMC provides only partial protection against HIV. They may also be able to influence their male partners to get circumcised and practice other HIV protective measures after VMMC. This study was conducted in two phases of qualitative data collection. Phase 1 used in-depth interviews to explore women's understanding of partial protection and their role in VMMC. Phase 2 built on the findings from the Phase 1, using focus groups to test VMMC communication messages currently used in Nyanza Province and to further explore women's roles in VMMC. Sixty-four sexually active women between the ages of 18 and 35 participated. In Phase 1, all women said they had heard of partial protection, though some were not able to elaborate on what the concept means. When women in Phase 2 were exposed to messages about partial protection, however, participants understood the messages well and were able to identify the main points. In Phases 1 and 2, many participants said that they had discussed VMMC with their partner, and for several, it was a joint decision for the man to go for VMMC. These findings suggest that current VMMC messaging is reaching women, though communications could more effectively target women to increase their ability to communicate about partial HIV protection from VMMC. Also, women seem to be playing an important role in encouraging men to get circumcised, so reaching out to women could be a valuable intervention strategy for increasing VMMC uptake and promoting use of other HIV protective measures after VMMC. PMID:23028634
Lanham, Michele; L'engle, Kelly L; Loolpapit, Mores; Oguma, Isaac Onyango
AIM: To increase understanding of women's decision-making process concerning the medication use for anxiety and/or depression while pregnant. BACKGROUND: Anxiety and depression affects many pregnant women, yet the decision to take psychotropic medication is complex and possibly subject to social oppression. DESIGN: Cross-sectional descriptive survey design. METHODS: A web-based survey was used to collect data from a convenience sample of 143 pregnant women over 3 months beginning in early 2011. An independent t-test was conducted to determine differences in satisfaction between women with high and low levels of emancipated decision-making (EDM). A multiple regression analysis was conducted to determine which subscales of the emancipation scale best predict level of satisfaction with the decision. FINDINGS: The majority of respondents were White, between 25-34 years of age. The group with lower levels of emancipation reported lower mean satisfaction scores compared with those with higher levels of emancipation. Regression analysis showed that the three subscale emancipation model was a statistically significant predictor of satisfaction with the decision and accounted for 54% of the variance in satisfaction. The subconcept of personal knowledge was most predictive of satisfaction with decision. CONCLUSIONS: Women may be able to overcome oppressive forces by using an EDM process. EDM allows them to make a decision that feels right for them and to feel satisfied with the decision. PMID:23488910
Stepanuk, Kathleen M; Fisher, Kathleen M; Wittmann-Price, Ruth; Posmontier, Bobbie; Bhattacharya, Anand
Background Women’s long-term patterns of evidence-based preventive medication utilization following a coronary heart disease (CHD) diagnosis have not been sufficiently studied. Methods Postmenopausal women 50–79 years were eligible for randomization in the Women’s Health Initiative’s (WHI) hormone trials if they met inclusion and exclusion criteria and were >80% adherent during a placebo-lead-in period and in the dietary modification trial if they were willing to follow a 20% fat diet. Those with adjudicated myocardial infarction or coronary revascularization after the baseline visit were included in the analysis (n=2627). Baseline visits occurred between 1993 and 1998, then annually until the trials ended in 2002 through 2005; medication inventories were obtained at baseline and years 1, 3, 6 and 9. Results Utilization at the first WHI visit following a CHD diagnosis increased over time for statins (49% to 72%; p<0.0001), beta-blockers (49% to 62%; p=0.003), and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers (ACEI/ARBs ) [26 to 43%; p<0.0001]. Aspirin use remained stable at 76% (p=0.09). Once women reported using a statin, aspirin, or beta-blocker, 84–89% reported use at 1 or more subsequent visits, with slightly lower rates for ACEI/ARBS (76%). Statin, aspirin, beta-blocker, or ACEI/ARB use was reported at 2 or more consecutive visits by 57%, 66%, 48%, and 28% respectively. These drugs were initiated or resumed at a later visit by 24%, 17%, 15%, and 17%, respectively, and were never used during the period of follow-up by 19%, 10%, 33%, and 49% respectively. Conclusions Efforts to improve secondary prevention medication utilization should target both drug initiation and restarting drugs in patients who have discontinued them.
Robinson, Jennifer G; Wallace, Robert; Safford, Monika M.; Pettinger, Mary; Cochrane, Barbara; Ko, Marcia G.; O'Sullivan, Mary Jo; Masaki, Kamal; Petrovich, Helen
Background: Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain. Methods: All women born in 1960–79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individual's changes on study variables over time. Data were retrieved from national administrative registers. Results: Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20–25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children. Conclusion: Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women.
Hagman, Maud; Aronsson, Gunnar; Marklund, Staffan; Wikman, Anders
This study focused on revealing the cultural meanings assigned to womanhood and the health-disease process in women according to the discourse of medical residents in Obstetrics/Gynecology at the Fernandes Figueira Institute, a public reference hospital specializing in maternal-child care in Rio de Janeiro. The research had two components: participatory observation in Ob-Gyn meetings and recording of oral sources. The sign-based method was used to analyze the data. The methodology included qualitative analytical coding of interviews and subsequent semiotic analysis. According to the results: (a) women are seen essentially as mothers, and their illness focuses primarily on their childbearing function; (b) technological evolution, mainly with the increased use of imaging, has reduced the importance of semiology; and (c) within the biotechnological context medicalization is part of the material and semiotic practices. PMID:16680347
Gilbert, Ana Cristina Bohrer; Cardoso, Maria Helena Cabral de Almeida; Wuillaume, Susana Maciel
Non-medical use of prescription drugs (NMUPD) is one of the fastest growing forms of illicit drug use, with research indicating that college students represent a particularly high risk population. The current study examined demographic characteristics, health\\/mental health, substance misuse, and rape experiences as potential risk correlates of NMUPD among a national sample of college women (N=2000). Interviews were conducted via
Jenna L. McCauley; Ananda B. Amstadter; Alexandra Macdonald; Carla Kmett Danielson; Kenneth J. Ruggiero; Heidi S. Resnick; Dean G. Kilpatrick
The psychosocial functioning of children of unipolar depressed, bipolar, medically ill, and psychiatrically normal women was studied over a 2-year period. Ninety-six children aged 8–16 years were assessed at 6-month intervals on Child Behavior Checklist behavior problems, social competence, internalizing and externalizing behaviors, academic performance, and school behavior. The children of unipolar mothers showed significantly poorer functioning on all measures
This qualitative study sought to explore women's experiences of support and treatment for postnatal depression. In-depth interviews from seven women were analysed using the phenomenological method described by Creswell (1998). Findings indicate that partners provided women the most support. The women did not know where to seek professional help, often being identified and helped by the maternal health nurse who monitors and guides the progress of their babies' development. Hospital programs were criticised for not informing and involving family. The women were dissatisfied with hospital doctors and their GPs claiming they had limited time for counselling, preferring to prescribe medication that alleviated symptoms but reinforced feelings of inadequacy. Recommendations are made to involve families and to use the unique position of the maternal health nurse in assessing new mothers. PMID:12002628
Sociocultural and psychological investigations were conducted to determine why lower class Chilean women undergo abortions despite strong social, religious, and legal sanctions. According to various estimates, there are 2 undetected illegal abortions in Chile for each abortion leading to hospitalization of the woman. Some 120,000-150,000 abortions are estimated to occur each year, compared to perhaps 300,000 live births. Illegal abortion is the principal cause of maternal mortality in Chile, carrying 4 times greater risk of death than term pregnancy. Because of the extreme difficulty of obtaining systematic information on abortion in the society at large, the studies were conducted in hospital wards treating women for septic abortions. Qualitative studies were 1st conducted using intensive methods such as life histories and a test of body image to assess knowledge of reproductive anatomy and physiology. A more extensive study was then done 2 of the 6 health services in metropolitan Santiago and a health service in Valparaiso. The sample of 357 women represented almost all of the women treated for abortion in the services during the time of the study. The women were lower class, primarily of urban origin, and 16-34 years old for the most part. 60% were single and 10% were separated or widowed. 75% had some secondary education but only 20% had finished secondary school. 1/2 of the sample had no gainful employment and 60% of the rest lacked any type of social insurance. 1/2 of the abortions were in single women abandoned by their partners or who lived with their parents and feared their reactions. 15% were single women who feared loss of employment. 30% were married with children and gave economic reasons for seeking abortion. The women were found to have erroneous ideas about the reproductive cycle, believing pregnancy to be possible only around the time of menstruation. Their beliefs were part of a coherent system passed down by oral tradition and not challenged by any scientific teaching imparted in the educational process. Very few used modern contraception. They relied instead on periodic abstinence during the days they erroneously believed to be fertile. They were not strongly motivated to seek modern contraception and many believed they lacked access or did not meet qualifications for family planning programs. The products of conception were not viewed as a truly living thing until after the 1st months of gestation. They believed that once the lesser abortifacient actions such as drinking concoctions were undertaken the child would inevitably be deformed. They were thus motivated for the 2nd stage, traumatic introduction of foreign objects into the uterus to provoke abortion usually at the hands of unskilled person under septic conditions. Most of the women knew of safer means of abortion but were unable to pay for them. PMID:12281977
During the eighteenth century, orders of nursing sisters took on an expanded role in the rural areas of Brittany. This article explores the impact of religious change on the medical activities of these women. While limits were placed on the medical practice of unlicensed individuals, areas of new opportunity for nuns as charitable practitioners were created by devout nobles throughout the eighteenth century. These nuns provided comprehensive care for the sick poor on their patrons' estates, acting not only as nurses, but also in lieu of physicians, surgeons, and apothecaries. This article argues that the medical knowledge and expertise of these sisters from the nursing orders were highly valued by the elites of early modern Brittany.
During the eighteenth century, orders of nursing sisters took on an expanded role in the rural areas of Brittany. This article explores the impact of religious change on the medical activities of these women. While limits were placed on the medical practice of unlicensed individuals, areas of new opportunity for nuns as charitable practitioners were created by devout nobles throughout the eighteenth century. These nuns provided comprehensive care for the sick poor on their patrons' estates, acting not only as nurses, but also in lieu of physicians, surgeons, and apothecaries. This article argues that the medical knowledge and expertise of these sisters from the nursing orders were highly valued by the elites of early modern Brittany. PMID:21724643
A systemic family therapy intervention, Structural Ecosystems Therapy (SET), has been shown to promote adaptation to living with HIV by reducing psychological distress and family hassles. This investigation examines the effect of SET on HIV medication adherence relative to a person-centered condition and a community control condition. Medication adherence was assessed on 156 trial participants. Results of a two-part model showed that SET was significantly more likely to move women to high levels of adherence (defined as at least 95% adherence) than a person-centered therapy. Family hassles was also significantly reduced by SET, though the effect of SET on medication adherence did not appear related to this change in family hassles.
Feaster, Daniel J.; Brincks, Ahnalee M.; Mitrani, Victoria B.; Prado, Guillermo; Schwartz, Seth J.; Szapocznik, Jose
Abstract: Research indicates that two major forms of partner violence exist, intimate terrorism (IT) and situational couple violence (SCV). The current study (N ¼ 389) used a subgroup,of women,who,responded,to the Chicago Women’s,Health Risk Study to examine,whether,type of violence experienced,is differentially related to formal (e.g., police, medical agencies, counseling) and informal (e.g., family, friends\\/neighbors) help seeking. IT victims were more,likely to
Janel M. Leone; Michael P. Johnson; Catherine L. Cohan
The Seeking Michigan website is part of a collaboration between the Library of Michigan and Archives of Michigan, and its aim is to provide "access to unique historical information that promotes Michigan's cultural heritage." Some of the historical information visitors will find on the site includes images, documents, oral histories, maps, films, and artifacts. The "Look" section of the website is a blog where various people author articles about a story or item they have chosen from the site, for example Randy Riley of the Library of Michigan writes about Elmore Leonard, often called "The Dickens of Detroit" by his fans. Visitors who are Detroit Red Wings fans will appreciate the article about their last game at Olympia Stadium, authored by Matt Zarb of the Michigan Historical Museum. Lastly, visiting educators will find that the "Teach" link has a short video about the "History of the Photograph", which is the introduction to a lesson for young people on how to analyze the many historic photographs on the Seeking Michigan website. The link to the lesson is at the end of the video.
Survival after diagnosis of cancer is one of the major outcome measurements and a key criterion for assessing quality of cancer control related to both the preventive and the therapeutic level. The purpose of this study was to determine the 8-year survival time in Malaysia based on socio-demographic and clinical characteristics. A retrospective study of 472 Malaysian women with breast cancer from the Medical Record Department at University Kebangsaan Malaysia Medical Centre (UKMMC) was therefore performed with survival analysis carried out using the Kaplan-Meier with log-rank test for univariate analysis and Cox-regression for multivariate analysis. Women who had cancer or family history of cancer had a longer 8-year survival time (p = 0.008) compared with others who did not have such a history. Tamoxifen use, positive oestrogen receptor status, and race were prognostic indicators for 8-year survival time (p = 0.036, p = 0.018, p = 0.053, respectively) in univariate analysis. Multivariate analysis showed that being Malays and having no family history of cancer were independent prognostic factors for shorter survival time (p = 0.008, p = 0.012, respectively). In conclusion, being Chinese and having a family history of cancer are predictors of longer survival among the Malaysian breast cancer women. PMID:20192587
Al-Naggar, Redhwan Ahmed Mohammed; Isa, Zaleha Md; Shah, Shamsul Azhar; Nor, Md Idris Mohd; Chen, Robert; Ismail, Fuad; Al-Dubai, Sami Abdo Radman
Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements.
This study of 302 Israeli women sought to investigate the associations among stressful reproductive experiences (e.g. fertility problems, abortions, and traumatic births), chronic medical conditions, pain, and depression. The specific aims of the study were to examine (1) the effect of stressful reproductive experiences, chronic medical conditions, and pain on depressive symptoms and (2) the effect of stressful reproductive experiences,
BACKGROUND The majority of women prescribed category D or X medications may not receive adequate contraceptive counseling or a reliable\\u000a contraceptive method. Physicians who prescribe potentially teratogenic medications have a responsibility to provide women\\u000a with contraceptive counseling, a method of highly-effective contraception, or both.\\u000a \\u000a \\u000a \\u000a \\u000a OBJECTIVE Investigate the knowledge, beliefs and barriers of primary care physicians toward providing adequate contraception to women\\u000a taking
David L. Eisenberg; Catherine Stika; Ami Desai; David Baker; Kathleen J. Yost
The apathy encountered by battered women when they seek help from medical and other professions has been attributed to patriarchal norms and victim?blaming. Because of their place in the medical hierarchy this study hypothesized that: a) nurses would have more sympathetic attitudes toward battered women than physicians; and b) professional roles and not gender would explain the differences. The findings
Virus-infected medical personnel under certain circumstances might represent a risk for pregnant women. With regard to such nosocomial provider-to-patient transmissions, the pathogens rubella virus, herpes viruses and the hepatitis B and hepatitis C viruses are of particular concern. It will become clear from the following short communication that in this context one should strive to achieve optimal protection for the expectant mothers without restricting the professional activities of virus-infected members of the medical staff in an unjustified way. In this respect it always has to be kept in mind that the risk of provider-to-patient transmissions of viruses in obstetrics and neonatology can be significantly reduced by vaccinating all personnel working in these departments against infections by the rubella, varicella-zoster, and hepatitis B viruses, and that additional strict adherence to so-called universal hygienic precautions will add more than an incremental benefit. PMID:17999133
This study examines prevalence and correlates of help seeking for emotional problems among undergraduate female rape victims. A national college sample of women endorsing a lifetime history of rape (N=228) were interviewed in 2006 to assess demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse. Participants were asked if they ever sought help for emotional problems, and what type(s) of services were sought (medical professional, religious figure, or mental health professional). Prevalence of help seeking was 52%. Of help-seekers, 93% went to a mental health professional, 48% went to a medical doctor, and 14% sought religious counsel. Only PTSD was related to ever seeking help (OR=2.35). Findings suggest that university-based mental health and medical facilities should be well prepared to identify and treat PTSD and other rape-related sequelae. Health promotion campaigns are needed to target substance abusing and depressed rape victims, who were less likely to seek help. PMID:20620018
Amstadter, Ananda B; Zinzow, Heidi M; McCauley, Jenna L; Strachan, Martha; Ruggiero, Kenneth J; Resnick, Heidi S; Kilpatrick, Dean G
This study examines prevalence and correlates of help seeking for emotional problems among undergraduate female rape victims. A national college sample of women endorsing a lifetime history of rape (n=228) interviewed in 2006 to assess demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse. Participants were asked if they ever sought help for emotional problems, and what type(s) of services were sought (medical professional, religious figure, or mental health professional). Prevalence of help seeking was 52%. Of help-seekers, 93% went to a mental health professional, 48% went to a medical doctor, and 14% sought religious counsel. Only PTSD was related to ever seeking help (OR=2.35). Findings suggest that university-based mental health and medical facilities should be well prepared to identify and treat PTSD and other rape-related sequelae. Health promotion campaigns are needed to target substance abusing and depressed rape victims, who were less likely to seek help.
Amstadter, Ananda B.; Zinzow, Heidi M.; McCauley, Jenna L.; Strachan, Martha; Ruggiero, Kenneth J.; Resnick, Heidi S.; Kilpatrick, Dean G.
National studies indicate that Mexican immigrant women tend to have more positive birth outcomes than other groups, despite receiving relatively low levels of medical prenatal care. Our study-based on in-depth interviews with immigrant women who had recently given birth in Chicago-examines women's experiences seeking prenatal care. Qualitative findings contribute to understanding why many of these women received less than optimal
Objective: Many women with mental health problems do not seek help. Despite substantial research on predictors of help seeking, little is known about factors associated with help seeking in at-risk populations (e.g., rape victims). This study examines various forms of help seeking for emotional problems in relation to key variables in a national sample of female rape victims. Methods: We interviewed via telephone a representative sample of 3,001 women (aged 18-76 years). Those endorsing a lifetime history of rape were included in the present analyses (n=556). Demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse were assessed. Help seeking was assessed by asking if participants ever sought help, and if so, what type(s) of services were sought (medical professional, religious figure, or mental health professional). Results: Help seeking was endorsed by 60% of the sample. Final multivariable model showed that ever seeking help was positively associated with white race (OR=2.61), being single/divorced/widowed (OR=2.30), and having PTSD (OR=3.45). Specific forms of help seeking revealed unique predictor sets. Conclusions: Although help seeking among rape victims was high, 40% of victims did not seek services. Odds of help seeking were generally increased by the presence of a mental health disorder. Because mental health professionals were not the only types of professionals from whom rape victims sought emotional support, education and training regarding rape and associated disorders should be available to other professionals to support provision of care. Public policy should be strengthened regarding professionals' service provision, and should include reimbursement for mental health services.
Amstadter, Ananda B.; McCauley, Jenna L.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Kilpatrick, Dean G.
In 2001, the Medical Practitioners Board of Victoria received a complaint from an Australian Government Senator regarding a late-term abortion carried out in February 2000 at the Royal Women's Hospital, Melbourne. Five years later, the complaint of professional misconduct was finally dismissed by the Board as being frivolous and vexatious. The action highlights a number of deficiencies in the way medical practitioner boards deal with complaints against medical practitioners; in particular, the Board's lack of discretion to deal with complaints lacking substance. Early mediation of the dispute between the Royal Women's Hospital and the Medical Practitioners Board could have avoided a great deal of suffering and expense. As a result of this case, it is likely that the Victorian Medical Practitioners Board will be given additional powers in the future to deal with complaints without merit. PMID:17407433
Objectives. We sought to disentangle the relationships between race/ethnicity, socioeconomic status (SES), and unmet medical care needs. Methods. Data from the 2003–2004 Community Tracking Study Household Survey were used to examine associations between unmet medical needs and SES among African American and White women. Results. No significant racial/ethnic differences in unmet medical needs (24.8% of Whites, 25.9% of African Americans; P = .59) were detected in bivariate analyses. However, among women with 12 years of education or less, African Americans were less likely than were Whites to report unmet needs (odds ratio [OR] = 0.57; 95% confidence interval [CI] = 0.42, 0.79). Relative to African American women with 12 years of education or less, the odds of unmet needs were 1.69 (95% CI = 1.24, 2.31) and 2.18 (95% CI = 1.25, 3.82) among African American women with 13 to 15 years of education and 16 years of education or more, respectively. In contrast, the relationship between educational level and unmet needs was nonsignificant among White women. Conclusions. Among African American women, the failure to recognize unmet medical needs is related to educational attainment and may be an important driver of health disparities, representing a fruitful area for future interventions.
Person, Sharina D.; Kiefe, Catarina I.; Allison, Jeroan J.
Introduction Women veterans are a fast-growing segment of the veteran population, yet they face many barriers to medical care. The objective of this study was to examine factors that put women veterans at risk for a financial barrier to medical care. Methods We conducted repeated cross-sectional analyses of data from the 2003, 2004, 2009, and 2010 Behavioral Risk Factor Surveillance System. We used weighted logistic regression to examine the risk of a financial barrier to medical care as the primary outcome in a multivariate model controlling for factors in health-related domains. Results In 2010, there were an estimated 1,719,750 (11.6%) working-aged veterans who needed to see a doctor in the previous 12 months but could not because of cost. For women, 13.4% faced this financial barrier. Over the study period, facing a financial barrier was consistently associated with insurance coverage, physical and mental distress days, and having children in the home. Other associations emerged in particular years, such as binge drinking in 2010. The trends for women veterans relative to men and for younger women veterans relative to older women veterans show reduction in financial barriers to health care. Conclusion The Veteran’s Health Administration (VHA) should continue efforts to reduce financial and other barriers, especially among the higher risk groups we identified. This will help meet the VHA’s objectives of providing comprehensive care to all veterans including women.
IMPORTANCE Antihypertensive agents are the most commonly prescribed class of medications in the United States. Evidence regarding the relationship between different types of antihypertensives and breast cancer risk is sparse and inconsistent, and prior studies have lacked the capacity to assess impacts of long-term use. OBJECTIVE To evaluate associations between use of various classes of antihypertensive medications and risks of invasive ductal and invasive lobular breast cancers among postmenopausal women. DESIGN, SETTING, AND PARTICIPANTS Population-based case-control study in the 3-county Seattle-Puget Sound metropolitan area. Participants were women aged 55 to 74 years, 880 of them with invasive ductal breast cancer, 1027 with invasive lobular breast cancer, and 856 with no cancer serving as controls. EXPOSURES Recency and duration of use of antihypertensive medications. MAIN OUTCOMES AND MEASURES Risks of invasive ductal and invasive lobular breast cancers. RESULTS Current use of calcium-channel blockers for 10 or more years was associated with higher risks of ductal breast cancer (odds ratio [OR], 2.4; 95% CI, 1.2-4.9) (P?=?.04 for trend) and lobular breast cancer (OR, 2.6; 95% CI, 1.3-5.3) (P?=?.01 for trend). This relationship did not vary appreciably by type of calcium-channel blocker used (short-acting vs long-acting, dihydropyridines vs non-dihydropyridines). In contrast, use of diuretics, ?-blockers, and angiotensin II antagonists were not associated with risk. CONCLUSIONS AND RELEVANCE While some studies have suggested a positive association between calcium-channel blocker use and breast cancer risk, this is the first study to observe that long-term current use of calcium-channel blockers in particular are associated with breast cancer risk. Additional research is needed to confirm this finding and to evaluate potential underlying biological mechanisms. PMID:23921840
Li, Christopher I; Daling, Janet R; Tang, Mei-Tzu C; Haugen, Kara L; Porter, Peggy L; Malone, Kathleen E
The theme of self-discovery through research has now become part of my PhD project. Although this may not be uncommon in the context of qualitative research methodology and practice (Meloy 1994), particularly amongst women, the realisation that I may be seeking myself in the face, form and philosophy of my subject organisation is nevertheless an unexpected discovery of my academic
Recent changes in New Zealand's HIV and immigration situations have sparked a need to understand the experiences of HIV-positive African newcomers there. Here a narrative lens was brought to a previous qualitative study to harvest stories about discrimination in medical settings in New Zealand, told by four HIV-positive African women. Despite describing positive experiences with specialist HIV providers, their accounts shed light on weaknesses within the health care system regarding the rights and treatment of immigrants living with HIV. Participants reported inappropriate use of universal precautions, violations of confidentiality rights, discriminatory comments about Africans or persons with HIV, and misinformation about HIV transmission. Interventions must include enforcement of The Privacy Law and consistent training and monitoring of employee behavior in health care organizations. PMID:24028736
Africa's distribution of specialized private health services is severely disproportionate. Mismatch between South Africa's excess supply and a huge demand potential in an under-serviced continent represents an entrepreneurial opportunity to attract patients to South Africa for treatment and recuperative holidays. However, effective demand for intra-African medical tourism could be constrained by sub-Saharan poverty. Results from interviewing 320 patients and five staff at the Johannesburg Breast care Centre of Excellence, however, reject this proposition, Africa's middle class women being the target market estimated to grow annually by one million while breast cancer incidence increases with middle-class lifestyles. Uncovering this potential involves an extensive marketing strategy. PMID:22392794
Ahwireng-Obeng, Frederick; van Loggerenberg, Charl
After completing a full-time practicum with the Women's League of Burma (WLB) and the Shan Women's Action Network (SWAN), I accompanied their delegation to the U.N. Commission on the Status of Women's 49th Session, at the United Nations Headquarters in New York in March 2005. It was during this conference that I had the opportunity to answer my research questions:
Background Self-report is commonly used as a source of information on the use of medicine. The aim of this study was to investigate the relationship between self-reported and register-based information on the use of psychoactive medication, especially in respect to antidepressants, and reasons of non-reporting. Methods Study subjects (n?=?11,031) originated from a population-based cohort of postmenopausal women born in 1932–41 from Eastern Finland who responded to a postal enquiry in 1999. Self-reported currently used prescribed medications were compared to the National prescription register data. Diuretics served as a reference for psychoactive medications. Results Only 44% out of 1,638 women reported their use of psychoactive medication when compared to the prescription register within a 4-month time window preceding their response to enquiry. Altogether, 55% out of 777 women reported their use of antidepressants and 29% out of 861 reported their use of other psychoactive medications. In comparison 83% reported their use of diuretics. After excluding the occasional use, an increase in sensitivity by approximately 10 percentage points was seen regardless of the group of psychoactive medication. High use and history of work disability pension due to psychiatric cause were associated with a much higher likelihood of reporting psychoactive medication use (for antidepressants 70% and 81%, respectively). Conclusions For research purposes, self-reported current use of psychoactive medication seems to be a sufficient indicator for regular use of antidepressants or in respect of use of any psychoactive medication, for subjects with severe psychiatric disease.
|The purpose of this case study was to explore a model of leadership development for women faculty and staff in higher education. This study is significant because it explored the only identified campus-based program open to both faculty and staff. The campus-based Women's Institute for Leadership Development (WILD) program at the University of…
BACKGROUND: The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid to investigate the ability of pregnant women to access and effectively utilize these services. OBJECTIVES: To describe the experience and perceptions of pregnant
Godfrey M Mubyazi; Paul Bloch; Pascal Magnussen; Øystein E Olsen; Jens Byskov; Kristian S Hansen; Ib C Bygbjerg
BACKGROUND: To describe malaria knowledge, attitudes toward malaria and bed net use, levels of ownership and use of bed nets, and factors associated with ownership and use among pregnant women attending their first antenatal care (ANC) visit in Kinshasa, DRC. METHODS: Women attending their first ANC visit at one maternity in Kinshasa were recruited to take part in a study
Audrey Pettifor; Eboni Taylor; David Nku; Sandra Duvall; Martine Tabala; Steve Meshnick; Frieda Behets
A cross sectional descriptive study of awareness and practice of family planning methods among 200 women of reproductive age attending gynecology out patient department (GOPD) of Nepal Medical College Teaching Hospital from 14 th May 2008 to 14 th July, 2008 was carried out. Most of the respondents (93.0%) were aware of at least one of family planning methods out
The legally binding consent of a patient to surgical operations of certain diagnostic measures during hospitalisation is actually guaranteed only in cases where the medical information is oriented to the individual level of understanding of the patient. The real extent of actual knowledge about health relevant aspects is not always known. Immigrant women constitute a large portion of the patients
In 2001, the Medical Practitioners Board of Victoria received a complaint from an Australian Government Senator regarding a late-term abortion carried out in February 2000 at the Royal Women's Hospital, Melbourne. • Five years later, the complaint of professional misconduct was finally dismissed by the Board as being frivolous and vexatious. • The action highlights a number of deficiencies in
Tubal sterilization is the most common contraceptive method used by Brazilian HIV-positive women. This cross sectional study describes the main reasons why HIV-positive women decide to be sterilized and identifies factors associated with choosing sterilization in HIV-positive women in Ceará, northeast Brazil. Data from 229 non-sterilized women, 80 women sterilized before HIV diagnosis and 48 women sterilized after diagnosis were
F. Oliveira; L. Kerr; A. Frota; A. Nóbrega; Z. Bruno; T. Leitão; C. Kendall; M. Galvão
|This study evaluated and analyzed medical school executives' perceptions of the low level of advancement of women into the healthcare c-suite. As well, medical school executives' recommendations for increasing the number of women entering and experiencing sustained success in executive positions were assessed. Related to these observations were…
Hispanics, Blacks, and women are disproportionately burdened by intimate partner violence. Barriers to seekingmedical care play an important role in victims accessing the full myriad of services they need. A secondary analysis of data collected over a 6-month period at a coordinated domestic violence social agency was completed to assess predictors of seekingmedical care after experiencing intimate partner violence. A hierarchical logistic regression was conducted to assess the predictive ability of socioeconomic factors, type of abuse, and severity of abuse. Hispanic victims of intimate partner violence were less likely to seekmedical attention compared to non-Hispanic Whites, even after controlling for socioeconomic factors, type of abuse, and severity of abuse, Adjusted Odds Ratio (AOR) = .40, p = .05, 95% CI [.164, .995]. Victims reporting physical abuse were over seven times more likely to seekmedical attention, AOR = 8.02, p = .04, 95% CI [2.35, 27.34]. Medical care needs to be incorporated into coordinated social services offered to victims of intimate partner violence.
Lawson, Sarah L.; Laughon, Kathryn; Gonzalez-Guarda, Rosa M.
This paper focuses on women's (mother's) use of psychotropic medication in both Greece and Portugal. Reference is made to the types of psychological and social problems women experience which lead them to the use and eventual abuse of psychotropics as well to the kinds of reactions and experiences the children of these women have. Specific attention is given to how
There is a considerable number of women with inherited bleeding disorders in Iran. von Willebrand disease, Glanzman thrombasthenia and factor XIII deficiency are the most common coagulation disorders. The main cause of this high rate of coagulation disorders is attributed to a high rate of consanguineous marriages in Iran. Medical care continues to improve for individuals affected with coagulation disorders in Iran. However, these disorders continue to have a significant impact on the affected Iranian women. As a result of the hereditary nature of these disorders, the impact extends to the psychosocial dimension of the lives of the women. Therefore it is recommended that women with coagulation disorders are provided with psychological and social support along with coagulation therapy. PMID:21692929
Reviews literature on employee feedback-seeking behavior and the literature on information seeking by organizational newcomers. Highlights the various motives that affect the decision of whether or not to seek information. Offers an integrated model of antecedents, dynamics, forms, and outcomes of employee information seeking. Concludes with…
Public health initiatives to ‘test and treat’ HIV-infected persons require understanding HIV care seeking. A study of 101 HIV-infected women receiving anti-retroviral medications in Kampala, Uganda, examined barriers to HIV care. Participants entered HIV\\/AIDS care late, despite knowing their risk and having sought care for symptoms. Over half of the participants (51%) reported delays of up to 5 years from
Janet W. McGrath; David Kaawa-Mafigiri; Sarah Bridges; Nelson Kakande
The study aimed to examine utilisation of medical and health social work services among ageing recent and long-term immigrants, to identify barriers to service utilisation, and to examine factors related to utilisation. Participants (n = 402) recruited from a random community sample of immigrants from the former Soviet Union in Israel, aged 55 and over, residing in urban areas throughout the country were interviewed by telephone. Using an expanded framework of Andersen's behavioural model, the independent variables included predisposing, enabling and need variables, and additional variables--barriers to utilisation or difficulties encountered during utilisation of services. For multivariate analyses of the dependent variables, a linear multiple regression model was employed for utilisation of medical services and a logistic regression model for utilisation of social work services. The main findings show that utilisation rates were high for medical services, but low for social work services. Recent immigrants had similar utilisation rates of medical services but utilised more social work services than long-term immigrants. There were few barriers but numerous difficulties in utilisation of medical services, while there were barriers but negligible difficulties in utilisation of social work services. Predisposing and need variables explained utilisation of medical services, whereas a combination of predisposing, enabling and need variables explained utilisation of social work services. The findings suggest that different factors are associated with the use of non-discretionary versus discretionary (social work) services. There is a need to reduce difficulties in utilisation of medical services and to enhance awareness about health social work services among the immigrants. PMID:16324189
This study was a pilot project, set up to assess ageing skin using a multi-disciplinary approach. The main aim of this study was to evaluate whether the use of more radical ('medical') treatments in the management of skin ageing would bring superior results and ultimately make people look younger, than the use of cosmetics ('non-medical' treatments). A simple post-hoc study design was used, whereby medical treatments varied within the group, all of them completed at least 2 weeks before the start of the study. In addition, it was of interest to assess the suitability of the proposed combination of methods. A total of 21 female participants were recruited for this study: 11 for the non-medical and 10 for the medical group. The multi-disciplinary approach consisted of instrumental measurements, self-assessment, expert assessment by Merz scales and a public perception survey. The majority of nearly 70 sets of instrumental skin data obtained in this study did not differ significantly between the non-medical and the medical group. However, the medical group gave higher self-assessment scores for their faces. The scores for hands were lower than scores for faces by both groups. This was partly supported by instrumental data (lower skin hydration on hands than on the face). The findings of the public perception survey of nine matched pairs of subjects scored the non-medical group as younger looking. Data analysis has shown that the judgement of youthfulness did not depend on either the gender or the age of observers. PMID:22809000
Tamburic, S; Grant-Ross, P; Labedzka, M; Daniels, G
This article targets the relationship between psychosocial determinants and abnormal screening mammography follow-up in a medically underserved population. Health belief scales were modified to refer to diagnostic follow-up versus annual screening. A retrospective cohort study design was used. Statistical analyses were performed examining relationships among sociodemographic factors, psychosocial determinants, and abnormal mammography follow-up. Women with lower mean internal health locus of control scores (3.14) were two times more likely than women with higher mean internal health locus of control scores (3.98) to have inadequate follow-up (OR=2.53, 95% CI=1.12-5.36). Women with less than a high school education had lower cancer fatalism scores than women who had completed high school (47.5 vs. 55.2, p-value=.02) and lower mean external health locus of control scores (3.0 vs. 5.3) (p-value<.01). These constructs have implications for understanding mammography follow-up among minority and medically underserved women. Further comprehensive study of these concepts is warranted. PMID:20173286
Fair, Alecia Malin; Wujcik, Debra; Lin, Jin-Mann Sally; Zheng, Wei; Egan, Kathleen M; Grau, Ana M; Champion, Victoria L; Wallston, Kenneth A
This article targets the relationship between psychosocial determinants and abnormal screening mammography follow-up in a medically underserved population. Health belief scales were modified to refer to diagnostic follow-up versus annual screening. A retrospective cohort study design was used. Statistical analyses were performed examining relationships among sociodemographic factors, psychosocial determinants, and abnormal mammography follow-up. Women with lower mean internal health locus of control scores (3.14) were two times more likely than women with higher mean internal health locus of control scores (3.98) to have inadequate follow-up (OR = 2.53, 95% CI = 1.12–5.36). Women with less than a high school education had lower cancer fatalism scores than women who had completed high school (47.5 vs. 55.2, p-value = .02) and lower mean external health locus of control scores (3.0 vs. 5.3) (p-value<.01). These constructs have implications for understanding mammography follow-up among minority and medically underserved women. Further comprehensive study of these concepts is warranted.
Fair, Alecia Malin; Wujcik, Debra; Lin, Jin-Mann Sally; Zheng, Wei; Egan, Kathleen M.; Grau, Ana M.; Champion, Victoria L.; Wallston, Kenneth A.
Purpose Morbid obesity is associated with urinary incontinence (UI). The study purpose was to determine the prevalence of fecal incontinence\\u000a (FI), its associated risk factors, and its impact on quality of life (QOL) in morbidly obese women.\\u000a \\u000a \\u000a \\u000a Materials and methods A questionnaire-based study on morbidly obese women [body mass index (BMI)???35 m\\/kg2], attending a bariatric surgery seminar, was conducted. Data included demographics, past
Nir Wasserberg; Mark Haney; Patrizio Petrone; Peter Crookes; Jason Rosca; Manfred Ritter; Howard S. Kaufman
BACKGROUND: Cannabis (marijuana) had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of
Background Cannabis (marijuana) had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of cannabis in 1996, and it was recently estimated that between 250,000 and 350,000 Californians may now possess the physician's recommendation required to use it medically. More limited medical use has also been approved in 12 additional states and new initiatives are being considered in others. Despite that evidence of increasing public acceptance of "medical" use, a definitional problem remains and all use for any purpose is still prohibited by federal law. Results California's 1996 initiative allowed cannabis to be recommended, not only for serious illnesses, but also "for any other illness for which marijuana provides relief," thus maximally broadening the range of allowable indications. In effect, the range of conditions now being treated with federally illegal cannabis, the modes in which it is being used, and the demographics of the population using it became potentially discoverable through the required screening of applicants. This report examines the demographic profiles and other selected characteristics of 4117 California marijuana users (62% from the Greater Bay Area) who applied for medical recommendations between late 2001 and mid 2007. Conclusion This study yielded a somewhat unexpected profile of a hitherto hidden population of users of America's most popular illegal drug. It also raises questions about some of the basic assumptions held by both proponents and opponents of current policy.
Among women of Ashkenazi Jewish (Eastern European) descent, carriers of one of the three most common BRACA1/2 mutations have a 40-73% chance of breast cancer by the age of 70 and a 6-28% chance of ovarian cancer. Few options exist for primary prevention o...
The prevalence of cardiovascular disease (CVD) in American women is staggering. In 2008, the American Heart Association reported\\u000a that one in three women had some form of CVD. An estimated 7.3 million women alive today have had a heart attack or are living\\u000a with angina pectoris. This year, almost 500,000 new and recurrent myocardial infarctions are expected in women. Education
This study of the differences between 23 men and 18 women who were convicted of partner homicide in Missouri found that the women were more likely to be injured and to seekmedical attention as a result of the battering they received than were the men and had a higher level of fear of the batterers before they killed them.
In two studies, saliva cortisol responses to the psychological stress of public speaking and mental arithmetic were investigated in women using oral contraceptives (OC; n = 28) and in control women (n = 29). While no significant differences in baseline levels were observed, altered adrenocortical responses were found in OC users. These women showed significantly attenuated cortisol responses to the
Clemens Kirschbaum; Karl-martin Pirke; Dirk H. Hellhammer
Introduction For many women, undergoing assisted reproductive technology can be a difficult experience, and can result in changes in physical and emotional health and wellbeing. Recent research has suggested that acupuncture may be helpful for women undergoing assisted reproductive technology. To date, there is no information describing the traditional Chinese medicine (TCM) syndromes seen in women undergoing assisted reproductive technology,
OBJECTIVE--To determine whether the interval between the onset of symptoms of acute myocardial infarction and the patient's call for medical assistance (patient delay) is related to left ventricular function at the time of presentation. DESIGN--Prospective observational study. SETTING--Coronary care unit of Aberdeen Royal Infirmary. PATIENTS--93 consecutive patients with acute myocardial infarction. MAIN OUTCOME MEASURES--Left ventricular stroke distance, expressed as a
R. J. Trent; E. L. Rose; J. N. Adams; K. P. Jennings; J. M. Rawles
Congressional eligibility reforms have profoundly changed the array of services to be made available to women veterans in Department of Veterans Affairs (VA) health care facilities. These include access not only to primary and specialty care services already afforded VA users, but also to a full spectrum of gender-specific services, including prenatal, obstetric, and infertility services never before provided in
Elizabeth M Yano; Donna L Washington; Caroline Goldzweig; Cynthia Caffrey; Carole Turner
We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR]?=?1.85; 95% confidence interval [CI]?=?1.21, 2.83), clinical breast exam (OR?=?3.03; 95% CI?=?1.82, 5.03), and a Pap smear (OR?=?2.34; 95% CI?=?1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women.
Lee, Jessica; Tran, Jacqueline H.; Kagawa-Singer, Marjorie; Foo, Mary Anne; Nguyen, Tu-Uyen N.; Valdez-Dadia, Annalyn; Thomson, Jasmin; Tanjasiri, Sora Park
We examined whether the impact of medical interpretation services was associated with the receipt of a mammogram, clinical breast exam, and Pap smear. We conducted a large cross-sectional study involving four Asian American and Pacific Islander (AAPI) communities with high proportions of individuals with limited English proficiency (LEP). Participants were recruited from community clinics, churches and temples, supermarkets, and other community gathering sites in Northern and Southern California. Among those that responded, 98% completed the survey rendering a total of 1,708 AAPI women. In a series of multivariate logistic regression models, it was found that women who typically used a medical interpreter had a greater odds of having received a mammogram (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.21, 2.83), clinical breast exam (OR = 3.03; 95% CI = 1.82, 5.03), and a Pap smear (OR = 2.34; 95% CI = 1.38, 3.97) than those who did not usually use an interpreter. The study provides support for increasing language access in healthcare settings. In particular, medical interpreters may help increase the utilization of breast and cervical cancer screening among LEP AAPI women. PMID:20352398
Dang, Jeff; Lee, Jessica; Tran, Jacqueline H; Kagawa-Singer, Marjorie; Foo, Mary Anne; Nguyen, Tu-Uyen N; Valdez-Dadia, Annalyn; Thomson, Jasmin; Tanjasiri, Sora Park
In postmenopausal women, levels of estrogens, androgens, and perhaps prolactin have been related to risk of breast and other hormonal cancers in women. However, the determinants of these hormone concentrations have not been firmly established. Associations among various demographic, menstrual, and reproductive factors, medication use and endogenous sex hormone concentrations (estradiol, free estradiol, estrone, estrone sulfate, testosterone, free testosterone, sex hormone binding globulin, androstenedione, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), dihydrotestosterone, and prolactin) were evaluated in a cross-sectional analysis from a simple random sample of 274 postmenopausal women selected from the Women's Health Initiative Dietary Modification Trial. In multiple regression analyses on log-transformed hormones, the concentrations of DHEA, and DHEAS were negatively and statistically significantly associated with age (both beta=-0.03, P<0.001, respectively). Estradiol, estrone, DHEA, and free testosterone concentrations were higher in African-American than in non-Hispanic White women, but after multivariate adjustment the associations were statistically significant only for free testosterone (beta=0.38, P=0.01). Women who had a history of bilateral oophorectomy had a mean 35% lower testosterone concentration compared with women with at least one ovary remaining (beta=-0.43, P=0.002), and lower free testosterone (beta=-0.42, P=0.04) after multivariate adjustment. Women who reported regular use of NSAIDs had higher DHEA concentrations (beta=0.20, P=0.04) and lower prolactin concentrations (beta=-0.18, P=0.02) compared with non-users. These results suggest that while age, oophorectomy status, and NSAID use may be associated with selected sex hormone concentrations, few menstrual or reproductive factors affect endogenous sex hormones in the postmenopausal period. PMID:18297397
McTiernan, Anne; Wu, LieLing; Barnabei, Vanessa M; Chen, Chu; Hendrix, Susan; Modugno, Francesmary; Rohan, Thomas; Stanczyk, Frank Z; Wang, C Y
Various studies conducted over the past three decades have highlighted the social, political, and economic impact that women homesteaders had on the western prairie region. Their involvement on the family homestead, whether taking part in subsistence and domestic chores or as workers in the fields, was a necessary aspect of the development and success of family farming and an agriculture-based economy in Western Canada. This paper reveals details of another aspect of family labor that often fell on the shoulders of women, that is, the provision of medical care needed to ensure the health of themselves, their spouses, and their children. Given the labor-intensive nature of the frontier lifestyle, the associated physical hazards, the number of disease-susceptible children in the region, and the scarcity of medical institutions and personnel, women were often called upon by their families and neighbors to deal with outbreaks of disease, injuries, and health crises. Using survey data collected by the Saskatchewan Archives Board in 1955 to illustrate the nature of the work performed, this paper argues that women's health care labor efforts were vital to the preservation of homesteading families in the prairie region. PMID:19244715
Intimate partner violence (IPV) and suicidal behavior are major public health problems in the African American community.\\u000a This study investigated whether or not IPV and suicidal ideation are correlated in urban African American women, and if the\\u000a IPV–suicidal ideation link is explained by symptoms of depression and posttraumatic stress disorder (PTSD). With 323 abused\\u000a African American females, path analysis revealed
Amy S. Leiner; Michael T. Compton; Debra Houry; Nadine J. Kaslow
Despite many retention studies, little is known about the performance of students in academic difficulty (SDs) who recover and graduate. In this study (1973-1982), the authors tracked 213 women, minorities, and older students in academic difficulty, those with three or more failures. Improvement measures were retention, National Board scores, and class rank at graduation. Minority students had significantly more difficulty, lower retention, and impaired recovery. Older students had considerable difficulty, but those who survived did well. Sixty-eight percent of majority women, 54 percent of all majorities, and 14 percent of minority women SDs recovered completely, graduating with a class rank of average or above. Minority men made significantly better recovery than minority women. Minority women's complete recovery rate rose from 6 to 23 percent. Incidence of difficulty for minorities decreased, though not significantly. Results suggest that many minority students, especially women, experience academic difficulty and have trouble recovering, but that the situation is ameliorating over time.
Lesser, Elena K.; Demuth, George W.; Rogowsky, Leslie
Research using electronic monitoring of medication taking patterns is emerging as the “gold standard” for assessing medication compliance. The purpose was to examine patterns of medication-taking after a cognitive-behavioral intervention (CBI) comprised of a 30- day home based program involving reading tailored messages and or home blood pressures only. The CBI was designed to structure knowledge or cognitive representations of
ObjectiveTo assess the willingness of young men and women to be tested for Chlamydia trachomatis in three non-medical settings.MethodsMen and women aged between 16 and 24 years were invited to complete a self-administered questionnaire and provide a urine sample in non-medical settings: 'education' (one further education college), 'health and fitness' (three local authority leisure centres) and 'workplace' (two call centres).ResultsEighty-four
The reporting of health and medicine in the media played an important role in the way people perceived, defined and coped with everyday health problems in the second half of the twentieth century. It was and still is predominantly a supply-market which is dominated by the medical approach; creating a medical aura of progress and the self-evidence of a cure. Although the medical approach figured also prominently in women's magazines, the reporting of illness and health is far more a product of supply and demand with a lively interaction between readers and the editorial office by the means of topic-related letter columns. As such women's magazines not only offer a gender-specific but also a more balanced source for acquiring a better understanding of how public definitions and perceptions of illness and health changed over time. In this article we will focus on the communication about the management of health problems related to depression, anxiety and sleeplessness in the prototypical Dutch women's magazine 'Margriet' between 1950 and 1960. Our guiding research question has been: how do notions about depression, anxiety and and about responsive health behaviour, of which psychotropic drug use is a part, change over time in the reporting of health problems in Margriet? This question is of particular interest to learn more about the historical dynamics of the culture- and gender-specific public interplay between patients and doctors in terms of conceptualising the aforementioned health problems and defining medical coping strategies. Among other things we show that although there was hardly any mention of any 'functional division of labour' between mind and body in 1950, the mind-body dichotomy started to play an important role in the way health problems were perceived in 1960. PMID:12688239
Depression is an illness increasingly constructed as a gendered mood disorder and consequently diagnosed in women more than men. The diagnostic criteria used for its assessment often perpetrate and reproduce gender stereotypes. The stigma associated with mental illness and the gendered elements of depression suggest there are likely numerous discourses that position, explain, and justify help-seeking practices. This qualitative study explored men's discourses of seeking help for depression. The methodological approach was informed by a social constructionist perspective of language, discourse and gender that drew on methods from discourse analysis. We conducted individual in-depth, semi-structured interviews with 38 men with depression, either formally diagnosed or self reported. The analysis revealed five discursive frames that influenced the men's talk about help-seeking and depression: manly self-reliance; treatment-seeking as responsible independent action; guarded vulnerability; desperation; and genuine connection. The findings are discussed within a broader context of social discourses of gender, the limitations of current help-seeking literature and the evidence for how men seek help in ways that extend traditional notions of medical treatment. PMID:21707661
Johnson, Joy L; Oliffe, John L; Kelly, Mary T; Galdas, Paul; Ogrodniczuk, John S
Background Polyunsaturated fatty acids are essential nutrients for humans. They are structural and functional components of cell membranes and pre-stages of the hormonally and immunologically active eicosanoids. Recent discoveries have shown that the long-chained omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) also play an important role in the central nervous system. They are essential for normal brain functioning including attention and other neuropsychological skills. Materials and methods In our large observational study we monitored 810 children from 5 to 12 years of age referred for medical help and recommended for consuming polyunsaturated fatty acids (PUFA) in combination with zinc and magnesium by a physician over a period of at least 3 months. The food supplement ESPRICO® (further on referred to as the food supplement) is developed on the basis of current nutritional science and containing a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc. Study objective was to evaluate the nutritional effects of the PUFA-zinc-magnesium combination on symptoms of attention deficit, impulsivity, and hyperactivity as well as on emotional problems and sleep related parameters. Assessment was performed by internationally standardised evaluation scales, i.e. SNAP-IV and SDQ. Tolerance (adverse events) and acceptance (compliance) of the dietary therapy were documented. Results After 12 weeks of consumption of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc most subjects showed a considerable reduction in symptoms of attention deficit and hyperactivity/impulsivity assessed by SNAP-IV. Further, the assessment by SDQ revealed fewer emotional problems at the end of the study period compared to baseline and also sleeping disorders. Mainly problems to fall asleep, decreased during the 12 week nutritional therapy. Regarding safety, no serious adverse events occurred. A total of 16 adverse events with a possible causal relationship to the study medication were reported by 14 children (1.7%) and only 5.2% of the children discontinued the study due to acceptance problems. Continuation of consumption of the food supplement was recommended by the paediatricians for 61.1% of the children. Conclusion Our results suggest a beneficial effect of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc consumption on attentional, behavioural, and emotional problems of children and adolescents. Thus, considering the behavioural benefit in combination with the low risk due to a good safety profile, the dietary supplementation with PUFA in combination with zinc and magnesium can be recommended.
The literature make it clear that lung cancer in women differs from that in men in several specific aspects. We conducted a retrospective study of the 967 consecutive recorded patients (696 men and 91 women after exclusions) diagnosed with small cell lung cancers (SCLC) between 1981 and 1994 in the Bas-Rhin population-based cancer registry to determine if such particularities could
Bertrand Mennecier; Marie-Paule Lebitasy; Lionel Moreau; Guy Hedelin; Ashok Purohit; Cedric Galichet; Elisabeth Quoix
Minority and low socioeconomic status women are under-represented in clinical research due to logistical, informational, attitudinal, and sociocultural barriers. The primary objective of this study was to explore factors associated with research participation among African American and low socioeconomic status White women using the Theory of Planned Behavior. A secondary goal was to assess differences in barriers to research participation
Deborah F. Farmer; Sharon A. Jackson; Fabian. Camacho; Mark A. Hall
Some, but not all, antipsychotics elevate serum prolactin. Antipsychotic-induced hyperprolactinemia is thought to account for high rates of menstrual dysfunction and diminished estrogen levels in women with schizophrenia. However, few studies have directly assessed the relationships between prolactin, menstrual function, and ovarian hormone levels in this population. Sixteen premenopausal women with schizophrenia and schizoaffective disorder, eight treated with an antipsychotic
Carla M. Canuso; Jill M. Goldstein; Joanne Wojcik; Ree Dawson; Danielle Brandman; Anne Klibanski; Joseph J. Schildkraut; Alan I. Green
There are more than 55,000 women on active duty in the U.S. Navy. Previous research has shown that women utilize health care services at higher rates than men, and that obstetric and gynecologic (OB/GYN) health care are among the most frequent reasons for...
The relation of criminal victimization to health perceptions (self-rated current health) was determined among women health maintenance organization patients. Data were survey responses from 2,291 women (45% response rate), 57% of whom had experienced crime. Reliability was evaluated by assessing 241 respondents both by survey and by interview. Data were analyzed by hierarchical multiple regression, which indicated that criminal victimization
Summary African-American (AA) women with breast cancer have higher mortality rates than Caucasian woman, and some studies have suggested that this disparity may be partly explained by unequal access to medical care. The purpose of this study was to analyze racial differences in patterns and costs of care and survival among women treated for invasive breast cancer at a large
Lead poisoning still occurs in the United States despite extensive prevention efforts and strict regulations. Exposure to lead can damage the brain, kidneys, and nervous and reproductive systems. Fetal exposure to lead can adversely affect neurodevelopment, decrease fetal growth, and increase the risk for premature birth and miscarriage. During 2011-2012, the New York City Department of Health and Mental Hygiene (DOHMH) investigated six cases of lead poisoning associated with the use of 10 oral Ayurvedic medications made in India. All six cases were in foreign-born pregnant women assessed for lead exposure risk by health-care providers during prenatal visits, as required by New York state law. Their blood lead levels (BLLs) ranged from 16 to 64 µg/dL. Lead concentrations of the medications were as high as 2.4%; several medications also contained mercury or arsenic, which also can have adverse health effects. DOHMH distributed information about the medications to health-care providers, product manufacturers, and government agencies in the United States and abroad, via postal and electronic mail. DOHMH also ordered a local business selling contaminated products to cease sales. Health-care providers should ask patients, especially foreign-born or pregnant patients, about any use of foreign health products, supplements, and remedies such as Ayurvedic medications. Public health professionals should consider these types of products when investigating heavy metal exposures and raise awareness among health-care providers and the public regarding the health risks posed by such products. PMID:22914225
Many women in Kenya with breast cancer symptoms do not seekmedical attention until their cancer is very advanced, leading to high mortality rates and a heavy cancer burden on the nation. In this study we employed eight focus groups with low- and middle-income rural and urban Kenyan women to explore their knowledge, attitudes, and behaviors concerning breast cancer and
This study reports on 2,755 womenseekingmedical termination of pregnancy (MTP), and concurrent contraceptive acceptance, at a clinic in rural India from 1976 to 1987. The level of contraceptive acceptance among married womenseeking MTP between 1976 and 1987 was 88.2 percent. Among married womenseeking MTP in their first trimester of pregnancy, 43.4 percent accepted the IUD as a method of contraception and 41.8 percent accepted sterilization. By contrast, only 11.5 percent of women in their second trimester accepted the IUD, but 70.2 percent accepted sterilization. Seventy-two percent of the unmarried women and 43 percent of the married womenseeking MTP were in their second trimester. Recommendations are made to: (1) combine contraceptive services and counseling with MTP whenever possible, (2) examine the consequences of policies that exclude unmarried women from contraceptive services, (3) investigate the reasons why so many women in this study sought MTP so late in pregnancy, and (4) obtain information on the determinants of contraceptive acceptance among women who seek MTP. PMID:3176097
This is a study of the physical performance and injury rate for seven classes of women midshipmen at the United States Naval Academy. Women comprise only 6.2% of the brigade of midshipmen, but men and women live in the same dormitory, undergo the same physical training and fitness tests, study the same academic curriculum, and live in an environment where performance and activities can be constantly monitored. The required number of hours of physical education are the same for men and women. The conclusions from this study are: (1) women midshipmen continue to improve their fitness level more rapidly than men; (2) while some disparities in performance are correctly attributed to physiological differences, many of the present disparities should be attributed to societal conditions; (3) should physical performance requirements ever become the same, women will have to work harder than men to achieve the same standards because of the physiological differences; (4) women continue to seekmedical attention for stress-related problems (i.e., shin splints, stress fractures) more often than men, but do so less often as they become acclimated to the active life of the Naval Academy; (5) women midshipmen have the same number of serious injuries as men, and in some sports are more susceptible to certain types of injuries. PMID:6742310
This paper examines mental health service use among publicly insured white and African-American pregnant and postpartum women who live in a metropolitan area. The study examines the extent to which ethnicity, physical health problems, and behavioral health risk factors are associated with the probability of service use during the prenatal-postpartum period. It also analyzes the patterns of service utilization for those women who used mental health services. Medicaid claims and eligibility data, County Reporting System claims and admissions data, and Pennsylvania State Vital Birth Records were integrated using a unique algorithm. Logistic regression was employed to estimate the probability of mental health service use among 3,841 low-income women residing in Philadelphia who were continuously enrolled in Medicaid for 9 months preceding delivery and 6 months postpartum. Analyses were also conducted on the intensity and location of service use, as well as psychiatric diagnosis, during pregnancy and the postpartum period. About 10% of the women used mental health services during the study period. Women were more likely to use services if they were Caucasian, had a number of chronic diseases, had a number of pregnancy complications, and smoked. Among users, the same proportion (ca. 6%) used services during pregnancy and postpartum, with the average number of outpatient visits slightly higher during pregnancy than during the postpartum period. Most outpatient services (86%) were delivered in the specialty sector. Most women who used mental health services (84%) were diagnosed with minor psychiatric disorders including minor depression and anxiety disorders. Women who used services during the postpartum only were more likely to be diagnosed with major depression, whereas women who used services throughout the perinatal period were more likely to be diagnosed with severe mental disorders. Health providers can use information generated in this study to identify women who are likely to have a need for mental health services. PMID:15002880
Song, Dayoung; Sands, Roberta G; Wong, Yin-Ling Irene
Objective: This study examined whether disparities in mammography use between women of differing socioeconomic status (SES; income and education) and varying access to medical care (healthcare insurance and routine medical check-up) remained over time despite overall increased breast cancer screening. Methods: Analysis of changes over time were made using data from the 1992, 1996, and 2000 Behavioral Risk Factor Surveillance
Mario Schootman; Donna B. Jeffe; Anat H. Reschke; Rebecca L. Aft
This commentary presents a response to 'Cassandra's prophecy' from the perspective of a final-year medical student, in an attempt to gauge the particular relevance of age-related fertility decline to female doctors. Women in the UK are increasingly trying to have children at an older age, with a resultant rise in the incidence of age-related fertility decline and obstetric problems. The literature suggests that the trend towards older motherhood is seen particularly among highly educated women, but that such women lack sufficient knowledge about how fertility and obstetric outcomes decline with age. Recent data indicate that female doctors have children significantly later than women in the general population, but are overall no more likely to remain childless. However, there is significant variation between different specialties; for instance, female surgeons have children significantly later and are more likely to be childless by age 35, as compared with both male surgeons and female doctors in other specialties. This commentary explores various explanations for and implications of these data, in the context of recent changes in NHS workforce gender demographics. PMID:23683846
Background Although factors associated with the utilisation of bone density measurement (BDM) and osteoporosis treatment have been regularly assessed in the US and Canada, they have not been effectively analysed in European countries. This study assessed factors associated with the utilisation of BDM and osteoporosis medication (OM) in Switzerland. Methods The Swiss Health Survey 2007 data included self-reported information on BDM and OM for women aged 40 years and older who were living in private households. Multivariable logistic regression analysis was used to identify sociodemographic, socioeconomic, healthcare-related and osteoporosis risk factors associated with BDM and OM utilisation. Results The lifetime prevalence of BDM was 25.6% (95% CI: 24.3-26.9%) for women aged 40 years and older. BDM utilisation was associated with most sociodemographic factors, all the socioeconomic and healthcare-related factors, and with major osteoporosis risk factors analysed. The prevalence of current OM was 7.8% (95% CI: 7.0-8.6%) and it was associated with some sociodemographic and most healthcare-related factors but only with one socioeconomic factor. Conclusions In Swiss women, ever having had a BDM and current OM were low and utilisation disparities exist according to sociodemographic, socioeconomic and healthcare-related factors. This might foster further health inequalities. The reasons for these findings should be addressed in further studies of the elderly women, including those living in institutions.
Introduction: On-line continuing medical education (CME) provides advantages to physicians and to medical educators. Although practicing physicians increasingly use on-line CME to meet their educational needs, the overall use of on-line CME remains limited. There are few data to describe the physicians who use this new educational medium; yet,…
Harris, John M., Jr.; Novalis-Marine, Cheryl; Harris, Robin B.
The retrospective comparative analysis of the following three groups is presented: control group composed of 100 somatically healthy pregnant women; 592 pregnant women with recurrent pregnancy loss complicated with placental dysfunction in the past medical history - the 1st group; and 592 pregnant women with recurrent pregnancy loss without placental dysfunction in the past medical history - the 2nd group. The fetal cardiotocography was analyzed with determination of non-stress test, fetus ultrasound investigation; the fetus biophysical profile was determined; the fates of the current pregnancy and childbearing and the state of the newborn infant were studied; using the statistical analysis, the risk factors affecting the progression of placental dysfunction in women with recurrent pregnancy loss in the past medical history were discovered. PMID:24099808
Nearly 130,000 American women are human immunodeficiency virus (HIV) seropositive. The present study sought to establish a comprehensive programme to address their fertility needs in order to minimize infectious, medical and reproductive risks to prospective patients. Forty women, aged 27–42 years, were evaluated. HIV was diagnosed 7.2 ± 0.7 years prior to their seeking care, and most women (n =
Nataki C Douglas; Jeff G Wang; Bo Yu; Sreedhar Gaddipati; Michael M Guarnaccia; Mark V Sauer
Tested 63 new items for the Sensation Seeking Scale (SSS) in an attempt to develop new scales representative of hypothesized dimensions of sensation seeking. An experimental form was given to 332 and 92 undergraduates at 2 universities. Data from the 1st university was factor analyzed separately for males and females. Besides the general factor running through diverse items, 4 factors
Patients with low-trauma fractures are at risk of future fractures and so should be evaluated and treated for osteoporosis. This study was conducted to assess and compare bone medication use and calcium and vitamin D intake at the time of and after an acute fracture. One hundred and six patients, mean age 66.7±10.3 years, were administered medical history and diet
Alejandra Pro-Risquez; Susan S. Harris; Lingyi Song; Sally Rudicel; Brien Barnewolt; Bess Dawson-Hughes
Studies have documented the construct validity of Bornstein and Languirand's (2003) Relationship Profile Test (RPT) in college students, psychotherapy patients, and nursing home residents, but no studies have examined the utility of RPT Destructive Overdependence (DO), Dysfunctional Detachment (DD), and Healthy Dependency (HD) scores in community samples. To fill this gap, we assessed links between RPT scores and theoretically related
Robert F. Bornstein; John H. Porcerelli; Steven K. Huprich; Tsveti Markova
Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. From 2000–2002, patients (N > 3500) were enrolled at 77 Italian hospitals. Women aged ?50 years (N = 1013) were stratified into age groups (?35, 36–40, 41–45, and 46–50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed. Results. Younger women more frequently had tumors with ER/PgR-negative(?2 = 7.07; P = .008), HER2 amplification (?2 = 5.76; P = .01), and high (?10%) Ki67 labelling index (?2 = 9.53; P = .002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P < .0001). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ?40, P < .0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR = 0.93, P = .0021). Conclusion. This cohort study suggests that age per sè is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.
Pronzato, P.; Mustacchi, G.; De Matteis, A.; Di Costanzo, F.; Rulli, E.; Floriani, I.; Cazzaniga, M. E.
Background: Yoga has been shown to have many short-term health benefits, but little is known about the extent to which these benefits accrue over a long time frame or with frequent practice. Aims: The purpose of this study was to examine the extent to which body mass index (BMI) and medication use in a sample of female yoga practitioners over 45 years varied according to the length and frequency of yoga practice. Materials and Methods: We administered online surveys to 211 female yoga practitioners aged 45 to 80 years. We used regression analyses to evaluate the relationship of extent of yoga experience to both BMI and medication use after accounting for age and lifestyle factors. We also conducted comparisons with 182 matched controls. Results: Participants had practiced yoga for as long as 50 years and for up to 28 hours per week. There were significant inverse relationships between yoga experience and both BMI and medication load. These significant relationships remained after accounting for age and lifestyle factors. When we computed yoga experience in terms of total calendar years, without accounting for hours of practice, significant relationships did not remain. However, there was no obesity in the 49 participants with more than 25 years of yoga practice. Yoga practitioners were less likely than non-practitioners to use medication for metabolic syndrome, mood disorders, inflammation, and pain. Conclusions: A long-term yoga practice was associated with little or no obesity in a non-probability sample of women over 45 years. Relationships showed a dose-response effect, with increased yoga experience predicting lower BMI and reduced medication use.
Brigham and Women's Hospital (BWH), a major academic tertiary medical center, and Faulkner Hospital (Faulkner), a nearby community teaching hospital, both in the Boston, Massachusetts area, have established a close affiliation relationship under a common corporate parent that achieves a variety of synergistic benefits. Formed under the pressures of limited capacity at BWH and excess capacity at Faulkner, and the need for lower-cost clinical space in an era of provider risk-sharing, BWH and Faulkner entered into a comprehensive affiliation agreement. Over the past seven years, the relationship has enhanced overall volume, broadened training programs, lowered the cost of resources for secondary care, and improved financial performance for both institutions. The lessons of this relationship, both in terms of success factors and ongoing challenges for the hospitals, medical staffs, and a large multispecialty referring physician group, are reviewed. The key factors for success of the relationship have been integration of training programs and some clinical services, provision of complementary clinical capabilities, geographic proximity, clear role definition of each institution, commitment and flexibility of leadership and medical staff, active and responsive communication, and the support of a large referring physician group that embraced the affiliation concept. Principal challenges have been maintaining the community hospital's cost structure, addressing cultural differences, avoiding competition among professional staff, anticipating the pace of patient migration, choosing a name for the new affiliation, and adapting to a changing payer environment. PMID:15734807
Sussman, Andrew J; Otten, Jeffrey R; Goldszer, Robert C; Hanson, Margaret; Trull, David J; Paulus, Kenneth; Brown, Monte; Dzau, Victor; Brennan, Troyen A
The study explored the relationship between HIV medication adherence and alcohol, cognitive, social and affective factors in 272 persons with alcohol problems. Alcohol and cognitive factors significantly differentiated those who did and did not adhere. Specifically, adherence confidence and number of drinks emerged as subfactors driving the associations to adherence. Among those who were less than perfectly adherent (n = 154), only alcohol factors predicted levels of nonadherence. Cognitive factors play a role in understanding some of the differences between those who do and do not adhere to their HIV medications, but they do not differentiate among levels of nonadherence. PMID:17284499
Parsons, Jeffrey T; Rosof, Elana; Mustanski, Brian
Low-income women of color who are HIV positive and living in violent relationships are at significant risk for stigma and problems with attachment security. This article explores the ways in which these women may experience internalized stigma from incorporating society's negative views of HIV and domestic violence. It also addresses the ways in which insecure attachment may develop or intensify in this population through violence in their adult intimate relationships and/or living with a life threatening illness. A model of medical and psychosocial care utilized at the Women's HIV Program at the University of California San Francisco is offered as an intervention to reduce stigma and enhance healthy attachment. Clinical examples demonstrate how this system of medical and psychosocial care can help women in this situation establish stability and improve their lives despite the intense challenges they face. PMID:22443402
This paper examines mental health service use among publicly insured white and African-American pregnant and postpartum women who live in a metropolitan area. The study examines the extent to which ethnicity, physical health problems, and behavioral health risk factors are associated with the probability of service use during the pre-natal-postpartum period. It also analyzes the patterns of service utilization for
Dayoung Song; Roberta G. Sands; Yin-Ling Irene Wong
Background Medical male circumcision (MMC) reduces the risk of HIV acquisition for men in heterosexual encounters by 50-60%. However, there is no evidence that a circumcised man with HIV poses any less risk of infecting his female partner than an uncircumcised man. There may be an additional risk of HIV transmission to female partners during the 6-week healing period and if condoms are used less often after circumcision. The aim was to explore young women's perspectives on MMC, with a view to developing clear messages about the limitations of MMC in reducing women's HIV risk. Methods: We explored women's perspectives on MMC in KwaZulu-Natal, South Africa, with a sample of 30 female tertiary students via four focus groups (two for women only; two mixed gender). Results: In all groups, women communicated a thorough understanding of the partial efficacy of MMC, but believed that others would not understand this concept. Participants noted that MMC affords no direct benefit to women. Most thought that MMC would increase females' risk of contracting HIV, that circumcised men may engage in risky behaviours and that men would increase their number of sexual partners after circumcision. Participants believed that condom use would decrease after MMC and speculated that men would have sex during the healing period, which could further compromise women's sexual health. Conclusion: The concerns expressed by women regarding MMC highlight the need for including women in the dialogue about MMC and for clarifying the impact of MMC on HIV risk for women. PMID:23448912
Mantell, Joanne E; Smit, Jennifer A; Saffitz, Jane L; Milford, Cecilia; Mosery, Nzwakie; Mabude, Zonke; Tesfay, Nonkululeko; Sibiya, Sibusiso; Rambally, Letitia; Masvawure, Tsitsi B; Kelvin, Elizabeth A; Stein, Zena A
Across many jurisdictions, a key institutional response to sexual assault is centred on the collection of medico-legal evidence through a medical forensic examination (MFE). Despite the increased routinization of this practice, such evidence often is not related to positive criminal justice outcomes. As there has been little systematic investigation of the perspectives of victims regarding the MFE, we conducted semi-structured,
Janice Du Mont; Deborah White; Margaret J. McGregor
It is well known that patients with low-trauma fractures are at greater risk for future fractures and that they stand to benefit from evaluation and treatment for osteoporosis. Treatment consists of supplementation with calcium and vitamin D and/or the use of a bone medication. This study assesses...
The purpose of this study was to assess the reliability, validity and responsiveness of a health-related quality of life (HRQOL) instrument, the Medical Outcomes Short-Form 20-ltem General Health Survey (MOS SF-20), in a sample of women with the human immunodeficiency virus (HIV). Longitudinal data were collected on 202 HIV-infected women without AIDS who were receiving care at Kings County Hospital
M. Y. Smith; J. Feldman; P. Kelly; J. A. DeHovitz; K. Chirgwin; H. Minkoff
This article presents findings from a multisite study on adopting and implementing an evidence-based practice, Seeking Safety, for women with co-occurring disorders and experiences of physical and sexual abuse. It focuses on what implementation decisions different sites made to optimize the compatibility of Seeking Safety with the site's needs and experiences and on issues posed by Rogers (1995) as relevant
Vivian B. Brown; Lisa M. Najavits; Sharon Cadiz; Norma Finkelstein; Jennifer P. Heckman; Elke Rechberger
In this article we explore the process leading to help seeking following childhood trauma among women who were currently in treatment. We interviewed 13 participants from six treatment groups for clients exposed to human-inflicted traumas. Transcripts were analyzed using a hermeneutical-phenomenological approach. Help seeking was initiated after a prolonged period of time (13 to 58 years after first trauma exposure), during which participants relied heavily on a strategy of managing on their own. Self-management contributed to delays in help seeking, but was also an important resource. High levels of distress were reported prior to help seeking, often without help seeking being considered as an option. The participants sought help when encountering situational demands exceeding available resources, resulting in experiences of exhaustion and loss of control. We present a model of the help-seeking process, underlining the importance of respecting and exploring the individual process of seeking help when offering trauma-specific treatment. PMID:23990251
Stige, Signe Hjelen; Træen, Bente; Rosenvinge, Jan H
Two reproductive technologies—emergency contraception and medical abortion—have the potential to reduce unintended pregnancy significantly in Latin America. Lack of knowledge and negative attitudes about the methods may limit their impact, however. Results from focus group discussions with middle-class men and women of reproductive age residing in Mexico City indicate that knowledge about emergency contraception and medical abortion is low. After
Heather Gould; Charlotte Ellertson; Georgina Corona
OBJECTIVE Homelessness is a significant and growing problem in the United States. Women and families are the fastest growing segments of the homeless population. Homelessness increases the risk of having health problems and encountering barriers to care. This study determines how much perceived unmet need for medical care there is among homeless women, what homeless women perceive to be barriers to health care, and how barriers and other factors are associated with unmet needs. DESIGN Cross-sectional study of homeless women, utilizing structured interviews. SETTING AND PARTICIPANTS Community-based probability sample of 974 homeless women aged 15 to 44 years. MAIN OUTCOME MEASURES Perceived unmet need for medical care in the past 60 days. Relationship between unmet need and demographic variables, place of stay, source of health care, insurance, and perceived barriers to care. RESULTS Of the 974 women, 37% reported unmet need for medical care. Controlling for other factors, the odds of unmet need were lower among those with a regular source of care (odds ratio [OR] to .35, 95% confidence interval [CI], .21 to 58), while having health insurance was not significantly associated. The odds of unmet need were higher among those who experienced the barriers: not knowing where to go (OR 2.27, 95% CI, 1.40 to 3.69), long office waiting times (OR 1.89, 95% CI 1.27 to 2.83) and being too sick to seek care (OR 2.03, 95% CI, 1.14 to 3.62). CONCLUSIONS There is significant unmet need for medical care among homeless women. Having a regular source of care was more important than health insurance in lowering the odds of unmet need. Homeless women must be educated regarding sources of care, and clinics serving the homeless must decrease waiting times.
Lewis, Joy H; Andersen, Ronald M; Gelberg, Lillian
Oocyte donation can satisfy the desire to have children in women with premature ovarian failure (POF) but little progress has been made to improve reproduction using the patients' own gametes. The aim of this study was to assess the effectiveness of alternative treatments to oocyte donation in patients with POF. A systematic search of MEDLINE, EMBASE and Cochrane databases from January 1988 to January 2012 using descriptors related to POF, ovulation induction, and pregnancy was made. Randomized clinical trials of women with POF undergoing various treatments to achieve ovulation induction, often compared with alternative treatment and placebo groups, were only selected. Outcomes of interest were those related to pregnancy (biochemical and live birth). Twelve trials were included and analysed for methodology, inclusion and exclusion criteria, number of patients included, characteristics and type of intervention, and results in terms of ovulation rate, pregnancy rate and ongoing pregnancy rate. The large methodological variability among studies prevented to combined data for a meta-analysis. None of the studies showed statistically significant differences between the study groups. The lack of case-control studies with a placebo group makes it impossible to establish differences between a treatment and no treatment. PMID:23772774
Robles, Ana; Checa, Miguel A; Prat, Maria; Carreras, Ramón
In 2010, the Brazilian Government agency responsible for drug-related issues formulated official Resolutions that categorized the consumption of ayahuasca by pregnant women and children in the Santo Daime and União do Vegetal ayahuasca-based religions as an "exercise of parental rights." Although ayahuasca groups do enjoy a relative degree of social legitimacy and formal legal recognition in Brazil, the participation of pregnant women and children nevertheless continues to provoke heated discussion. This article raises the main issues involved in the public debate over this subject. In the first part, a diverse group of biomedical and health specialists was consulted, and their opinions were briefly analyzed. In the second, a full interview with a follower of one branch of Santo Daime, mother of four children who took ayahuasca during all her pregnancies, and whose children all drink ayahuasca, is presented. Her interview reveals important cultural parameters of ayahuasca consumption. The article explores common themes and contradictions found between the biomedical, anthropological, and ayahuasca-users' discourses. It raises central issues regarding the limits of freedom of religion and the state's right to interfere in family matters. The following analysis also has implications regarding the role of science in influencing policy decisions on drug use. PMID:21615005
With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care. PMID:22298132
The aim of the research was to discover the experience and meaning of prayer of patients in hospital when undergoing coronary artery bypass graft surgery. Ethnographic-type post discharge interviews with 13 participants formed the major data source. Using the grounded theory method, the basic social psychological process was labeled seeking comfort through prayer. This was the process of engaging in prayer with God. The participants believed that God listened to their prayers and answered them when they were seeking comfort. It was this reassurance that gave them the strength to face uncertainty and possible death, and also gave them comfort in their psychophysiological condition at the time. Seeking comfort had three stages (maintaining or re-establishing a relationship with God; making peace with God; and asking God to be with them during the hospitalisation). This last stage involved five levels of prayer (acquiescence, instinctive prayer, survival, confiding and honouring). PMID:9748926
For a concise summary of the medical assistant profession the Medical Assistants entry in the Bureau of Labor Statistics' Occupational Outlook Handbook is must read. The site covers topics ranging from the nature of the profession, working conditions, earnings, and more. The section on training, qualifications and advancement will be of special interest to medical assistant faculty and students. The section on sources of addition information will also be a good launching point for anyone seeking additional online resources.
This study identifies social, political, and cultural barriers to help seeking from health care organizations faced by abused Latina and Asian immigrant women. Qualitative data were collected through four semistructured ethnic-specific focus group interviews with 28 abused Latina and Asian immigrant women. Participants who had suffered intimate partner abuse were recruited through urban community-based organizations in San Francisco, California. Sociopolitical barriers to help seeking and patient-provider communication included social isolation, language barriers, and, for some, discrimination and fears of deportation. Sociocultural barriers included dedication to the children and family unity, shame related to the abuse, and the cultural stigma of divorce. Abused Latina and Asian immigrant women face significant social, cultural, and political barriers to patient-provider communication and help seeking. Medical and social service providers and policy makers may improve the quality of care for these women by understanding and addressing these barriers. PMID:10778041
Bauer, H M; Rodriguez, M A; Quiroga, S S; Flores-Ortiz, Y G
Objective Data are scarce regarding the sociodemographic predictors of antenatal and postpartum depression. This study investigated whether race/ethnicity, age, finances, and partnership status were associated with antenatal and postpartum depressive symptoms. Setting 1662 participants in Project Viva, a US cohort study. Design Mothers indicated mid?pregnancy and six month postpartum depressive symptoms on the Edinburgh postpartum depression scale (EPDS). Associations of sociodemographic factors with odds of scoring >12 on the EPDS were estimated. Main results The prevalence of depressive symptoms was 9% at mid?pregnancy and 8% postpartum. Black and Hispanic mothers had a higher prevalence of depressive symptoms compared with non?Hispanic white mothers. These associations were explained by lower income, financial hardship, and higher incidence of poor pregnancy outcome among minority women. Young maternal age was associated with greater risk of antenatal and postpartum depressive symptoms, largely attributable to the prevalence of financial hardship, unwanted pregnancy, and lack of a partner. The strongest risk factor for antenatal depressive symptoms was a history of depression (OR?=?4.07; 95% CI 3.76, 4.40), and the strongest risk for postpartum depressive symptoms was depressive symptoms during pregnancy (6.78; 4.07, 11.31) or a history of depression before pregnancy (3.82; 2.31, 6.31). Conclusions Financial hardship and unwanted pregnancy are associated with antenatal and postpartum depressive symptoms. Women with a history of depression and those with poor pregnancy outcomes are especially vulnerable to depressive symptoms during the childbearing year. Once these factors are taken in account, minority mothers have the same risk of antenatal and postpartum depressive symptoms as white mothers.
Rich-Edwards, Janet W; Kleinman, Ken; Abrams, Allyson; Harlow, Bernard L; McLaughlin, Thomas J; Joffe, Hadine; Gillman, Matthew W
Novelty seeking can be a positive trait leading to creativity and innovation, but it is also related to increased risk of damaging addictive behaviour. We have assessed novelty seeking with a three armed bandit task, in which novel stimuli were occasionally introduced, replacing choice options from which the participants had been choosing. This allowed us to assess whether or not they would be prone to selecting novel stimuli. We tested 25 non impulsive patients with Parkinson s disease (PD) and 27 PD patients with impulsive compulsive behaviours (ICB). Both patient groups were examined “on” and “off” dopaminergic medication in a counterbalanced order and their behaviour was compared with 24 healthy controls. We found that PD patients with ICBs were significantly more prone to choose novel options than either non impulsive PD patients or controls, regardless of medication status. Our findings suggest that attraction to novelty is a personality trait in all PD patients with ICBs which is independent of medication status.
Djamshidian, Atbin; O'Sullivan, Sean S.; Wittmann, Bianca C.; Lees, Andrew J.; Averbeck, Bruno B.
Novelty seeking can be a positive trait leading to creativity and innovation, but it is also related to increased risk of damaging addictive behaviour. We have assessed novelty seeking with a three armed bandit task, in which novel stimuli were occasionally introduced, replacing choice options from which the participants had been choosing. This allowed us to assess whether or not they would be prone to selecting novel stimuli. We tested 25 non impulsive patients with Parkinson's disease (PD) and 27 PD patients with impulsive compulsive behaviours (ICBs). Both patient groups were examined "on" and "off" dopaminergic medication in a counterbalanced order and their behaviour was compared with 24 healthy controls. We found that PD patients with ICBs were significantly more prone to choose novel options than either non impulsive PD patients or controls, regardless of medication status. Our findings suggest that attraction to novelty is a personality trait in all PD patients with ICBs which is independent of medication status. PMID:21565210
Djamshidian, Atbin; O'Sullivan, Sean S; Wittmann, Bianca C; Lees, Andrew J; Averbeck, Bruno B
The officer-in-charge of information and motivation with the Family Planning Association of Hong Kong (FPAHK) granted an interview to JOICFP News during JOICFP's IEC Workshop for the Production of Video Script for Women's Health in Tokyo, Japan. FPAHK does a checkup of every woman who seeks services at its family planning clinics. These clinics also provide medical services for women not using contraceptives and postmenopausal women. They provide family planning services to betrothed women. FPAHK promotes the self health care concept. It has education programs and primary screening services. FHAPK has recently done a survey of the general health conditions of women. It shows that even though most women are familiar with gynecological problems and the importance of taking care of themselves, they do not act on this knowledge. Women tend to know about and use contraceptives, but many contraception failures occur. Most women do not seek family planning services during their first 6 months of sexual activity. During this period, they use safe as well as unsafe contraceptives. These behaviors result in many women undergoing an abortion. The FPAHK officer claimed that the IEC workshop informed her about the major issues of women's health in other countries and women's needs. PMID:12318570
Objective: To examine whether there are latent trajectory classes in response to treatment and whether they moderate the effects of medication versus psychotherapy. Method: Data come from a 1-year randomized controlled trial of 267 low-income, young (M = 29 years), minority (44% Black, 50% Latina, 6% White) women with current major depression…
Siddique, Juned; Chung, Joyce Y.; Brown, C. Hendricks; Miranda, Jeanne
Evidence of group differences in reproductive control and access to reproductive health care suggests the continued existence of “stratified reproduction” in the United States. Women of color are overrepresented among people with infertility but are underrepresented among those who receive medical services. The authors employ path analysis to uncover mechanisms accounting for these differences among black, Hispanic, Asian, and non-Hispanic
Arthur L. Greil; Julia McQuillan; Karina M. Shreffler; Katherine M. Johnson; Kathleen S. Slauson-Blevins
|Objective: To examine whether there are latent trajectory classes in response to treatment and whether they moderate the effects of medication versus psychotherapy. Method: Data come from a 1-year randomized controlled trial of 267 low-income, young (M = 29 years), minority (44% Black, 50% Latina, 6% White) women with current major depression…
Siddique, Juned; Chung, Joyce Y.; Brown, C. Hendricks; Miranda, Jeanne
Investigation on the medical ethnobotany of the Q’eqchi Maya of Livingston, Izabal, Guatemala, was undertaken in order to explore Q’eqchi perceptions, attitudes, and treatment choices related to women’s health. Through participant observation and interviews a total of 48 medicinal plants used to treat conditions related to pregnancy, childbirth, menstruation, and menopause were collected and identified followed by the evaluation of 20 species in bioassays relevant to women’s health. Results of field interviews indicate that Q’eqchi cultural perceptions affect women’s health experiences while laboratory results (estrogen receptor and serotonin receptor binding assays) provide a scientific correlation between empirical medicinal plant use among the Q’eqchi and the pharmacological basis for their administration. These data can contribute to Guatemala’s national effort to promote a complementary relationship between traditional Maya medicine and public health services and can serve as a basis for further pharmacology and phytochemistry on Q’eqchi medicinal plants for the treatment of women’s health conditions.
Discussion of information retrieval and information seeking behavior focuses on a multi-dimensional conceptual model called MISE (multiple information-seeking episodes). Identifies eight different reasons why people engage in multiple information-seeking episodes, characterizes them in terms of traits of Multiple Information Seeking Episode…
Contents: Statistics and Facts; What is Domestic Violence; Power and Control Wheel and Types of Abuse; Myths and Facts; Identifying and Treating; Interviewing Battered Women: Guidelines; Interacting with Battered Women; Ageism; Understanding the Experienc...
Homeopathy, or homeopathic medicine, is a holistic system of treatment and is based on the idea that substances that produce symptoms of sickness in healthy people will have a curative effect when given in very dilute quantities to sick people who exhibit those same symptoms. Homeopathic physicians seek to cure their patients on the physical, mental and emotional levels, and
Contests have different, sometimes quite complex, organisational structures. In particular, while most of the existing literature focuses on simultaneous contests, multistage contests are also quite frequently encountered. This paper seeks to provide a rationale for the latter by endogenising the choice of a contest structure, which is made by an organiser of a contest interested in maximising the efforts expended
An adaptive control method that seeks the unknown resonant frequency of a load and drives it at its resonant frequency to achieve optimal performance is proposed and investigated. The method is based on estimating the derivative of the average power delivered to the load with respect to the driving frequency and using this estimate to adaptively control the driving frequency.
This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American womenseekingmedical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more
Martie P. Thompson; Nadine J. Kaslow; J. B. Kingree; Akil Rashid; Robin Puett; Diana Jacobs; Alex Matthews
Polycystic ovary syndrome (PCOS) is probably the most common endocrinopathy in women of childbearing age, and is particularly common in African-American and Hispanic ethnic groups. It is characterized by oligo-amenorrhea, clinical and/or biochemical hyperandrogenism, polycystic ovaries, and, often, morbid obesity. PCOS is associated with infertility and frequent 1st trimester miscarriage, and with an increased risk of gestational diabetes. Insulin resistance with compensatory hyperinsulinemia plays an important role in the pathogenesis of PCOS. Reduction of hyperinsulinemia with metformin-diet is associated not only with improvement of the biochemical endocrinopathy, but, commonly, with restoration of menstrual cycles and fertility. The combination of metformin and clomiphene citrate (CC) in CC resistant patients provides additional benefit to a subset of patients, not responsive to metformin alone. Metformin appears to be safe for mothers and neonates (non-teratogenic) during pregnancy, though the results of double-blinded placebo-controlled studies are not yet available. Benefits from metformin therapy during pregnancy include reduction of miscarriage, reduction in likelihood of developing gestational diabetes, reduction in fetal macrosomia, and prevention of excessive maternal weight gain during pregnancy. Rosiglitazone and pioglitazone are effective therapy for ovulation induction, but pregnancy class C and should not be used during pregnancy. PMID:18277353
Background? People with intellectual disabilities (ID) receive primary care in community-based practices and are encouraged to participate in the physician-patient relationship. However, the nature of this participation is not known. Methods? Qualitative data were analysed to obtain perspectives from patients and providers regarding clinic visits. Patient participants were recruited from community organisations, while physician participants were recruited from emails and phone calls to local and regional practices and a national and regional list serve. Analysis methods derived from grounded theory were used. Results? Twenty-seven women with ID and 22 family physicians were interviewed. Themes important to both groups included time, how the support worker should be used in the encounter and the nature of the physician-patient relationship. Patients expressed frustration at how little time they spent with their physician, and wished that physicians would speak directly to them instead of to their support worker. Physicians felt that patients with ID took too much time, and said that they preferred communicating with the support worker. The interviews also revealed unconscious biases about people with ID. Conclusions? Patient participation is encouraged for people with ID, but is limited because of both physician and patient factors. Greater awareness of these factors may improve care for patients with ID. PMID:22974084
Objective To determine rate of and risk factors for birth defects in infants born to HIV-infected women receiving nucleoside and protease inhibitor antiretroviral (ARV) therapy. Methods Birth defects were evaluated among infants on the Pediatric AIDS Clinical Trials Group 316 trial that studied addition of peripartum nevirapine to established ARV regimen for prevention of mother-to-child transmission. Maternal therapy was categorized by trimester of earliest exposure. Birth defects were coded using conventions of the Antiretroviral Pregnancy Registry. Results Birth defects were detected in 60/1414 (4.2%; 95% CI 3.3–5.4%) infants including 30/636 (4.7%; 95% CI 3.2–6.7%) with first trimester ARV exposure and 30/778 (3.9%; 95% CI 2.6–5.5%) with exposure only after the first trimester (P=0.51). Rates of classes of defects were similar between first trimester compared to later exposure groups except heart defects which occurred in 16 (2.5%; 95% CI 1.4–4.1%) with first trimester ARV exposure and in six (0.8%; 95% CI 0.3–1.7%) infants with later exposure (P=0.02). Exposure to ARV was not associated with specific types of heart defects. Two cases of cardiomyopathy were noted. Conclusion ARV use in early pregnancy was not associated with an increased risk of birth defects overall. The possible association of ARV exposure with heart defects requires further surveillance.
Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs). A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit) or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90). Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared to individual visits. If GMCs prove to be effective and efficient, implementation of GMCs in regular care for BRCA mutation carriers will be recommended. Trial registration The study is registered at ClinicalTrials.gov (NCT01329068)
Previous investigations have identified individuals who meet criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) substance dependence as applied to caffeine, but there is little research on treatments for caffeine dependence. This study aimed to thoroughly characterize individuals who are seeking treatment for problematic caffeine use. Ninety-four individuals who identified as being psychologically or physically dependent on caffeine, or who had tried unsuccessfully to modify caffeine consumption participated in a face-to-face diagnostic clinical interview. They also completed measures concerning caffeine use and quitting history, reasons for seeking treatment, and standardized self-report measures of psychological functioning. Caffeine treatment seekers (mean age 41 years, 55% women) consumed an average of 548 mg caffeine per day. The primary source of caffeine was coffee for 50% of the sample and soft drinks for 37%. Eighty-eight percent reported prior serious attempts to modify caffeine use (mean 2.7 prior attempts), and 43% reported being advised by a medical professional to reduce or eliminate caffeine. Ninety-three percent met criteria for caffeine dependence when generic DSM-IV-TR substance dependence criteria were applied to caffeine use. The most commonly endorsed criteria were withdrawal (96%), persistent desire or unsuccessful efforts to control use (89%), and use despite knowledge of physical or psychological problems caused by caffeine (87%). The most common reasons for wanting to modify caffeine use were health-related (59%) and not wanting to be dependent on caffeine (35%). This investigation reveals that there are individuals with problematic caffeine use who are seeking treatment and suggests that there is a need for effective caffeine dependence treatments. PMID:22369218
Juliano, Laura M; Evatt, Daniel P; Richards, Brian D; Griffiths, Roland R
The purpose of this pilot study was to determine if an accurate diagnosis could be made concerning the knee joint using only the patients' medical history information. Only women were chosen for this study because of existing unpublished data on a cohort of 100 women with normal knees to act as a control (group I). From the 2,266 knee surgical procedures in the database of one surgeon, two other groups were selected. Group II was those women with only a torn medial meniscus. Group III were those women with only a torn anterior cruciate ligament (ACL). The medical history data of one half of the database were statistically analyzed to determine the questions that were the best predictors of each group. The medical history questions discovered to be best predictors were different from what might be expected from an individual surgeon's experience, expert opinion, or a medical consensus opinion panel, but the predictors did have a foundation in fact and are substantiated by statistical analyses. Using these predictors, a validation was performed on the other half of the database. When the top 142 predicting questions were used, the diagnostic accuracy was 98%; 98 of 100 of the "normal" group, 57 of 59 cases classified as having a torn meniscus, whereas 128 of 129 cases classified as having a torn ACL were correctly identified. When the only the 30 strongest predictors were used, the diagnostic accuracy was 85%: 100 of 100 cases were correctly classified as normal, 45 of 59 cases were correctly classified as having a torn meniscus, and 101 of 129 cases were correctly classified as having a torn ACL. This study demonstrated that statistical methods applied to medical historical data can make a differential clinical diagnosis of an unknown knee joint problem with high degree of accuracy and with statistical significance. In the future, computerized medical diagnostic instruments can be constructed using these statistical methods. PMID:9115560
Johnson, L L; Johnson, A L; Colquitt, J A; Simmering, M J; Pittsley, A W
In Bangladesh, maternal mortality is estimated to be 320 per 100,000 live births, among the highest in the world, and most deliveries in rural areas occur at home. Women with obstetric complications fear to seek hospital care for various reasons; one of which is the tremendous cost. This paper shows how cost impedes rural, poor women's access to emergency obstetric
Intimate partner violence is underreported to police. A study was conducted utilizing focus group methodology to identify women's perceptions of the barriers to seeking police help for intimate partner violence (IPV). Facilitators used a structured format with open-ended questions for five focus group sessions that were recorded and subsequently analyzed using Ethnograph software. Participants were 41 women identified from social
Marsha E. Wolf; Uyen Ly; Margaret A. Hobart; Mary A. Kernic
The emphasis of Indonesia's experiment with village distribution of contraceptives, begun in 1974, is on maintenance rather than initiation of oral contraceptive use. As part of the experiment, it was decided to make resupplies available without charge outside the clinics on Java and Bali experimentally. The effort operated on the principles of avoiding standardization and focusing on resupply. In the province of West Java, resupply depots were established in the homes of acceptors whoowere also known village leaders. Each month the depot holders received a resupply, had their record-keeping reviewed, and were advised on how to deal with complaints. Presently, there are about 1600 village distribution centers with each of these units serving several subunits of a village. Effective village distribution efforts have also been established in Central Java and East Java. A unique feature of the East Java program is a lottery created to sustain the interest of those already in the program as well as to attract new acceptors. The Bali program is different from those of East Java in that most acceptors are IUD users. In this program emphasis is on recruiting new acceptors and maintaining those already in the program, and motivational effort is directed to the male. Village distribution effort data in Indonesia suggest that as the number of village distribution outlets increases, the proportion of married women of reproductive age who use contraception also increases. In addition to the government supported family planning program, there is now a combined effort supported by the Indonesian government and Aid to International Development to achieve acceptance of the condom and increased involvement of men in family planning. PMID:12277532
The purpose of this study was to examine the sociocultural factors associated with health maintenance and health care seeking among Latina immigrants. Data were collected from eight focus groups with 54 Latina immigrants between the ages of 19 and 62 (M=29.3+/-9.34). The PEN-3 model provided the framework for the study. Most of the participants came from Mexico; 46% had not completed high school; 85.2% had been in the United States for less than 7 years, and 73.6% reported not having health insurance coverage. Participants identified both positive and negative perceptions, enablers, and nurturers associated with health maintenance and health care seeking. Participants acknowledged the importance of physical, mental, and spiritual health and what they should do to be healthy. Despite such knowledge, they tended to engage in unhealthy behaviors due to a variety of nonstructural barriers such as lack of time, "tradition," and procrastination. They tended to use alternative/complementary medicine first, and then seekmedical help if these practices are not effective. Many women believe that they do not have control over their own health attributing this lack of control to the "system." Participants also mentioned structural barriers to seeking health care such as lack of transportation, lack of proper documentation, lack of health insurance, language barriers, long waiting time at the clinics, and lack of knowledge on where to go for affordable care. Our study suggests that there are important structural and nonstructural barriers that hinder health maintenance and care seeking. The findings also lend support to the PEN-3 model, and suggest that positive perceptions, enablers, and nurturers associated with health maintenance and health care seeking, if properly reinforced, can counterbalance negative perceptions, enablers and nurturers in this population. PMID:16636902
Clinical evidence supports the value of BRCA1/2 genetic counseling and testing (GC/T) for managing hereditary breast and ovarian cancer risk; however, BRCA1/2 GC/T is underutilized among Black women and reasons for low use remain elusive. We examined the potential influence of socio-cultural factors (medical mistrust, concerns about genetic discrimination) on GC/T engagement in a sample of 100 Black women at increased risk for carrying a BRCA1/2 mutation. Eligible participants fell into one of three groups: 1) healthy women with ? 1 first-degree relative (FDR) affected by breast and/or ovarian cancer, 2) women diagnosed with breast cancer at age ? 50, and 3) women diagnosed with breast and/or ovarian cancer at age ? 50 with either one FDR or two second degree relatives with breast and/or ovarian cancer. Participants were recruited from clinical and community settings and completed a semi-structured interview. Study variable relationships were examined using bivariate tests and multivariate regression analysis. Forty-three percent of participants were aware of GC/T services. Yet referral and receipt of GC/T services in this sample was low (28%). After accounting for sociodemographic factors, women with higher self-efficacy had greater GC/T engagement (B = 0.37, p < .001), while those with higher medical mistrust had lower GC/T engagement (B = ?0.26, p <. 01). Interventions targeted towards increasing provider referrals may facilitate higher levels of engagement in GC/T services. Individual interventions that enhance women’s personal confidence in obtaining GC/T may also be useful in promoting GC/T engagement.
Sheppard, Vanessa B.; Mays, Darren; LaVeist, Thomas; Tercyak, Kenneth P.
Background Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world.\\u000a Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking\\u000a and symptom interpretation process among Danish women, who have a very high mortality rate.\\u000a \\u000a \\u000a \\u000a \\u000a Methods The health seeking and symptom interpretation process was analysed
Lene Seibaek; Lone K Petersen; Jan Blaakaer; Lise Hounsgaard
Background:In acute myocardial infarction the risk of death and loss of myocardial tissue is at its highest during the first few hours. However, the process from symptom onset to the decision to seekmedical care can take time. To comprehend patients' pre-hospital delay, attention must be focused on the circumstances preceding the decision to seekmedical care.Aim:To add a deeper understanding of patients' thoughts, feelings and actions that preceded the decision to seekmedical care when afflicted by an acute myocardial infarction.Methods:Fourteen men and women with a first or second acute myocardial infarction were interviewed individually in semi-structured interviews. Data were analysed by qualitative content analysis.Results:Four themes were conceptualized: 'being incapacitated by fear, anguish and powerlessness', 'being ashamed of oneself', 'fear of losing a healthy identity' and 'striving to avoid fear by not interacting with others'. Patients were torn between feelings such as anguish, fear, shame and powerlessness. They made an effort to uphold their self-image as being a healthy person thus affected by an unrecognized discomfort. This combined with a struggle to protect others from involvement, strengthened the barriers to seeking care.Conclusions:The present study indicates that emotional reactions are important and influence patients' pre-hospital behaviour. Being ashamed of oneself stood out as a novel finding. Emotions might be an important explanation of undesired and persisting patient delays. However, our findings have to and should be evaluated quantitatively. Such a study is in progress. PMID:23341477
Nymark, Carolin; Mattiasson, Anne-Cathrine; Henriksson, Peter; Kiessling, Anna
The help-seeking attitudes for sexual health of Indian men living in Australia was explored. Of all survey respondents (n=225), many preferred to seek help from medical doctors. Young (18-25 years) Indian men were three times more likely to prefer a specialist medical doctor than older men. Ethnicity and gender of the medical doctor was 'not important' for the majority of men. Most men preferred to seek help from their regular general practitioner. PMID:23618230
A questionnaire-based study was undertaken to assess women's satisfaction with the home medical abortion service. Over a 15-month period, questionnaires were conducted at 24 h and 2 weeks following the procedure. A total of 127 women took part in the study and filled in a questionnaire at 24 h, with 77 completing the questionnaire at 2 weeks. At 24 h, over 95% of women who responded, agreed or strongly agreed that they felt prepared for the pain and bleeding that they experienced at home. At 2 weeks, 97.3% of respondents felt that they had had enough information and knew what to expect, and were therefore satisfied with the procedure. Only 15% of women were lost to clinical follow-up at 2 weeks. The majority of women are satisfied with the home medical abortion service. These high satisfaction rates are maintained at 2 weeks. Telephone follow-up 2 weeks after the abortion was safe and effective. PMID:23919859
We present the results of a clinical trial that tested the efficacy of using motivational interviewing (MI) in a group format to promote adherence to antiretroviral medications and risk reduction behaviors (RRB) in 203 predominately African American HIV infected women. It was compared to a group health promotion program. Participants were followed for 9 months. Adherence was measured by MEMS®; and RRB by self-report. Controlling for recruitment site and years on ART, no significant group by time effects were observed. Attendance (?7/8 sessions) modified the effects. Higher MI attendees had better adherence at all follow-ups, a borderline significant group by time effect (p = 0.1) for % Doses Taken on Schedule, a significantly larger proportion who reported abstinence at 2 weeks, 6, and 9 months, and always used protection during sex at 6 and 9 months. Though not conclusive, the findings offer some support for using MI in a group format to promote adherence and some risk reduction behaviors when adequate attendance is maintained.
If medical confidentiality is not observed patients may well be reluctant to disclose information to their doctors or even to seekmedical advice. Therefore, argues the author, it is of the utmost importance that doctors strive to protect medical confidentiality, particularly now when it is under threat not only in this country but also overseas. The profession must cease to regard ethical issues to do with confidentiality, and indeed to do with all areas of medical practice, as abstract phenomena requiring no justification. If it does not then it will come under increasing and justified criticism from the community it serves.
This paper presents emerging research on young women's participation in virtual heterosexual mate-seeking in two bustees (urban slum communities) in Kolkata. I begin the paper by reviewing the context of online friendship, dating and romance in India. I show how greater educational and social achievements in the bustees are prompting some young Muslim women to pursue online friendship and mate-seeking.
The relationships of epidemiological (objective) risk indices, perceived disease characteristics, and cognitive heuristics to women's perceived susceptibility to breast cancer, heart disease, and osteoporosis in a community sample of 312 women ages 40–86 were examined. Epidemiological indices accounted for a small to moderate proportion of the variance in perceived susceptibility. Psychological factors (perceived similarity to women who contract the target
Mary A. Gerend; Leona S. Aiken; Stephen G. West; Mindy J. Erchull
Expert seeking is an activity in which one seeks expertise from someone else in order to solve certain problems. When one realizes he or she requires helps to accomplish tasks that need new skills and knowledge, the process of expert seeking is initiated. This process involves many elements including formulating goals and strategies, identifying and selecting experts, and repeating the
This paper reports on a study designed to explore individual differences in uncertainty-reducing behavior regarding new and existing friends via online information seeking (OIS). Personality traits and social context were measured by surveying a sample of 377 Facebook users. Global uncertainty had a positive relationship with active information seeking about new friends, whereas communication apprehension was associated with seeking information
Michael A. Stefanone; Carolyn M. Hurley; Z. Janet Yang
|The aim of the present study was to analyze the relationship between students' (100 children aged 8 to 12) help-seeking behavior and impulsivity. Help-seeking behavior was evaluated using a naturalistic experimental paradigm in which children were placed in a problem-solving situation and had the opportunity to seek help from the experimenter, if…
BACKGROUND: Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We
Tamer Edirne; Secil Gunher Arica; Sebahat Gucuk; Recep Yildizhan; Ali Kolusari; Ertan Adali; Muhammet Can
Objective: To determine the efficacy of a peer-led social support intervention involving support groups and telephone contacts compared with standard clinical care to enhance antiretroviral medication adherence. Design: Randomized controlled trial with follow-up. Participants were 136 HIV-positive indigent mainly African American and Puerto Rican men and women recruited from an outpatient clinic in the Bronx, New York. The 3-month intervention
Jane M. Simoni; David W. Pantalone; Mary D. Plummer; Bu Huang
Stress urinary incontinence (SUI) is a socially disabling disorder that affects a large population of women around the world.\\u000a Surgical treatments for SUI typically seek to recapitulate the support of the endopelvic fascia and reduce urethral hypermobility\\u000a or improve urethral compressive forces. Radiofrequency energy is a potent tool for such treatment, as it is in other medical\\u000a specialties. The development
Transcultural nursing, psychiatry, and medical anthropology have theorized that practitioners and researchers need more flexible instruments to gather culturally relevant illness experience, meaning, and help seeking. The state of the science is sufficiently developed to allow standardized yet ethnographically sound protocols for assessment. However, vigorous calls for culturally adapted assessment models have yielded little real change in routine practice. This paper describes the conversion of the Diagnostic and Statistical Manual IV, Appendix I Outline for Cultural Formulation into a user-friendly Clinical Ethnographic Interview (CEI), and provides clinical examples of its use in a sample of highly distressed Japanese women.
Men score higher than women on measures of sensation-seeking, defined as a willingness to engage in novel or intense activities. This sex difference has been explained in terms of evolved psychological mechanisms or culturally transmitted social norms. We investigated whether sex differences in sensation-seeking have changed over recent years by conducting a meta-analysis of studies using Zuckerman's Sensation Seeking Scale, version V (SSS-V). We found that sex differences in total SSS-V scores have remained stable across years, as have sex differences in Disinhibition and Boredom Susceptibility. In contrast, the sex difference in Thrill and Adventure Seeking has declined, possibly due to changes in social norms or out-dated questions on this sub-scale. Our results support the view that men and women differ in their propensity to report sensation-seeking characteristics, while behavioural manifestations of sensation-seeking vary over time. Sex differences in sensation-seeking could reflect genetically influenced predispositions interacting with socially transmitted information.
Cross, Catharine P.; Cyrenne, De-Laine M.; Brown, Gillian R.
Is Earth unique in the universe? What is a habitable planet? How abundant are habitable planets? NASAâs Kepler Mission team seeks answers to these questions. Launching in 2009, Kepler is NASAâs first mission capable of finding Earth-sized and smaller planets in the habitable zone of other stars in our galaxy. This space mission offers an intriguing context for teaching and learning science concepts that support the National Science Education Standards in âEarth and Space Sciencesâ and âScience as Inquiry.â These activities include building models, positing explanations, understanding our solar system and extending that knowledge to other planetary systems, interpreting graphical data, and applying mathematics to analyze science data.
|Provides an overview of the major federal and state health care programs serving children and pregnant women, including (1) Medicaid; (2) the Maternal and Child Health Block Grant Program; (3) the Community and Migrant Health Center Program; and (4) the Special Supplemental Food Program for Women, Infants, and Children. (SLD)|
This article draws on data from ethnographic fieldwork in an urban housing project to examine the social context and meanings of surgical sterilization for low-income women in Brazil. Low-income women resort to sterilization because they distrust or are unsatisfied with alternative methods and because it helps them to fulfill the requirements of modern, responsible motherhood. Although sterilization is an option
The ‘woman doctor question’ was a title given to the public debates that erupted in early twentieth-century New South Wales (Australia) over the employment of women doctors in general hospitals. Two wellqualified women, Drs Susie O'Reilly and Jessie Aspinall, were rejected from hospital residencies in Sydney, which led a wide variety of groups and individuals to mobilise in print, not
The interactive relationship between psychological distress and physical health is a particularly salient one for women. Routine screening for abuse history and current psychological disturbance is essential in providing comprehensive patient care. The present study examines the utility of a brief screening measure in detecting psychological factors in female patients at a primary care facility. Sixty-nine percent of 108 women
Jennifer P. Read; Amy Leventhal Stern; Jessica Wolfe; Paige Crosby Ouimette
Songbirds sing at high rates within multiple contexts, suggesting that they are highly motivated to communicate and that the act of singing itself may be rewarding. Little is known about the neural regulation of the motivation to communicate. Dopamine and opioid neuropeptides play a primary role in reward seeking and sensory pleasure. In songbirds, these neurochemicals are found within brain regions implicated in both motivation and reward, including the medial preoptic nucleus (mPOA) and ventral tegmental area (VTA). Several lines of research indicate that dopamine and opioids in these regions play a role in birdsong that differs depending upon whether song is used to attract females (female-directed song) or is not directed towards other individuals (undirected song). Evidence is reviewed supporting the hypotheses 1) that distinct patterns of dopamine activity influence the motivation to produce undirected and female-directed song, 2) that undirected communication is intrinsically reinforced by immediate release of opioids induced by the act of singing, and 3) that directed communication is socially reinforced by opioids released as part of social interactions.
Songbirds sing at high rates within multiple contexts, suggesting that they are highly motivated to communicate and that the act of singing itself may be rewarding. Little is known about the neural regulation of the motivation to communicate. Dopamine and opioid neuropeptides play a primary role in reward seeking and sensory pleasure. In songbirds, these neurochemicals are found within brain regions implicated in both motivation and reward, including the medial preoptic nucleus (mPOA) and ventral tegmental area (VTA). Several lines of research indicate that dopamine and opioids in these regions play a role in birdsong that differs depending upon whether song is used to attract females (female-directed song) or is not directed towards other individuals (undirected song). Evidence is reviewed supporting the hypotheses: (1) that distinct patterns of dopamine activity influence the motivation to produce undirected and female-directed song, (2) that undirected communication is intrinsically reinforced by immediate release of opioids induced by the act of singing, and (3) that directed communication is socially reinforced by opioids released as part of social interactions. PMID:21251924
There is considerable evidence that high novelty seekers are at increased risk for using drugs of abuse relative to low novelty seekers. This review examines the potential biological mechanism that may help explain the relationship between novelty seeking and drug seeking behavior. Evidence is summarized to suggest that exposure to novelty activates, at least in part, the same neural substrate
This paper proposes a new sliding mode design concept, namely adaptive seeking sliding mode control for a class of nonlinear systems. While reserving the properties of the sliding mode control, like insensitivity to parameter variations and complete rejection of disturbances, adaptive seeking sliding mode control offers a promising robust sliding mode control solutions for real-life engineering applications with simple control
Explicit information-seeking actions are needed to evaluate alternative actions in problem-solving tasks. Information-seeking costs are often traded off against the utility of information. We present three experiments that show how subjects adapt to the cost and information structures of environments in a map-navigation task. We found that…
...MEDICAL CLEARANCE PROCESS FOR DEPLOYMENT TO ANTARCTICA Â§ 675.2 Medical examinations. (a) Any individual seeking to travel to Antarctica under sponsorship of the United...physically qualified for deployment to Antarctica. (b) The medical and...
...MEDICAL CLEARANCE PROCESS FOR DEPLOYMENT TO ANTARCTICA Â§ 675.2 Medical examinations. (a) Any individual seeking to travel to Antarctica under sponsorship of the United...physically qualified for deployment to Antarctica. (b) The medical and...
There are a variety of reasons why women are believed to be more susceptible than men to the effects of alcohol. Physical factors, such as body water content and hereditary predisposition to alcoholism, differentiate women from men. Social factors include secretive drinking, role model in the family, and a perceived increase in promiscuity. Societal stigmas make it difficult for alcoholic women to seek help, yet the mortality rates are high for those women who continue to drink.
Searches of the literature or Internet using the term "medical tourism" produce two sets of articles: travel for the purpose of delivering health care or travel for the purpose of seeking health care. The first usage primarily appears in the medical literature and is beyond the scope of this article, which focuses on travel to seek health care. Still, there are some aspects these two topics have in common: both are affected by ease and speed of international travel and communication associated with globalization, and both raise questions about continuity of care as well as issues related to cultural, language, and legal differences; both also raise questions about ethics. This article describes some of the motivating factors, contributing elements, and challenges in elucidating trends, as well as implications for clinicians who provide pretravel advice and those who care for ill returning travelers. PMID:19061760
The mortality and morbidity of women who terminated their pregnancy before the 1973 Supreme Court decision in Roe v Wade are compared with post-Roe v Wade mortality and morbidity. Mortality data before 1973 are from the National Center for Health Statistics; data from 1973 through 1985 are from the Centers for Disease Control and The Alan Guttmacher Institute. Trends in serious abortion-related complications between 1970 and 1990 are based on data from the Joint Program for the Study of Abortion and from the National Abortion Federation. Deaths from illegally induced abortion declined between 1940 and 1972 in part because of the introduction of antibiotics to manage sepsis and the widespread use of effective contraceptives. Deaths from legal abortion declined fivefold between 1973 and 1985 (from 3.3 deaths to 0.4 death per 100,000 procedures), reflecting increased physician education and skills, improvements in medical technology, and, notably, the earlier termination of pregnancy. The risk of death from legal abortion is higher among minority women and women over the age of 35 years, and increases with gestational age. Legal-abortion mortality between 1979 and 1985 was 0.6 death per 100,000 procedures, more than 10 times lower than the 9.1 maternal deaths per 100,000 live births between 1979 and 1986. Serious complications from legal abortion are rare. Most women who have a single abortion with vacuum aspiration experience few if any subsequent problems getting pregnant or having healthy children. Less is known about the effects of multiple abortions on future fecundity. Adverse emotional reactions to abortion are rare; most women experience relief and reduced depression and distress. PMID:1433765
In this article the practice of end of life decisions is applied to pregnant women. This is not an easy task as shown by the extensive case law and literature on the subject. The main conclusion of the article is that the pregnant woman's wishes should always be respected whatever the consequences for the foetus may be. Another position would unjustly sacrifice the woman's fundamental rights to bodily integrity and self-determination for the benefit of a non-person. The result is repeated in the situation where the woman is found to be incompetent or brain dead. PMID:21133244
The current study examined prevalence and correlates of non-medical use of prescription drugs (NMUPD), with particular emphasis on lifetime history of rape and PTSD as risk associates. Interviews conducted via telephone using Computer-Assisted Telephone Interviewing technology, resulting in a nationally representative sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18–86 years) residing in households with a telephone. Demographic characteristics, rape history, general health/mental health, and substance abuse variables were assessed. NMUPD was assessed by asking if, in the past year, participants had misused a prescription drug. Multivariable logistic regressions were conducted for each theoretically derived predictor set. Significant predictors from each set then entered into final multivariable logistic regression to determine significant predictors of past-year NMUPD. NMUPD was endorsed by 5.5% of the sample (n=164). Final multivariable model showed that lifetime posttraumatic stress disorder, other forms of substance use/abuse, and a history of drug or alcohol facilitated rape were significantly associated with increased likelihood of NMUPD. Risk reduction efforts targeting non-medical prescription drug use among women who have experienced traumatic events and/or abuse substances are warranted. Trauma-focused interventions for drug or alcohol facilitated rape victims should include treatment or prevention modules that specifically address NMUPD.
McCauley, Jenna L.; Amstadter, Ananda B.; Danielson, Carla Kmett; Ruggiero, Kenneth J.; Kilpatrick, Dean G.; Resnick, Heidi S.
The content and valence of women's body image attitudes, general and enduring positive or negative feelings about the body, are studied with psychometric analyses of measures and contrasted groups. Data from two frequently used measures (Body Image Scale, Derogatis & Melisaratos, 1979; Body Satisfaction Scale, Berscheid, Walster & Bohrnstedt, 1973) provided an evaluation of the construct and the assessment of
Men are more reluctant to seek help for their problems than women. This difference is attributed to social expectations regarding the male gender role. Today, help-seeking is moving online: instead of traditional peer groups and counselors, people depend on online communities and e-counselors. But online users can appear in guises that differ from their physical sex. An empirical study was
Mika Lehdonvirta; Yosuke Nagashima; Vili Lehdonvirta; Akira Baba
|Differences in and relationships of Asian cultural values, cultural congruity, perception of the university environment, and help-seeking attitudes for 1st- and 2nd-generation Korean American undergraduates (N = 228) were examined. Women reported significantly higher cultural congruity and more positive help-seeking attitudes than did men. Asian…
Gloria, Alberta M.; Castellanos, Jeanett; Park, Yong Sue; Kim, Daniel
Objectives: This study examined reasons for seeking treatment reported by obese patients diagnosed with binge eating disorder (BED).Research Methods and Procedures: Participants were 248 adults (58 men and 190 women) who met DSM criteria for BED. Participants were recruited through advertisements for treatment studies looking for persons who wanted to “stop binge eating and lose weight.” Patients’ reasons for seeking
Scores on the Zuckerman Sensation Seeking Scales (SSS) are consistently elevated in samples of psychopathic patients or prisoners suggesting that sensation seeking is an aspect of antisocial personality disorder. This was investigated in a sample of 171 Chinese university students (102 women and 69 men) who also completed the Dimensional Assessment of Personality Pathology – Basic Questionnaire (DAPP) which assesses
Xueqin Ke; Xujun Ye; Yi Xu; Mowei Shen; Xian Gao; Yuqing Zhang; W. John Livesley; Kerry L. Jang; Wei Wang
In the recent past, physicians found answers to questions by consulting colleagues, textbooks, and professional journals. Now, the availability of medical information through electronic resources has changed physician information-seeking behaviors. Evidence-based medicine is now the accepted decision-making paradigm, and a physician's ability to…
|Female corporate leaders are becoming more common, but that does not mean it was a snap for them to get there. Much has been said about the hard road faced by women who seek top spots in corporate America. Many point out, for instance, that women executives still often are paid less than their male counterparts, and that they face stereotypes,…
Background Studies exploring the use of complementary and alternative medicine (CAM) to enhance fertility are limited. While Australian trends indicate that women are using CAM during pregnancy, little is known about women's use of CAM for fertility enhancement. With the rising age of women at first birth, couples are increasingly seeking assisted reproductive technologies (ART) to achieve parenthood. It is likely that CAM use for fertility enhancement will also increase, however this is not known. This paper reports on an exploratory study of women's use of CAM for fertility enhancement. Methods Three focus groups were conducted in Melbourne, Australia in 2007; two with women who used CAM to enhance their fertility and one with CAM practitioners. Participants were recruited from five metropolitan Melbourne CAM practices that specialise in women's health. Women were asked to discuss their views and experiences of both CAM and ART, and practitioners were asked about their perceptions of why women consult them for fertility enhancement. Groups were digitally recorded (audio) and transcribed verbatim. The data were analysed thematically. Results Focus groups included eight CAM practitioners and seven women. Practitioners reported increasing numbers of women consulting them for fertility enhancement whilst also using ART. Women combined CAM with ART to maintain wellbeing and assist with fertility enhancement. Global themes emerging from the women's focus groups were: women being willing to 'try anything' to achieve a pregnancy; women's negative experiences of ART and a reluctance to inform their medical specialist of their CAM use; and conversely, women's experiences with CAM being affirming and empowering. Conclusions The women in our study used CAM to optimise their chances of achieving a pregnancy. Emerging themes suggest the positive relationships achieved with CAM practitioners are not always attained with orthodox medical providers. Women's views and experiences need to be considered in the provision of fertility services, and strategies developed to enhance communication between women, medical practitioners and CAM practitioners. Further research is needed to investigate the extent of CAM use for fertility enhancement in Australia, and to explore the efficacy and safety of CAM use to enhance fertility, in isolation or with ART.
Medical education has been closely linked with the necessity of medical relief and the quality of services required. The aim has been to turn out medical men and women fundamentally equipped to be practising doctors. The object of medical education has been to provide the students with a foundation for training to be a general practitioner, or a specialist, or
... serious illness. Women should not change medications or stop taking medications without first talking with their doctor ... serious conditions. Women should not change medications or stop taking medications without first talking with their doctor ...
Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant womenseeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant womenseeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services. PMID:22139045
We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment-seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community-dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, including family-related stress and social stress due to racism, is cyclical, and has serious consequences but can be controlled by treatment. Participants endorsed low perceptions of stigma. Major preferred coping strategies included praying and seekingmedical and mental health care. Age differences were found in all variables except stigma.
The proceedings of a seminar on medical malpractice are presented. The seminar was held in Salt Lake City, Utah on August 11 - 12, 1975. The seminar was convened to seek workable solutions to the medical malpractice problem at the State level. It was sugg...
CDC created U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, from guidance developed by the World Health Organization (WHO) and finalized the recommendations after consultation with a group of health professionals who met in Atlanta, Georgia, during February 2009. This guidance comprises recommendations for the use of specific contraceptive methods by women and men who have certain characteristics or medical conditions. The majority of the U.S. guidance does not differ from the WHO guidance and covers >60 characteristics or medical conditions. However, some WHO recommendations were modified for use in the United States, including recommendations about contraceptive use for women with venous thromboembolism, valvular heart disease, ovarian cancer, and uterine fibroids and for postpartum and breastfeeding women. Recommendations were added to the U.S. guidance for women with rheumatoid arthritis, history of bariatric surgery, peripartum cardiomyopathy, endometrial hyperplasia, inflammatory bowel disease, and solid organ transplantation. The recommendations in this document are intended to assist health-care providers when they counsel women, men, and couples about contraceptive method choice. Although these recommendations are meant to serve as a source of clinical guidance, health-care providers should always consider the individual clinical circumstances of each person seeking family planning services. PMID:20559203
The gap in cancer information seeking between high-socioeconomic-status (high-SES) cancer patients and low-SES cancer patients deserves serious attention, considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients' overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and
Chul-joo Lee; A. Susana Ramírez; Nehama Lewis; Stacy W. Gray; Robert C. Hornik
The prevalence of domestic violence (DV) during pregnancy could be high and is associated with significant psychological and\\u000a physical impairment for mother and the fetus. The major objective of this study was to determine the prevalence of DV in expectant\\u000a mothers who have attended the Iran University of Medical Sciences’ Hospitals (IUMS). In this cross-sectional study, 1,800\\u000a subjects were interviewed
The interaction of psychiatric symptoms with drug dependence during pregnancy is not well understood. This study examines the relationship of psychiatric symptoms to severity of drug use and drug-related problems among participants in a clinical trial of pharmacologic treatment of opioid dependence during pregnancy (N = 174). A total of 64.6% reported additional psychiatric symptoms (48.6% mood symptoms, 40.0% anxiety symptoms, and 12.6% suicidal thinking). Women who endorsed co-occurring psychiatric symptoms showed more severe impairment on the Addiction Severity Index. Further investigation is warranted to understand the effect of psychiatric symptoms on long-term maternal and neonatal outcomes. PMID:20716304
Benningfield, Margaret M; Arria, Amelia M; Kaltenbach, Karol; Heil, Sarah H; Stine, Susan M; Coyle, Mara G; Fischer, Gabriele; Jones, Hendrée E; Martin, Peter R