Sormanti, Mary; Shibusawa, Tazuko
Although intimate partner violence (IPV) may occur throughout a woman's life course, there has been a paucity of research on the experiences of victimization among midlife and older women. This article examines both the prevalence of IPV among a sample of women ages 50 to 64 (N = 620), who were recruited at an emergency department and primary care…
Tiihonen Möller, Anna; Bäckström, Torbjörn; Söndergaard, Hans Peter; Helström, Lotti
Objectives Rape has been found to be the trauma most commonly associated with Posttraumatic Stress Disorder (PTSD) among women. It is therefore important to be able to identify those women at greatest risk of developing PTSD. The aims of the present study were to analyze the PTSD prevalence six months after sexual assaults and identify the major risk factors for developing PTSD. Methods Participants were 317 female victims of rape who sought help at the Emergency Clinic for Raped Women at Stockholm South Hospital, Sweden. Baseline assessments of mental health were carried out and followed up after six months. Results Thirty-nine percent of the women had developed PTSD at the six month assessment, and 47% suffered from moderate or severe depression. The major risk factors for PTSD were having been sexually assaulted by more than one person, suffering from acute stress disorder (ASD) shortly after the assault, having been exposed to several acts during the assault, having been injured, having co-morbid depression, and having a history of more than two earlier traumas. Further, ASD on its own was found to be a poor predictor of PTSD because of the substantial ceiling effect after sexual assaults. Conclusions Development of PTSD is common in the aftermath of sexual assaults. Increased risk of developing PTSD is caused by a combination of victim vulnerability and the extent of the dramatic nature of the current assault. By identifying those women at greatest risk of developing PTSD appropriate therapeutic resources can be directed. PMID:25340763
Nikbakht Nasrabadi, Alireza; Sabzevari, Sakineh; Negahban Bonabi, Tayebeh
Background Today, women empowering is an important issue. Several methods have been introduced to empower women. Health information seeking is one of the most important activities in this regard. A wide range of capabilities have been reported as outcomes of health information seeking in several studies. As health information seeking is developed within personal-social interactions and also the health system context, it seems that the qualitative paradigm is appropriate to use in studies in this regard. This study aimed to explore how women’s empowerment through health information seeking is done. Methods In this qualitative content analysis study, data collection was done with regard to inclusion criteria, through purposive sampling by semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneous with data collection. Results Four central themes were emerged to explain women’s empowerment through health information seeking that included: a) Health concerns management with three subcategories of Better coping, Stress management, Control of situation, b) Collaborative care with two subcategories of Effective interaction with health professions and Participation in health decision making c) Individual development d) Self-protection with four sub- categories of Life style modification, Preventive behaviors promoting, Self-care promoting, and medication adherence. Conclusion The results of this study indicate the importance of women empowerment through foraging their health information seeking rights and comprehensive health information management. PMID:26005690
Smith, Elizabeth M.
Concerned professionals in various parts of the country have formed crisis-oriented counseling services to meet the needs of women who request abortions. This article presents information obtained from a sample of women seeking abortions and discusses the counselor's role in the decision making process. (Author)
Kligfeld, Marnin; Hoffman, Kaaren I.
To explore the antecedents of emotional distress among physicians, the relationship between year in medical school and student attitude toward seeking professional psychological help was investigated using students at the University of Southern California. For women, no attitudinal changes were noted; an early, significant positive change was…
Women who experience symptoms of an acute myocardial infarction (MI) are less likely than men to seek medical 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
Bean, Glynis; Kidder, Louise H.
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…
Young, Alma T.; And Others
When New York State's abortion laws were liberalized in 1970, there was a sharp rise in the number of clinic patients who requested abortions. Because social workers at Mount Sinai Medical Center believed that abortion still is an emotional risk for many women, a study was conducted to determine which patients needed intensive counseling. (Author)
Tamang, Anand; Puri, Mahesh; Lama, Kalyan; Shrestha, Prabhakar
In Nepal, despite policy restrictions, both registered and unregistered brands of mifepristone and misoprostol can easily be obtained at pharmacies. Since many women visit pharmacies for abortion information, ensuring that they receive effective care from pharmacy workers remains an important challenge. We conducted an operations research study to examine whether trained pharmacy workers can correctly provide information on safe use of mifepristone and misoprostol for early first trimester medical abortion. Pharmacy workers in one district were given orientation and training using a harm-reduction approach, and compared with a non-equivalent comparison group in the second district. Overall, trained pharmacy workers' knowledge increased substantially, but no increase was found in the comparison group. Compared to the baseline (65%), 97% of trained pharmacy workers knew up to what stage of pregnancy and how women should use mifepristone and misoprostol. A higher percentage of pharmacy workers in the intervention group (77%) compared to the comparison group (49%) were knowledgeable at follow-up about determining whether an abortion was successful, implying a need for improving this aspect of training. As many mid-level health providers run their own pharmacies and offer medical abortion pills, it is important for the government to consider training these providers and registering their pharmacies as safe medical abortion service outlets. PMID:25702074
Sabina, Chiara; Cuevas, Carlos A; Schally, Jennifer L
The current study aimed to examine formal and informal help-seeking responses to interpersonal victimization among a national sample of Latino women. In addition, an examination of help-seeking by victimization type was undertaken. Data came from the Sexual Assault Among Latinas (SALAS) study that obtained help-seeking rates among a victimized subsample of Latino women (n = 714; 35.7% of a national sample). Results show a majority (76.6%) of the victimized participants engaged in some form of help-seeking with informal resources (68.9%) more often used than formal (32.5%). Medical attention was the type of formal help-seeking sought most often among victimized women who were injured (34.7%), and parents were the most common source of informal help-seeking (26.6%). However, logistic regression analyses show that help-seeking responses were significantly affected by type of victimization. Latino women who experienced childhood victimization were significantly less likely to engage in formal and informal help-seeking. Latino women who experienced stalking were significantly less likely to engage in formal help-seeking. Victimization with a weapon was significantly related to increased odds of formal help-seeking. Thus, women respond to violence in a way that is shaped by the dynamics of the victimization experience. Practice implications include the need to increase knowledge and availability of formal help-seeking venues. PMID:21859753
Ho, Pak Chung
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 abortion found it acceptable and would choose the same method again if they needed another abortion in the future. They would also recommend this procedure to other women who need an abortion. In selected women, the administration of misoprostol at home was also acceptable. The acceptability of medical abortion may decrease with increasing gestational age of pregnancy, failure of medical abortion, prolonged bleeding and high levels of discomfort and anxiety during the abortion procedure. There was no significant difference in the emotional responses or incidences of psychiatric morbidity between women undergoing medical and women undergoing surgical abortion. PMID:16781253
Horton, Sarah; Cole, Stephanie
Despite the growing prevalence of transnational medical travel among immigrant groups in industrialized nations, relatively little scholarship has explored the diverse reasons immigrants return home for care. To date, most research suggests that cost, lack of insurance and convenience propel US Latinos to seek health care along the Mexican border. Yet medical returns are common even among Latinos who do have health insurance and even among those not residing close to the border. This suggests that the distinct culture of medicine as practiced in the border clinics Latinos visit may be as important a factor in influencing medical returns as convenience and cost. Drawing upon qualitative interviews, this article presents an emic account of Latinos' perceptions of the features of medical practice in Mexico that make medical returns attractive. Between November 15, 2009 and January 15, 2010, we conducted qualitative interviews with 15 Mexican immigrants and nine Mexican Americans who sought care at Border Hospital, a private clinic in Tijuana. Sixteen were uninsured and eight had insurance. Yet of the 16 uninsured, six had purposefully dropped their insurance to make this clinic their permanent "medical home." Moreover, those who substituted receiving care at Border Hospital for their US health insurance plan did so not only because of cost, but also because of what they perceived as the distinctive style of medical practice at Border Hospital. Interviewees mentioned the rapidity of services, personal attention, effective medications, and emphasis on clinical discretion as features distinguishing "Mexican medical practice," opposing these features to the frequent referrals and tests, impersonal doctor-patient relationships, uniform treatment protocols and reliance on surgeries they experienced in the US health care system. While interviewees portrayed these features as characterizing a uniform "Mexican medical culture," we suggest that they are best described as unique to the private clinics and hospitals returning migrants visit. In short, we suggest that the perceived contrast in cultures of medicine derives from the difference in organization of health care services on each side of the border. PMID:21531062
Choo, Chun Wei; Marton, Christine
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.…
Brown-Bowers, Amy; McShane, Kelly; Wilson-Mitchell, Karline; Gurevich, Maria
Canada has one of the world's largest refugee resettlement programs in the world. Just over 48 percent of Canadian refugees are women, with many of them of childbearing age and pregnant. Refugee and asylum-seeking women in Canada face a five times greater risk of developing postpartum depression than Canadian-born women. Mainstream psychological approaches to postpartum depression emphasize individual-level risk factors (e.g. hormones, thoughts, emotions) and individualized treatments (e.g. psychotherapy, medication). This conceptualization is problematic when applied to refugee and asylum-seeking women because it fails to acknowledge the migrant experience and the unique set of circumstances from which these women have come. The present theoretical article explores some of the consequences of applying this psychiatric label to the distress experienced by refugee and asylum-seeking women and presents an alternative way of conceptualizing and alleviating this distress. PMID:25389234
SusanS Glander; MaryLou Moore; Robert Michielutte; LinnH Parsons
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 women seeking outpatient abortion. The survey included demographic information, abuse screening, and items regarding partner
Background The current political climate with regards to abortion in the US, along with the economic recession may be affecting women’s reasons for seeking abortion, warranting a new investigation into the reasons why women seek abortion. Methods Data for this study were drawn from baseline quantitative and qualitative data from the Turnaway Study, an ongoing, five-year, longitudinal study evaluating the health and socioeconomic consequences of receiving or being denied an abortion in the US. While the study has followed women for over two full years, it relies on the baseline data which were collected from 2008 through the end of 2010. The sample included 954 women from 30 abortion facilities across the US who responded to two open ended questions regarding the reasons why they wanted to terminate their pregnancy approximately one week after seeking an abortion. Results Women’s reasons for seeking an abortion fell into 11 broad themes. The predominant themes identified as reasons for seeking abortion included financial reasons (40%), timing (36%), partner related reasons (31%), and the need to focus on other children (29%). Most women reported multiple reasons for seeking an abortion crossing over several themes (64%). Using mixed effects multivariate logistic regression analyses, we identified the social and demographic predictors of the predominant themes women gave for seeking an abortion. Conclusions Study findings demonstrate that the reasons women seek abortion are complex and interrelated, similar to those found in previous studies. While some women stated only one factor that contributed to their desire to terminate their pregnancies, others pointed to a myriad of factors that, cumulatively, resulted in their seeking abortion. As indicated by the differences we observed among women’s reasons by individual characteristics, women seek abortion for reasons related to their circumstances, including their socioeconomic status, age, health, parity and marital status. It is important that policy makers consider women’s motivations for choosing abortion, as decisions to support or oppose such legislation could have profound effects on the health, socioeconomic outcomes and life trajectories of women facing unwanted pregnancies. PMID:23829590
Hoagland, K. Elaine
Women scientists met to make policy recommendations on issues related to the participation of women in scientific research. The group suggested programs that would reduce sex-role stereo-typing at the lower educational levels as a way to prevent the wastage of talent that they feel now occurs in the sciences. (Author/MA)
Cuts in government funding mean that Canada's medical schools have to seek new ways to raise funds. Susan Thorne examines some of the ways faculties of medicine are coping with change. In the brave new world of medical education, schools are combining classes for medical students and other health professionals, seeking business alliances, encouraging attendance by full-tuition students from other countries and diversifying revenue bases through new programs, such as McGill's new 5-year MD-MBA degree. PMID:9176430
Ward, Earlise C.; Clark, Le Ondra; Heidrich, Susan
Little is known about African American women's beliefs about mental illness. In this qualitative study we employed the Common Sense Model (CSM) to examine African American women's beliefs about mental illness, coping behaviors, barriers to treatment seeking, and variations in beliefs, coping, and barriers associated with aging. Fifteen community-dwelling African American women participated in individual interviews. Dimensional analysis, guided by the CSM, showed that participants believed general, culturally specific, and age-related factors can cause mental illness. They believed mental illness is chronic, with negative health outcomes. Participants endorsed the use of prayer and counseling as coping strategies, but were ambivalent about the use of medications. Treatment-seeking barriers included poor access to care, stigma, and lack of awareness of mental illness. Few age differences were found in beliefs, coping behaviors, and barriers. Practice and research implications are discussed. PMID:19843967
Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G
Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8?kg?m(-2) ) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ?10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. PMID:26256916
Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were collected in a longitudinal two-wave study (n?=?2305 workers). The outcome measures were visits (yes/no and frequency) to a general practitioner (GP), a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. Results In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance) was the only work characteristic associated with more care-seeking (GP). For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency), high levels of decision latitude (GP frequency) and high levels of social support by the supervisor (medical specialist). Other work characteristics led to more care-seeking: high levels of engagement (GP), full time work (GP frequency) and experiencing a work handicap (physical therapist). Conclusions We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. The association between work characteristics and later medical care-seeking differed between health care providers and between men and women. If we aim at reducing health care costs for workers by preventing unnecessary or inefficient care, it is important to reduce the number of workers that report that health complaints impede their work performance. The supervisor could provide more social support, closely monitor workload in combination with work pressure and decision latitude, and when possible help to adjust working conditions. Health care providers could reduce medical costs by taking the work relatedness of health complaints into account and act accordingly, by decreasing the time to referral and waiting lists, and by providing appropriate care and avoiding unnecessary or harmful care. PMID:22938384
Mary K. Feeney; Margarita Bernal
Supporting and advancing women’s science careers continues to be of interest to researchers, scientists, science funders,\\u000a and universities. Similarly, professional advice and support networks are important to understanding the advancement of scientific\\u000a careers. This research aims to marry these two lines of research to investigate and compare the ways in which men and women\\u000a scientists seek advice and support from
Riessman, C K; Whalen, M H; Frost, R O; Morgenthau, J E
Although previous research shows that adult women in intimate relations tend to enjoy better health than women without partners, this study finds the opposite tends to be true for late adolescent women. We followed a college entering class prospectively for 4 years and measured romantic involvement and various aspects of health and illness behavior in a questionnaire. Health service use was determined from the medical record, and disaggregated into distress and health maintenance visits, as well as visits expressly for psychological counseling. First year students who were romantically involved had more physical symptoms, more medical visits, but not more counseling visits, than non-involved women. At senior year, they continued to have more health maintenance, more counseling, but not more distress visits, and they tended to experience greater interference in social role performance due to illness when compared to non-involved women. When several mediators of the relationship between romantic involvement and health service use were controlled-number and intensity of physical symptoms, sexual activity, stress in the relationship, and social network characteristics--the differences persisted. Romance appears to motivate help-seeking among late adolescent women for reasons that are not easily explained empirically. Recent work on adolescent women's development offers theoretical leads that can guide future investigations. PMID:1807069
Leone, Janel M; Lape, Megan E; Xu, Yili
This study examined the help-seeking decisions of low-income women (n = 389) in two types of physically violent heterosexual relationships-intimate terrorism (i.e., physical violence used within a general pattern of coercive control) and situationally violent (i.e., physical violence that is not part of a general pattern of coercive control). Intimate terrorism victims were significantly more likely than situational couple violence victims to cite fear as a reason for not seeking help from the police, medical centers, and counselors/agencies. In contrast, situational couple violence victims more often said that they did not need help. Regression analyses also indicate that additional violence-related factors predict women's help-seeking. Findings emphasize the importance of distinguishing between types of male partner violence and recognizing women's exertions of personal choice and perceptions of dangerousness when examining their decisions about seeking help from service providers. PMID:24366964
Janine Farrell; Thea Cacchioni
The medicalization of women's sexual problems under the overall rubric of female sexual dysfunction (FSD) has been thoroughly critiqued by feminist scholars, health practitioners, and sex therapists. However, there has been much less commentary on the medicalization of women's sexual pain—currently, a subset of an official FSD diagnosis. This article critically examines interdisciplinary understandings and ways of addressing sexual pain.
Minassian, Vatche A; Yan, Xiaowei; Lichtenfeld, Marc J; Sun, Haiyan; Stewart, Walter F
Aims To determine predictors of health care utilization in women with urinary incontinence (UI) from the population to specialty care. Methods The General Longitudinal Overactive Bladder Evaluation – UI is a population-based study on the natural history of UI in women ? 40 years of age. Prevalence of UI was estimated by using the bladder health survey (BHS). Survey data were linked with electronic health records (EHR) to examine factors associated with a clinical UI diagnosis using logistic regression. Risk factors analyzed included: UI symptoms, subtypes, bother, severity, duration and effect on quality of life, and demographic and other health characteristics. All statistical tests were two-sided with a p-value < 0.05 being significant. Results The overall prevalence of any UI based on responses to the BHS was 1,618/4064 (40%). Of the 1,618 women with UI, there were only 398 (25%) women with EHR (clinical) diagnosis of UI. Women with UI versus those without UI were more likely to be have a BMI >25kg/m2 (70% versus 58%), more likely to be parous (91% versus 87%) and college educated (54% versus 46%), P<0.001. After adjusting for confounders in the model, variables significantly associated with clinical UI diagnosis included: older age (OR=1.96), higher parity (> 1 birth) (OR=1.76), higher urgency UI (OR=1.08), adaptive behavior (OR=1.2), and UI bother scores (OR=1.01), as well as more frequent outpatient visits (OR=1.03), P<0.05. Conclusions UI is a highly prevalent condition with only a minority of women seeking care. Factors associated with health care utilization include older age, parity (1+), number of doctor visits, urgency UI subtype, UI bother and impact on behavior. PMID:22378605
Rehan, N; Inayatullah, A; Chaudhary, I
A study of the characteristics of Pakistani women seeking abortion and a profile of abortion clinics was conducted in 32 abortion clinics in three provincial capitals of the country. All 452 women who had their pregnancies terminated between October and December 1997 were interviewed. Except for 39 women (8.6%), all study subjects were married. A majority of the women (36.6%) were aged >35 years, 61.0% had given birth to > or =5 children, and 40.2% were illiterate. The predominant reasons for abortion were "too many children" (64.4%), contraceptive failure (20.3%), premarital affairs (8.6%), medical reasons (5.4%), and extramarital affairs (1.3%). Nearly two thirds of the abortions were induced by inadequately trained persons. Only 22% of the abortion clinics met the World Health Organization (WHO) standards required for safe termination of pregnancy. At all these clinics, the procedure used to terminate the pregnancy was dilatation and curettage (D&C). Only one clinic was using manual vacuum aspiration (MVA). Induced abortion seems to be fairly common among married women of high parity, advanced age, and low educational status. Keeping in view the large number of terminations, new medical and surgical techniques of pregnancy termination should be introduced to those already providing abortion services. PMID:11703893
Collaborative information seeking is integral to many professional activities. In hospital work, the medication process encompasses continual seeking for information and collaborative grounding of information. This study investigates breakdowns in collaborative information seeking through analyses of the use of the electronic medication record adopted in a Danish healthcare region and of the reports of five years of medication incidents at
Kwok, Cannas; Sullivan, Gerard
Preventive medicine is an important element of the Australian health care system. An essential aspect of the biomedical model of health care is screening for the early detection of disease in otherwise asymptomatic people. There is ample evidence that acceptance levels of western medicine vary and that a variety of health epistemologies and health practices coexist. To examine the extent to which Chinese-Australian women integrate western medicine practices in their health seeking behaviour, a qualitative study was conducted, which involved in-depth interviews in Cantonese with 20 women. Although adherence to western health beliefs and practices varied, in general these Chinese-Australian women sought medical help only after they felt unwell. Commonly, they first tried traditional remedies for minor diseases. Many saw no reason to participate in screening when they were asymptomatic. Direct communication with health care providers who speak the same language appears to be important to many Chinese-Australian women when seeking health care services. It is recommended that ethnic health workers should participate in screening programmes and other health promotion activities. PMID:17606701
Chen, Guowei; Wei, Yongxiang; Miao, Xutao; Li, Kunyan; Ren, Yuanyuan; Liu, Jia
Background Olfactory disorders are common complaints in ENT clinics. We investigated causes and relevant features of olfactory disorders and the need for gustatory testing in patients with olfactory dysfunction. Material/Methods A total of 140 patients seeking medical consultations were enrolled. All patients were asked about their olfactory disorders in a structured interview of medical history and underwent thorough otolaryngologic examinations and imaging of the head. Results Causes of olfactory disorders were classified as: upper respiratory tract infection (URTI), sinonasal diseases (NSD), head trauma, idiopathic, endoscopic sinus surgery, congenital anosmia, and other causes. Each of the various causes of olfactory dysfunction had its own distinct clinical features. Nineteen of 54 patients whose gustation was assessed had gustatory disorders. Conclusions The leading causes of olfactory dysfunction were URTI, NSD, head trauma, and idiopathic causes. Gustatory disorders were fairly common in patients with olfactory dysfunction. High priority should be given to complaints of olfactory disorders. PMID:23748259
Notzer, N; Brown, S
This paper describes the current status of women physicians in Israel at various stages in their professional careers: in medical school, in the medical specialties and in academia. In the past, as in most western countries, medicine in Israel was regarded as a man's profession. The last decade has seen major demographic changes: the proportion of women entering medical school is now similar to that of men, and as a result of immigration from the former Soviet Union, the percentage of women physicians is approaching the level in eastern European countries. Recent findings show an increase in women in all specialty areas. However, they are concentrated in the lower status strata and in primary care, occupying the base of the academic pyramid. It appears that when objective criteria are employed, such as for admission to medical school and licensing examinations, women and men have similar levels of achievement. However, when subjective criteria are used, such as in admission to residency training, gender-based differences in distribution in the medical specialties are apparent. We suggest implementing objective standards for acceptance for residency training which should help equalize the status of women in the Israeli medical establishment. PMID:8846948
Sabina, Chiara; Cuevas, Carlos A.; Schally, Jennifer L.
The current study aimed to examine formal and informal help-seeking responses to interpersonal victimization among a national sample of Latino women. In addition, an examination of help-seeking by victimization type was undertaken. Data came from the Sexual Assault Among Latinas (SALAS) study that obtained help-seeking rates among a victimized…
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
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 seek medical care at a hospital where they might be sanctioned for having an abortion and even reported to the police. PMID:23259660
Stavri, P Z
This study was designed to explore the relationship between certain attributes of a diagnostic problem and a particular information-seeking question. Using case vignettes under experimental conditions, fifty residents in internal medicine and family practice informed the experimenter of the most important thing they would need to know to make a preliminary diagnosis. These data were classified nominally using a preexisting taxonomy. Significant results indicated that Quantification questions tend to be asked under urgent conditions and Verification questions tend to be asked when the least amount of information is presented. While the taxonomy used to classify the questions did not prove rich enough to describe information needs fully, results did suggest some consistency in question asking, a skill that could be developed further during medical education. PMID:8883985
Arvind Karunakaran; Young Hee-Nam; Madhu Reddy
Collaborative information seeking (CIS) is an intrinsic part of medical work. Patient care teams increasingly rely upon various systems, such as Electronic Medical Records (EMRs), to support collaborative information seeking across hierarchical, functional and occupational boundaries of the organization in order to enhance the quality of medical care. However, despite their proven benefits, there still are several challenges to using
Prata, Ndola; Holston, Martine; Fraser, Ashley; Melkamu, Yilma
Limited access to modern contraceptives in populations that desire smaller families can lead to repeat unintended pregnancy and repeat abortions. We conducted an analysis of the medical records of 1,200 women seeking abortion-related services in public and private facilities in Addis Ababa, Ethiopia from October 2008 to February 2009. We examined the characteristics of initial and repeat abortion clients including prior contraceptive use and subsequent method selection. The incidence of repeat abortion was 30%. Compared with women seeking their first abortion, significantly more repeat abortion clients had ever used contraceptives and they were nearly twice as likely to leave the facility with a method. However, repeat abortion clients were significantly more likely to have ever used short-term reversible methods and to choose short-term methods post-abortion. Contraceptive counseling services for repeat abortion clients' should address reasons for previous contraceptive failure, discontinuation, or non-use. Post-abortion family planning services should be strengthened to help decrease repeat abortion. PMID:24558782
Buhi, Eric R.; Clayton, Heather; Surrency, Heather Hepler
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…
Maxwell, Bruce D.
BETTY COFFEY AWARD The Women's and Gender Studies Committee seeks nominations for the Betty Coffey rewards two kinds of activities: 1. Research and scholarship leading to the creation of a new course to the success of women on campus. Research leading to programs designed to enhance the participation of women
Gwee, Kok Ann; Setia, Sajita
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. PMID:22505828
Mainuddin, AKM; Ara Begum, Housne; Rawal, Lal B.; Islam, Anwar; Shariful Islam, SM
Objective: Over the last few decades, Bangladesh has made significant progress towards achieving targets for the Millennium Development Goals (MDGs) and women empowerment. This study is aimed at identifying the levels and patterns of women empowerment in relation to health seeking behavior in Bangladesh. Materials and methods: We conducted a cross-sectional study among 200 rural married women in Cox’s Bazar district in Bangladesh using multi stage sampling technique and face-to-face interview. Data was collected on socio-economic characteristics, proxy indicators for women empowerment in mobility and health seeking behavior related decision making. Bivariate and multivariate regression analyses were performed to identify associations between women empowerment in relation to health seeking behavior on mobility and decision making, controlling the effect of other independent variables. Results: The results showed that only 12% women were empowered to decide on their own about seeking healthcare and 8.5% in healthcare seeking for their children. In multivariate analysis women empowerment in health seeking behavior was higher among age group 25-34 years (OR 1.76, [CI = 0.82-3.21]), women’s education, husband’s education, age at marriage > 18 years (OR 6.38, [CI = 0.98-4.21]) and women’s working status (OR 16.44, [CI = 0.79-2.71]). Conclusion: Women empowerment enhances their decision-making authority regarding health seeking behavior. Acknowledging and adopting the implications of these findings are essential for an integrated health and development strategy for Bangladesh and achieving the MDGs. PMID:26175761
Objectives: The purpose of the study was to discover how women found out about uterine fibroid embolization (UFE) for the treatment of symptomatic uterine fibroids. Methods: The study retrospectively tracked women from the beginning of their illnesses and analyzed their information-seeking behaviors. Twenty-eight women who had the procedure at the Detroit Medical Center were interviewed using a standard script. Median values and frequencies were calculated to represent information needs, information sources, and perceived helpfulness. Spearman correlations were calculated to find relationships between demographics and information needs. Results: Although the women expressed a great need for almost all types of information (median = 5), those with higher levels of education indicated a greater need to know the reasons that their doctors had for suggesting treatments (r = 0.55). The gathered frequencies indicated that friends, magazines, television, and the Internet were important information sources. A preliminary model of information seeking showed that while friends, magazines, and television made several of the women aware of the new procedure, the Internet was heavily utilized for learning about treatment options. Conclusions: Health sciences librarians may inform women about their health and treatment options by guiding women to easily readable, authoritative, and reliable information sources, including Web information sites. PMID:17443249
Schoen, Eva G; Lee, Sharon; Skow, Christine; Greenberg, Stefanie T; Bell, Allison S; Wiese, Joanna E; Martens, Jessica Kelly
This qualitative study retrospectively explored the help-seeking process in women with eating disorders. Interviews were conducted with 14 college-age women suffering from anorexia nervosa, bulimia nervosa, or eating disorder NOS. Grounded theory was utilized to develop a preliminary model of the help-seeking process. Participants described a gradual shift from denial to increased awareness of self and the impact of the illness. This core process was transient in nature and influenced by interpersonal feedback, critical incidents, the women's general attitude toward help- seeking, and prior treatment experiences. Implications for clinicians include an increased focus on the transient awareness of self and the illness. PMID:22188057
Khakbazan, Zohreh; Taghipour, Ali; Latifnejad Roudsari, Robab; Mohammadi, Eesa
Background and Objective Patient delay makes a critical contribution to late diagnosis and poor survival in cases of breast cancer. Identifying the factors that influence patient delay could provide information for adopting strategies that shorten this delay. The aim of this meta-ethnography was to synthesize existing qualitative evidence in order to gain a new understanding of help seeking behavior in women with self-discovered breast cancer symptoms and to determine the factors that influence patient delay. Methods The design was a meta-ethnography approach. A systematic search of the articles was performed in different databases including Elsevier, PubMed, ProQuest and SCOPUS. Qualitative studies with a focus on help seeking behaviors in women with self-discovered breast cancer symptoms and patient delay, published in the English language between 1990 and 2013 were included. The quality appraisal of the articles was carried out using the Critical Appraisal Skills Programme qualitative research checklist and 13 articles met the inclusion criteria. The synthesis was conducted according to Noblit and Hare’s meta-ethnographic approach (1988), through reciprocal translational analysis and lines-of-argument. Findings The synthesis led to identification of eight repeated key concepts including: symptom detection, initial symptom interpretation, symptom monitoring, social interaction, emotional reaction, priority of medical help, appraisal of health services and personal-environmental factors. Symptom interpretation is identified as the important step of the help seeking process and which changed across the process through active monitoring of their symptoms, social interactions and emotional reactions. The perceived seriousness of the situation, priority to receive medical attention, perceived inaccessibility and unacceptability of the health care system influenced women’s decision-making about utilizing health services. Conclusion Help seeking processes are influenced by multiple factors. Educational programs aimed at correcting misunderstandings, erroneous social beliefs and improving self-awareness could provide key strategies to improve health policy which would reduce patient delay. PMID:25470732
Eric R. Buhi; Heather Clayton; Heather Hepler Surrency
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
Kostick, Kristin M; Schensul, Stephen L; Jadhav, Kalpita; Singh, Rajendra; Bavadekar, Amruta; Saggurti, Niranjan
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 safed pani is disproportionately high among poor women, representing a physical, emotional and financial burden for low-income families. Safed pani is only rarely indicative of a reproductive tract or sexually transmitted infection. The discrepancy between symptom reports and observed pathology has led some researchers to characterize safed pani as a culturally based expression of more generalized negative life situation. Data are drawn from two prevention intervention studies (2002-2006 and 2007-2012) conducted in economically marginal communities in Mumbai. Results show that husbands as problem generators and spousal abusers and women's greater perceived empowerment and reported tension are significantly associated with safed pani. These results provide the basis for identifying women at greater risk for psychosocial distress and providing supports at the locations at which they seek treatment. PMID:20533080
Hamberger, L. Kevin; Saunders, Daniel G.
Although many battered women seek help from their family physicians as outpatients, rates of current and lifetime victimization among outpatient female patients have not been well studied. This study tested two hypotheses regarding whether battered women presented to the clinic in a different manner than did nonbattered women. First, within the…
Godfrey, Emily M.; Wheat, Santina G.; Cyrier, Rosalie; Wong, William; Trussell, James; Schwarz, Eleanor. Bimla
Objectives To determine the contraceptive needs (including emergency contraception (EC)) of women seeking care from a publicly-funded sexually transmitted infection (STI) clinic and to better understand women’s knowledge of and attitudes towards EC. Methods An anonymous survey was administered to 197 women seeking services at one Chicago Department of Public Health STI clinic. Results After excluding women unlikely to become pregnant within the next year because of age, sexual orientation, hysterectomy, and those that desired pregnancy (n=47), data from 150 women were available for analysis. Thirteen percent were using “very effective” contraception (intrauterine contraception, implant, or sterilization) and 26% were using “effective” contraception (contraceptive pill, patch, ring or injectable). Approximately 23% (95% CI 16.5–30.0%) may have benefited from immediate use of EC as they reported at least one act of unprotected intercourse within the past 5 days. Conclusion Many women seeking care from public STI clinics are at high risk of unintended pregnancy. A substantial number of women have an immediate need of EC at the time of their clinical visit. Efforts are needed to improve provision of EC as well as effective ongoing contraception for this population. PMID:21074018
Ingram, J; Rawls, R D; Moberly, H D
Expanded Medicaid eligibility and case-managed care have contributed to improved birth outcomes and reduced Medicaid expenditures in Alabama. In 1990, 26.5 percent of all women delayed entry to care until the fourth month of pregnancy or later. Additionally, more than 1,000 women in the state received no care at all. In many of these cases, women perceived prenatal care as unimportant or unnecessary until later in pregnancy. As a result, the Alabama Medicaid Agency developed Healthy Beginnings, an incentive and awareness program which utilizes coupons to motivate women to seek prenatal care. Pregnant women can receive the coupon book (worth about $300) simply by dialing a toll-free number. To take advantage of the free gifts and discounts, expectant mothers must visit a private physician or health clinic and have their coupons validated monthly. The project was initiated in August, 1990, and already there is clear evidence that the use of incentives represents a viable outreach strategy to motivate poor and uninsured women to seek care. In the program's first year, more than 20,000 women received the coupons, of which 78 percent were Medicaid recipients, uninsured or in a presumptive (Medicaid) eligibility period. Focus group studies, field visits and a survey were used to evaluate the effectiveness of the new program. Preliminary data analysis has revealed that the incentive program may be a significant factor in motivating women to seek early and continuous prenatal care. PMID:10128261
Malek, Angela M.; Chang, Chung-Chou H.; Clark, Duncan B.; Cook, Robert L.
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 seek medical care more rapidly, reduction of social stigmas, and improved access to testing options. PMID:24078858
Olatokun, Wole Michael; Ajagbe, Enitan
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…
Gollop, C J
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. PMID:9160150
Background In sub-Saharan Africa, women must overcome numerous barriers when they need modern healthcare. Respect of gender norms within the household and the community may still influence women's ability to obtain care. A lack of gender-sensitive instruments for measuring women's ability to overcome barriers compromises attempts to adequately quantify the burden and risk of exclusion they face when seeking modern healthcare. The aim of this study was to create and validate a synthetic measure of women's access to healthcare from a publicly available and possibly internationally comparable population-based survey. Method Seven questionnaire items from the Burkina Faso 2003 DHS were combined to create the index. Cronbach's alpha coefficient was used to test the reliability of the index. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to evaluate the factorial structure and construct validity of the index while taking into account the hierarchical structure of the data. Results The index has a Cronbach's alpha of 0.75, suggesting adequate reliability. In EFA, three correlated factors fitted the data best. In CFA, the construct of perceived ability to overcome barriers to healthcare seeking emerged as a second-order latent variable with three domains: socioeconomic barriers, geographical barriers and psychosocial barriers. Model fit indices support the index's global validity for women of reproductive age in Burkina Faso. Evidence for construct validity comes from the finding that women's index scores increase with household living standard. Conclusion The DHS items can be combined into a reliable and valid, gender-sensitive index quantifying reproductive-age women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso. The index complies conceptually with the sector-cross-cutting capability approach and enables measuring directly the perceived access to healthcare. Therefore it can help to improve the design and evaluation of interventions that aim to facilitate healthcare seeking in this country. Further analyses may examine how far the index applies to similar contexts. PMID:22369583
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…
Morgan-Lopez, Antonio A.; Saavedra, Lissette M.; Hien, Denise A.; Campbell, Aimee N.; Wu, Elwin; Ruglass, Lesia
Objective The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. We test this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use. Method Data from 353 women in a six-site, randomized controlled effectiveness trial within the NIDA Clinical Trials Network were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use. Results Significant reductions in alcohol use among women in Seeking Safety (compared to Health Education) were observed; women in the Seeking Safety condition who followed up with TSA had the greatest reductions over time in alcohol use. Reductions in cocaine use over time were also observed but did not differ between treatment conditions nor were there interactions with post-treatment TSA. Conclusions Findings advance understanding of the complexities for treatment and continuing recovery processes for women with PTSD and SUDs, and further support the chronic disease model of addiction. PMID:23558158
Jerry Finn; Mary Banach
This article describes the problems and dangers that may be encountered when women seek health and human services on the Internet. Issues related to online counseling and online self-help groups include: difficulties in ascertaining the credentials and identity of service providers, accessing inaccurate information, reliance on untested methods, difficulties in on- line assessment, exposure to disinhibited communication, development of inappropriate
Kim, Jae Yop; Lee, Ji Hyeon
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…
Sánchez-Anguiano, Luis Francisco; Alvarado-Esquivel, Cosme; Reyes-Romero, Miguel Arturo; Carrera-Rodríguez, Margarita
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 women seeking 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. PMID:16504014
Cash Ghee, Anna; Bolling, Lanny C.; Johnson, Candace S.
This study examined the efficacy of a condensed version of the "Seeking Safety" intervention in the reduction of trauma-related symptoms and improved drug abstinence rates among women in residential chemical dependence treatment. One hundred and four women were randomly assigned to treatment including a condensed (six session) "Seeking Safety"…
Khan, M S; Unemo, M; Zaman, S; Lundborg, C Stålsby
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
Everett, Bethany G.; Mollborn, Stefanie
Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women. PMID:25382887
Das, Ashavaree; Sarkar, Madhurima
Objectives: Understanding health information-seeking behaviors and barriers to care and access among pregnant women can potentially moderate the consistent negative associations between poverty, low levels of literacy, and negative maternal and child health outcomes in India. Our seminal study explores health information needs, health information-seeking behaviors, and perceived information support of low-income pregnant women in rural India. Methods: Using the Wilson Model of health information-seeking framework, we designed a culturally tailored guided interview to assess information-seeking behaviors and barriers to information seeking among pregnant women. We used a local informant and health care worker to recruit 14 expectant women for two focus group interviews lasting 45 minutes to an hour each. Thirteen other related individuals including husbands, mothers, mothers-in-law, and health care providers were also recruited by hospital counselors for in-depth interviews regarding their pregnant wives/daughters and daughters-in-law. Interviews were transcribed and analyzed by coding the data into thematic categories. Results: The data were coded manually and emerging themes included pregnancy-related knowledge and misconceptions and personal, societal, and structural barriers, as well as risk perceptions and self-efficacy. Lack of access to health care and pregnancy-related health information led participants to rely heavily on information and misconceptions about pregnancy gleaned from elder women, friends, and mothers-in-law and husbands. Doctors and para-medical staff were only consulted during complications. All women faced personal, societal, and structural level barriers, including feelings of shame and embarrassment, fear of repercussion for discussing their pregnancies with their doctors, and inadequate time with their doctors. Conclusion: Lack of access and adequate health care information were of primary concern to pregnant women and their families. Policy Implications: Our study can help inform policies and multi-sectoral approaches that are being taken by the Indian government to reduce maternal and child morbidity and burdens. PMID:25191141
Wong, Li Ping; Awang, Halimah; Jani, Rohana
In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting. PMID:23127220
Dedobbeleer, Nicole; Morissette, Pauline; Rojas-Viger, Celia
This paper examines the relative influence of social network norms on sexual risk-taking among women seeking 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 partners (e.g., family, friends, internet or newspapers virtual communities), with a minority following prescribed condom use habits. Further the results indicate that among the study participants the search for love and well being, social proximity, feelings of trust and intimacy that appear to evolve almost instantly in new encounters, are in conflict with the prescribed condom-use norms. These results suggest that there is a need to build new norms for starting relationships, for improved dialogue among women and between women and men on affective solitude. The findings also underscore the need for public health interventions that seek to influence social networks as well as the behavior of individuals. PMID:15970576
Rozic-Hristovski, Anamarija; Hristovski, Dimitar; Todorovski, Ljupco
The Central Medical Library (CMK) at the Faculty of Medicine, University of Ljubljana, Slovenia, started to build a library Website that included a guide to library services and resources in 1997. The evaluation of Website usage plays an important role in its maintenance and development. Analyzing and exploring regularities in the visitors' behavior can be used to enhance the quality and facilitate delivery of information services, identify visitors' interests, and improve the server's performance. The analysis of the CMK Website users' navigational behavior was carried out by analyzing the Web server log files. These files contained information on all user accesses to the Website and provided a great opportunity to learn more about the behavior of visitors to the Website. The majority of the available tools for Web log file analysis provide a predefined set of reports showing the access count and the transferred bytes grouped along several dimensions. In addition to the reports mentioned above, the authors wanted to be able to perform interactive exploration and ad hoc analysis and discover trends in a user-friendly way. Because of that, we developed our own solution for exploring and analyzing the Web logs based on data warehousing and online analytical processing technologies. The analytical solution we developed proved successful, so it may find further application in the field of Web log file analysis. We will apply the findings of the analysis to restructuring the CMK Website. PMID:11999179
Rozic-Hristovsk, Anamarija; Hristovski, Dimitar; Todorovski, Ljupco
The Central Medical Library (CMK) at the Faculty of Medicine, University of Ljubljana, Slovenia, started to build a library Website that included a guide to library services and resources in 1997. The evaluation of Website usage plays an important role in its maintenance and development. Analyzing and exploring regularities in the visitors' behavior can be used to enhance the quality and facilitate delivery of information services, identify visitors' interests, and improve the server's performance. The analysis of the CMK Website users' navigational behavior was carried out by analyzing the Web server log files. These files contained information on all user accesses to the Website and provided a great opportunity to learn more about the behavior of visitors to the Website. The majority of the available tools for Web log file analysis provide a predefined set of reports showing the access count and the transferred bytes grouped along several dimensions. In addition to the reports mentioned above, the authors wanted to be able to perform interactive exploration and ad hoc analysis and discover trends in a user-friendly way. Because of that, we developed our own solution for exploring and analyzing the Web logs based on data warehousing and online analytical processing technologies. The analytical solution we developed proved successful, so it may find further application in the field of Web log file analysis. We will apply the findings of the analysis to restructuring the CMK Website. PMID:11999179
Cheng, Tyrone C; Lo, Celia C
A study with 591 low-income women examined domestic violence's role in treatment seeking for mental health or substance abuse problems. (The women resided in one of two California counties.) Following Aday's behavioral model of health services utilization, the secondary data analysis considered the women's need, enabling, and predisposing factors. Generalized estimating equations analyzed the women's longitudinal records of treatment seeking. Results showed that those in the sample who were likely to seek treatment had experienced three or more controlling behaviors and only one abusive behavior. Multivariate data analysis showed treatment-seeking women were likely to be white and older; responsible for few dependent children; not graduates of high school; employed; not participating in Medicaid; diagnosed; and perceiving a need for treatment. The implications of these results for services and policies are discussed. PMID:25626226
Hsieh, Yichuan; Brennan, Patricia Flatley
As a result of the Human Genome Project, more genetic diagnostic tests have become available to the public and genetic-related information has also grown exponentially. Pregnant women are now routinely offered tests for chromosomal disorders and screenings for genetic conditions that are relevant to their situations. In order to facilitate the information system (IS) development to support their informed decision-making, it is imperative for the IS designer to recognize their unique information needs and patterns of information seeking behavior (ISB) first. This paper presents results of a pilot study that examined pregnant women’s information needs, ISBs, and information resources used prior to their prenatal genetic counseling. Findings suggest three distinctive areas, content, format, and timing, for IS design considerations. PMID:16779061
Huaman Ayala, Laura S; Blumenthal, Paul D; Sarnquist, Clea C
This qualitative study aimed to assess factors influencing pregnant women's decision to seek or avoid antenatal care (ANC) in the Andes of Peru. Open-ended, semi-structured interviews were conducted with 24 women utilizing ANC (+) and 10 women avoiding ANC (-). Interviews were translated to English from Quechua and Spanish, transcribed, and analyzed using grounded theory. Factors influencing ANC- women included: expecting criticism for having additional children; long ANC wait time and inconvenient hours of operation; and masculine gender of health workers. For ANC+ women, motivating factors included: maximizing positive health outcomes; past negative maternity experiences; pressure from family members; and avoidance of rumored fines or fees associated with ANC non-attendance and in-hospital deliveries, respectively. Both ANC+ and ANC- women were fearful and embarrassed about possible criticism for having additional children and the gender of the health workers, yet they weighed these factors differently. To better understand how rural women make decisions about ANC attendance, it is important to consider the value they place on the factors influencing their decision, and their emotional assessment of such issues. PMID:22956365
Li, Hai-Jiang; Sun, Jiang-Zhou; Zhang, Qing-Lin; Wei, Dong-Tao; Li, Wen-Fu; Jackson, Todd; Hitchman, Glenn; Qiu, Jiang
Help seeking (HS) is a core coping strategy that is directed towards obtaining support, advice, or assistance as means of managing stress. Women have been found to use more HS than men. Neural correlates of sex differences have also been reported in prefrontal-limbic system (PLS) regions that are linked to stress and coping, yet structural differences between men and women relating to HS in the PLS are still unknown. Thus, the association between gray matter volume (GMV) and HS was investigated using voxel-based morphometry (VBM) in a large healthy sample (126 men and 156 women). Results indicated women reported more HS than men did. VBM results showed that the relation between HS scores and GMV differed between men and women in regions of the bilateral orbitofrontal cortex extending to the subgenual anterior cingulate cortex(OFC/sgACC). Among women, higher HS scores were associated with smaller GMV in these areas while a positive correlation between GMV and HS scores was observed among men. These results remained significant after controlling for general intelligence, stress, anxiety and depression. Thus, this study suggested that structural differences between men and women are correlated to characteristic brain regions known to be involved in the PLS which is considered critical in stress regulation. PMID:25027617
Voigt, Robert G; Johnson, Shirley K; Hashikawa, Andrew H; Mellon, Michael W; Campeau, Lynnelle J; Williams, Arthur R; Yawn, Barbara P; Juhn, Young J
The reasons underlying parents' decisions to seek medical evaluations for their mildly ill children are not well understood. This cross-sectional study tracked parents' requests for on-site medical evaluations at a sick child care program. A logistic regression model identified factors associated with parents' decisions to seek medical evaluations for their children based on the data from parent-completed questionnaires. A convenience sample of 196 parents completed all questionnaires; 62 (31.6%) parents sought medical evaluations. Parents were more likely to seek medical evaluations if they were concerned about missing work (odds ratio = 8.6; 95% confidence interval, 3.3-22.0; P = .0001), if they smoked (odds ratio = 3.7; 95% confidence interval, 1.1-12.4; P = .037), or if their spouse's highest educational attainment was some high school (odds ratio = 0.4; 95% confidence interval, 0.1-1.0; P = .044). The data highlight the problems working parents have in accessing health care during usual working hours and the potential value of convenient health care programs. PMID:18057151
CORLISS, HEATHER L.; GRELLA, CHRISTINE E.; MAYS, VICKIE M.; COCHRAN, SUSAN D.
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 and bisexual women recruited through multiple strategies were used. Multiple logistic regression was employed to describe patterns of reported drug use and to compare lifetime severity of drug use with demographic characteristics, recent drug use, indicators of current social and emotional problems, and help-seeking behaviors. Results Drug use, especially marijuana (33% used in the past year), was fairly common. Overall, 16.2% of the women in the study reported lifetime drug use that was associated with self-reported severity of substance use, and another 10.8% indicated moderate-risk use. Extent of lifetime drug use was positively correlated with self-reported recent drug use as well as current life problems. Of the respondents who evidenced more problematic drug use, 41.5% indicated that they had received professional help for a substance use problem, and 16.3% wanted but had not received such help. Conclusions The women in this study reported elevated rates of illicit drug use that was frequently associated with impairment and specific life problems. A significant proportion wanted and had not received professional treatment for their drug use problems. Future studies that examine pathways by which lesbians and bisexual women can obtain referrals and treatment for substance use problems are needed. PMID:16796483
Zamani, Maryam; Soleymani, Mohammad Reza; Afshar, Mina; Shahrzadi, Leila; Zadeh, Akbar Hasan
Background: Patients, as one of the most prominent groups requiring health-based information, encounter numerous problems in order to obtain these pieces of information and apply them. The aim of this study was to determine the information-seeking behavior of cardiovascular patients who were hospitalized in Isfahan University of Medical Sciences hospitals. Materials and Methods: This is a survey research. The population consisted of all patients with cardiovascular disease who were hospitalized in the hospitals of Isfahan University of Medical Sciences during 2012. According to the statistics, the number of patients was 6000. The sample size was determined based on the formula of Cochran; 400 patients were randomly selected. Data were collected by researcher-made questionnaire. Two-level descriptive statistics and inferential statistics were used for analysis. Results: The data showed that the awareness of the probability to recover and finding appropriate medical care centers were the most significant informational needs. The practitioners, television, and radio were used more than the other informational resources. Lack of familiarity to medical terminologies and unaccountability of medical staff were the major obstacles faced by the patients to obtain information. The results also showed that there was no significant relationship between the patients’ gender and information-seeking behavior, whereas there was a significant relationship between the demographic features (age, education, place of residence) and information-seeking behavior. Conclusion: Giving information about health to the patients can help them to control their disease. Appropriate methods and ways should be used based on patients’ willingness. Despite the variety of information resources, patients expressed medical staff as the best source for getting health information. Information-seeking behavior of the patients was found to be influenced by different demographic and environmental factors. PMID:25250349
Fanslow, Janet L.; Robinson, Elizabeth M.
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…
Moreau, Caroline; Trussell, James; Desfreres, Julie; Bajos, Nathalie
Background Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women’s preferences in the decision making process. Study design The data are drawn from a nationally representative survey of 8,245 women undergoing an elective abortion in France in 2007. Analyses of factors associated with the type of abortion technique were performed among the 4,650 women who were identified as being eligible for the two techniques. Results Sixty-seven percent of all abortions were medical procedures among women eligible for both techniques. The type of abortion technique was not dependent on women’s age, parity, cohabitation status, socioeconomic circumstances nor on the type of facility providing the abortion (private or public). Conversely, women’s participation in the decision making process was strongly associated with the type of abortion method. Among the 50% of women who reported they had been given a choice, 84% underwent a medical procedure versus 52% of those who were not offered a choice. Among the 2,286 women who were not involved in the decision, 35% indicated they trusted their doctor to make the best choice for them, while 44% were told it was too late for a medical procedure, although they had consulted before 8 weeks of amenorrhea. Conclusion In this sample of French women who participated in a national survey on abortion, those who were involved in the decision making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure. PMID:21843684
Tobin, Carolyn L; Murphy-Lawless, Jo
Background Immigration and asylum seeking has been an important social and political phenomenon in Ireland since the mid 1990s. Inward migration to Ireland was seen in unprecedented numbers from 1995 onward, peaking in 2002 with 11,634 applications for refugee status. Asylum and immigration is an issue of national and international relevance as the numbers of displaced people worldwide continues to grow, reaching the highest level in 20 years at 45.2 million in 2012. Midwives provide the majority of care to childbearing women around the world, whether working as autonomous practitioners or under the direction of an obstetrician. Limited data currently exist on the perspectives of midwives who provide care to childbearing women while they are in the process of seeking asylum. Such data are important to midwifery leaders, educators, and policy-makers. The aims of this study were to explore midwives’ perceptions and experiences of providing care to women in the asylum process and to gain insight into how midwives can be equipped and supported to provide more effective care to this group in the future. Methods Data were collected via indepth unstructured interviews with a purposive sample of ten midwives from two sites, one a large urban inner city hospital, and the second, a smaller more rural maternity hospital. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis. Results Five themes emerged from the data, barriers to communication, understanding cultural difference, challenges of caring for women who were unbooked, the emotional cost of caring, and structural barriers to effective care. Conclusion Findings highlight a need to focus on support and education for midwives, improved maternity services for immigrant women, and urgent policy revision. PMID:24516340
Machado, Carolina Leme; Fernandes, Arlete Maria Dos Santos; Osis, Maria José Duarte; Makuch, Maria Yolanda
In Brazil, abortion is permitted by law in cases of rape-related pregnancy. This study reports on various aspects in the experience of women that have been sexually assaulted: diagnosis of the pregnancy, seeking legal abortion, and hospitalization in a university hospital. This was a qualitative study that interviewed ten women 18 to 38 years of age, with at least eight years of schooling, one to five years after legal abortion. The women had been previously unaware of their right to a legal abortion, were ashamed about the sexual assault, kept it secret, and had not sought immediate care. The diagnosis of pregnancy provoked anxiety and the wish to undergo an abortion. Women treated through private health plans received either insufficient orientation or none at all. Respectful treatment by the healthcare staff proved relevant for the women to cope with the abortion. The study highlights the need to publicize the right to abortion in cases of rape-related pregnancy and the healthcare services that perform legal abortion, in addition to training healthcare and law enforcement teams to handle such cases. PMID:25760168
Lim, B H; Mahmood, T A
There has been a large increase in legal abortions in England in the last 10 years. The cause can be partially attributed to the decline in use of various contraceptive methods, particularly pills and IUD's. the statistics presented pertain to patients seeking abortion in the Scottish Highlands and include single and married women from 15-40 years of age. Of these women, 80% had 1st trimester abortions, and the other 20% had abortions between the 12-18 weeks of pregnancy. 25% were married, 13% divorced or separated, and 62% single. 64% of these women did not use any birth control method at the time of the unwanted pregnancies, and 74% were under 27 years of age. Fill failure occurred in 19% of cases and condom failure in 10%, with the remaining failures attributed to IUD's, caps, and diaphragms. Other factors causing increased numbers of abortions are economic conditions and reductions in family planning clinics. In this area local doctors are the main source of family planning information and services. Since most of these cases are young unmarried women, the need for better access to family planning education and birth control is obvious. The number of women of all ages not using contraceptives shows a need for reevaluation of family planning services for all age groups. PMID:12282924
FOCUS Medical Student Fellowship in Women's Health Research Website: www.med.upenn.edu/focus/StudentFellowships.shtml Contacts: Hillary Bogner MD MPH & Patricia Scott #12;FOCUS Medical Student Fellowship · Offers between 2 Out and/or WHS Certificate Contacts: Hillary Bogner MD MPH & Patricia Scott Web: www.med.upenn.edu/focus/StudentFellowships
Brown, Philip H; Theoharides, Caroline
Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice. PMID:19551751
Newman, Frederick L; Seff, Laura R; Beaulaurier, Richard L; Palmer, Richard C
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
Moradi, Bonnie; Funderburk, Jamie R.
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…
Background Stress urinary incontinence (SUI) leads to considerable physical and psychological morbidity. The highest prevalence reported was found in Caucasian Americans (range 23% -67%) and the lowest in Singaporean females (4.8%). The study assessed the prevalence, perceptions, predisposing factors and health seeking behaviour of women with SUI in an Asian setting which may have different sociocultural implications. Methods 400 consecutive women >20 years of age attending the outpatient department of a tertiary care hospital in Sri Lanka, for non-urinary conditions were studied over a 3 week period using an interviewer administered questionnaire. SUI was diagnosed on clinical history alone when leakage of urine occurred either with coughing, sneezing, walking or lifting heavy objects. The severity was graded using the Finnish Gynaecological Society’s Urinary Incontinence Severity Score (UISS). Data were analysed using SPSS version 20. Odds ratios were calculated using univariate and multivariate analysis. Results Ninety three (23.33%) had SUI and only 12 (12.9%) had sought treatment. The prevalence among women >50 years of age was 34.71% ( n = 121) compared to 18.28% (n = 279) in those ?50 years. 25 (26.88%) had mild SUI, 66 (70.97%) moderate and 2 (2.15%) severe as per UISS. SUI was perceived as an illness by 210 (52.5%). SUI was significantly associated with pregnancy, parity, vaginal delivery, complicated labour, diabetes mellitus, chronic cough, constipation and faecal incontinence (p < 0.05). Among those affected main reasons for not seeking medical advice included; being embarrassed (n?=?27, 33.33%), not knowing that it is remediable (n?=?23, 28.40%), perceiving SUI to be a normal consequence of childbirth (n?=?19, 23.46%) and having to attend to needs of the family (n?=?12, 14.81%). None who had been pregnant (n?=?313) had received advice on postnatal pelvic floor exercises. SUI interfered with social activities (71;76.34%), sexual function (21; 22.58%) and resulted in despair (67; 72.09%). It was associated with clinically diagnosed candidiasis (50; 53.76%) and soreness in the perineal region (49; 52.69%). Conclusions SUI is a common and neglected gynaecological problem with poor healthcare seeking behaviour. Community based education may help to minimize the occurrence and improve the quality of life of those affected. PMID:24985068
Flicker, Sharon M.; Cerulli, Catherine; Zhao, Xi; Tang, Wan; Watts, Arthur; Xia, Yinglin; Talbot, Nancy L.
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 were less likely to seek help, women who experienced concomitant stalking were more likely to seek help, whereas concomitant psychological abuse was not associated with help-seeking. Ethnic differences were 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
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
Sheridan, Jennifer T.; Fine, Eve; Pribbenow, Christine Maidl; Handelsman, Jo; Carnes, Molly
One opportunity to realize the diversity goals of academic health centers comes at the time of hiring new faculty. To improve the effectiveness of search committees in increasing the gender diversity of faculty hires, the authors created and implemented a training workshop for faculty search committees designed to improve the hiring process and increase the diversity of faculty hires at the University of Wisconsin–Madison. They describe the workshops, which they presented in the School of Medicine and Public Health between 2004 and 2007, and they compare the subsequent hiring of women faculty in participating and nonparticipating departments and the self-reported experience of new faculty within the hiring process. Attendance at the workshop correlates with improved hiring of women faculty and with a better hiring experience for faculty recruits, especially women. The authors articulate successful elements of workshop implementation for other medical schools seeking to increase gender diversity on their faculties. PMID:20505400
Sabina, Chiara; Cuevas, Carlos A; Schally, Jennifer L
Interpersonal violence research on Latinos has largely ignored the ethnic group variations that are included under the pan-ethnic term Latino. The current study adds to the literature by utilizing a national sample of Latino women to examine the interpersonal victimization experiences and help-seeking responses to victimization by ethnic group. The sample was drawn from the Sexual Assault Among Latinas Study (SALAS; Cuevas & Sabina, 2010) that surveyed 2,000 self-identified adult Latino women. For the purpose of this study, victimization in the United States was examined among Mexican ethnics (73.3% of sample), Cuban ethnics (14%), and other ethnics (12.8%). Mexican ethnicity was found to be significantly associated with increased odds of experiencing any, physical, sexual, threat, and stalking victimization. Findings also show that higher levels of Latino orientation and being an immigrant were associated with decreased odds of experiencing any victimization, whereas Anglo orientation, as measured by the Brief ARSMA-II (Cuéllar, Arnold, & Maldonado, 1995), was associated with greater odds of experiencing any victimization. Anglo orientation was significantly associated with formal help seeking. Taken as a whole, these findings emphasize the importance of bilingual and culturally competent services and also reveal that culturally competent services includes developing an understanding of the cultural differences between Latino ethnic groups. Specifically, service providers should be aware that Latinos of Mexican ethnicity may face unique risks for victimization. PMID:25111549
Maternowska, M Catherine; Mashu, Alexio; Moyo, Precious; Withers, Mellissa; Chipato, Tsungai
In Zimbabwe, abortions are legally restricted and complications from unsafe abortions are a major public health concern. This study in 2012 explored women's and providers' perspectives in Zimbabwe on the acceptability of the use of misoprostol as a form of treatment for complications of abortion in post-abortion care. In-depth interviews were conducted with 115 participants at seven post-abortion care facilities. Participants included 73 women of reproductive age who received services for incomplete abortion and 42 providers, including physicians, nurses, midwives, general practitioners and casualty staff. Only 29 providers had previously used misoprostol with their own patients, and only 21 had received any formal training in its use. Nearly all women and providers preferred misoprostol to surgical abortion methods because it was perceived as less invasive, safer and more affordable. Women also generally preferred the non-surgical method, when given the option, as fears around surgery and risk were high. Most providers favoured removing legal restrictions on abortion, particularly medical abortion. Approving use of misoprostol for post-abortion care in Zimbabwe is important in order to reduce unsafe abortion and its related sequelae. Legal, policy and practice reforms must be accompanied by effective reproductive health curricula updates in medical, nursing and midwifery schools, as well as through updated training for current and potential providers of post-abortion care services nationwide. Our findings support the use of misoprostol in national post-abortion care programmes, as it is an acceptable and potentially life-saving treatment option. PMID:25702065
van Zanten, Marta; Boulet, John R.
The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to…
Davis, Kevin C; Uhrig, Jennifer; Rupert, Douglas; Fraze, Jami; Goetz, Joshua; Slater, Michael
"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
Pelzer, N L; Leysen, J M
Veterinary medical students at Iowa State University were assessed for general use of the veterinary library and for their information-seeking behavior. The library was most frequently used for studying and for making photocopies of materials. The typical respondent relied on course textbooks and handouts for current information on unfamiliar topics, instead of using indexes or abstracts for guidance to recent literature. Light use of library information resources raises the concern that students are developing an inadequate base of retrieval skills for finding information on new procedures, diseases and drugs. No differences were found between students with and without formal bibliographic instruction in their approaches to seeking information or in library use. PMID:3224224
Objective The objective of the study was to describe our early experience with a comprehensive uterine fibroid center and report our results in women seeking a second opinion for management of symptomatic uterine leiomyoma. Methods We performed a HIPAA-complaint, IRB-approved retrospective study of women seeking second opinion for management of uterine fibroids at our multidisciplinary fibroid treatment center in a tertiary care facility from July 2008 to August 2011. After a review of patients’ history, physical examination, and magnetic resonance imaging (MRI) findings, treatment options were discussed which included conservative management, uterine-preserving options, and hysterectomy. We performed Fisher’s exact test for categorical variables between the cohort that did or did not undergo a uterine-preserving treatment. Differences were considered significant at p?0.05. Results The mean age of the 205 patient study cohort was 43.8 years (SD 7.5). One hundred sixty-two (79.0%) patients had no prior therapy. Based on MRI, one or more fibroids were detected in 178/205 (86.8%), adenomyosis in 8/205 (3.9%), and a combination of fibroid and nonfibroid condition (i.e., adenomyosis, endometrial polyp) in 18/205 (8.8%). In those who desired to transition their care to our institution (n?=?109), 85 patients underwent 90 interventions: 39 MRgFUS (magnetic resonance-guided high-intensity focused ultrasound surgery), 14 UAE (uterine artery embolization), 25 myomectomies, 8 hysterectomies, 3 polypectomies, and 1 endometrial ablation. Five patients had two procedures. Intramural and subserosal fibroids were most commonly treated with MRgFUS followed by myomectomy and then UAE; in contrast, pedunculated fibroids were frequently managed with myomectomy. Conclusions Multidisciplinary fibroid evaluation may facilitate the increase use of less invasive options over hysterectomy for symptomatic fibroid treatment. PMID:25512867
Walton, Georgia D; Ross, Lori E; Stewart, Donna E; Grigoriadis, Sophie; Dennis, Cindy-Lee; Vigod, Simone
The purpose of this study was to examine decision-making among women considering antidepressant medication use in pregnancy. Decisional conflict was assessed using the Decisional Conflict Scale (DCS) among pregnant women considering antidepressant medication treatment (N?=?40). Overall DCS and subscale scores were compared between women who were antidepressant users and non-users. Semi-structured interviews (N?=?10) explored barriers and facilitators of decision-making. Twenty-one women (52 %) had moderate or high decisional conflict (DCS???25). Overall DCS scores did not differ between groups, but antidepressant use was associated with feeling more adequately informed (subscale mean 17.5, SD 17.9 vs. 42.1, SD 23.8, p?=?0.001) and clear about values (subscale mean 16.7, SD 15.1 vs. 29.8, SD 24.0, p?=?0.043). Barriers to decision-making were (1) difficulty weighing maternal versus infant health, (2) lack of high quality information, (3) negative external influences, and (4) emotional reactions to decision-making. Facilitators were (1) interpersonal supports, (2) accessible subspecialty care, and (3) severe depressive symptoms. Many pregnant women facing decisions regarding antidepressant medication use experience decisional conflict. Interventions that provide accurate information, assistance with weighing risks and benefits of treatment, management of problematic external influences, and emotional support may reduce decisional conflict and facilitate the decision-making process. PMID:25104244
Dowell, Jon; Jones, Anni; Snadden, David
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. PMID:11791812
Pelzer, N L; Wiese, W H; Leysen, J M
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. PMID:9681170
Kratzke, Cynthia; Wilson, Susan
Although growing research supports cancer survivor information-seeking, little is known about breast cancer prevention information-seeking among women. The purpose of the study was to examine differences in breast cancer risk factor knowledge, information sources, and desired mobile messages among Hispanic and non-Hispanic rural women. Women were recruited to complete a survey at an imaging center during a mammography screening visit. A total of 156 women (mean age?=?61, SD?=?12.07) completed the survey. Breast cancer risk factor knowledge was significantly higher for non-Hispanic women compared to Hispanic women (p?=?.035). Television, magazines, and Internet were the most frequent information sources. Providers were the most frequent interpersonal information source. Nearly 87 % used cell phones and 47 % used texting. Hispanic women were more likely to desire breast cancer prevention cell voice messages (p?.001) and text messages (p?=?.001) compared to non-Hispanic women. No significant differences were found for text appointment reminders by ethnicity. Health educators and clinicians must promote mobile messages for Hispanics and non-Hispanics for mammography adherence, breast cancer prevention education, and best practices to manage screening appointments. PMID:24163017
Escobedo, Ana D.
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…
Waisbren, S E; Hamilton, B D; St James, P J; Shiloh, S; Levy, H L
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. PMID:7503337
Ramos, Silvina; Romero, Mariana; Aizenberg, Lila
This article presents the findings of a qualitative study exploring the experiences of women living in Buenos Aires Metropolitan Area, Argentina, with the use of misoprostol for inducing an abortion. We asked women about the range of decisions they had to make, their emotions, the physical experience, strategies they needed to use, including seeking health care advice and in dealing with a clandestine medical abortion, and their overall evaluation of the experience. An in-depth interview schedule was used. The women had either used misoprostol and sought counselling or care at a public hospital (n=24) or had used misoprostol based on the advice of a local hotline, information from the internet or from other women (n=21). Four stages in the women's experiences were identified: how the decision to terminate the pregnancy was taken, how the medication was obtained, how the tablets were used, and reflections on the outcome whether or not they sought medical advice. Safety and privacy were key in deciding to use medical abortion. Access to the medication was the main obstacle, requiring a prescription or a friendly drugstore. Correct information about the number of pills to use and dosage intervals was the least easy to obtain and caused concerns. The possibility of choosing a time of privacy and having the company of a close one was highlighted as a unique advantage of medical abortion. Efforts to improve abortion law, policy and service provision in Argentina in order to ensure the best possible conditions for use of medical abortion by women should be redoubled. PMID:25702064
Drawing upon research conducted on cross-border patients living in Laos and seeking care in Thailand, this paper examines the important role played by social networks in patients' decision-making and on the itineraries they choose to seek treatment on the Thai side of the border. Due to the vastly contrasting situations between the two countries in terms of healthcare supply, and considering Laotians' increasing demand for high quality healthcare, a number of them have managed to satisfy their needs by combining cross-border treatment with the use of the healthcare facilities provided by their own country. This study consisted first of household surveys conducted in five border areas (2006-2007) in Laos in order to quantify and map out cross-border healthcare-related travel patterns. Afterwards, interviews were conducted with cross-border patients (55), Laotian and Thai medical doctors (6), Thai social workers (5), and officials working in public institutions (12). While socioeconomic and spatial factors partly explain cross-border mobility, patients' social networks significantly influence treatment itineraries throughout the decision-making process, including logistical and financial considerations. The social networks existing at different geographical levels (neighbourhood, regional and global) are therefore a powerful analytical tool not only for understanding the emergence of these cross-border movements but also for justifying them in an authoritarian political environment such as Lao PDR's. PMID:25454637
Yousaf, Omar; Grunfeld, Elizabeth A; Hunter, Myra S
Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80?+?) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals. PMID:26209212
Turner-Moss, Eleanor; Zimmerman, Cathy; Howard, Louise M; Oram, Siân
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
Strauss, Jennifer L; Marx, Christine E; Weitlauf, Julie C; Stechuchak, Karen M; Straits-Troster, Kristy; Worjoloh, Ayaba W; Sherrod, Christina B; Olsen, Maren K; Butterfield, Marian I; Calhoun, Patrick S
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 and seroprevalence among women receiving outpatient mental health care at a Veterans Affairs (VA) medical center. Each woman completed an assessment interview composed of validated measures that queried childhood sexual trauma; substance use; and risk behaviors, including trading sex for money, drugs, shelter, food, or other things. History of MST was derived from mandated VA screening results and chart notes. Overall, 19.7% reported a history of trading sex. Those who reported trading sex had a higher rate of MST than those who did not report trading sex (87.2% vs. 62.9%, respectively). A multivariable logistic regression model examined the relationship between trading sex and MST, controlling a priori for substance abuse and childhood sexual trauma (both associated with trading sex in civilian samples) and education, which was associated with trading sex in our sample. In this adjusted model, MST was associated with trading sex: odds ratio = 3.26, p = .025, 95% confidence interval = [1.16, 9.18]. To our knowledge, this is the 1st report of an association between MST and trading sex. Results extend previously observed associations between sexual trauma and trading sex in civilian cohorts and underscore the pernicious influence of sexual victimization across the lifespan. PMID:21534097
Jadva, V.; Freeman, T.; Tranfield, E.; Golombok, S.
STUDY QUESTION What are the characteristics, motivations and expectations of men and women who search for a co-parent online? SUMMARY ANSWER Male and female prospective co-parents differed in terms of their motivations, choice of co-parent and expectations of co-parenting, while differences according to sexual orientation were less marked. WHAT IS KNOWN ALREADY Very few studies have addressed the experiences of elective co-parents, i.e. men and women who are not in a relationship with each other creating and raising a child together. No study has examined the motivations and experiences of those who seek co-parents online. STUDY DESIGN, SIZE AND DURATION An online survey was completed by 102 participants (61 men, 41 women) who were members of Pride Angel, an online connection website that facilitates contact between people looking for someone with whom to have a child. The survey was live for 7 weeks. PARTICIPANTS/MATERIALS, SETTING, METHODS Details of the survey were emailed to all members of Pride Angel. The survey obtained data on participants' demographic characteristics, motivations, choice of co-parent and expectations of co-parenting. Data were analysed to examine differences by gender and by sexual orientation within each gender. MAIN RESULTS AND THE ROLE OF CHANCE Approximately one-third of men and one half of women seeking co-parenting arrangements were heterosexual. The majority (69, 68%) of participants were single, although significantly more gay and bisexual men (15, 36%) and lesbian and bisexual women (11, 55%) had a partner compared with heterosexual men (4, 20%) and heterosexual women (2, 12%), respectively. Overall, the most important motivation for seeking co-parenting arrangements was in order for both biological parents to be involved in the child's upbringing. Co-parents were looking for someone with a good medical history. Most female co-parents expected the child to live with them, whereas male co-parents either wished the child to reside with the mother or to live equally in both households. A higher proportion of gay and bisexual men than heterosexual men wanted daily contact with the child. LIMITATIONS, REASONS FOR CAUTION Although this study presents data from the largest sample of elective co-parents to date, the main limitations were the low response rate and that only members of one website were approached. The findings may not be representative of all potential elective co-parents. WIDER IMPLICATIONS OF THE FINDINGS This study provides important insights into the new phenomenon of elective co-parenting. With the increasing use of assisted reproductive technologies and the diversification of family forms, a growing number of people are seeking co-parenting arrangements to have children. While up until now, elective co-parenting has been principally associated with the gay and lesbian community, this study shows that, with the rise of co-parenting websites, increasing numbers of heterosexual men and women are seeking these types of parenting arrangements. This study generates the first findings on the expectations and motivations of those who seek co-parents online and examines whether these differ according to gender and sexual orientation. Future studies are needed to assess the impact of this new form of parenting on all involved, particularly the children. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Wellcome Trust (097857/Z/11/Z). Erika Tranfield is the co-founder of the website Pride Angel, the remaining authors have no conflicts of interest to declare. PMID:26040481
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
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.
Webber, Gail C.; Chirangi, Bwire
In rural Africa, deaths from childbirth are common and access to health care facilities with skilled providers is very limited. Leading causes of death for women are bleeding and infection. In this pilot study, we establish the feasibility of distributing oral medications to women in rural Tanzania to self-administer after delivery to reduce bleeding and infection. Of the 642 women provided with medications, 90% of the women took them appropriately, while the remaining 10% did not require them. We conclude that is it feasible to distribute oral medications to rural women to self-administer after delivery. PMID:24786175
Elaine Scallan; Timothy F. Jones; Alicia Cronquist; Stepy Thomas; Paul Frenzen; Dina Hoefer; Carlota Medus; Fredrick J. Angulo
Laboratory-based surveillance is a foundation for public health and is essential for determining the incidence of most foodborne diseases caused by bacterial pathogens; however, reported cases represent a subset of infections in the community. To identify the factors associated with seeking medical care and submitting a stool specimen among persons with acute diarrheal illness, we used multivariate logistic regression to
Kratzke, Cynthia; Wilson, Susan; Vilchis, Hugo
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
Decker, Michele R; Nair, Saritha; Saggurti, Niranjan; Sabri, Bushra; Jethva, Meghna; Raj, Anita; Donta, Balaiah; Silverman, Jay G
Domestic violence is a significant public health issue. India is uniquely affected with an estimated 1 in 3 women facing abuse at the hands of a partner. The current mixed-methods study describes violence-related coping and help-seeking, and preferences for health care-based intervention, among perinatal women residing in low-income communities in Mumbai, India. In-depth interviews were conducted with women who had recently given birth and self-reported recent violence from husbands (n = 32), followed by survey data collection (n = 1,038) from mothers seeking immunization for their infants ages 6 months or younger at 3 large urban health centers in Mumbai, India. Participants described fears and other barriers to abuse disclosure, and there was a low level of awareness of formal support services related to violence. Qualitative and quantitative findings indicated that formal help-seeking is uncommon and that informal help sources are most frequently sought. Quantitative results revealed that, while few (<5%) women had been screened for violence in the health care setting, most (67%) would be willing to disclose abuse if asked. When presented with a list of possible clinic-based violence support interventions, participants endorsed crisis counseling and safety planning as most helpful (90.9%). Findings provide direction for violence-related intervention services for perinatal women. A multipronged approach that includes strengthening the informal support system, for example, neighbors and family members, as well as facilitating access to formal services building on the health care system, warrants exploration in this context. PMID:23295374
Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M.; Kenton, Anthony; Turner, Andrew; French, David P.
Background Prompt treatment following Transient Ischemic Attack (TIA) can reduce the risk of subsequent stroke and disability. However, many patients delay in making contact with medical services. This study aimed to explore TIA patients' accounts of delay between symptom onset and contacting medical services including how decisions to contact services were made and the factors discussed in relation to delay. Methods Twenty interviews were conducted with TIA patients in England. Using a previous systematic review as an initial framework, interview data were organised into categories of symptom recognition, presence of others and type of care sought. A thematic analysis was then conducted to explore descriptions of care-seeking relevant to each category. Results Delay in contacting medical services varied from less than an hour to eight days. Awareness of typical stroke symptoms could lead to urgent action when more severe TIA symptoms were present but could lead to delay when experienced symptoms were less severe. The role of friends and family varied widely from deciding on and enacting care-seeking decisions to simply providing transport to the GP practice. When family or friends played a greater role, and both made and enacted care-seeking decisions, delays were often shorter, even when patients themselves failed to identify symptoms. Healthcare professionals also impacted on patients' care-seeking with greater delays in seeking further care for the same episode described when patients perceived a lack of urgency during initial healthcare interactions. Conclusions This study provides new information on patients' decisions to contact medical services following TIA and identifies overlapping factors that can lead to delay in receiving appropriate treatment. While recognition of symptoms may contribute to delay in contacting medical services, additional factors, including full responsibility being taken by others and initial healthcare interactions, can over-ride or undermine the importance of patients' own identification of TIA. PMID:25137185
Background Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Methods Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Results Study participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. Conclusions UP adversely affects women’s daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP. PMID:24490616
Southern California, University of
and one of the most decorated players in the history of USC women's basketball. Other speakers include's conference is expected to draw more than 800 women to campus -- a record number in the conference's history Olympian Cynthia Cooper-Dyke, the head coach of North Carolina Wilmington's women's basketball program
Kenna, George A.; Zywiak, William H.; Swift, Robert M.; McGeary, John E.; Clifford, James S.; Shoaff, Jessica R.; Fricchione, Samuel; Brickley, Michael; Beaucage, Kayla; Haass-Koffler, Carolina L.; Leggio, Lorenzo
The purpose of this exploratory study was to examine the interaction of 5-HTTLPR and DRD4 exon III polymorphisms with gender in non-treatment seeking alcohol dependent (AD) individuals while alternately taking ondansetron and sertraline. Evidence suggests that alcohol dependence may be influenced by a genetic interaction that may be gender specific with temporal changes making pharmacological treatment with serotonergic drugs complex. The main trial was a within-subject double-blind placebo-controlled human laboratory study with 77 non-treatment-seeking AD individuals randomized (55 completed, 49 complete data) to receive 200mg/day of sertraline or 0.5mg/day of ondansetron for 3-weeks followed by an alcohol self-administration experiment (ASAE), then placebo for three weeks followed by a second ASAE, then receive the alternate drug, in a counterbalanced order, for three weeks followed by a third ASAE. Results for men were not significant. Women with the LL 5-HTTLPR genotype receiving ondansetron and SS/SL 5-HTTLPR genotypes receiving sertraline (matched), drank significantly fewer drinks per drinking day (DDD) during the 7-days prior to the first and third ASAEs than women receiving the mismatched medication (i.e. sertraline to LL and ondansetron to SS/SL). In a three-way interaction, 5-HTTLPR alleles by DRD4 alleles by medications, women with the LL genotype who received ondansetron and had DRD4 ?7 exon III repeats drank significantly fewer DDD as did SS/SL women who received sertraline but conversely had DRD4 <7-repeats in the 7-day period leading up to the first and third ASAEs. Consistent with these data was a significant reduction of milliliters consumed ad lib during these same ASAEs. These exploratory findings add possible support to gender and genetic differences among AD individuals in response to serotonergic pharmacotherapies. Future trials should be powerful enough to take into account that endophenotypes and a targeting of serotonergic interactions may be essential to successfully treat alcohol dependence. PMID:25212749
... Recommendations Medications for the Risk Reduction of Primary Breast Cancer in Women The U.S. Preventive Services Task Force ( ... shown to reduce a woman’s risk of developing breast cancer. These medications work by blocking the effects of ...
Electronic information is becoming prevalent worldwide, and its use is growing exponentially as more and more users are recognizing the potential that it offers in terms of access and delivery. However, with the introduction of new tools for e-information searching and retrieval, users have to readjust their information-seeking behavior to cope with the corresponding changes. The University of Sharjah library is steadily increasing its investment in e-resources to offer ubiquitous access to the growing body of literature in areas that interest the community it serves. This study reports the findings of a survey conducted to investigate the information-seeking behavior of medical students at the medical library. Results showed evidence of use of e-resources, but they did not explicitly establish that some of the major problems mentioned by participants did hinder the information searches of the respondents. An extensive literature review sets the background for the study. PMID:21058178
Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton
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 women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether
Ragusa, Angela T
Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study applies a sociological lens by framing the IPV and legal help-seeking experiences of rural Australian women gained from 36 in-depth face-to-face interviews as socially contextualized interactions. Findings reveal police and court responses reflect broader social inequalities and rurality exacerbates concerns such as anonymity and lack of service. Cultural differences and power imbalances between survivors and formal support providers are manifested to inform future research seeking to improve survivors' willingness to engage and satisfaction with formal services. Finally, the important role police and the criminal justice system play in de-stigmatizing IPV and legitimating its unacceptability is argued a crucial, yet unrecognized, key to social change. PMID:22929344
Grotegut, Chad A.; Chisholm, Christian A.; Johnson, Lauren N. C.; Brown, Haywood L.; Heine, R. Phillips; James, Andra H.
Objective The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older. Methods The Nationwide Inpatient Sample was used to identify pregnant woman during admission for delivery. Deliveries were identified using International Classification of Diseases, Ninth Revision (ICD-9-CM) codes. Using ICD-9-CM codes, pre-existing medical conditions and medical and obstetric complications were identified in women at the time of delivery and were compared for women aged 45 years and older to women under age 35. Outcomes among women aged 35–44 were also compared to women under age 35 to determine if women in this group demonstrated intermediate risk between the older and younger groups. Logistic regression analyses were used to calculate odds ratios with 95% confidence intervals for pre-existing medical conditions and medical and obstetric complications for both older groups relative to women under 35. Multivariable logistic regression analyses were also developed for outcomes at delivery among older women, while controlling for pre-existing medical conditions, multiple gestation, and insurance status, to determine the effect of age on the studied outcomes. Results Women aged 45 and older had higher adjusted odds for death, transfusion, myocardial infarction/ischemia, cardiac arrest, acute heart failure, pulmonary embolism, deep vein thrombosis, acute renal failure, cesarean delivery, gestational diabetes, fetal demise, fetal chromosomal anomaly, and placenta previa compared to women under 35. Conclusion Pregnant women aged 45 and older experience significantly more medical and obstetric complications and are more likely to die at the time of a delivery than women under age 35, though the absolute risks are low and these events are rare. Further research is needed to determine what associated factors among pregnant women aged 45 and older may contribute to these findings. PMID:24769856
Thompson, Linda V.; Robinson, Sharon E.
Three groups of women who varied in abortion status were formed to investigate the self-concept and locus of control of a total of 90 women. No significant differences in self-concept were found among the three groups, nor was there a relationship between locus of control and repeated abortion. (Author/ABB)
Godin, G.; Naccache, H.; Pelletier, R.
OBJECTIVE: To identify beliefs associated with seeking medical advice promptly when symptoms of HIV infection are suspected among HIV-negative gay men. DESIGN: Qualitative study of beliefs among focus group participants. SETTING: Quebec city, Que, metropolitan area. PARTICIPANTS: Referred sample of 20 HIV-negative gay men 18 to 45 years old who attended bars, university, or gay associations in Quebec city. METHOD: Three focus groups of five to seven subjects were formed and each 2-hour session was tape-recorded. MAIN OUTCOME FINDINGS: Participants thought that seeking medical advice promptly when symptoms of HIV are suspected would help them be informed about their health status and would eliminate unnecessary anxiety and fear, but would force them to face reality and make major changes. Barriers were the quality of the relationship with their physicians and concern about discussing their sexual lives. Normative beliefs were sought from members of community groups, circles of close friends, health providers, and the media. CONCLUSIONS: Several beliefs could influence the motivation of seronegative gay men to seek medical advice promptly when symptoms of HIV infection are suspected. These beliefs should be integrated into programs promoting early consultation with physicians and into clinical counseling, as integration could facilitate early treatment and care. Physicians should give special attention to establishing relationships of trust with these patients. PMID:10790818
Ansara, Donna L; Hindin, Michelle J
While numerous studies have documented the prevalence, correlates, and consequences of intimate partner violence (IPV); most of this research has used a criminal justice framework that has focused on acts of physical violence. However, critics argue that this narrow conceptualization of IPV belies the heterogeneity in this experience with respect to the nature of coercive control in the relationship. Moreover, they contend that the different types of abusive and controlling relationships not only have a different etiology, health consequences, and help-seeking characteristics, they also have a different relationship by gender. This study examined the extent to which different patterns of violence, abuse, and control were differentially associated with formal and informal help-seeking in a national Canadian sample. Data from the 2004 General Social Survey were analyzed, which included 696 women and 471 men who reported physical or sexual violence by a current or ex-spouse or common-law partner. The most commonly reported formal sources for women and men were health professionals (i.e., doctors, nurses, counselors, psychologists) and the police. For women, informal sources (i.e., family, friends, neighbors) were commonly reported across all IPV subgroups. However, the importance of almost all of the formal sources (e.g., health professionals, police, lawyers, shelters, crisis centers) increased as the severity of the violence and control increased. Shelters and crisis centers were also reported by a notable proportion of women who experienced the most severe pattern of violence and control. For men, both formal and informal sources were more commonly reported by those who experienced moderate violence and control compared with those who experienced relatively less severe acts of physical aggression. The results suggest that research that more sensitively examines people's experiences of violence and control can help identify their health, social, and safety needs; and ultimately better inform the development of programs and services aimed at addressing these needs. PMID:20122774
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.
Using data from the 2002 Eritrea and 2005 Ethiopia Demographic and Health Surveys (DHS), this study was carried out to investigate the link between women's autonomy and maternal health care utilization in relation to socioeconomic factors. Although some dimensions of women's autonomy are significantly linked to an increased likelihood of receiving health care, they do not emerge to be mediators of the link between socioeconomic factors and use of health services for antenatal care and delivery care. In order to derive a complete understanding of the determinants of maternal health care utilization, both women's autonomy and socioeconomic indicators should be analyzed. PMID:20526926
Wauchope, Barbara A.
This study tested the learned helplessness theory, stress theory, and a modified stress theory to determine the best model for predicting the probability that a woman would seek help when she experienced severe violence from a male partner. The probability was hypothesized to increase as the stress of the violence experienced increased. Data were…
Wright, Steve; Twardzicki, Maya; Gomez, Fabio; Henderson, Claire
Rates of mental illness and self-harm are very high among women prisoners. Questionnaires assessed prisoners' knowledge of and attitudes towards mental health problems, and relevant behavioural intentions before and after the intervention, to evaluate the effectiveness of a comedy show in a women's prison to reduce mental health stigma and improve coping and help-seeking for mental health problems. The intervention appeared to have been successful in improving some aspects of prisoners' knowledge about the effectiveness of psychotherapy (Z = - 2.304, p = 0.021) and likelihood of recovery from mental health problems (Z = - 2.699, p = 0.007). There were significant post-intervention increases in the proportion who stated they would discuss or disclose mental health problems with all but one of the sources of help in the questionnaire, which was consistent with the increases in the number of prisoners who rated themselves as likely to start using different sources of help or prison activities. There was no improvement in intentions to associate with people with a mental health problem. The intervention appeared effective in improving factors that might increase help-seeking and improve coping, but not those that would change behaviour towards others with a mental health problem. PMID:25137108
Kulikova, N G; Omeltchuk, N N; Zalenskiy, V A; Tkachenko, A S
The article presents the following new data. The medical social aspects of women with stomatological pathology during post-natal period are characterized by age gender, professional, educational and organizational aspects. The issues of impact of characteristics of medical stomatological care of women in post-natal period are considered. The results of survey of women in post-natal period using questionnaire targeted to detection of stomatological diseases are presented. PMID:25219040
Mangan, Katherine S.
While many institutions still treat pregnancy and childbirth strictly as medical disabilities, some have adopted flexible policies that allow for reduced teaching loads, unpaid time off, and longer probationary periods before tenure decisions. The AAUP believes pregnancy should be treated strictly as a medical disability. (MLW)
Gerster, S; Günzler, C; Roesler, C; Leiber, C; Berner, M M
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
Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali
Background: Infertility is a major life event that brings about social and psychological problems. The type and rate these problems in the context of socio-cultural of different geographical areas and sex of people is different. Objective: The aim of this qualitative study was to explain the psychological consequences of infertility in Iranian infertile women seeking treatment. Materials and Methods: This qualitative study was done using qualitative content analysis on 25 women affected by primary and secondary infertility with no surviving children in 2012. They were purposefully selected with maximum sample variation from a large Fertility Health Research Center in Tehran, Iran. Data were collected using 32 semi-structured interviews and analyzed by the conventional content analysis method. Results: The findings of this study include four main themes: 1. Cognitive reactions of infertility (mental engagement; psychological turmoil). 2. Cognitive reactions to therapy process (psychological turmoil; being difficult to control in some situations; reduced self-esteem; feelings of failure). 3. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt; grief and depression; regret). 4. Emotional-affective reactions to therapy process (fear, anxiety and worry; fatigue and helplessness; grief and depression; hopelessness). Conclusion: This study revealed that Iranian infertile women seeking treatment face several psychological-emotional problems with devastating effects on the mental health and well-being of the infertile individuals and couples, while the infertility is often treated as a biomedical issue in Iranian context with less attention on the mental-emotional, social and cultural aspects. This article extracted from Ph.D. thesis. (Seyede Batool Hasanpoor-Azghady) PMID:24799871
Background Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women’s health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Methods Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. Results The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Conclusions Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health. PMID:23448583
Ey, Sydney; Moffit, Mary; Kinzie, J. Mark; Choi, Dongseok; Girard, Donald E.
Background High rates of burnout and distress in resident physicians suggest a significant number would benefit from counseling. Intervention A resident wellness program (RWP) was designed to lower known barriers limiting resident access to services. Methods In 2011, medical residents and fellows were surveyed and logistic regression analyses were conducted to identify demographic and training program differences in perceived barriers and willingness to access the RWP. Results Of the 88% of trainees who knew about the RWP, 87% indicated they would be very likely or somewhat likely to seek out services. Time remained the biggest barrier for residents to getting help. Being male (odds ratio [OR]??=??0.54, 95% confidence interval [CI] 0.34–0.84) or an ethnic/racial minority (OR??=??0.49, 95% CI 0.28–0.85) was associated with greater unwillingness to seek counseling. Reluctance to access the RWP was associated with concerns about helpfulness, confidentiality, being unable to take a break, and stigma. Women (OR??=??1.60, 95% CI 1.06–2.42) and primary care residents (OR??=??1.58, 95% CI 0.98–2.54) were more likely to be concerned about taking a break. Men were more likely to question the helpfulness of counseling (OR??=??0.55, 95% CI 0.36–0.85). Conclusions The RWP removed barriers of cost and knowledge about counseling services. More educational outreach is needed to address sex and ethnic differences about RWP utilization and attitudes in medical culture about a physician's right to address personal health care needs. PMID:24404315
Johnson, Emily; Lahey, Joanna
Obtaining an entry-level job can be critically important for women with little education, particularly those who have taken time out of the labor force. This article uses archival data from a field experiment, called a resume audit study, to examine the characteristics of entry-level resumes that are important to potential employers. In accordance…
Bowen, Shelly-Ann; Williams, Edith M.; Stoneberg-Cooper, Chayah M.; Glover, Saundra H.; Williams, Michelle S.; Byrd, Michael D.
Purpose The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity. Design Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up. Setting Individual telephone interviews were conducted with 16 women with confirmed breast anomaly. Participants Low-income women screened through a national breast cancer early detection program. Method Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package. Results For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact of social and economic inequities creates a psychosocial context underlined by structural and cultural barriers to treatment that forecasts the mechanism that generates differences in health outcomes. The absence of insurance due to underemployment and unemployment and inadequate public infrastructure intensified emotional stress impacting participants’ health decisions. Conclusion The findings that emerged offer explanations of how consistent patterns of social injustice impact treatment decisions in a high-risk vulnerable population that have implications for health promotion research and systems-level program improvement and development. PMID:23448411
Jovic, Olga S
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
Xinyi Hu; Robert A. Bell; Richard L. Kravitz; Sharon Orrange
The authors examined online support group members’ reliance on their Internet community and other online and offline health resources as they prepare for a scheduled medical appointment. Adult members of an online support group (N = 505) with an upcoming medical appointment completed an online questionnaire that included measures of illness perceptions, control preference, trust in the physician, and eHealth literacy; a
Lie, Désirée A; Boker, John
Background There is significant and growing national interest for introducing Complementary and Alternative Medicine (CAM) instruction into allopathic medical education. We measured CAM attitudes, use, and information-seeking behaviors as a baseline to evaluate future planned CAM instruction. Methods Cross-sectional and longitudinal survey data on CAM attitudes, modality use, and common information resources was collected for (a) medical students (n = 355), (b) interns entering residencies in medical and surgical disciplines (n = 258), and (c) faculty from diverse health professions attending workshops on evidence-based CAM (n = 54). One student cohort was tracked longitudinally in their first, second and third years of training. Results Compared to medical students and interns, faculty who teach or intend to integrate CAM into their instruction had significantly (p < .0005) more positive attitudes and used CAM modalities significantly (p < .0005) more often. Medical students followed longitudinally showed no change in their already positive attitudes. The 3 survey groups did not differ on the total number of CAM information resources they used. Each group surveyed used about two out of the five common information sources listed, with the Internet and journals most frequently cited. Conclusion Students, interns and a selected faculty group demonstrate positive attitudes toward CAM and frequently use various CAM modalities. CAM instruction should therefore be focused on acquiring knowledge of available CAM modalities and skills to appraise evidence to appropriately advise patients on best approaches to CAM use. Trainees may benefit from exposure to a wider array of CAM information resources. PMID:17156463
Cerulli, Catherine; Kothari, Catherine; Dichter, Melissa; Marcus, Steve; Kim, Tae Kuen; Wiley, Jim; Rhodes, Karin V
Following a criminal case disposition, an intimate partner violence (IPV) victim's willingness to seek future police and prosecutorial assistance may depend on her prior experiences within the system. This longitudinal study examines the relationship between IPV victims' future help-seeking based on past experiences. We hypothesized women would return to the criminal justice system if their adjudication wishes corresponded with prosecutors' actions. Contrary to the hypothesis, results suggest women return to the criminal system and other venues even if prosecutors' actions do not correspond to their earlier stated wishes. This has important policy implications given pro-prosecution protocols that encourage adjudication regardless of a woman's participation. PMID:25774412
Yilu Zhou; Jialun Qin; Hsinchun Chen
As the number of non-English resources available on the Web is increasing rapidly, developing information retrieval techniques for non-English languages is becoming an urgent and challenging issue. In this research to facilitate information seeking in a multilingual world, we focused on discovering how search-engine techniques developed for English could be generalized for use with other languages. We proposed a general
Kratzke, Cynthia; Amatya, Anup; Vilchis, Hugo
The purpose of this study was to examine among college women acquired breast cancer prevention information-seeking, desired apps and texts, and information given to mothers. Using a cross-sectional study, a survey was administered to college women at a southwestern university. College women (n = 546) used the Internet (44 %) for active breast cancer prevention information-seeking and used the Internet (74 %), magazines (69 %), and television (59 %) for passive information receipt. Over half of the participants desired breast cancer prevention apps (54 %) and texts (51 %). Logistic regression analyses revealed predictors for interest to receive apps were ethnicity (Hispanic), lower self-efficacy, actively seeking online information, and older age and predictors for interest to receive texts were lower self-efficacy and higher university level. Eighteen percent of college women (n = 99) reported giving information to mothers and reported in an open-ended item the types of information given to mothers. Predictors for giving information to mothers were actively and passively seeking online information, breast self-exam practice, and higher university level. Screenings were the most frequent types of information given to mothers. Breast cancer prevention information using apps, texts, or Internet and daughter-initiated information for mothers should be considered in health promotion targeting college students or young women in communities. Future research is needed to examine the quality of apps, texts, and online information and cultural differences for breast cancer prevention sources. PMID:23979671
Bailey, Genie L; Herman, Debra S; Stein, Michael D
Most patients with opioid addiction do not receive medication at the time of discharge from brief inpatient detoxification programs despite the high risk of relapse and the availability of three FDA-approved medications. We surveyed 164 inpatient opioid detoxification patients to assess desire for pharmacotherapy following detoxification program discharge. Participants were predominantly male (71.3%) and 80% had detoxed in the past. Reporting on their most recent previous inpatient detoxification, 27% had relapsed the day they were discharged, 65% within a month of discharge, and 90% within a year of discharge. 63% reported they wanted medication-assisted treatment (MAT) after discharge from the current admission. The odds of desiring a treatment medication increased by a factor of 1.02 for every 1% increase in perceived relapse risk (p<.01). These data suggest patient preference discussions including relapse risk could increase post-detox abstinence. PMID:23786852
Dawn Edge; Sara C. MacKian
Background. Perinatal depression among Black Caribbean women in the UK remains an intriguingly under-researched topic. Despite high levels of known psychosocial risks, Black Caribbeans remain relatively invisible among those seeking\\/receiving help for depression during and after pregnancy.Methods. In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a larger sample (n=101) to examine prevalence and
Pine, R N
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
New Hampshire, University of
a medical service charge, and then need to seek reimbursement. When you submit claims for reimbursement will be sent only to a domestic address. Send this claim information to: Consolidated Health Plans, 2007. or Provides Medical Advice SOS Arranges the Office Visit Insured Service Member Pays for Service Member Pays
Background Although antenatal care coverage in Ghana is high, there exist gaps in the continued use of maternity care, especially utilization of skilled assistance during delivery. Many pregnant women seek care from different sources aside the formal health sector. This is due to negative perceptions resulting from poor service quality experiences in health facilities. Moreover, the socio-cultural environment plays a major role for this care-seeking behavior. This paper seeks to examine beliefs, knowledge and perceptions about pregnancy and delivery and care-seeking behavior among pregnant women in urban Accra, Ghana. Methods A qualitative study with 6 focus group discussions and 13 in-depth interviews were conducted at Taifa-Kwabenya and Madina sub-districts, Accra. Participants included mothers who had delivered within the past 12 months, pregnant women, community members, religious and community leaders, orthodox and non-orthodox healthcare providers. Interviews and discussions were audio-taped, transcribed and coded into larger themes and categories. Results Evidence showed perceived threats, which are often given socio-cultural interpretations, increased women’s anxieties, driving them to seek multiple sources of care. Crucially, care-seeking behavior among pregnant women indicated sequential or concurrent use of biomedical care and other forms of care including herbalists, traditional birth attendants, and spiritual care. Use of multiple sources of care in some cases disrupted continued use of skilled provider care. Furthermore, use of multiple forms of care is encouraged by a perception that facility-based care is useful only for antenatal services and emergencies. It also highlights the belief among some participants that care from multiple sources are complementary to each other. Conclusions Socio-cultural interpretations of threats to pregnancy mediate pregnant women’s use of available healthcare services. Efforts to encourage continued use of maternity care, especially skilled birth assistance at delivery, should focus on addressing generally perceived dangers to pregnancy. Also, the attractiveness of facility-based care offers important opportunities for building collaborations between orthodox and alternative care providers with the aim of increasing use of skilled obstetric care. Conventional antenatal care should be packaged to provide psychosocial support that helps women deal with pregnancy-related fear. PMID:24246028
R C Henshaw; S A Naji; I T Russell; A A Templeton
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
American Medical Women's Association, New York, NY.
This project involved a broad multi-faceted national program to increase participation and recognition of women, including minority women, in medical education. It included a grass roots change agency to initiate, coordinate, sustain, measure, and disseminate carefully planned educational reform. Activities carried out during the 7-year project…
Grant, Linda; And Others
Women and men medical students' (N=192) intended commitments to profession and family were explored at three times during their training. Over time all students' intended hours in profession increased and hours in family decreased. Global-level measures suggested change in division of domestic labor among women and men, but specific-level measures…
Casebeer, Linda; Bennett, Nancy; Kristofco, Robert; Carillo, Anna; Centor, Robert
Responses from 2,200 physicians indicated that nearly all have Internet access and use it primarily for medical information and professional development, not for communicating with patients. Credibility of source, speed, accessibility, and searching ease were most important. Barriers included information overload and too little information…
...treat the covered injury or its health complications and the amounts paid or expected...treat a covered injury or its health complications, the requester may submit, in addition...treat the covered injury or its health complications in the future. The medical...
Mody, Sheila K.; Wu, Jennifer; Ornelas, Marla; Kernahan, Colleen; Salas, Elizabeth; Kao, Kelly; Felix, Robert; Chambers, Christina
Background Women taking teratogens may not receive teratogen and contraceptive counseling. The objective of this study is to explore the feasibility of an electronic medical record (EMR) alert and referral system to improve teratogen and contraceptive counseling. Methods We conducted a descriptive study in an academic outpatient setting to evaluate the feasibility of an EMR alert and referral system. Reproductive age women taking category D or X medications seen in family medicine clinics were referred by means of an EMR alert for teratogen and contraceptive counseling. A subset of these women consented to follow-up surveys assessing contraceptive usage before counseling, intended contraceptive method after counseling and satisfaction with the counseling. Participants were contacted at 1 and 3 months to assess contraceptive usage. Results A total of 354 women were prescribed category D or X medications by clinicians who received the EMR alert, 170 women were referred, 59 women received counseling, and 33 participants enrolled in the study. One participant did not use any contraception. Among the 32 participants using contraception, 12 (37.5%) used oral contraceptives, 11 (34.4%) used condoms, 3 (9.4%) used withdrawal, 3 (9.4%) used intrauterine devices, 2 (6.3%) used contraceptive rings, and 1 (3.1%) used the diaphragm. After counseling, one-third of participants were considering more effective contraception. Almost all participants strongly agreed or agreed that the counseling was helpful. Conclusion Creating an EMR alert and referral system for women prescribed category X or D medications is feasible. Counseling on teratogen exposure and contraception may improve the acceptability of more effective contraception. PMID:26100297
Verma, Anjana; Kumar Meena, Jitendra; Banerjee, Bratati
Background. In developing countries, women are at high risk for several reproductive health problems especially RTI/STIs. Since all RTIs/ STIs are preventable and most of them are curable, it is pertinent to study the determinants of the health seeking behaviour. Objectives. To compare the prevalence and treatment seeking behaviour about RTI/STI symptoms among the married women of reproductive age group (18–45 years) living in urban and rural area of Delhi. Methods. A cross-sectional study was done among the married women of reproductive age group residing in Pooth Khurd, a village in North West district of Delhi, and Delhi Gate, an urban locality situated in central Delhi. Results. In this study, the prevalence of RTI/STI symptoms was found to be similar in both urban (42.3%) and rural area (42%). In urban area, 73% sought treatment, while in rural area only 45.6% sought treatment. Prevalence of the symptoms was found to be higher among the study subjects who were not using any contraceptive method, had history of abortion, and were with lower educational status, in both urban and rural areas. Treatment seeking behaviour was significantly higher among the educated women, contraceptive users, and older age group women in both rural and urban area. PMID:25763407
Verma, Anjana; Kumar Meena, Jitendra; Banerjee, Bratati
Background. In developing countries, women are at high risk for several reproductive health problems especially RTI/STIs. Since all RTIs/ STIs are preventable and most of them are curable, it is pertinent to study the determinants of the health seeking behaviour. Objectives. To compare the prevalence and treatment seeking behaviour about RTI/STI symptoms among the married women of reproductive age group (18-45 years) living in urban and rural area of Delhi. Methods. A cross-sectional study was done among the married women of reproductive age group residing in Pooth Khurd, a village in North West district of Delhi, and Delhi Gate, an urban locality situated in central Delhi. Results. In this study, the prevalence of RTI/STI symptoms was found to be similar in both urban (42.3%) and rural area (42%). In urban area, 73% sought treatment, while in rural area only 45.6% sought treatment. Prevalence of the symptoms was found to be higher among the study subjects who were not using any contraceptive method, had history of abortion, and were with lower educational status, in both urban and rural areas. Treatment seeking behaviour was significantly higher among the educated women, contraceptive users, and older age group women in both rural and urban area. PMID:25763407
Blundell Jones, Joanna; Walsh, Sue; Isaac, Claire
Treatments for depression and anxiety in multiple sclerosis (MS) are effective but evidence suggests that individuals do not always seek help for emotional difficulties. This study explored how ten women with MS (aged 30-64), recruited via a hospital based MS clinic, coped with and understood their emotions. The semi-structured interviews were analysed using interpretative phenomenological analysis. Eight participants discussed the analytic process and themes. Four overarching themes emerged: Disclosure stress, Uncomfortable dependence, Facing deterioration and One step at a time. The women struggled emotionally with many aspects of living with MS yet coping alone provided a way of defying MS and maintaining independence and control. The women needed emotional support but reported thinking others either did not notice or understand; their emotions often felt invisible. More holistic care from services was desired. Non help-seeking for distress was partially influenced by a desire to keep things "normal" and a lack of knowledge regarding service provision. PMID:25217970
A cross-sectional, descriptive survey and a medical chart review of 154 pre- and post-retirement age injured Dutch dancers were performed. The purpose was to examine dancers' health care seeking behavior and perceptions of the medical profession in context of the current health care system in The Netherlands, which includes both universal access and expertise in performing arts medicine. No logistical or perceptual restrictions to health care were reported by the dancers in this study. Only three younger dancers (< 35 years) lacked a primary care physician. No dancer reported monetary or insurance hindrances to acquiring an appointment or fear of going to the doctor. A small percentage of the younger group (18%), but none of the older dancers, reported that they felt the doctor would not understand them (chi(2) = 2.2, df = 1, p = 0.14). Dancers in both age groups most often sought first treatment from either a physiotherapist (36% to 40%) or a medical doctor (38.8% to 40.8%). When a physician was not consulted first, the primary reason was that dancers had already seen a physiotherapist and thought this treatment was sufficient. Approximately one-third of dancers expected their medical problem to go away on its own. Dutch dancers were additionally found to have a positive relationship with the medical profession, including high satisfaction and confidence. The majority of dancers were satisfied or very satisfied with their medical treatment prior to presenting to the dance medicine specialist (67% older dancers, 52% younger, chi(2) = 1.19, df = 1, p = 0.2). Nearly every dancer was satisfied or very satisfied after treatment by the specialist (100% older dancers, 93% younger dancers, chi(2) = 1.46, df = 1, p = 0.2), and moderately or completely confident of full recovery (80%, each group). Differences in older and younger dancers' perceptions and behaviors were nevertheless found. Older dancers were significantly more likely to continue to dance when injured than younger dancers (100% versus 82%, chi(2) = 5.14, df = 1, p = 0.02), although pain and perceived level of artistic hindrance were similar between the groups at first presentation to a dance medicine clinic (pain: 32.6 versus 34.0 mm, respectively, p = 0.83; artistic hindrance: 49.3 versus 58.0 mm, p = 0.29, respectively). Older dancers were more likely to wait and see for themselves whether an injury would get better by itself (14% versus 4%, chi(2) = 4.1, df = 1, p = 0.05). Average time to seek treatment from a medical doctor was four times longer among older than younger dancers (8.4 versus 2.1 months, respectively, p = 0.004), and older dancers had less confidence in full recovery at first visit (40% versus 61%, chi(2) = 3.8, df = 1, p = 0.05). Thus, the medical system of The Netherlands is one that confers improved health care access and perceptions of the medical profession among dancers, yet there remain areas to be addressed in terms of equalization of health care delivery. PMID:19508808
Albright, Brittany; Skipper, Betty; Riley, Shawne; Wilhelm, Peggy; Rayburn, William F.
Objective: The study objective was to determine whether medical students' attendance at a rehabilitation residence for pregnant women with substance-use disorders yielded changes in their attitudes and comfort levels in providing care to this population. Methods: This randomized educational trial involved 96 consecutive medical students during…
This qualitative study sought to identify the complex issues facing Asian/Pacific Islander (API) women students at one Midwestern medical school as they subjectively experience their medical training. Students reported parental and Asian community influences on their decision to enter medicine; most thought faculty perceive them as "quiet," often…
Harkness, Deborah E
In Elizabethan London, women occupied a significant position in the city's medical marketplace, both as consumers of medical services and as practitioners. Though male medical authors of the period objected to the presence and practices of these women, a very different view of their medical work emerges if we shift our historical vantage point to the streets, houses, churches, and hospitals of the city. Using relatively underutilized sources such as parish records, probate records, lists of immigrants to London, hospital records, and individual manuscripts it is possible to draw a richer, more detailed portrait of how female health-care workers engaged with the business of health and healing. Women emerge from these records as active, prominent, and acknowledged participants in the delivery of services that promoted and preserved the health of many Londoners from cradle to grave. Hired by public institutions such as parishes and hospitals, as well as by private individuals, women were central figures in the delivery of nursing, medical, pharmaceutical, and surgical services throughout the city as part of organized systems of health care. Exploring how Londoners saw female practitioners, and how women played a recognized role within the city's range of health-care options, demonstrates that women were crucial to community health, and were also valued as such by their neighbors and patients. PMID:18344585
Carter, J. H.; Rogers, C.
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. PMID:8776062
Wildemuth, B M; de Bliek, R; Friedman, C P; Miya, T S
To solve a problem, a person often asks questions of someone with more expertise. This paper reports on a study of the types of questions asked and how the experts are chosen. In the study, sixty-three first-year medical students responded to clinical scenarios, each describing a patient affected by a toxin and asking questions concerning the identity of the toxin and its characteristics. After answering those questions, the students were asked to imagine that they had access to a medical reference librarian and an internist specializing in toxicology. The students then generated two questions for each expert about each clinical scenario. Each question was categorized according to the type of information requested, and the frequency of each type of question was calculated. The study found that students most often asked for the identification of the toxin(s), references about the scenario, or the effects of the toxin; an explanation of the patient's symptoms; or a description of the appropriate treatment. Students were more likely to address questions on the identity of the toxin and references to the hypothetical librarian; they were more likely to ask the internist for explanations of the symptoms and descriptions of the treatment. The implications of these results for the design of information and educational systems are discussed. PMID:7920340
Diaa E. E. Rizk; Aisha Al-Shebah; Margaret A. El-Zubeir; Letha B. Thomas; Mohammed Y. Hassan; Mutairu Ezimokhai
Objective: The purpose of this study was to determine the experiences, satisfaction, and comfort of women with medical student participation in outpatient care during obstetric and gynecology clerkships. Study Design: A consecutive sample of 303 women who attended the clinic were interviewed before consultation; a structured questionnaire was used. Results: Two hundred sixty-four women (87.1%) accepted student involvement; 158 women
Behets, F. M.; Miller, W. C.; Cohen, M. S.
The syndromic treatment of gonococcal and chlamydial infections in women seeking primary care in clinics where resources are scarce, as recommended by WHO and implemented in many developing countries, necessitates a balance to be struck between overtreatment and undertreatment. The present paper identifies factors that are relevant to the selection of specific strategies for syndromic treatment in the above circumstances. Among them are the general aspects of decision-making and caveats concerning the rational decision-making approach. The positive and negative implications are outlined of providing or withholding treatment following a specific algorithm with a given accuracy to detect infection, i.e. sensitivity, specificity and predictive values. Other decision-making considerations that are identified are related to implementation and include the stability of risk factors with regard to time, space and the implementer, acceptability by stakeholders, and environmental constraints. There is a need to consider empirically developed treatment algorithms as a basis for policy discourse, to be evaluated together with the evidence, alternatives and arguments by the stakeholders. PMID:11731816
Tao, Donghua; Demiris, George; Graves, Rebecca S; Sievert, MaryEllen
Advances in information technology have introduced both new capabilities and interesting challenges in accessing medical literature. More and more information resources exist in electronic format, such as online databases, journals, books, etc. instead of the traditional print format. In late 1998, there were thirty-five journal titles available online; in 2001, the number rose to over 4,000.1 Desk-top access to online resources is changing library use patterns, which challenges libraries to adjust to this transformed information access environment. Studies of the impact of the internet on information seeking behavior of users in medical environments could provide very valuable information for medical libraries seeking to adapt to this rapid and great evolution. This study aims to explore the impact of the Internet on information seeking behavior of medical students and faculty and their medical library use, to address the possible reasons for this change of information seeking behavior, and to identify the measures essential to the transition from traditional in-library use of resources to remote access. This study is conducted in two phases. PMID:14728530
Tyer-Viola, LA; Corless, IB; Webel, A; Reid, P; Sullivan, KM; Nichols, P
Objective Women infected with HIV live with many factors that affect antiretroviral (ARV) medication adherence. Social Action Theory (SAT) explains how context, environment, and psychological factors influence behavior. How these factors are related to HIV adherence in women is unique. The purpose of this analysis was to explore the relationships among contextual, environmental, and regulatory factors with ARV medication adherence in order to assist care providers in improving care for women living with HIV. Design Convenience descriptive multicenter Setting Sixteen HIV clinics and service organizations in North America Participants This sample was drawn from a larger study of 2,182 persons living with HIV recruited from clinics and service from September 2009 to January, 2011. Our study included 383 North American women living with HIV who were taking ARV medications. Methods We assessed the relationship of contextual, environmental, and psychological factors specific to women living with HIV with adherence to ARV medication. Descriptive and multivariate statistics were used to examine the effects of these factors on self-reported ARV adherence. Results Age, depression symptoms, stigma, and engagement with health care provider, and four psychological factors were correlated with self-reported ARV medication adherence (p = .01). Regression analysis indicated that adherence self-efficacy and depression symptoms accounted for 19% for 3-day and 22% for 30-day self-reported medication adherence. Conclusions Adherence self-efficacy and depression symptoms predict ARV medication adherence in women and should be evaluated by nurses. Future research is needed to identify antecedents to and interventions that support adherence self-efficacy and decrease depression symptoms. PMID:24502460
Abel, Willie M.; Efird, Jimmy T.
Background: Black women have the highest prevalence of hypertension in the world. Reasons for this disparity are poorly understood. The historical legacy of medical maltreatment of Blacks in the U.S. provides some insight into distrust in the medical profession, refusal of treatment, and poor adherence to treatment regimens. Methods: Black women (N?=?80) who were prescribed antihypertensive medications were recruited from urban communities in North Carolina. Study participants completed the Trust in Physician and Hill-Bone Compliance to High Blood Pressure Therapy questionnaires. An exact discrete-event model was used to examine the relationship between trust and medication adherence. Results: Mean age of study participants was 48?±?9.2?years. The majority of participants (67%) were actively employed and 30% had incomes at or below the federal poverty level. Increasing levels of trust in the health care provider was independently associated with greater medication adherence (PTrend?=?0.015). Conclusion: Black women with hypertension who trusted their health care providers were more likely to be adherent with their prescribed antihypertensive medications than those who did not trust their health care providers. Findings suggest that trusting relationships between Black women and health care providers are important to decreasing disparate rates of hypertension. PMID:24350234
Dotters-Katz, Sarah K.; Heine, R. Phillips; Grotegut, Chad A.
Objective. Pyelonephritis is a common cause of antepartum admission and maternal morbidity. Medical complications associated with pyelonephritis during delivery are not well described; thus the objective of this study was to estimate medical, infectious, and obstetric complications associated with pyelonephritis during the delivery admission. Study Design. We conducted a retrospective cohort study using the Nationwide Inpatient Sample (NIS) for the years 2008–2010. The NIS was queried for all delivery-related discharges. During the delivery admission, the ICD-9-CM codes for pyelonephritis were used to identify cases and were compared to women without pyelonephritis. A multivariable logistic regression model was constructed for various medical, infectious, and obstetric complications among women with pyelonephritis compared to women without, while controlling for preexisting medical conditions and demographics. Results. During the years 2008–2010, there were 26,397 records with a diagnosis of pyelonephritis during the delivery admission, for a rate of 2.1 per 1000 deliveries. Women with pyelonephritis had increased associated risks for transfusion, need for mechanical ventilation, acute heart failure, pneumonia, pulmonary edema, acute respiratory distress syndrome, sepsis, acute renal failure, preterm labor, and chorioamnionitis, while controlling for preexisting medical conditions. Conclusions. Pyelonephritis at delivery admissions is associated with significant medical and infectious morbidity. PMID:24194632
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 women about costs and cost barriers for accessing ANC services with emphasis on IPTp in rural Tanzania. Methods Qualitative data were collected in the districts of Mufindi in Iringa Region and Mkuranga in Coast Region through 1) focus group discussions (FGDs) with pregnant women and mothers to infants and 2) exit-interviews with pregnant women identified at ANC clinics. Data were analyzed manually using qualitative content analysis methodology. Findings FGD participants and interview respondents identified the following key limiting factors for women's use of ANC services: 1) costs in terms of money and time associated with accessing ANC clinics, 2) the presence of more or less official user-fees for some services within the ANC package, and 3) service providers' application of fines, penalties and blame when failing to adhere to service schedules. Interestingly, the time associated with travelling long distances to ANC clinics and ITN retailers and with waiting for services at clinic-level was a major factor of discouragement in the health seeking behaviour of pregnant women because it seriously affected their domestic responsibilities. Conclusion A variety of resource-related factors were shown to affect the health seeking behaviour of pregnant women in rural Tanzania. Thus, accessibility to ANC services was hampered by direct and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of selected public health services, including IPTp, are urgently needed measures for increasing equity in health services in Tanzania. PMID:20163707
Garman, Jamie L.
The purpose of the study was to document how individuals' experiences and understanding of genetics concepts affects their medical experiences. Recently pregnant women were interviewed because they represent a population that needs to comprehend biological and genetic information to understand their health. Three women were designated as science experts (SE) defined as having extensive university level science education and three women were designated as science non-experts (SNE). In general, SEs described a more positive pregnancy experience. Both SEs and SNEs demonstrated a basic understanding of genetic concepts but varied in the application of concepts to personal medical issues. Participants' views and experiences of pre and postnatal tests were linked to their understanding of nature of science components such as recognition that tests have limitations. Results from this study indicate an incomplete understanding of the nature of science among participants may have led to unsatisfactory medical experiences.
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. PMID:23570255
Liu, Honghu; Longshore, Doug; Williams, John K.; Rivkin, Inna; Loeb, Tamra; Warda, Umme S.; Carmona, Jennifer; Wyatt, Gail
Substance abuse increases the risks for infections and impairs medication adherence among HIV/AIDS patients. However, little is known about the characteristics of substance abuse and its impact on medication adherence among HIV-positive women with a history of child sexual abuse (CSA). In the present study, 148 HIV-positive women with a history of CSA completed a structured interview assessing CSA severity, psychological status, substance abuse, medication adherence, and sexual decision-making. Severity of CSA was significantly associated with substance use but not with adherence. Participants who had used hard drugs and who had lower self-esteem and adherence self-efficacy reported significantly lower levels of adherence. Additional research on how CSA experiences impact health behaviors is needed to help develop culturally congruent interventions to reduce risk behaviors and facilitate better medication adherence for this vulnerable population. PMID:16501869
Bhatt, R. V.; And Others
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)
Udovika, N O; Romanenko, I Iu; Lieonov, O O
Efficacy Erbisol in combination with Lymphomyosot and Echinacea compositum C in medical rehabilitation of women of reproductive age with fatigue syndrome and chronic gynecological pathology was studied. It was found that this complex of medications promotes faster and more effective reduction of the level of circulating immune complexes in the serum, achievement of persistent clinical remission of disease and liquidation of fatigue syndrome manifestations, what improves the quality of life of patients. PMID:25286603
Fogel, Joshua; Teichman, Chaim
This study examines variables associated with seeking information from doctors, the Internet, and a combination of both doctors and Internet after exposure to direct-to-consumer advertisements. Data were analyzed from 462 college students. Younger age, women, and health insurance were associated with greater odds for doctor; women, subjective norms, intentions, and greater time since seen doctor were associated with greater odds for Internet; and African American, Hispanic, subjective norms, intentions, and health insurance were associated with greater odds for both doctor and Internet. Marketers of direct-to-consumer advertisements can use these findings for tailoring and targeting direct-to-consumer advertisements. PMID:24878404
Morgenstern, Lewis B; Adelman, Eric E; Hughes, Rebecca; Wing, Jeffrey J; Lisabeth, Lynda D
Women are more likely to live alone compared with men, and therefore have more difficulty activating emergency medical systems for stroke. The goal of this study was to examine the benefit of wearing medical alert devices to activate emergency medical systems for elderly women living alone. This was a randomized, controlled pilot trial. Women over 60 with at least 1 stroke risk factor were recruited from Southeast Michigan. Subjects received either a medical alert device or control. The primary outcome was change in health-related quality of life (HRQOL) from baseline to 90 days of wearing the device or control. A planned sample size of 320 could not be reached, and the trial was stopped at 265 women randomized prior to data examination. On average, the treatment group was older, reported lower prevalence of high cholesterol, and was less likely to complete follow-up. There was a nonsignificant smaller loss of healthy days in the past month in the intervention group (0.46) compared with the control group (2.23) (p?=?0.213). Similarly, the secondary outcomes of changes in anxiety, depression, and changes in perceived isolation did not differ by treatment and control groups. This study did not establish improvement in HRQOL among women who wore the device compared with those that did not, nor the feasibility of a trial to study the efficacy of medical alert devices in elderly women. Newer devices that use cellular technology may be more accepted than the landline-based system used in this study. PMID:26031786
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 +…
De Jesus, Maria
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 health communication (i.e., quantity of media-based health information received) is more likely to influence Hispanic adults' health decision-making and medical advice-seeking behavior compared to health literacy and language proficiency variables. Results indicated that quantity of media-based health information is positively associated with health decision-making and medical advice-seeking behavior above and beyond the influence of health literacy and English and Spanish language proficiency. In a context where physician-patient dynamics are increasingly shifting from a passive patient role model to a more active patient role model, media-based health information can serve as an influential cue to action, prompting Hispanic individuals to make certain health-related decisions and to seek more health advice and information from a health provider. Study implications are discussed. PMID:22888787
Women in the Nontraditional Workforce. Hearing before the Subcommittee on Labor of the Committee on Labor and Human Resources. United States Senate, One Hundredth Congress, First Session on Examining the Problems Facing Women Who Seek Jobs in Fields Traditionally Dominated by Men, Particularly in Construction and High Technology Areas (November 17, 1987).
Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.
This congressional hearing examines the problems facing women who seek jobs in fields traditionally dominated by men, particularly in construction and high technology areas. Witnesses include women who tell about barriers they personally have faced as they seek careers in high-tech and construction, who lead organizations that are working hard to…
Boulton, Tiffany N; Malacrida, Claudia
In this article we provide a comparative analysis of qualitative, semistructured interviews with 24 women who had undergone different forms of cosmetic breast surgery (CBS). We argue that women must negotiate three types of risk: potential medical risks, lifestyle risks connected with choosing "frivolous" self-enhancements, and countervailing social risks affiliated with pressures to maximize one's feminine beauty. In addition, we highlight the challenges faced in negotiating these risks by examining the limits to traditional forms of medical informed consent provided to the women, who received little information on the medical risks associated with CBS, or who were given uncertain and contradictory risk information. Even respondents who felt that they were well informed expressed difficulties in making "wise" choices because the risks were distant or unlikely, and hence easily minimized. Given this, it is fairly understandable that the known social risks of "failed" beauty faced by the women often outweighed the ambiguous or understated risks outlined by medicine. We argue that traditional notions of informed consent and risk awareness might not be adequate for women choosing CBS. PMID:21908704
Johnson, Timothy P.; Hughes, Tonda L.; Cho, Young Ik; Wilsnack, Sharon C.; Aranda, Frances; Szalacha, Laura A.
Objective: Sexual-minority women are at heightened risk for a number of mental health problems, including hazardous alcohol consumption, depression, and anxiety. We examined self-medication and impaired-functioning models of the associations among these variables and interpreted results within a life course framework that considered the unique social stressors experienced by sexual-minority women. Method: Data were from a sample of 384 women interviewed during the first two waves of the Chicago Health and Life Experiences of Women (CHLEW) study. Results: Covariance structure modeling revealed that (a) consistent with a self-medication process, anxiety was prospectively associated with hazardous drinking and (b) consistent with an impaired-functioning process, hazardous drinking was prospectively associated with depression. Conclusions: Our findings support a life course perspective that interprets the mental health of adult sexual-minority women as influenced by adverse childhood experiences, age at drinking onset, first heterosexual intercourse, and first sexual identity disclosure, as well as by processes associated with self-medication and impaired functioning during adulthood. PMID:23739020
Dunatov, Linda J.
The purpose of this narrative inquiry study was to gain a richer understanding from the perspective of gender about how third and fourth year women osteopathic medical students at the University of Pikeville-Kentucky College of Osteopathic Medicine (KYCOM) constructed their developing professional identities as future osteopathic physicians. This…
Ramakrishnan, Aditi; Sambuco, Dana; Jagsi, Reshma
Although much literature has focused on the status of female physicians in the United States, limited English-language studies have examined the role of women in the medical profession elsewhere in the world. This article synthesizes evidence regarding the status of female physicians in three purposively selected regions outside the United States: Japan, Scandinavia, and Russia and Eastern Europe. These three regions markedly differ in the proportion of female physicians in the workforce, overall status of the medical profession, cultural views of gender roles, and workforce policies. Through a review of studies and articles published between 1992 and 2012 examining women's representation, status measures such as salary and leadership positions, and experiences of female physicians, the authors discuss potential relationships between the representation of female physicians, their status in medicine, and the overall status of the profession. The findings suggest that even when women constitute a high proportion of the physician workforce, they may continue to be underrepresented in positions of leadership and prestige. Evolving workforce policies, environments, and cultural views of gender roles appear to play a critical role in mediating the relationship between women's participation in the medical profession and their ability to rise to positions of influence within it. These insights are informative for the ongoing debates over the impact of the demographic shifts in the composition of the medical workforce in the United States. PMID:25320867
Ka'opua, Lana Sue; Mitschke, Diane; Lono, Joelene
The cancer burden falls heavily on Native Hawaiian women, and of particular concern are those living in medically underserved communities where participation in potentially helpful clinical studies may be limited. Difficulty in accrual of Native Hawaiian women to a culturally-grounded intervention led researchers to conduct focus groups aimed at exploring attitudes towards research, use of a traditional Hawaiian practice for family discussion, and study promotion. Social marketing theory guided the development of discussion questions and a survey. Through purposive sampling, 30 women from medically underserved communities were recruited. Content analysis was used to identify major discussion themes. Findings indicate that lack of informational access may be a major barrier to participation. Study information disseminated through community channels with targeted outreach to social and religious organizations, promotion through face-to-face contact with researchers, and culturally tailored messages directed to families were preferred. Community oriented strategies based on linkages with organizational networks may increase participation. PMID:16281696
Puthuchira Ravi, Rejoice; Athimulam Kulasekaran, Ravishankar
Background. Sexually transmitted infections (STIs) may be either asymptomatic or symptomatic. Regardless of the presence or absence of symptoms all STIs can lead to major complications if left untreated. Objective. To assess the care seeking behaviour and barriers to accessing services for sexual health problems among young married women in rural areas of Thiruvarur district of Tamil Nadu state in India. Methods. A community based cross-sectional study was conducted in 28 villages selected using multistage sampling technique for selecting 605 women in the age group of 15–24 years during July 2010–April 2011. Results. The prevalence rate of reproductive tract infections (RTIs) and STIs was observed to be 14.5% and 8.8%, respectively, among the study population. Itching/irritation over vulva, thick white discharge, discharge with unpleasant odor, and frequent and uncomfortable urination were most commonly experienced symptoms of sexual health problems. Around three-fourth of the women received treatment for sexual health problems. Perception of symptoms as normal, feeling shy, lack of female health workers, distance to health facility, and lack of availability of treatment were identified as major barriers for not seeking treatment for RTIs/STIs. Conclusion. Family tradition and poor socioeconomic conditions of the family appear to be the main reasons for not utilizing the health facility for sexual health problems. Integrated approach is strongly suggested for creating awareness to control the spread of sexual health problems among young people.
Grodensky, Catherine A; Golin, Carol E; Jones, Chaunetta; Mamo, Meheret; Dennis, Alexis C; Abernethy, Melinda G; Patterson, Kristine B
The population of older people living with HIV in the United States is growing. Little is known about specific challenges older HIV-infected women face in coping with the disease and its attendant stressors. To understand these issues for older women, we conducted semi-structured in-depth interviews with 15 women (13 African American, 2 Caucasian) 50 years of age and older (range 50-79 years) in HIV care in the southeastern United States, and coded transcripts for salient themes. Many women felt isolated and inhibited from seeking social connection due to reluctance to disclose their HIV status, which they viewed as more shameful at their older ages. Those receiving social support did so mainly through relationships with family and friends, rather than romantic relationships. Spirituality provided great support for all participants, although fear of disclosure led several to restrict connections with a church community. Community-level stigma-reduction programs may help older HIV-infected women receive support. PMID:24630627
D. E. E. Rizk; H. Shaheen; L. Thomas; M. Y. Hassan
: The aim of this study was to determine the prevalence and sociodemographics of urinary incontinence (UI) in women in the\\u000a United Arab Emirates (UAE). Women at risk, such as multiparous and climacteric women, were selected from the community (n= 200) and health-care centers (n= 200) and interviewed about inappropriate urine loss in the past 12 months, using a structured
Flicker, Sharon M.; Cerulli, Catherine; Swogger, Marc T.; Talbot, Nancy L.
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 women seeking 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
Bell, Margret E.; Goodman, Lisa A.; Dutton, Mary Ann
Despite assumptions that leaving the batterer offers the best chance for improvement in battered women's lives, few studies provide conclusive data on this issue. Although many women eventually reunite with partners, also unexamined is the influence of relationship course over time. Five waves of data from 206 low-income, largely Black,…
Tunis, Sandra L.; And Others
A sample of pregnant women (N=705) was given the monopolar version of the Profile of Mood States (POMS) in prenatal counseling for advanced maternal age to develop normative data and to determine the factor structure of the POMS for this group of women in the first trimester of pregnancy. (SLD)
Golden, Annis G
This study was undertaken in partnership with a publicly funded reproductive healthcare organization to better understand barriers to utilization of its services as perceived by low income African American women in its community and how those barriers might be managed. The study uses a place-based, ecological perspective to theorize privacy challenges across different levels of the communication ecology. Analysis of participant observation, interviews, and focus group data identified three key public-private problematics in African American women's experience of reproductive healthcare seeking in a smaller urban setting: a public-private problematic of organizational identity, of organizational regions, and of organizational members. Potential strategies are identified for managing these problematics by the organization and community members. PMID:24641878
Ragusa, Angela T.
Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study…
Westling, Erika; Garcia, Kelli; Mann, Traci
Discovery of meaning in response to illness has been linked to positive health outcomes. The mechanisms through which this occurs are unknown. This study tests a previously unexamined mechanism, engagement in healthier behaviors, which has been left uncontrolled in most studies. Forty-one HIV-infected women completed a one-month writing intervention. This writing was coded for signs of discovery of meaning. Adherence to medications was measured before (Time 1) and after (Time 2) the intervention. Women whose writing indicated that they had discovered meaning showed significantly greater adherence to their medical regimens at Time 2, controlling for Time 1 adherence. Discovery of meaning may result in positive health outcomes by leading individuals to engage in healthier behaviors. PMID:17584813
Moffitt, Pertice M; Vollman, Ardene Robinson
Medical travel policies are instituted in all rural and remote areas of Canada as a means of providing universal health care services to residents. These policies are framed, developed and implemented from a colonial perspective and require re-examination through a more inclusive and collaborative postcolonial lens. The purpose of this paper is to discuss the medical travel policy for childbirth in Canada's Northwest Territories from a postcolonial perspective and in consideration of the cultural safety of pregnant Tlicho women. The context within which Tlicho birthing and this policy thrives is reviewed along with the exploration of future possibilities. Personal, socioeconomic, political and legal factors surrounding birthing are highlighted. It is anticipated, that by illuminating the oppressive and paternalistic nature of this childbirth policy, there will be heightened awareness that fosters transitions within the system to transform current risk discourse creating new possibilities for Tlicho women in the birth of their babies. PMID:17026430
Jayasuriya, Vathsala; Wijewardena, Kumudu; Axemo, Pia
This article presents findings from a cross-sectional community survey exploring intimate partner violence (IPV) against women in the Western province of Sri Lanka. Findings show that lifetime prevalence of physical violence (34%), controlling behavior (30%), and emotional abuse (19%) was high and the prevalence of sexual violence was low (5%). Young women and those with partners who abused alcohol/drugs and had extra-marital affairs are at increased risk of violence. Although living in a patriarchal society, low prevalence of child marriages and lack of dowry-related violence could be to Sri Lankan women's advantage relative to their Asian counterparts in preventing IPV. PMID:21890530
Cooper, Cyrus; Roux, Christian; Díez-Pérez, Adolfo; Guillemin, Francis; Jonsson, Bengt; Ortolani, Sergio; Pfeilschifter, Johannes; Horne, Rob; Kakad, Shilpa; Shepherd, Susan; Möller, Gerd; Marciniak, Anne; Martinez, Luc
Summary Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU®) is an ongoing longitudinal cohort study that utilises physician- and patient-reported measures to describe the characteristics and management of postmenopausal women on bone loss therapies. We report the study design and baseline characteristics of 3,402 women recruited from general practice across five European countries. Purpose The POSSIBLE EU® is a study describing the characteristics and management of postmenopausal women receiving bone loss medications. Methods Between 2005 and 2008, general practitioners enrolled postmenopausal women initiating, switching or continuing treatment with bone loss treatment in France, Germany, Italy, Spain and the UK. Patients and physicians completed questionnaires at study entry and at 3-month intervals, for 1 year. Results Of 3,402 women enrolled (mean age 68.2 years [SD] 9.83), 96% were diagnosed with low bone mass; 55% of these using dual energy X-ray absorptiometry. Most women (92%) had comorbidities. Mean minimum T score (hip or spine) at diagnosis was ?2.7 (SD 0.89; median ?2.7 [interquartile range, ?3.2, ?2.2]) indicating low bone mineral density. Almost 40% of the women had prior fractures in adulthood, mostly non-vertebral, non-hip in nature, 30% of whom had at least two fractures and more than half experienced moderate/severe pain or fatigue. Bisphosphonates were the most common type of bone loss treatment prescribed in the 12 months preceding the study. Conclusions POSSIBLE EU® characterises postmenopausal women with low bone mass, exhibiting a high rate of prevalent fracture, substantial bone fragility and overall comorbidity burden. Clinical strategies for managing osteoporosis in this population varied across the five participating European countries, reflecting their different guidelines, regulations and standards of care. PMID:21258637
De la Cruz-Sánchez, Ernesto; Aguirre-Gómez, Loli
The objective of this work is to study the differences in health related behavior, habits and preventive health care attendance between women living in rural areas and their metropolitan counterparts in Spain. We analyzed health related behavior (such as leisure time physical activity, smoking, alcohol use and other health related dietary patterns) and preventive medical attendance (gynecological attendance, mammography frequency, flu vaccinations, cholesterol and blood pressure checks) in a total of 17,833 women older than 16 from the Spanish National Health Survey 2006. A multinomial logistic regression model was employed to compare groups (adjusted for age and social class). The main findings of this study is that the likelihood of receiving and attending to preventive public health care services was significantly lower for women in medium-sized urban or rural and remote locations than those living in metropolitan areas, as well as differences in health-related lifestyle behaviours. PMID:24057806
Clarke, L L; Miller, M K; Albrecht, S L; Frentzen, B; Cruz, A
OBJECTIVE: To examine the associations between maternal medical conditions and behavioral risks and the patterns of prenatal care use among high-risk women. DATA SOURCE/STUDY DESIGN: Data on over 25,000 high-risk deliveries to African American and white women using multinomial logistic regression to predict the odds of adequate-plus care relative to three other categories of care. DATA COLLECTION/EXTRACTION METHODS: Data were extracted from records maintained by the University of Florida/Shands Hospital maternity clinic on all deliveries between 1987 and 1994; records for white and for African American women were subset to examine racial differences in medical conditions, health behaviors, and patterns of prenatal care use. PRINCIPAL FINDINGS: Net of sociodemographic and fertility-related characteristics, African American and white women with late antepartum conditions and hypertension problems had significantly higher odds of receiving adequate-plus care, as well as no care or inadequate care, relative to adequate care. White women with gynecological disease and medical/surgical problems were significantly less likely to receive no care or inadequate care, as were African American women with gynecological disease. CONCLUSIONS: Maternal medical conditions explain much but not all of the adequate-plus prenatal care use. More than 13 percent of African American women and 20 percent of white women with no reported medical problems or behavioral risks used adequate-plus care. Additional research is needed to understand this excess use and its possibilities in mediating birth outcomes. PMID:10201856
Thompson, Jennifer L.; Kuklina, Elena V.; Bateman, Brian T.; Callaghan, William M.; James, Andra H.; Grotegut, Chad A.
OBJECTIVE To estimate nationwide trends in the prevalence of maternal congenital heart disease (CHD) and determine whether women with CHD are more likely than women without maternal CHD to have medical and obstetric complications. METHODS The 2000–2010 Nationwide Inpatient Sample was queried for International Classification of Diseases, 9th Revision, Clinical Modification codes to identify delivery hospitalizations of women with and without CHD. Trends in the prevalence of CHD were determined and then rates of complications were reported for CHD per 10,000 delivery hospitalizations. For Nationwide Inpatient Sample 2008–2010, logistic regression was used to examine associations between CHD and complications. RESULTS From 2000 to 2010, there was a significant linear increase in the prevalence of CHD from 6.4 to 9.0 per 10,000 delivery hospitalizations (P<.001). Multivariable logistic regression demonstrated that all selected medical complications, including mortality (17.8 compared with 0.7/10,000 deliveries, adjusted odds ratio [OR] 22.10, 95% confidence interval [CI] 13.96–34.97), mechanical ventilation (91.9 compared with 6.9/10,000, adjusted OR 9.94, 95% CI 7.99–12.37), and a composite cardiovascular outcome (614 compared with 34.3/10,000, adjusted OR 10.54, 95% CI 9.55–11.64) were more likely to occur among delivery hospitalizations with maternal CHD than without. Obstetric complications were also common among women with CHD. Delivery hospitalizations with maternal CHD that also included codes for pulmonary circulatory disorders had higher rates of medical complications compared with hospitalizations with maternal CHD without pulmonary circulatory disorders. CONCLUSION The number of delivery hospitalizations with maternal CHD in the United States is increasing, and although we were not able to determine whether correction of the cardiac lesion affected outcomes, these hospitalizations have a high burden of medical and obstetric complications. PMID:26241425
Bentley, Kia J; Price, Sarah Kye; Cummings, Cory R
In their work in human services organizations and community agencies across service sectors, social workers encounter pregnant and postpartum women experiencing mental health challenges. This article offers an evidence-informed Decision Support Guide designed for use by social workers working with pregnant and postpartum women who are struggling with complicated decisions about psychiatric medication use. The guide is built on contemporary notions of health literacy and shared decision making and is informed by three areas: (1) research into the lived experiences of pregnant and postpartum women and health care providers around psychiatric medication decision making, (2) a critical review of existing decision aids, and (3) feedback on the strategy from social work practitioners who work with pregnant and postpartum women. Emphasizing the relational nature of social work in supporting effective health-related decision making, the guide relies on maintaining a collaborative practice milieu and using a decision aid that engages clients in discussions about mental health during and around the time of pregnancy. The guide offers social workers a practice tool to support responsive and compassionate care by embracing their roles in problem solving and decision making, providing emotional and psychosocial support, and making appropriate referrals to prescribers. PMID:25365831
Derbyshire, Emma; Dancey, Darren
Background. Smartphone medical applications have a major role to play in women's health with their roles being very broad, ranging from improving health behaviours to undertaking personalised tests. Objective(s). Using Medline, Web of Knowledge, and the PRISMA guidelines 15 randomized controlled trials (RCTs) were identified, with mobile interventions being tested on 1603 females, in relation to key aspects of health. Using a similar systematic approach an iPhone database search identified 47 applications (apps) developed to improve women's health. Findings. Ten RCTs used text messaging or app interventions to support weight loss, with significant improvements being observed in eight studies. For other aspects of women's health RCTs are needed to determine possible health benefits. iPhone store data analysis identified that a substantial number of women's health apps did not have star ratings or feedback comments (68 and 49 per cent, resp.), raising concerns about their validity. Conclusion. Peer-review systems, supporting statements of evidence, or certification standards would be beneficial in maintaining the quality and credibility of future health-focused apps. Patient groups should also ideally be involved in the development and testing of mobile medical apps. PMID:24454354
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
Golden, Annis G; Pomerantz, Anita
In the context of reproductive and sexual health, African American women have higher incidence of disease and poorer outcomes on key indicators when compared with White women. In this study, we used discourse analysis to identify and examine the workings of two clusters of interpretive resources ("interpretative repertoires") associated with reproductive/sexual health care seeking among low-income African American women who participated in semistructured interviews as part of a health promotion initiative. Interpretative repertoires are ways of accounting for engaging in or refraining from engaging in actions, which are shared by people in a community. We labeled the two interpretative repertoires "Don't Want to Know," and "Take Charge of Your Health." Within the "Don't Want to Know" repertoire, that testing would lead to threatening findings was assumed, a chain of devastating consequences was imagined, and a preference for uncertainty over certain knowledge was expressed. Conversely, the "Take Charge of Your Health" repertoire valued certainty over uncertainty, though in both interpretive frameworks, knowledge-based and emotion-based decision-making were intertwined. We conclude that health promotion initiatives--if they are to succeed in encouraging women to obtain valuable preventive health care services--must respond, in their choices of language and outreach strategies, to the expressed dilemma of wishing for reassurance but fearing bad news, to the intertwining of emotional reasoning and technorationality in health decision making, and to the particular relational experiences of African American women. Failure to do so will contribute to the continuation of reproductive and sexual health disparities. PMID:25144501
Abate, Meskerem; Assefa, Nega; Alemayehu, Tadesse
Background Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. Objectives To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. Methods A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant’s knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. Result Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR?=?0.027, 95% CI (0.007, 0.105)]. Conclusion The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. Recommendations Health professions should give attention in increasing knowledge and uptake of Emergency Contraception. PMID:25330229
Naqvi, Syed Mansoor; Hasnain, Aziz Fatima
Due to cultural and religious reasons, Pakistani women can be reluctant to seek medical 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.
Cooperman, Nina A.; Shastri, Jayanthi S.; Shastri, Aditi; Schoenbaum, Ellie
Three hundred women presenting to a sexually transmitted infection 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 non-commercial sex partners. Most believed condom preparation is a male responsibility (58%), condom use is a sign that partner trust is lacking (84%), and, 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 intervention. PMID:23659311
This paper will look at work carried out with asylum-seeking families and children within a hospital paediatric setting, exploring theories that can help us to understand how highly traumatic experiences, emotionally and cognitively unprocessed, may become expressed bodily. The case examples will show how these shattered and dislocated patients…
Price, Sarah Kye; Proctor, Enola K.
Context/Purpose: To examine a low-income sample of women in the rural Midwest (N = 1,086) who were screened for perinatal depression through the outreach and education activities within a Healthy Start Initiative project. Specifically, we describe the frequency and severity of depressive symptoms, explore social and demographic correlates of…
McCoy, Shannon K.; Newell, Ellen E.; Gardner, Susan K.
Faculty retention is of increasing importance in the current economic climate. We examined the role of an institution's environmental conditions (e.g., climate, collegiality, and administration) in faculty well-being (i.e., job satisfaction, intent to leave, emotional and physical health). Women reported significantly lower well-being and a…
Marton, Christine; Choo, Chun Wei
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…
Battaglia, Tracy A.; Santana, M. Christina; Bak, Sharon; Gokhale, Manjusha; Lash, Timothy L.; Ash, Arlene S.; Kalish, Richard; Tringale, Stephen; Taylor, James O.; Freund, Karen M.
Background We sought to measure time and identify predictors of timely follow-up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities. Methods Eligible women had an abnormality detected on a mammogram or Pap test between January 2004 and December 2005 in one of six community health centers in Boston, MA. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality). Results Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 versus 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow up for both mammogram and Pap test abnormalities. Conclusions Site specific community based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations. PMID:20052731
Suvak, Michael K.; Taft, Casey T.; Goodman, Lisa A.; Dutton, Mary Ann
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…
Sinclair, R; Patel, M; Dawson, T L; Yazdabadi, A; Yip, L; Perez, A; Rufaut, N W
Androgenetic alopecia affects both men and women. In men it produces male pattern hair loss with bitemporal recession and vertex baldness. In women it produces female pattern hair loss (FPHL) with diffuse alopecia over the mid-frontal scalp. FPHL occurs as a result of nonuniform hair follicle miniaturization within follicular units. Diffuse alopecia is produced by a reduction in the number of terminal fibres per follicular unit. Baldness occurs only when all hairs within the follicular units are miniaturized and is a relatively late event in women. The concepts of follicular units and primary and secondary hair follicles within follicular units are well established in comparative mammalian studies, particularly in sheep. However, discovery of these structures in the human scalp hair and investigation of the changes in follicular unit anatomy during the development of androgenetic alopecia have provided a clearer understanding of the early stages of androgenetic alopecia and how the male and female patterns of hair loss are related. FPHL is the most common cause of alopecia in women and approximately one-third of adult caucasian women experience hair loss. The impact of FPHL is predominantly psychological. While men anticipate age-related hair loss, hair loss in women is usually unexpected and unwelcome at any age. Treatment options to arrest hair loss progression and stimulate partial hair regrowth for FPHL include the androgen receptor antagonists spironolactone and cyproterone acetate, the 5?-reductase inhibitor finasteride and the androgen-independent hair growth stimulator minoxidil. These treatments appear to work best when initiated early. Hair transplantation should be considered in advanced FPHL that is resistant to medical treatments. Hair transplantation requires well-preserved hair growth over the occipital donor area. The psychological impact of FPHL may also be reduced by cosmetic products that improve the appearance of the hair. These agents work to minimize hair fibre breakage, improve hair volume or conceal visible bald scalp. PMID:22171680
van Zanten, Marta
Background: The purpose of the first phase of the present research was to examine medical education accreditation practices around the world, with special focus on the Caribbean region, to determine the association of accreditation of medical schools with student/graduate performance on examinations. The aim of the second phase of this research…
Damasceno, Karla Santana Azevedo; Alves dos Prazeres, José Carlos; Araújo, Maria Alix Leite; Valdanha Netto, Américo
The objective of this study is to analyze the perinatal results of the prophylactic measures adopted in the prevention of the vertical transmission of HIV. The study was carried out using the medical records of 168 women with HIV and their newborns in a public maternity unit of Fortaleza, in the state of Ceará, from 2005 to 2009. The data was obtained between the months of March and September 2010 and was analyzed using the program SPSS 10.0. The women diagnosed before pregnancy received timely care that permitted them an effective antiretroviral therapy and a greater number of check-ups (p<0,05). Antiretroviral therapy was administered to 97.6% of the pregnant women, and triple therapy in 88.7%. AZT was administered intrapartum in 95.2% of the women and oral AZT in syrup to 100% of the newborns. Birth by cesarean section was predominant (92.8%) and was associated to the intrapartum use of AZT when compared to vaginal birth (p<0.001). Cesarean section favored intrapartum administration of AZT. PMID:24500549
Feldman, Candace H; Bermas, Bonnie L; Zibit, Melanie; Fraser, Patricia; Todd, Derrick J; Fortin, Paul R; Massarotti, Elena; Costenbader, Karen H
Objective Systemic lupus erythematosus (lupus) disproportionately affects women, racial/ethnic minorities and low-income populations. We held focus groups for women from medically underserved communities to discuss interventions to improve care. Methods From our Lupus Registry, we invited 282 women, > 18 years, residing in urban, medically underserved areas. Hospital-based clinics and support groups also recruited participants. Women were randomly assigned to 3 focus groups. 75-minute sessions were recorded, transcribed and coded thematically using interpretative phenomenologic analysis and single counting methods. We categorized interventions by benefits, limitations, target populations and implementation questions. Results 29 women with lupus participated in 3 focus groups, (n=9, 9, 11). 80% were African American and 83% were from medically underserved zip codes. Themes included the desire for lupus education, isolation at the time of diagnosis, emotional and physical barriers to care, and the need for assistance navigating the healthcare system. 20 of 29 participants (69%) favored a peer support intervention; 17 (59%) also supported a lupus health passport. Newly diagnosed women were optimal intervention targets. Improvements in quality of life and mental health were proposed outcome measures. Conclusion Women with lupus from medically underserved areas have unique needs best addressed with an intervention designed through collaboration between community members and researchers. PMID:23087258
Background In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. The situation increases the risk of death for both mother and child and has severe maternal complications. The purpose of this study was to describe women's perceptions of homebirths in the medical districts of Ouargaye and Diapaga. Methods A qualitative approach was used to gather information. This information was collected by using focus group discussions and individual interviews with 30 women. All the interviews were tape recorded and managed by using QSR NVIVO 2.0, qualitative data management software. Results The findings show that homebirths are frequent because of prohibitive distance to health facilities, fast labour and easy labour, financial constraints, lack of decision making power to reach health facilities. Conclusion The study echoes the need for policy makers to make health facilities easily available to rural inhabitants to forestall maternal and child deaths in the two districts. PMID:21276252
Ilboudo, Patrick GC; Somda, Serge MA; Sundby, Johanne
Introduction Despite the universal recognition of unsafe abortion as a major public health problem, very little research has been conducted to document its precipitating factors in Burkina Faso. Our aim was to investigate the key determinants of induced abortion in a sample of women who sought postabortion care. Materials and methods A cross-sectional household survey was carried out from February to September 2012 in Ouagadougou, Burkina Faso. Data of 37 women who had had an induced abortion and 267 women who had had a spontaneous abortion were prospectively collected on sociodemographic characteristics, pregnancy and birth history, abortion experience, including previous abortion experience, and selected clinical information, including the type of abortion. A two-step regression analysis consisting of a univariate and a multivariate logistic regression was run on Stata version 11.2 in order to identify the key determinants of induced abortion. Results The findings indicated that 12% of all abortions were certainly induced. Three key factors were significantly and positively associated with the probability of having an induced abortion: whether the woman reported that her pregnancy was unwanted (odds ratio [OR] 10.45, 95% confidence interval [CI] 3.59–30.41); whether the woman reported was living in a household headed by her parents (OR 6.83, 95% CI 2.42–19.24); and if the woman reported was divorced or widowed (OR 3.47, 95% CI 1.08–11.10). On the contrary, being married was protective against induced abortion, with women who reported being married having an 83% (OR 0.17, CI 0.03–0.89) lower chance of having an induced abortion, even when the pregnancy was unwanted. Conclusion This study has identified three major determinants of induced abortion in Ouagadougou, Burkina Faso. Improved targeted programs on family planning counseling, methods of contraception, and availability of contraceptives should be widely promoted. PMID:24920938
Lima, Kledoaldo Oliveira de; Salustiano, Daniela Medeiros; Cavalcanti, Ana Maria Salustiano; Leal, Élcio de Souza; Lacerda, Heloísa Ramos
The HIV-1 epidemic in Brazil has displayed new characteristics over time, with an increase in heterosexual transmission and a decline in the male-to-female ratio in AIDS cases. HIV screening was offered to patients attending the Voluntary Counseling and Testing Center in Paulista, Greater Metropolitan Recife, Pernambuco State, in Northeast Brazil, to determine HIV-1 incidence. BED capture enzyme immunoassay (BED-CEIA) was used to measure HIV-1 incidence, comparing it to the AxSYM avidity index method (Ax-AI). From 2006 to 2009, 14,014 individuals were tested, and only 18 pregnant women were diagnosed with HIV infection, resulting in 0.15% annual incidence (95%CI: 0-0.33), significantly lower than in men (1.03; 95%CI: 0.45-1.61) and non-pregnant women (0.50; 95%CI: 0.11-0.89). Despite the low HIV-1 incidence in pregnant women, the high rate of recent infection detected during prenatal care emphasizes the need to increase measures to prevent vertical transmission. PMID:26200379
Whited, Matthew C; Schneider, Kristin L; Appelhans, Bradley M; Ma, Yunsheng; Waring, Molly E; DeBiasse, Michele A; Busch, Andrew M; Oleski, Jessica L; Merriam, Philip A; Olendzki, Barbara C; Crawford, Sybil L; Ockene, Ira S; Lemon, Stephenie C; Pagoto, Sherry L
An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient ?=? 0.01 95% CI = 0.01 - 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms. PMID:24587338
de Bessa, Gina Hunter
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 among few alternatives, and one that has subjected women to greater medical management and intervention, I argue that sterilization also represents poor women's active struggle to improve their lives and to resist the burdens placed on them by unequal gender relations. This article contributes to a growing anthropological literature that demonstrates how reproduction has become a central site where social values are constituted and contested, and it details women's diverse responses to the process of medicalization. PMID:16895828
Yager, J; Landsverk, J; Edelstein, C K
Help-seeking patterns and satisfaction with care were described by 641 women with eating disorders participating in a national magazine survey. Between 60.6% and 92.9% of respondents in three diagnostic groups sought professional treatment. Professional treatments most often entered were individual psychotherapy (52.9%), behavioral therapy (28.0%), group therapy (24.6%), and nutritional therapy (18.6%). Treatments were generally seen as helping "a little." Only bulimic anorexia nervosa respondents perceived any interventions to be more harmful than helpful, specifically Overeaters Anonymous and self-help groups, both nonprofessional interventions. Caregivers selected as "experts" regarding eating disorders were rated as more efficacious than others, helping "a little" to "somewhat." PMID:2794990
Rains, Stephen A; Tukachinsky, Riva
Uncertainty management theory outlines the processes through which individuals cope with health-related uncertainty. Information seeking has been frequently documented as an important uncertainty management strategy. The reported study investigates exposure to specific types of medical information during a search, and one's information-processing orientation as predictors of successful uncertainty management (i.e., a reduction in the discrepancy between the level of uncertainty one feels and the level one desires). A lab study was conducted in which participants were primed to feel more or less certain about skin cancer and then were allowed to search the World Wide Web for skin cancer information. Participants' search behavior was recorded and content analyzed. The results indicate that exposure to two health communication constructs that pervade medical forms of uncertainty (i.e., severity and susceptibility) and information-processing orientation predicted uncertainty management success. PMID:26132807
Lallukka, T; Arber, S; Laaksonen, M; Lahelma, E; Partonen, T; Rahkonen, O
Work and family are two key domains of life among working populations. Conflicts between paid work and family life can be detrimental to sleep and other health-related outcomes. This study examined longitudinally the influence of work-family conflicts on subsequent sleep medication. Questionnaire data were derived from the Helsinki Health Study mail surveys in 2001-2002 (2929 women, 793 men) of employees aged 40-60 years. Data concerning sleep medication were derived from the Finnish Social Insurance Institution's registers covering all prescribed medication from 1995 to 2007. Four items measured whether job responsibilities interfered with family life (work to family conflicts), and four items measured whether family responsibilities interfered with work (family to work conflicts). Cox proportional hazard models were fitted, adjusting for age, sleep medication five years before baseline, as well as various family- and work-related covariates. During a five-year follow-up, 17% of women and 10% of men had at least one purchase of prescribed sleep medication. Among women, family to work conflicts were associated with sleep medication over the following 5 years after adjustment for age and prior medication. The association remained largely unaffected after adjusting for family-related and work-related covariates. Work to family conflicts were also associated with subsequent sleep medication after adjustment for age and prior medication. The association attenuated after adjustment for work-related factors. No associations could be confirmed among men. Thus reasons for men's sleep medication likely emerge outside their work and family lives. Concerning individual items, strain-based ones showed stronger associations with sleep medication than more concrete time-based items. In conclusion, in particular family to work conflicts, but also work to family conflicts, are clear determinants of women's sleep medication. PMID:22721964
McCauley, Jenna L.; Amstadter, Ananda B.; Macdonald, Alexandra; Danielson, Carla Kmett; Ruggiero, Kenneth J.; Resnick, Heidi S.; Kilpatrick, Dean G.
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 telephone using Computer-Assisted Telephone Interviewing technology. NMUPD was assessed by asking if, participants had used a prescription drug non-medically in the past year. NMUPD was endorsed by 7.8% of the sample (n=155). Although incapacitated and drug–alcohol facilitated rape were associated with NMUPD in the initial model, the final multivariable model showed that only lifetime major depression and other forms of substance use/abuse were significantly uniquely associated with an increased likelihood of NMUPD. Implications for primary and secondary prevention and subsequent research are addressed. PMID:21356576
Raymond, Elizabeth G; Grossman, Daniel; Wiebe, Ellen; Winikoff, Beverly
The requirement that every woman desiring medical abortion must come in person to a clinical facility to obtain the drugs is a substantial barrier for many women. To eliminate this requirement in the United States, two key components of the standard initial visit would need to be restructured. First, alternatives to ultrasound and pelvic exam would need to be identified for ensuring that gestational age is within the limit for safe and effective treatment. This is probably feasible: for example, data from a large study suggest that in selected patients menstrual history is highly sensitive for this purpose. Second, the Food and Drug Administration would need to remove the medically unwarranted restriction on distribution of mifepristone. These two changes could allow provision of the service by a broader range of providers in nontraditional venues or even by telemedicine. Such options could have profound benefits in reducing cost and expanding access to abortion. PMID:26134280
Yusoff, Nasir; Taib, Nur Aishah Mohd; Ahmad, Aini
The aim of this study was to assess why women delay in getting treatment (i.e. surgery) for breast cancer, as well as to explore on what type of issues are involved in such delay cases. Basic interpretative of qualitative methodology was applied to construct the reality of delay phenomena, and its interaction with social worlds. Six themes were identified: new conception of breast cancer treatment, psychological defenses, health support system, symtomatology experience, model and barriers. The delay issue in breast cancer requires attention as a multidimensional problem as this will facilitate more comprehensive and effective intervention to reduce delay. PMID:22320956
Hernández-Díaz, Sonia; Su, Yung-Cheng; Mitchell, Allen A.; Kelley, Katherine E.; Calafat, Antonia M.; Hauser, Russ
Objective To evaluate the association between the use of medications potentially containing phthalates and urinary concentrations of specific phthalate metabolites around conception. Methods Women enrolled in the Environment and Reproductive Health project from 2006 to 2009 completed questionnaires about the use of medications and provided multiple urine samples before and after conception. We compared the mean urinary concentration of phthalate metabolites between users of phthalate containing medications and a matched unexposed control group. Results One woman used Asacol® (mesalamine), which utilizes dibutyl phthalate (DBP) as a delayed release coating material, and had a mean urinary concentration of the main DBP metabolite 200 times higher than the controls (8176 ?g/L vs. 37.5 ?g/L). The three users of stool softeners had a higher concentration of the main diethyl phthalate (DEP) metabolite (8636 ?g/L vs. 714.2 ?g/L). Neither the three additional Prilosec® (omeprazole) users nor one cyclobenzaprine user had higher urinary concentration than controls. Conclusion Selected medications may be important sources of DBP and DEP exposures around conception. PMID:23333816
Background Stress and distress among medical students are thoroughly studied and presumed to be particularly high, but comparative studies including other student groups are rare. Methods A web-based survey was distributed to 500 medical students and 500 business students. We compared levels of study stress (HESI), burnout (OLBI), alcohol habits (AUDIT) and depression (MDI), and analysed their relationship with self-assessed mental health problems by logistic regression, with respect to gender. Results Medical students' response rate was 81.6% and that of business students 69.4%. Business students scored higher on several study stress factors and on disengagement. Depression (OR 0.61, CI95 0.37;0.98) and harmful alcohol use (OR 0.55, CI95 0.37; 0.75) were both less common among medical students. However, harmful alcohol use was highly prevalent among male students in both groups (medical students 28.0%, business students 35.4%), and among female business students (25.0%). Mental health problems in need of treatment were equally common in both groups; 22.1% and 19.3%, respectively, and was associated with female sex (OR 2.01, CI95 1.32;3.04), exhaustion (OR 2.56, CI95 1.60;4.10), lower commitment to studies (OR 1.95, CI95 1.09;3.51) and financial concerns (OR 1.81 CI95 1.18;2.80) Conclusions Medical students may not be more stressed than other high achieving student populations. The more cohesive structure of medical school and a higher awareness of a healthy lifestyle may be beneficial factors. PMID:22059598
Michel, Joanna; Duarte, Reinel Eduardo; Yao, Ping; Bolton, Judy L.; Huang, Yue; Cáceres, Armando; Veliz, Mario; Soejarto, Djaja Doel; Mahady, Gail B.
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. PMID:17826926
Pandey, Kishore Raj; Kafle, Phanindra Prasad; Karki, Debendra
by Nepal Medical College and Teaching Hospital to conduct this research. The services provided by Mrs Bimala Singh as Reserch Assistant and co-operation provided by Mrs Lalita Risal at the Department of Paediatrics and Ms. Sarita Joshi at the Department...
Too little attention has been paid over the past forty years to the complete lack of a factual record in Roe v. Wade and Doe v. Bolton, and to the Court's fundamental assumption that drove the outcome. The decision and opinions were driven by the medical claim that "abortion was safer than childbirth," which was raised for the first time in the briefs in the Supreme Court without any lower court record. This medical premise directly and profoundly shaped virtually every major aspect of Roe and Doe, including the creation of the trimester system and the prohibition of health and safety regulations in the first trimester. Because of this medical assumption, the Justices extended the right to abortion throughout pregnancy. It was key to the Court's historical rationale for a "right" to abortion. Because of this notion, the Justices gave abortion providers complete discretion to manage any issues of health and safety, and they prohibited public health officials from regulating abortion in the first trimester. This medical assumption was the most consequential factual assumption of the abortion decisions of 1973 and it has been assumed to be true in subsequent abortion decisions by the Court. The notion that "abortion is safer than childbirth" has become even less tenable for at least five reasons: (1) the dysfunctional abortion data reporting system in the United States that relies completely on voluntary reporting; (2) the incomparability of the published abortion mortality rate and the published maternal (childbirth) mortality rate; (3) medical data on the increasing rate of maternal mortality in the second trimester; (4) the growing body of international medical studies finding long-term risks to women from abortion; and (5) maternal mortality data from countries with superior abortion recordkeeping collection and reporting systems, which find a higher rate of abortion mortality than childbirth mortality. These concerns and the growth in international medical data over the past two decades should counsel the Supreme Court to give greater deference to the states in their attempt to protect maternal health. PMID:25936207
Osaki, Haika; Mshana, Gerry; Wambura, Mwita; Grund, Jonathan; Neke, Nyasule; Kuringe, Evodius; Plotkin, Marya; Mahler, Hally; Terris-Prestholt, Fern; Weiss, Helen; Changalucha, John
Voluntary Medical Male Circumcision (VMMC) for HIV prevention in Tanzania was introduced by the Ministry of Health and Social Welfare in 2010 as part of the national HIV prevention strategy. A qualitative study was conducted prior to a cluster randomized trial which tested effective strategies to increase VMMC up take among men aged ?20 years. During the formative qualitative study, we conducted in-depth interviews with circumcised males (n = 14), uncircumcised males (n = 16), and participatory group discussions (n = 20) with men and women aged 20–49 years in Njombe and Tabora regions of Tanzania. Participants reported that mothers and female partners have an important influence on men’s decisions to seek VMMC both directly by denying sex, and indirectly through discussion, advice and providing information on VMMC to uncircumcised partners and sons. Our findings suggest that in Tanzania and potentially other settings, an expanded role for women in VMMC communication strategies could increase adult male uptake of VMMC services. PMID:26402231
Cannon Poindexter, Cynthia
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
Ahwireng-Obeng, Frederick; van Loggerenberg, Charl
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
Sheppard, Vanessa B; Mays, Darren; LaVeist, Thomas; Tercyak, Kenneth P
Clinical evidence supports the value of BRCA1/2 genetic counseling and testing for managing hereditary breast and ovarian cancer risk; however, BRCA1/2 genetic counseling and testing are underutilized among black women, and reasons for low use remain elusive. We examined the potential influence of sociocultural factors (medical mistrust, concerns about genetic discrimination) on genetic counseling and testing engagement in a sample of 100 black women at increased risk for carrying a BRCA1/2 mutation. Eligible participants fell into 1 of 3 groups: (1) healthy women with at least 1 first-degree relative affected by breast and/or ovarian cancer, (2) women diagnosed with breast cancer at age less than or equal to 50 years; and (3) women diagnosed with breast and/or ovarian cancer at age greater than or equal to 50 years with either 1 first-degree relative or 2 second-degree relatives with breast and/or ovarian cancer. Participants were recruited from clinical anid community settings and completed a semistructured interview. Study variable relationships were examined using bivariate tests and multivariate regression analysis. As expected, genetic counseling and testing engagement among this sample was low (28%). After accounting for;sociodemographic factors and self-efficacy (beta=0.37, p<.001), women with higher medical mistrust had lower genetic counseling and testing engagement (beta=-0.26, p<.01). Community-level and individual interventions are needed to improve utilization of genetic counseling and testing among underserved women. Along with trust building between patients and providers, strategies should enhance women's personal confidence. The impact of medical mistrust on the realization of the benefits of personalized medicine in minority populations should be further examined in future studies. PMID:23862292
Mack, Yvette E.
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…
Haddad, Lisa B.; Feldacker, Caryl; Jamieson, Denise J.; Tweya, Hannock; Cwiak, Carrie; Bryant, Amy G.; Hosseinipour, Mina C.; Chaweza, Thomas; Mlundira, Linly; Kachale, Fanny; Stuart, Gretchen S.; Hoffman, Irving; Phiri, Sam
Objective To determine medical eligibility for contraceptive use, contraceptive preference, and acceptance of a copper intrauterine device (IUD) among a cohort of HIV-infected women receiving antiretroviral therapy (ART). Methods All HIV-infected women who received ART and sought contraceptive services at the Lighthouse clinic, an integrated HIV/ART clinic in Lilongwe, Malawi, between August and December 2010 were invited to participate in a structured interview. Eligibility and preference for the following contraceptive methods were assessed: combined hormonal contraceptives, progestogen-only pills, copper IUD, injectable depot medroxyprogesterone acetate (DMPA), and contraceptive implants. Results The final sample included 281 women; five were pregnant. The remaining 276 women were eligible for at least three contraceptive methods, with 242 (87.7%) eligible for all five methods evaluated. After counseling, 163 (58.0%) selected DMPA and 98 (34.9%) selected an IUD as their preferred contraceptive method. Regardless of their method of choice, 222 (79.0%) women agreed to have an IUD placed on the same day. Conclusion Most methods of contraception are safe for use by HIV-infected women. Approximately 80% of the women were willing to receive an IUD. Efforts must be made to increase education about, and access to, long-acting reversible methods that may be acceptable and appropriate contraceptive options for HIV-infected women. PMID:24890746
Lee Davis, Dona; Maurstad, Anita; Dean, Sarah
Pink t-shirts that proclaim "My horse is my therapist" are for sale in a wide variety of horse-sport catalogues. Literature on the healing power of human-nonhuman animal encounters and the practice of a variety of animal-assisted therapy programs, such as hippotherapy and equine-facilitated therapy, show dramatic growth over the last 30 years. Less attention is paid to the role that horse-human interactions may play in more popular accountings of well-being and impairment among a sample of everyday riders. Analysis of 50 lifecycle narratives, collected from accomplished but nonprofessional equestriennes, demonstrates the complex and ambiguous ways in which women draw from their experience of human-horse relationships as they challenge and transgress the borderlands between pleasure and impairment. Combining the perspectives of multispecies ethnography and medical anthropology that engages the complexities of well-being, analysis is informed by and contributes to recent controversies concerning the medicalization of normality and pleasure in DSM 5. PMID:25348804
Correia, Katharine F.; Ginsburg, Elizabeth S.
Objective Compare the efficacy of surrogate or gestational carrier (GC) cycles to that of autologous in vitro fertilization (IVF)/intracytoplasmic sperm injections (ICSI) in patients with gynecologic or medical co-morbidities contraindicative to pregnancy. Design Retrospective cohort study. Setting Infertility patients from a single university hospital-based program from 1998-2009. Intervention(s) 128 GC cycles from 80 intended parents were identified and compared with 15,311 IVF or ICSI cycles. Main Outcome Measure(s) The peak estradiol (E2), number of oocytes retrieved, cycle cancellation, ongoing pregnancy, and live-birth were compared between GCs and autologous IVF carriers. Indications for GC use were also identified. Multiple cycles contributed by the same patient were accounted for using multivariable generalized estimating equations and two-sided Wald p-values. Results Uterine factors (67%) was the most common indication for using a GC, followed by non-gynecologic medical conditions including coagulopathies (13%), end stage renal disease (10%), cardiovascular disease (5%) and cancer (5%). Adjusting for age, ovulation induction in GC cycles had similar peak E2 levels and number of oocytes retrieved relative to IVF cycles (p = 0.23 and 0.43, respectively). Clinical pregnancy (49% vs. 42%, p = 0.28) and live-birth rates (31% vs. 32%, p = 0.74) were also comparable. A sub-analysis of GC cycles in those women with uterine factor indications, demonstrated significantly higher clinical pregnancy rates (OR = 2.0; CI = 1.2 - 3.5) with 60% greater odds of live-birth relative to IVF/ICSI cycles, however this odds was not statistically significant for differences in live-birth (CI = 0.9 - 2.9). Conclusions: GCs are a viable alternative to start families for patients with medical co-morbidities precluding pregnancy. PMID:25664218
Cook, Katsi; And Others
Seven Native American women (including Mohawk, Bolivian, Apache, Nicaraguan Miskito, and Hopi women) discuss women's responsibilities and roles within the family and community, spirituality, birth and puberty ceremonies, child rearing and traditional education of the young (particularly girls), the healing of men through women, union organizing in…
FRED MOLITOR; JUAN D. RUIZ; JEFFREY D. KLAUSNER; WILLIAM McFarland
Data from a population-based, door-to-door survey of young women were used to investigate the relationship between forced sex and STD\\/HIV risk behaviors and history of diagnostic medical care. The Young Women Survey recruited women from low-income neighborhoods within five California counties including and near San Francisco. A history of forced sex was related to use of alcohol and illicit drugs,
Calizo, Lee Scherer Hawthorne
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…
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
This essay opens its discussion of violence against women by referring to the 1994 television broadcast of a 10-year-old Egyptian girl undergoing female genital mutilation (FGM) without benefit of infection control measures or anesthesia at the hands of a local barber. After presenting a brief description of FGM, its various justifications, and its impacts on its victims, the official Egyptian policy is described as ambiguous, and the broadcast is shown to have caused influential religious leaders and medical personnel to defend FGM and, thus, led to postponement of a bill to outlaw FGM. The next section of the essay shows that Egypt's response to FGM reflects the international debate on all forms of violence against women emerging from and reinforcing the social relationships that give men power over women. These forms of violence include domestic violence in almost all societies; the dowry-related, bride-burning homicides that claim 5000-12,000 lives each year in India; son preference that leads to abortion of female fetuses and female infanticide; and crimes such as rape, sexual abuse, and forced prostitution. The essay continues with a look at the costs of violence hidden in the damage to women that increases health care costs substantially and reduces economic productivity. Violence towards women, which occurs throughout the world and can prevent women from participating in public life or from controlling their fertility, is a male tool to inhibit women from gaining autonomy outside the home. The essay concludes that victims of violence are beginning to break the silence that surrounded these deeds and are seeking legislative protection. Laws may not result in real-life changes, but the movement to eliminate FGM may prove to be the first success in women's efforts to achieve human rights. An example is the important precedent being set in the US by a woman seeking asylum to avoid facing an arranged marriage and FGM in her native Togo. PMID:12291323
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
Kim, Sojung Claire; Shah, Dhavan V; Namkoong, Kang; McTavish, Fiona M; Gustafson, David H
This study attempts to examine the role of social support perception and emotional well-being on online information seeking among cancer patients within the context of CHESS, a well-established Interactive Cancer Communication System (ICCS). Factor and regression analyses conducted among 231 breast cancer patients revealed that social support perception and emotional well-being interacted with each other to influence online health information seeking. Patients with low social support perception and high emotional well-being were most likely to seek health information, whereas patients with high social support perception and high emotional well-being sought out the same information least. Practical implications of the study findings were further discussed. PMID:24634575
Kim, Sojung Claire; Shah, Dhavan V.; Namkoong, Kang; McTavish, Fiona M.; Gustafson, David H.
This study attempts to examine the role of social support perception and emotional well-being on online information seeking among cancer patients within the context of CHESS, a well-established Interactive Cancer Communication System (ICCS). Factor and regression analyses conducted among 231 breast cancer patients revealed that social support perception and emotional well-being interacted with each other to influence online health information seeking. Patients with low social support perception and high emotional well-being were most likely to seek health information, whereas patients with high social support perception and high emotional well-being sought out the same information least. Practical implications of the study findings were further discussed. PMID:24634575
Severe, Linda; Fitzgerald, Daniel W.; Deschamps, Marie M.; Reif, Lindsey; Post, Kendall; Johnson, Warren D.; Pape, Jean W.; Boutin-Foster, Carla
Haitian women are twice as likely as men to have HIV/AIDs. Factors underlying the feminization of HIV are complex. Self-esteem is an important correlate of sexual behavior. However, its meaning and impact on health behaviors may be influenced by cultural factors. This qualitative study took place in Haiti 4 months after the 2010 earthquake and examines the meaning of self-esteem among young Haitian women seeking treatment for a recurrent sexually transmitted infection (STI). The meaning of self-esteem was derived from a sense of gratitude and was rooted in their ability to provide for family. This may have led to behaviors such as not using condoms or having sex with partners in concurrent relationships. This article highlights the resilience and resourcefulness of Haitian women, provides insight into how women with apparent positive self-images were led to make choices that placed them at high risk for contracting HIV, and concludes with recommendations for future interventions. PMID:24694329
Japan lags behind other industrialized nations in terms of gender equality. To improve the work environment for surgeons, the opinions of female surgeons must be respected. The Committee on Women Surgeons of the Japan Surgical Society (JSS) conducted two surveys 3 years apart of the numbers of female councilors and directors in the member societies of the Japanese Association of Medical Sciences. In the nonsurgical medical societies, although there was an increase in the number of female councilors, only one female director was named over the past 3 years. On the other hand, there were no female directors in any of the 12 surgical societies in 2011. The JSS was founded in 1899. No female surgeon has ever been elected as director and there are currently no female councilors due to the new election system. The Gender Equality Bureau of the Cabinet Office should therefore provide greater support to improve gender equality in Japan. PMID:23224261
Jadva, V.; Freeman, T.; Tranfield, E.; Golombok, S.
, when comparing gay 365 men seeking to have children via co-parenting, surrogacy and adoption arrangements, the 366 value of genetic connections in defining parent-child relationships was most clearly 367 expressed in the co-parenting group (Smietana...
Epstein, Yoram; Yanovich, Ran; Moran, Daniel S; Heled, Yuval
Anthropometric and physiological factors place the average female soldier at a disadvantage relative to male soldiers in most aspects of physical performance. Aerobic and anaerobic fitness levels are lower in women than in men. Thus, women have a lower overall work capacity and must therefore exert themselves more than men to achieve the same output. The lower weight and fat-free mass and the higher body fat of women are associated with lower muscle strength and endurance, placing them at disadvantage compared with men in carrying out military tasks such as lifting and carrying weights or marching with a load. Working at a higher percentage of their maximal capacity to achieve the same performance levels as men, women tire earlier and are at increased risk of overuse injuries. Their smaller size, different bone geometry and lower bone strength also predispose women to a higher incidence of stress fractures. Although training in gender-integrated groups narrows the gaps in fitness, significant differences between the genders after basic training still remain. Nevertheless, integration of women into military combat professions is feasible in many cases. Some 'close combat roles' will still be an exception, mainly because of the extreme physical demands that are required in those units that are beyond the physiological adaptability capacities of an average female. There is no direct evidence that women have a negative impact on combat effectiveness. Once the gender differences are acknowledged and operational doctrines adjusted accordingly, female soldiers in mixed-gender units can meet the physical standards for the assigned missions. PMID:23238928
Harris, John M., Jr.; Novalis-Marine, Cheryl; Harris, Robin B.
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,…
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.
Brewer, LaPrincess C.; Parker, Monica W.; Balls-Berry, Joyce E.; Halyard, Michele Y.; Pinn, Vivian W.; Radecki Breitkopf, Carmen
Abstract Objective: To examine perceptions and attitudes toward health-related research participation among professional African American women. Methods: Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. Results: A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, “Participation in research will mean better care,” 24% agreed “Participation in research is risky” and 3% agreed “Scientists cannot be trusted.” Fifty-two percent agreed with the statement, “Research conducted in the U.S. is ethical.” Mean ITP in research was 4.9±1.7 on a rating scale of 1 (“definitely no”) to 7 (“definitely yes”). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. Conclusion: Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types. PMID:25046058
Yu, Foo Qing; Murugiah, Muthu Kumar; Khan, Amer Hayat; Mehmood, Tahir
Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta- synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system. PMID:25640342
Pereira, Ana Rita; Vieira, Duarte Nuno; Magalhães, Teresa
Intimate partner violence (IPV) is an important cause of women's health and socio-familial severe problems, the most extreme being the victims' homicide. This is the first nationwide Portuguese autopsy-based and judicial-proven study about female intimate partner homicide. At least 62 women over 15 years old were killed by current or former men-intimate partners, corresponding to an IPV-related female mortality rate of 0.44/100.000 women; intimate partner violence was the reason of homicide in 60.8% of all autopsied women. The typical Portuguese victim showed to be a young adult woman, employed, killed by a current husband in a long-term relationship, usually with children in common and with a history of previous IPV. The typical Portuguese perpetrator showed to be older than the victim, employed, owning a firearm and without criminal records. At the time of the fatal event 59.7% of the relationships were current. In 57.9% of the former relationships women were killed during the 1st year after its terminus. Near half of the perpetrators attempted or committed suicide afterward. Most women were killed by gunshot wounds (45.2%), especially in the thorax (48.4%), with multiple fatal injuries; 56.5% also presented non-fatal injuries. The detection of prior IPV and the risk evaluation seems to be fundamental to decrease these fatal outcomes, but also, the prevention of perpetrators' alcohol abuse and carrying weapons. This work emphasizes the need to deepen the research on this issue, aiming to contribute to prevent both fatal and non-fatal IPV-related cases. PMID:24237830
Lang, Elvira V.; Berbaum, Kevin S.; Faintuch, Salomao; Hatsiopoulou, Olga; Halsey, Noami; Li, Xinyu; Berbaum, Michael L.; Laser, Eleanor; Baum, Janet
Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. 236 women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0–10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women’s anxiety increased significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = ?0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = ?0.27, p < 0.001). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management. PMID:16959427
Lawson, Sarah L.; Laughon, Kathryn; Gonzalez-Guarda, Rosa M.
Hispanics, Blacks, and women are disproportionately burdened by intimate partner violence. Barriers to seeking medical 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 seeking medical 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 seek medical 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 seek medical 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. PMID:23268315
Sinal, Sara; And Others
The results of a study on women physicians' timing of pregnancy are reported, with 70 percent of the respondents considered "after completion of residency" to be the best time to become pregnant. Only a third reported that their training or work sites had maternity leave policies. (Author/MLW)
Burns, Risa B; Potter, Jennifer E; Ricciotti, Hope A; Reynolds, Eileen E
Pelvic examinations have historically been a part of regular preventive care. However, because women can now be screened for cervical cancer at intervals up to every 5 years, the question of whether women need to be seen annually for routine pelvic examinations has arisen. In July 2014, the American College of Physicians (ACP) issued a guideline presenting the available evidence on screening for pathologic conditions using pelvic examination in adult, asymptomatic women at average risk. The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice had previously issued a committee opinion in August 2012 on the need for annual examinations and provided guidelines on important elements of this procedure, including when to examine asymptomatic women. ACOG reaffirmed its initial position after publication of the ACP guideline. The guidelines differ-the ACP guideline recommends against and the ACOG committee opinion recommends in favor of routine annual pelvic examination. This paper summarizes a discussion between an internist and a gynecologist on how they would balance these recommendations in general and what they would suggest for an individual patient. PMID:26436618
Comparison on information-seeking behavior of postgraduated students in Isfahan University of Medical Sciences and University of Isfahan in writing dissertation based on Kuhlthau model of information search process
Abedi, Mahnaz; Ashrafi-rizi, Hasan; Zare-Farashbandi, Firoozeh; Nouri, Rasoul; Hassanzadeh, Akbar
Introduction: Information-seeking behaviors have been one of the main focuses of researchers in order to identify and solve the problems users face in information recovery. The aim of this research is Comparative on Information-Seeking Behavior of the Postgraduate Students in Isfahan University of Medical Sciences and Isfahan University in Writing Dissertation based on Kuhlthau Model of Information Search Process in 2012. Materials and Methods: The research method followed is survey and the data collection tool is Narmenji questionnaire. Statistical population was all postgraduate students in Isfahan University of Medical Sciences and Isfahan University. The sample size was 196 people and sampling was stratified randomly. The type of statistical analyses were descriptive (mean and frequency) and inferential (independent t test and Pearson's correlation) and the software used was SPSS20. Results: The findings showed that Isfahan Medical Sciences University followed 20% of the order steps of this model and Isfahan University did not follow this model. In the first stage (Initiation) and sixth (Presentation) of feelings aspects and in actions (total stages) significant difference was found between students from the two universities. Between gender and fourth stage (Formulation) and the total score of feelings the Kuhlthau model there has a significant relationship. Also there was a significant and inverse relationship between the third stage (Exploration) of feelings and age of the students. Conclusion: The results showed that in writing dissertation there were some major differences in following up the Kuhlthau model between students of the two Universities. There are significant differences between some of the stages of feelings and actions of students’ information-seeking behavior from the two universities. There is a significant relationship between the fourth stage (Formulation) of feelings in the Kuhlthau Model with gender and third stage of the Feelings (Exploration) with age. PMID:25250354
Sussman, Andrew J; Otten, Jeffrey R; Goldszer, Robert C; Hanson, Margaret; Trull, David J; Paulus, Kenneth; Brown, Monte; Dzau, Victor; Brennan, Troyen A
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
Yu, Yon Sil
Ye Feng composed what was to become one of the most famous and widely-circulating medical works of the late imperial period, the Treatise on Easy Childbirth. Ye Feng proposed the idea of natural childbirth, When the correct moment for birth had arrived, the child would leave its mother's body as easily as "a ripe melon drops from the stem". He argued attempts to facilitate birth were therefore not only unnecessary, and female midwives artificial intervention was not required. However, this view is to overlook the pangs of childbirth, and women bear responsibility for the failure of delivery. So his views reflect the gender order in male-dominated. Also he constructed the negative image of the midwife and belittle her childbirth techniques. As a result, midwife are excluded from the childbirth field, male doctors grasp guardianship rights of the female body. Ye Feng declared that the key to safe and successful delivery could be summed up in just a few words: "sleep, endure the pain, delay approaching the birthing tub". This view must be consistent with the Confucian norms, women to export to equip the 'patience' and 'self-control'. These norms were exposed desire men want to monitor and control the female body, effect on consolidation of patriarchal family order. In sum, the discourse of "a ripe melon drops from the stem"and "sleep, endure the pain, delay approaching the birthing tub" comprised an important intellectual resource that male doctors drew on to legitimate themselves as superior overseers of women's gestational bodies. PMID:25985779
Janjua, Naveed Z; Mahmood, Bushra; Imran Khan, M
Injections with re-used syringes have been identified as a major risk factor for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Pakistan. We analyzed data from the 2006-2007 Pakistan Demographic Health Survey (PDHS) to describe the distribution of injections administered with newly opened syringes and assessed the association of knowledge about bloodborne pathogens with syringe reuse in Pakistan. In the PDHS, women aged 12-49 years were enrolled through a multistage stratified cluster-sampling strategy across Pakistan. Approximately 10,000 women were interviewed to collect information regarding receiving injections, the use of syringes taken out of new unopened packages for their last injections, and knowledge regarding the transmission of Human Immunodeficiency Virus (HIV), HBV and HCV through the re-use of syringes and transfusion of unscreened blood. Of the 5126/10,023 women who provided information concerning their last injection, 4342 (86%) received this injection with a new syringe taken out of an unopened package. The proportion of injections received with a new syringe increased with the education level, wealth, HIV knowledge and knowledge about HCV/HBV transmission through the re-use of syringes. In the multivariable model, respondents in the 4th (adjusted odds ratio (AOR): 2.1, 95%CI: 1.4-3.0) and 5th (AOR: 2.4, 95%CI: 1.6-3.5) wealth quintiles, with some education (AOR: 1.4, 95%CI: 1.1-1.9), those in the 4th quartile of the HIV knowledge score (AOR: 1.5, 95%CI: 1.1-2.0), and those with the knowledge that a new syringe protects against HCV/HBV and HIV (AOR: 2.3, 95%CI: 1.5-3.5) were more likely to receive injections with a newly opened syringe. The patients' knowledge regarding the transmission of bloodborne pathogens is an important factor in receiving injections with a new syringe. PMID:24861642
Labate, Beatriz Caiuby
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
Siddique, Juned; Chung, Joyce Y.; Brown, C. Hendricks; Miranda, Jeanne
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…
Heffron, Renee; Mugo, Nelly R.; Cohen, Craig R.; Hendrix, Craig W.; Celum, Connie; Bangsberg, David R.; Baeten, Jared M.
Introduction: Pre-exposure prophylaxis (PrEP) may be an important safer conception strategy for HIV-1–uninfected women with HIV-1–infected partners. Understanding medication adherence in this population may inform whether PrEP is a feasible safer conception strategy. Methods: We evaluated predictors of pregnancy and adherence to study medication among HIV-1–uninfected women enrolled in a randomized placebo-controlled trial of PrEP among African HIV-1–serodiscordant couples. Participants were counseled on HIV-1 risk reduction, contraception, and adherence and tested for pregnancy at monthly study visits. Pill counts of dispensed drug were performed and, at a subset of visits, plasma was collected to measure active drug concentration. Results: Among 1785 women, pregnancy incidence was 10.2 per 100 person-years. Younger age, not using contraception, having an additional sexual partner, and reporting unprotected sex were associated with increased likelihood of pregnancy. Monthly clinic pill counts estimated that women experiencing pregnancy took 97% of prescribed doses overall, with at least 80% pill adherence for 98% of study months, and no difference in adherence in the periconception period compared with previous periods (P = 0.98). Tenofovir was detected in plasma at 71% of visits where pregnancy was discovered. By multiple measures, adherence was similar for women experiencing and not experiencing pregnancy (P ? 0.1). Conclusions: In this clinical trial of PrEP, pregnancy incidence was 10% per year despite excellent access to effective contraception. Women experiencing pregnancy had high medication adherence, suggesting that PrEP may be an acceptable and feasible safer conception strategy for HIV-1–uninfected women with HIV-1–serodiscordant partners. PMID:25118795
Ravinetto, Raffaella M; Afolabi, Muhammed O; Okebe, Joseph; Van Nuil, Jennifer Ilo; Lutumba, Pascal; Mavoko, Hypolite Muhindo; Nahum, Alain; Tinto, Halidou; Addissie, Adamu; D'Alessandro, Umberto; Grietens, Koen Peeters
The freedom to consent to participate in medical research is a complex subject, particularly in socio-economically vulnerable communities, where numerous factors may limit the efficacy of the informed consent process. Informal consultation among members of the Switching the Poles Clinical Research Network coming from various sub-Saharan African countries, that is Burkina Faso, The Gambia, Rwanda, Ethiopia, the Democratic Republic of Congo (DRC) and Benin, seems to support the hypothesis that in socio-economical vulnerable communities with inadequate access to health care, the decision to participate in research is often taken irrespectively of the contents of the informed consent interview, and it is largely driven by the opportunity to access free or better quality care and other indirect benefits. Populations' vulnerability due to poverty and/or social exclusion should obviously not lead to exclusion from medical research, which is most often crucially needed to address their health problems. Nonetheless, to reduce the possibility of exploitation, there is the need to further investigate the complex links between socio-economical vulnerability, access to health care and individual freedom to decide on participation in medical research. This needs bringing together clinical researchers, social scientists and bioethicists in transdisciplinary collaborative research efforts that require the collective input from researchers, research sponsors and funders. PMID:25302444
Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, & Morahan, 2012). Additionally, Blacks and Hispanics are the two largest minority groups that are vastly underrepresented in medicine and biomedical research in the United States (AAMC, 2012; NSF, 2011). The purpose of this study is to examine specific barriers reported by students and post-degree professionals in the field through the following questions: 1. How do women who are either currently enrolled or graduated from biomedical research or medical programs define and make meaning of gender-roles as academic barriers? 2. How do underrepresented groups in medical schools and biomedical research institutions define and make meaning of the academic barriers they face and the challenges these barriers pose to their success as individuals in the program? These questions were qualitatively analyzed using 146 interviews from Project TrEMUR applying grounded theory. Reported gender-role barriers were explained using the "Condition-Process-Outcome" theoretical framework. About one-third of the females (across all three programs; majority White or Black between 25-35 years of age) reported gender-role barriers, mostly due to poor mentoring, time constraints, set expectations and institutional barriers. Certain barriers act as conditions, causing gender-role issues, and gender-role issues influence certain barriers that act as outcomes. Strategies to overcome barriers included interventions mostly at the institutional level (mentor support, proper specialty selection, selecting academia over medicine). Barrier analysis for the two largest URM groups indicated that, while Blacks most frequently reported racism, gender barriers, mentoring, and personal barriers, Hispanics most frequently reported economic barriers, language barriers, institutional and workplace environment barriers, and gender-role barriers. Examining barriers using the "Individual-Institutional" theoretical framework indicated that barriers do not occur in isolation, but due to an interaction between the individual and its institution. Additionally, the barriers of the two groups are qualitatively different and the "one size fits all" approach may not be suitable for interventions. Implications and recommendations were stated.
Hiranya S. Jayawickrama; Lisa H. Amir; Marie V. Pirotta
BACKGROUND: Many breastfeeding women seek medical care from general practitioners (GPs) for various health problems and GPs may consider prescribing medicines in these consultations. Prescribing medicines to a breastfeeding mother may lead to untimely cessation of breastfeeding or a breastfeeding mother may be denied medicines due to the possible risk to her infant, both of which may lead to unwanted
Erin C. Chong; Aqsa A. Khan; Jennifer T. Anger
Stress urinary incontinence (SUI) is a common medical problem affecting 25% to 50% of women in the United States.?This article\\u000a reviews the literature on the current systems- and population-based costs of management of SUI in women. A PubMed search was\\u000a conducted to seek studies examining the cost of various management options.?Both nonsurgical and surgical management can effectively\\u000a improve symptoms of
Johnson, Joy L; Oliffe, John L; Kelly, Mary T; Galdas, Paul; Ogrodniczuk, John S
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
Leal, Alexis D; Thompson, Carrie A; Wang, Alice H; Vierkant, Robert A; Habermann, Thomas M; Ross, Julie A; Mesa, Ruben A; Virnig, Beth A; Cerhan, James R
Classical myeloproliferative neoplasms (MPNs) are composed of essential thrombocythemia (ET), polycythemia vera (PV) and myelofibrosis (MF), the etiology of which is largely unknown. We investigated the role of anthropometric, medical and lifestyle factors with risk of MPN in a prospective cohort of 27,370 women aged 55-69 years at enrollment. After >250,000 person-years of follow-up, 257 cases of MPN were identified (172 ET, 64 PV, 21 MF). Risk factor profiles were mostly unique for the two most common types, ET and PV. ET was associated with energy balance factors including body mass index (RR = 1.52 for >29.3 vs. <23.4 kg/m(2) ; p-trend = 0.042), physical activity (RR = 0.66 for high vs. low; p-trend = 0.04) and adult onset diabetes (RR = 1.82; p = 0.009), while PV was not. PV was associated with current smoking (RR = 2.83; p-trend = 0.016), while ET was not. Regular use of aspirin was associated with lower risk of ET (RR = 0.68; p = 0.017). These results broadly held in multivariate models. Our results suggest distinct etiologies for these MPN subtypes and raise mechanistic hypotheses related to obesity-related inflammatory pathways for ET and smoking-related carcinogenic pathways for PV. Regular aspirin use may lower risk for ET. PMID:24114627
Holstad, Marcia McDonnell; DiIorio, Colleen; Kelley, Mary E.; Resnicow, Kenneth; Sharma, Sanjay
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. PMID:21165692
Morrison, Elizabeth Wolfe
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…
Wilson, Erin C; Chen, Yea-Hung; Arayasirikul, Sean; Wenzel, Conrad; Raymond, H Fisher
Findings on access to general healthcare for transgender people have emerged, but little is known about access to transition-related medical care for transwomen (i.e., hormones, breast augmentation, and genital surgery). Transgender women have low access to general medical care and are disproportionately at risk for substance use, mental illness, and HIV. We conducted an analysis to determine if utilization of transition-related medical care is a protective factor for health risks to transgender women and to investigate if care differs by important demographic factors and HIV status. A secondary analysis was conducted using data from a 2010 HIV surveillance study using respondent-driven sampling to recruit 314 transwomen in San Francisco. Survey-corrected logistic regression models were used to estimate odds ratios for six psychosocial health problems-binge drinking, injection drug use, anxiety, depression, suicidal ideation, and high-risk intercourse-comparing various levels of utilization of transition-related medical care. Odds ratios were also calculated to determine if utilization of transition-related medical care was related to less overlap of risk domains. We found that Latina and African American transwomen had significantly lower estimated utilization of breast augmentation and genital surgery, as did transwomen who identified as transgender rather than female. Overall, utilization of transition-related medical care was associated with significantly lower estimated odds of suicidal ideation, binge drinking, and non-injection drug use. Findings suggest that utilization of transition-related medical care may reduce risk for mental health problems, especially suicidal ideation, and substance use among transwomen. Yet, important racial/ethnic and gender identity disparities in utilization of transition-related medical care need to be addressed. PMID:25476958
The number of women in medicine has increased dra- matically in the last few decades, and women now repre- sent half of all incoming medical students. Yet residency training still resembles the historical model when there were few women in medicine. This article reviews the issues facing women in residency today. Data suggest that the experience of female residents is
Tan, Andy SL; Moldovan-Johnson, Mihaela; Gray, Stacy W; Hornik, Robert C; Armstrong, Katrina
Background Breast cancer surveillance is important for women with a known history of breast cancer. However, relatively little is known about the prevalence and determinants of adherence to surveillance procedures, including associations with seeking of cancer-related information from medical and nonmedical sources. Methods We conducted a longitudinal cohort study of breast cancer patients diagnosed in Pennsylvania in 2005. Our main analyses included 352 women who were eligible for surveillance and participated in both baseline (approximately one year after cancer diagnosis) and follow-up surveys. Outcomes were self-reported doctor visits and physical examination, mammography, and breast self-examination (BSE) at one-year follow-up. Results Most women underwent two or more physical examinations according to recommended guidelines (85%). For mammography, 56% of women were adherent (one mammogram in a year) while 39% reported possible over-utilization (two or more mammograms). About 60% of respondents reported regular BSE (five or more times in a year). Controlling for potential confounders, higher levels of cancer-related information seeking from nonmedical sources at baseline was associated with regular BSE (OR=1.52, 95% CI=1.01 to 2.29, p=0.046). There was no significant association between information seeking behaviors from medical or nonmedical sources and surveillance with physical examination or mammography. Conclusions Seeking cancer related information from nonmedical sources is associated with regular BSE, a surveillance behavior that is not consistently recommended by professional organizations. Impact Findings from this study will inform clinicians on the contribution of active information seeking toward breast cancer survivors’ adherence to different surveillance behaviors. PMID:23118144
Tower, Marion; Rowe, Jennifer; Wallis, Marianne
Domestic violence is a major public health issue that influences all aspects of affected women's lives (World Health Organisation, 2010). Women who are subjected to domestic violence seek help from a wide range of professionals within health and social care sectors, and evidence suggests that their experiences tend to be negative. We argue that current approaches are based on responses that are medically informed and provide an alternate lens from which to view women's health care needs. This paper reports on the findings of the second phase of a two-phase study. The first phase of the study reported on women's emerging health needs, efforts to seek help and experiences of seeking healthcare. The second phase examined how nurses constructed the health and health issues of women affected by domestic violence when women presented for health care. This paper brings together the findings of both phases to argue there is a disconnection in women's experiences and needs and how nurses construct needs and deliver care. Biographical disruption is a new lens from which to view women's experiences and is a framework which highlights how women experience significant dislocation of their sense of self as a result of domestic violence. PMID:23181373
Based on data gathered through a household survey of 1,474 urban residents in Beijing, this study examines Chinese help-seeking behaviors in times of psychological distress and perceived barriers to seeking professional help. The results demonstrate that most respondents rely on informal means of seeking help whereas mental health and medical…
Background Extended spectrum beta-lactamase producing bacteria (ESBL) are common causes of neonatal sepsis worldwide. Neonatal sepsis due to ESBL is associated with increased morbidity and mortality at Bugando Medical Centre (BMC). Due to limited information on the sources of these ESBL strains at BMC, this study was conducted to evaluate the existence, magnitude and transmission of ESBL from post-delivery women to neonates at BMC, Mwanza-Tanzania. Results A cross-sectional study was conducted at obstetrics and neonatal wards from May to July 2013, involving post-delivery women and their neonates. Rectal swabs were collected and processed to identify the ESBL strains and their antimicrobial susceptibility patterns. Patients’ data were obtained using a standardized data collection tool. We enrolled 113 women and 126 neonates with mean age of 26.5?±?5.5 years and median gestation age [IQR] of 39 [35–40] weeks respectively. The prevalence of ESBL carriage among women and neonates were 15% (17/113) and 25.4% (32/126) respectively. The acquisition of ESBL isolates among neonates on day 1, day 3 and day 7 were 60.0% (21/35), 25.7% (9/35) and 14.3% (5/35) respectively. There was no phenotypic similarity between ESBL strains from women and their respective neonates, suggesting other sources of transmission. Neonates given antibiotics were more likely to carry ESBL than those not given [100% (32/32) versus 86% (81/94), p?=?0.018]. Conclusion The carriage rate of ESBL strains among post-delivery women and neonates at BMC is high. Our findings suggest that neonates acquire these strains from sources other than post-delivery women and more than half acquire them on the first day of life. More studies are recommended to further explore the sources of ESBL strains among neonates. PMID:24886506
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.
Jean-pierre Cahier; L'hédi Zaher; Manuel Zacklad
Information Seeking gives users a wider range of access methods when retrieving business items (e.g. projects, products, skills, people, deliverables …) using (intra-) Web applications. The Information Seeking approach we propose is based on the concept of the \\
Blume, S B
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. PMID:3120219
Gronowski, Ann M; Schindler, Emily I
Many of the unique health issues facing women are related to reproductive health and pregnancy. However, several conditions that affect both sexes have distinct manifestations in women including cardiovascular disease, osteoporosis, and anemia. The extent of the effect that the physiological differences between men and women have on the natural course of these diseases and the validity of applying a standard treatment to both genders has not been fully explored. Historically, medical research has largely excluded women, rendering the application of evidence-based medicine to women's health issues somewhat of a misnomer. While most research in women's health originates from developed nations, consideration must be given to women in all regions of the world. Compared to women in developed nations, women in resource-poor countries are burdened with increased morbidity and mortality from gender-related health issues. In order to globally advance women's health, the physiologic and social differences between men and women must be more clearly characterized and these differences must be taken into consideration when designing research endeavors and developing health policy. PMID:25083885
Lupattelli, Angela; Spigset, Olav; Torgersen, Leila; Zerwas, Stephanie; Hatle, Marianne; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.; Nordeng, Hedvig
Introduction Little is known about medication use among women with eating disorders in relation to pregnancy. Aims To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0–6 months after pregnancy. Results The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5.00% BED (n = 3104). The highest over-time prevalence of psychotropic use was within the AN (3.7–22.2%) and EDNOS-P (3.3–9.8%) groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17–4.32). Having AN (adjusted RR: 5.11, 99% CI: 1.53–17.01) or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41–32.53) was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED) and laxatives (all eating disorders subtypes) were high at all time periods investigated. Conclusions Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum. PMID:26200658
Watkins, Joseph C.
THE MEDICAL PROFESSIONS Anthropology Professors Linda Green Mark Nichter Mimi Nichter Ivy Pike, and Household Economics ANTH 438A Women's Health in Global Perspective ANTH 444 Introduction to Medical medical and alternative medical professions Forensics Disaster Help #12;
As women approach midlife they become potential candidates for a range of health technologies. The study examined areas such as women's own assessments of the risks and benefits involved; the medical and informal knowledge ...
Rajaeieh, Golnaz; Marasi, Mohamadreza; Shahshahan, Zahra; Hassanbeigi, Fatemmeh; Safavi, Seied Morteza
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive women. Nearly 10% of young women in this period involved. Although factors such as Insulin Resistance, hyper insulinemia, obesity and dietary are suggested to be associated with PCOS, cause of PCOS is not completely understood. Dairy products (a key component of the usual diet) of participants can also affect the factors of this disease and may have beneficial effects on treatment of PCOS. However, research in this area is scarce. The purpose of this study was to evaluate the relationship between dairy products consumption and PCOS. Methods: This descriptive cross-sectional study of 400 women was conducted in Shahid Beheshti Hospital of Isfahan University of Medical Science, Iran. Dietary intake was evaluated by validated food frequency questionnaire. Other variables such as ovarian disease, inherited predisposition, age at menarche, physical activity and history of other diseases were evaluated using questionnaire. Data analysis was performed by a logistic regression test using SPSS software version 15 Predictive analytics software and solutions. Results: There were a significant association between PCOS and ovarian disease (P < 0.001), age (P < 0.001) and using medication (P = 0.001). Body mass index (BMI) was inversely associated with PCOS, but it was not significant (P = 0.068). There was a significant direct relationship between milk consumption and risk of PCOS after adjusting for confounding factors (P = 0.028). Conclusions: The findings of this study indicated that ovarian disease and medication use is directly linked to PCOS. Dairy consumption was not significantly correlated with PCOS. However, after adjustment for confounders, there was an direct relationship between milk consumption and risk of PCOS. PMID:25013687
If medical confidentiality is not observed patients may well be reluctant to disclose information to their doctors or even to seek medical 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. PMID:3981576
Dale, Sannisha; Cohen, Mardge; Weber, Kathleen; Cruise, Ruth; Kelso, Gwendolyn; Brody, Leslie
Abuse is highly prevalent among HIV+ women, leading to behaviors, including lower adherence to highly active antiretroviral therapy (HAART) that result in poor health outcomes. Resilience (functioning competently despite adversity) may buffer the negative effects of abuse. This study investigated how resilience interacted with abuse history in relation to HAART adherence, HIV viral load (VL), and CD4+ cell count among a convenience sample of 138 HIV+ women from the Ruth M. Rothstein CORE Center/Cook County Health and Hospital Systems site of the Women's Interagency HIV Study (WIHS). Resilience was measured by the 10-item Connor-Davidson Resilience Scale (CD-RISC). HAART adherence (?95% vs. <95% self reported usage of prescribed medication) and current or prior sexual, physical, or emotional/domestic abuse, were reported during structured interviews. HIV viral load (?20?vs. <20 copies/mL) and CD4+ count (200?vs. <200 cells/mm) were measured with blood specimens. Multiple logistic regressions, controlling for age, race, income, enrollment wave, substance use, and depressive symptoms, indicated that each unit increase in resilience was significantly associated with an increase in the odds of having ?95% HAART adherence and a decrease in the odds of having a detectable viral load. Resilience-Abuse interactions showed that only among HIV+ women with sexual abuse or multiple abuses did resilience significantly relate to an increase in the odds of ?95% HAART adherence. Interventions to improve coping strategies that promote resilience among HIV+ women may be beneficial for achieving higher HAART adherence and viral suppression. PMID:24568654
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
Blomberg, Marie; Birch Tyrberg, Rasmus; Kjølhede, Preben
Objectives To evaluate the associations between maternal age and obstetric and neonatal outcomes in primiparous women with emphasis on teenagers and older women. Design A population-based cohort study. Setting The Swedish Medical Birth Register. Participants Primiparous women with singleton births from 1992 through 2010 (N=798?674) were divided into seven age groups: <17?years, 17–19?years and an additional five 5-year classes. The reference group consisted of the women aged 25–29?years. Primary outcome Obstetric and neonatal outcome. Results The teenager groups had significantly more vaginal births (adjusted OR (aOR) 2.04 (1.79 to 2.32) and 1.95 (1.88 to 2.02) for age <17?years and 17–19?years, respectively); fewer caesarean sections (aOR 0.57 (0.48 to 0.67) and 0.55 (0.53 to 0.58)), and instrumental vaginal births (aOR 0.43 (0.36 to 0.52) and 0.50 (0.48 to 0.53)) compared with the reference group. The opposite was found among older women reaching a fourfold increased OR for caesarean section. The teenagers showed no increased risk of adverse neonatal outcome but presented an increased risk of prematurity <32?weeks (aOR 1.66 (1.10 to 2.51) and 1.20 (1.04 to 1.38)). Women with advancing age (?30?years) revealed significantly increased risk of prematurity, perineal lacerations, preeclampsia, abruption, placenta previa, postpartum haemorrhage and unfavourable neonatal outcomes compared with the reference group. Conclusions For clinicians counselling young women it is of importance to highlight the obstetrically positive consequences that fewer maternal complications and favourable neonatal outcomes are expected. The results imply that there is a need for individualising antenatal surveillance programmes and obstetric care based on age grouping in order to attempt to improve the outcomes in the age groups with less favourable obstetric and neonatal outcomes. Such changes in surveillance programmes and obstetric interventions need to be evaluated in further studies. PMID:25387756
McCauley, Jenna L; Amstadter, Ananda B; Danielson, Carla Kmett; Ruggiero, Kenneth J; Kilpatrick, Dean G; Resnick, Heidi S
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 3001 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. PMID:19375238
Stige, Signe Hjelen; Træen, Bente; Rosenvinge, Jan H
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
Miller, Stephania T.; Oates, Veronica J.; Brooks, Malinda A.; Shintani, Ayumi; Jenkins, Darlene M.
Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT) intervention, using motivational interviewing (MI). Research Design & Method. African American (AA) women with type 2 diabetes (T2D) participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24) were mostly of middle age (mean age 50.8 ± 6.3) with an average BMI of 39 ± 6.5. Compared to a gradual pre-intervention loss of HbA1c control and confidence in choosing restaurant foods, a significant post-intervention improvement in HbA1c (P = 0.03) and a near significant (P = 0.06) increase in confidence in choosing restaurant foods were observed with both returning to pre-intervention levels. 100% reported that they would recommend the study to other AA women with type 2 diabetes. Conclusion. The results support the potential efficacy of a group MNT/MI intervention in improving glycemic control and dietary self-care-related confidence in overweight/obese AA women with type 2 diabetes. PMID:25243082
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,…
Describes the hardships, harassments, psychological adjustments, and successes experienced by several women who have entered the traditionally male-dominated, skilled blue-collar workforce. Also included is a list of organizations and individuals who offer services to women seeking training and jobs in the construction industry. (BM)
Bennett, Nancy L.; Casebeer, Linda L.; Kristofco, Robert E.; Strasser, Sheryl M.
Introduction: Our understanding about the role of the Internet as a resource for physicians has improved in the past several years with reports of patterns for use and measures of impact on medical practice. The purpose of this study was to begin to shape a theory base for more fully describing physicians' information-seeking behaviors as they…
Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, &…
Background Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle. Methods/Design In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was decided to add a fourth non-randomized group, a PRCI Control group that received the PRCI and completed the questionnaires but did not complete daily monitoring. Discussion Positive reappraisal is one of the few ways of coping that has been shown to be associated with increased wellbeing during unpredictable and uncontrollable situations like medical waiting periods. A simple evidence based self-help intervention could facilitate coping during this common medical situation. This RCT study will evaluate the value of a self-help coping intervention designed for medical waiting periods in women undergoing fertility treatment. Trial registration The study is registered at the Clinical Tials.gov (NCT01701011). PMID:24004640
Harrow, Alison; Dryden, Ruth; McCowan, Colin; Radley, Andrew; Parsons, Mark; Thompson, Alastair M; Wells, Mary
Objective To explore women's experiences of taking adjuvant endocrine therapy as a treatment for breast cancer and how their beliefs about the purpose of the medication, side effects experienced and interactions with health professionals might influence adherence. Design Qualitative study using semistructured, one-to-one interviews. Setting 2 hospitals from a single health board in Scotland. Participants 30 women who had been prescribed tamoxifen or aromatase inhibitors (anastrozole or letrozole) and had been taking this medication for 1–5?years. Results Women clearly wished to take their adjuvant endocrine therapy medication as prescribed, believing that it offered them protection against breast cancer recurrence. However, some women missed tablets and did not recognise that this could reduce the efficacy of the treatment. Women did not perceive that healthcare professionals were routinely or systematically monitoring their adherence. Side effects were common and impacted greatly on the women’s quality of life but did not always cause women to stop taking their medication, or to seek advice about reducing the side effects they experienced. Few were offered the opportunity to discuss the impact of side effects or the potential options available. Conclusions Although most women in this study took adjuvant endocrine therapy as prescribed, many endured a range of side effects, often without seeking help. Advice, support and monitoring for adherence are not routinely offered in conventional follow-up settings. Women deserve more opportunity to discuss the pros, cons and impact of long-term adjuvant endocrine therapy. New service models are needed to support adherence, enhance quality of life and ultimately improve survival. These should ideally be community based, in order to promote self-management in the longer term. PMID:24928595
Cheng, Tyrone C; Lo, Celia C
Applying Aday and Andersen's health services utilization model, this examination of racial disparities in women's experience of intimate partner violence also looked at racial disparities in mental disorders and in use of mental health professionals' help. We conducted a secondary data analysis of 6,589 women completing the National Violence Against Women Survey. Per our linear regression results, minority women, versus White, tended proportionally to seek less help from mental health professionals. Help seeking by African American women was less likely if they were using illegal drugs; among Hispanic women, additional threats from partner curtailed help seeking from mental health professionals. "Other ethnic minority" women's help seeking decreased with their use of stimulants. Implications for intervention are discussed. PMID:25349016
Ängerud, Karin Hellström; Brulin, Christine; Eliasson, Mats; Näslund, Ulf; Hörnsten, Åsa
Background: People with diabetes have a higher risk for myocardial infarction (MI) than do people without diabetes. It is extremely important that patients with MI seek medical care as soon as possible after symptom onset because the shorter the time from symptom onset to treatment, the better the prognosis. Objective: The aim of this study was to explore how people with diabetes experience the onset of MI and how they decide to seek care. Methods: We interviewed 15 patients with diabetes, 7 men and 8 women, seeking care for MI. They were interviewed 1 to 5 days after their admission to hospital. Five of the participants had had a previous MI; 5 were being treated with insulin; 5, with a combination of insulin and oral antidiabetic agents; and 5, with oral agents only. Data were analyzed according to grounded theory. Results: The core category that emerged, “becoming ready to act,” incorporated the related categories of perceiving symptoms, becoming aware of illness, feeling endangered, and acting on illness experience. Our results suggest that responses in each of the categories affect the care-seeking process and could be barriers or facilitators in timely care-seeking. Many participants did not see themselves as susceptible to MI and MI was not expressed as a complication of diabetes. Conclusions: Patients with diabetes engaged in a complex care-seeking process, including several delaying barriers, when they experienced symptoms of an MI. Education for patients with diabetes should include discussions about their increased risk of MI, the range of individual variation in symptoms and onset of MI, and the best course of action when possible symptoms of MI occur. PMID:25325370
Lalos, A; Frankman, O; Jacobsson, L; von Schoultz, B
459 women seeking abortion answered a questionnaire about their motives, contraceptive methods and use, and their reasons for failing to use them. An additional 50 in-depth interviews were conducted to obtain a more detailed view of their relationship to partners, decision to seek abortion, and experience with contraceptives. Results indicated that 254 women (56%) admitted to not having used any contraception before getting pregnant, and 44% had used condoms. Socioeconomic factors were less important than geographical location for those seeking abortion. Those under 20 were most likely not to use contraceptives (67%), while only the 30-34 age group's usage pattern exceeded 50%. 174 women (38%) had had 1 or more previous abortions, while 11% had 3 or more. The rate of contraceptive use increased from 40% to 45% after abortion. Repeat abortions were typical for very fertile, sexually active women. Women who had harmonious relationships with their partners used contraceptives more extensively. 11 of 14 women who had problematic relationships had not used any contraception at the time the unwanted pregnancy occurred. Women with several partners tended to use contraceptives less -- a paradoxical finding. Women who made the decision about abortion alone were less likely to use contraception than those whose partners were also involved in the decision making. Only 37% of the women who were ambivalent about having a child in the future used contraception, evincing an unconscious desire to have children. Counseling after the abortion procedure combined with advice about contraception may help prevent repeat abortions. PMID:6621194
Auditoria médica: avaliação de alguns procedimentos inseridos no programa de atenção integral à saúde da mulher no posto de saúde da Vila Municipal, Pelotas, Rio Grande do Sul, Brasil Medical auditing: procedures assessment in the women's integral health care program in the Vila Municipal Health Clinic, Pelotas, Rio Grande do Sul, Brazil
Juvenal Soares Dias da Costa; Rafael Moura da Luz; Patricia Portantiolo Manzolli; Pedro Correa; Luis Fernando Recuero
This study is based on a medical audit of the Vila Municipal Health Clinic, Pelotas, Rio Grande do Sul. We collected data from family medical records in 1992, 1993, and 1994. The data concerned the Women's Integral Health Care Program. We collected information on age, vis- its for medical and non-medical reasons, blood pressure, breast examination, coverage of Pap smear
King, C R
During the 1800s, male physicians took over women's established sources of medical care and knowledge causing friction between women and their health matters and the rising medical profession. This conflict still exists today. Physicians provided little information on how to prevent pregnancy since to do so would interfere with their natural biologic function of motherhood. Reproduction no longer controlled women who used contraceptives, had an abortion, and those who supported such decisions. Since women had to actively terminate a pregnancy themselves or seek an abortionist, abortion posed a threat to the traditional male dominance of reproductive decisions. Even though no accurate data on the frequently of abortion existed, women often practice abortion in the absence of other means of fertility control. They even helped their fellow sisters by telling them what they can use to induce abortion. These women were often church-going women and well respected in their communities. During most of the century, the clergy did not condemn abortion. There were plenty of agents and materials available to induce abortion which were sometimes publicized as methods to regulate menstruation. Abortifacients included emmenagogues, purgatives, oxytocics, and herbal or botanical products. Yet many proprietary potions did not actually terminate pregnancies. Women often resorted to using sharp instruments, wax candles, penholders with attached wires, glass rods, hair curling tongues, sticks, spoons, knives, and catheters. Physicians during the 19th century did not have the diagnostics means to determine pregnancy so often women misled them so the physicians would perform medical interventions. In the mid-1800s, allopathic physicians strengthened their professional position by regulating physicians and forming the American Medical Association. This resulted in condemnation of abortionists and abortions. They blamed complications of abortion on women's reproductive decisions. The new political climate concerning abortion resulted in regulation of women and their sexuality. PMID:1628000
Examines historical and recent trends in the proportions of women accepted into medical school, women residents and specialists, women who are medical school faculty, and women who are medical school department chairs and deans. Compares the progress of men and women faculty. (LZ)
Low, E L; Whitaker, K L; Simon, A E; Sekhon, M; Waller, J
Objective To explore women's experiences of symptoms potentially indicative of gynaecological cancer in a community-based sample without imposing a cancer perspective. Design A qualitative interview study with thematic analysis of transcripts. Participants 26 women aged ?30?years, who had experienced a symptom that might indicate gynaecological cancer in the past 3?months, were recruited using a screening questionnaire distributed online and in community settings. Setting London, UK. Results Women attributed gynaecological symptoms to existing illnesses/conditions or considered themselves to be predisposed to them, either through their ‘genes’ or previous personal experience. Normalising symptoms by attributing them to demographic characteristics (eg, age, sex) was common, as was considering them a side effect of hormonal contraception. When women raised cancer as a possible cause, they often dismissed it as unlikely. Responses to symptoms included self-management (eg, self-medicating, making lifestyle changes), adopting a ‘lay system of care’, or consulting a healthcare professional. Triggers to help-seeking included persistent, painful or debilitating symptoms, concern about symptom seriousness, and feeling that help-seeking was legitimised. Barriers to help-seeking included lack of concern, vague symptoms, unusual symptom location, competing time demands, previous negative experiences with the healthcare system, and not wanting to be perceived as a time-waster. Conclusions Attributions of symptoms potentially indicative of a gynaecological cancer were varied, but most often involved women fitting symptoms into their expectations of what was ‘normal’. Normalising acted as a barrier to seeking help from a healthcare professional, alongside competing time demands and negative attitudes towards help-seeking. These barriers may lead to later diagnosis and poorer cancer survival. Our findings could be used to inform the development of interventions to encourage appropriate help-seeking. PMID:26150145
Anti-depressant treatment can be viewed as an exercise of biopower that is articulated through policies and practices aimed at the reduction of depression, population healthcare costs and effects on labour force productivity. Drawing upon a feminist governmentality perspective, this article examines the discourses that shaped women's experiences of anti-depressant medication in an Australian qualitative study on recovery from depression. The majority of women had been prescribed anti-depressants to treat a chemical imbalance in the brain, manage symptoms and restore normal functioning. One-third of participants identified anti-depressants as helpful in their recovery, while two-thirds were either highly ambivalent about, or critical of, medication as a solution to depression. Thirty-one women who identified the ;positive' benefits of anti-depressants actively constituted themselves as biomedical consumers seeking to redress a chemical imbalance. The problem of depression, the emergence of molecular science and the push for pharmacological solutions are contributing to the discursive formation of new subject positions - such as the neurochemically deficient self. Three themes were identified in relation to medication use, namely restoring normality, signifying recovery success and control/uncertainty. Anti-depressant medication offered women a normalized pathway to successful recovery that stood in stark contrast to the biologically deficient and morally failing self. These women's stories importantly reveal the gender relations and paradoxes arising from biopolitical technologies that shape selfhood for women in advanced liberal societies. PMID:19491233
Medical Evaluation of the Special Supplemental Food Program for Women, Infants and Children. Select Committee on Nutrition and Human Needs, United States Senate, Ninety-Fourth Congress, 2d Session. Committee Print.
Congress of the U.S., Washington, DC. Senate Select Committee on Nutrition and Human Needs.
This paper reports a medical evaluation of a federal program providing funds for special nutritious food supplements to low income pregnant and lactating women, infants, and children up to four years of age who are nutritional risks. Growth, dietary intake, and biochemical measures were obtained for study infants at the time of enrollment in the…
Highlights from the United States Food and Drug Administration's public workshop on the development of animal models of pregnancy to address medical countermeasures in an "at-risk" population of pregnant women: Influenza as a case study.
Williams, Denita; Basavarajappa, Mallikarjuna S; Rasmussen, Sonja A; Morris, Suzanne; Mattison, Donald
The U.S. Food and Drug Administration (FDA) and other federal agencies partner to ensure that medical countermeasures (e.g., drug therapies and vaccines) are available for public health emergencies (FDA, 2014). Despite continuing progress, providing medical countermeasures and treatment guidelines for certain populations (e.g., pregnant women) is challenging due to the lack of clinical and/or animal data. Thus, a workshop was convened to discuss animal models of pregnancy for the evaluation of disease progression and medical countermeasures. PMID:25296888
Markens, S; Browner, C H; Press, N
Most research on prenatal fetal testing in general, and maternal alpha-fetoprotein (AFP) screening in particular, has focused on women who accept and even actively seek prenatal diagnosis. Much of this work suggests that agreeing to prenatal diagnosis is inextricably linked to the processes associated with the 'medicalization' of reproduction and that most women do not see refusal as an option. In contrast, little attention has been paid to women who decline fetal diagnosis. Instead, it is generally assumed that women who do so are resisting this thrust toward medicalization and/or are opposed to abortion. Our research is designed to address this imbalance. We analyze how a group of US women who refused the offer of AFP screening account for their decisions and compare their explanations with those of women who took the test. Contrary to our expectations, we found that refusal did not signify rejection of and/or resistance to the offerings of science and technology. Rather, women who refused often employed biomedical categories, particularly the concept of 'risk', to reject its very offerings. Furthermore, refusers and acceptors were more alike than different in their views on abortion, medicalization and pregnancy. We conclude that the key difference between the two groups lies in their interpretation and application of biomedical concepts and modern risk-assessment. PMID:10414820
Powell-Jackson, Timothy; Acharya, Rajib; Filippi, Veronique; Ronsmans, Carine
Background Medical abortion (mifepristone and misoprostol) has the potential to contribute to reduced maternal mortality but little is known about the provision or quality of advice for medical abortion through the private retail sector. We examined the availability of medical abortion and the practices of pharmacists in India, where abortion has been legal since 1972. Methods We interviewed 591 pharmacists in 60 local markets in city, town and rural areas of Madhya Pradesh. One month later, we returned to 359 pharmacists with undercover patients who presented themselves unannounced as genuine customers seeking a medical abortion. Results Medical abortion was offered to undercover patients by 256 (71.3%) pharmacists and 24 different brands were identified. Two thirds (68.5%) of pharmacists stated that abortion was illegal in India. Only 106 (38.5%) pharmacists asked clients the timing of the last menstrual period and 38 (13.8%) requested to see a doctor’s prescription – a legal requirement in India. Only 59 (21.5%) pharmacists correctly advised patients on the gestational limit for medical abortion, 97 (35.3%) provided correct information on how many and when to take the tablets in a combination pack, and 78 (28.4%) gave accurate advice on where to seek care in case of complications. Advice on post-abortion family planning was almost nonexistent. Conclusions The retail market for medical abortion is extensive, but the quality of advice given to patients is poor. Although the contribution of medical abortion to women’s health in India is poorly understood, there is an urgent need to improve the practices of pharmacists selling medical abortion. PMID:25822656
Novak, Deanna L; Mather, Mara
The authors examined the influence of age on variety seeking in 3 experiments. When given choices among jellybeans or music, age differences in variety seeking emerged. Younger adults selected similar levels of variety when choosing what to consume immediately and what to consume later. In contrast, older adults consistently chose less variety when making choices to be consumed at a later time than when making choices to be consumed immediately. This pattern may be related to an increased focus on regulating future emotional experience that is associated with age. PMID:18179293
Lin, Shin-jeng; Belkin, Nicholas J.
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…
Osiobe, Stephen A.
Describes a study that examined the information seeking behavior of undergraduate students in Nigeria. The factors examined include the main sources of references to the literature used by students, and the effects of class standing and intellectual disciplines on choices of reference sources. (8 references) (CLB)
Budden, Lea M; Pierce, Penny F; Hayes, Barbara A; Buettner, Petra G
Women diagnosed with early breast cancer are now asked by their doctors to choose from a range of options for their preferred medical treatment plan. Little information is known about women's treatment decision-making and therefore nurses do not have evidence to guide this decision support. The aim of this descriptive survey was to investigate the prediagnostic decision-making behavior of a sample (N = 377) of Australian women, regarding their treatment choices for early breast cancer. The data were collected using the Pre-Decision Portfolio Questionnaire (PDPQ) by Pierce (1996), which includes the Michigan Assessment of Decision Styles (MADS). Of 366 participating women, 19.9% strongly agreed to all three items of the MADS factor Deferring Responsibility; 0.3% strongly agreed to all four factors of Avoidance; 32.7% strongly agreed on all four items of Information Seeking; and 63.4% strongly agreed to all five items of Deliberation. Women showed a variety of preferred decision styles, depending on age, education, occupation and employment status. Only 36% of women indicated it was critically important to "get the treatment over as soon as possible;" 55% to "participate in selecting treatment;" and 53% to "read a lot of information:" The understanding of factors that are important to women when they are making decisions for medical treatment is a mandatory step in designing customized evidence-based decision support, which can be delivered by nurses to help women during this distressing experience. PMID:12880217
Hecksher, Dorte; Hesse, Morten
Substance use disorders belong to the class of externalizing behaviours that are generally more common among men than women. Those women who do have substance disorders therefore deviate more from the norms of society compared with men, tend to live in an environment characterized by high risk of violence and other forms of abuse, and tend to be survivors of childhood trauma. In terms of seeking treatment, women often have difficulty acknowledging their problems with substance use disorders, and professionals are reluctant to ask women about drug or alcohol use. Even when they do seek treatment, women in many countries face practical and financial barriers to access treatment. For women who do enter treatment, outcomes are generally comparable to outcomes for men, suggesting that facilitating entry into treatment can yield substantial benefits for women with addictions. PMID:21836779
Otiashvili, David; Kirtadze, Irma; O’Grady, Kevin E.; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M.; Jones, Hendrée E.
Background In the Republic of Georgia, women comprise under 2% of patients in substance use treatment and to date there has been no empirical research to investigate what factors may facilitate or hinder their help-seeking behavior or access to treatment services. Methods This study included secondary analysis of in-depth interviews with 55 substance-using women and 34 providers of health-related services. Results The roles and norms of women in Georgian society were identified as major factors influencing their help-seeking behavior. Factors that had a negative impact on use of drug treatment services included an absence of gender-specific services, judgmental attitudes of service providers, the cost of treatment and a punitive legal position in regard to substance use. Having a substance-using partner served as an additional factor inhibiting a woman’s willingness to seek assistance. Conclusions Within the context of orthodox Georgian society, low self-esteem, combined with severe family and social stigma play a critical role in creating barriers to the use of both general health and substance-use-treatment services for women. Education of the public, including policy makers and health care providers is urgently needed to focus on addiction as a treatable medical illness. The need for more women-centered services is also critical to the provision of effective treatment for substance-using women. PMID:23756037
Growe, Roslin; Montgomery, Paula
The under-representation of qualified women in leadership positions has created a gender gap that exists not only in education but in many areas of the workplace. Society has determined that only males make good leaders; therefore it continues to deny easy access for women seeking leadership roles because they do not fit the norm. Women who seek…
Mullinax, Margo; Herbenick, Debby; Schick, Vanessa; Sanders, Stephanie A.; Reece, Michael
Research increasingly shows that genital attitudes have an impact on sexual well-being and health-seeking behaviours. This study explored what women and men like and dislike about women's genitals. Data are from open-ended items, part of a cross-sectional internet-based survey anonymously completed by 496 women and 198 men. Overall, both women and…
Cross, Catharine P.; Cyrenne, De-Laine M.; Brown, Gillian R.
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. PMID:23989235
Bardin, C W; Robbins, A; O'Connor, B M; Spitz, I
In 1996, an application was submitted to the US Food and Drug Administration for the use of mifepristone (RU-486) plus the prostaglandin misoprostol in medical abortion. Over 100,000 women in more than 20 countries have received this regimen, which results in pregnancy termination in 92.7-99.0% of treated women. This article presents state-of-the-art information on medical abortion. Reviewed are its pharmacokinetics and metabolism, mechanism of action, and history of use. The article outlines a standard protocol that includes RU-486 administration at the first visit (day 1), misoprostol administration at the second visit (day 3), and post-treatment examination at the third visit (days 14-20) and suggests counseling guidelines. It discusses the contraindications and potential complications of abortifacient agents. Finally, the article compares the experience in the US and Europe of medical versus surgical abortion in terms of effectiveness, complications, and acceptability. PMID:9174759
Diniz, Debora; Madeiro, Alberto
This paper analyzes the illegal trade in misoprostol, the medication predominantly used for abortion in Brazil. The study analyzed ten cases that came to the attention of the Public Prosecution Service for the Federal District between 2004 and 2010. The cases were organized into three categories: 1. women's stories; 2. profile of the vendors; 3. maternal mortality cases. The research was reviewed by an ethics committee. The main outcomes were: 1. young women in steady relationships use misoprostol in the home or with the assistance of drug vendors. Of the seven women indicted, three were reported on arrival at the public hospital to finalize abortion; 2. the drug vendors work at the community drugstore and are local agents for the sale of misoprostol. They instruct women on how to use the drug and how to prevent infections, but refuse to provide them with care in case of emergency. Traffickers operate via the internet and have a larger inventory of drugs; 3. there were two cases of maternal mortality due to the combination of high risk methods, such as a vaginal probe and misoprostol. The main causes for maternal mortality are the delay in seeking medical care, as the women fear criminal prosecution, and the combined use of misoprostol with high risk methods. PMID:22872341
Rivero-Méndez, Marta; Dawson-Rose, Carol S.; Solís-Báez, Solymar S.
This study examines healthcare providers’ perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers’ accounts revealed that women with HIV infection are living “beyond their strengths” attempting to reconcile the burden of the illness and keep adherent. Factors putting women beyond their strengths and influencing non-adherence behavior were: gender-related demands, fear of disclosure, and treatment complexity. Strategies to improve adherence included: ongoing assessment, education, collaborative work, support groups, networking, disguising pills, readiness, and seeking medications outside their towns. Provider-patient interactions are critical for women’s success and must assess all these factors in developing and providing health services. PMID:21243076
Hotz, Kendra G
This essay offers a theological exploration of the relationship between medical fatalism and religious belonging among African-American women in Memphis. Drawing on the work of black and womanist theologians and on conversations with participants in a diabetes intervention program administered by a faith-based community health provider, I argue that how we narrate the meanings of our bodies is irreducibly religious. The language we use to interpret and communicate the meaning of our bodily existence emerges from a set of assumptions, often unarticulated, about what is of ultimate value to us. The essay focuses on three interlocking features that link faith with fatalism or hope: (1) The idea that if "I don't claim that" disease cannot enter my body; (2) the role of faith-based clinics in re-establishing trust with marginalized communities; and (3) how nuanced attention to the social location of health seekers can re-frame our understanding of patient compliance. Disrupting fatalism can only be done from within a health seeker's own narrative, and therefore, healthcare providers who learn these narratives and respect their holiness will develop more effective interventions. PMID:25338304
A special report from the United Nations Development Fund for Women's (UNIFEM) program on Women and International Trade, Trade Liberalisation and Women seeks to explain how trade liberalisation, defined as the "process of systematically reducing and eventually eliminating all tariff and non-tariff barriers between countries as trading partners," is affecting the women of the world. The site explains how, as economies compete with each other, global liberalisation will drive down the working wages and working conditions of countries, thus affecting female workers. As well as this situational analysis, the site also includes extensive databases of related links, research, and books; UNIFEM's research into the subject of women and trade; and a list of organizations users can contact if they are interested in persuing issues related to women and trade liberalisation.
An important goal of nursing research in women's health is to develop knowledge and identify interventions that strive to promote, maintain, and enhance well-beingfor women. A new emphasis on the quality of life, health promotion, and cost-effective delivery modes has opened the door to nontraditional approachesfor a myriad of disease conditions. As women look to their healthcare providers for information regarding treatments for uncomfortable menopausal symptomatology, inconclusive and contradictory information has added to the confusion concerning hormone replacement therapy (HRT). A woman who has declined traditional treatments for menopausal symptomatology may resort to alternative therapies to meet her healthcare needs. As alternative therapies can be wide-ranging, the woman may seek information from healthcare providers regarding these therapies. Sensitivity to the woman's expressed concerns and knowledge of various traditional and alternative treatment modalities is essential in providing individualized wholistic care. This article reviews the literature and concludes care of perimenopausal/menopausal women who decline, traditional hormone replacement therapy for uncomfortable menopausal symptomatology and seek alternative treatments has received insufficient attention by the medical and nursing profession. PMID:16116767
Bottorff, J. L.; Balneaves, L. G.; Buxton, J.; Ratner, P. A.; McCullum, M.; Chalmers, K.; Hack, T.
OBJECTIVE: To describe experiences of women seeking information about their risk of hereditary breast cancer who fail to meet strict eligibility criteria for genetic counseling and testing. DESIGN: Qualitative descriptive study. SETTING: Hereditary cancer program in western Canada. PARTICIPANTS: Women who had received notification of their ineligibility for referral for hereditary breast cancer risk assessment (n = 20) and some of their referring physicians (n = 10). Of 28 attempted contacts, five women had moved, one declined the invitation to participate, and two could not be interviewed because of scheduling conflicts. Ten of 20 physicians declined the invitation to participate. METHOD: In-depth, open-ended telephone interviews were conducted. Transcribed interviews were systematically analyzed to identify salient themes. MAIN FINDINGS: Three themes emerged. The first theme, "It's always on your mind," points to the profound concern about breast cancer that underlies women's experiences in seeking genetic testing. The second theme, "A test is a test," reflects women's beliefs that the test was relatively simple and similar to other medical tests in that it would provide a definitive answer. The third theme, "Falling through the cracks," captures the experience of ineligibility. Women reacted with a range of emotional responses and were left frustrated in their search for more specific information about their personal risk for breast cancer. Although women were encouraged to contact their physicians, few did. CONCLUSION: These findings point to the psychological consequences in women who seek genetic testing for risk of breast cancer when they are told they are ineligible and they are not given adequate information and support. PMID:10925759
BATTLE, CYNTHIA L.; SALISBURY, AMY L.; SCHOFIELD, CASEY A.; ORTIZ-HERNANDEZ, SAMIA
Perinatal depression is prevalent and linked with a host of adverse consequences for women and newborns. Rates of engagement in depression treatment are, however, strikingly low among pregnant and postpartum women, with the majority of affected women receiving no mental health treatment. Research indicates that perinatal women are extremely reluctant to take antidepressant medications, yet the nature of women’s concerns and treatment decisionmaking patterns have not been well documented. Developing a clearer understanding of women’s treatment preferences and behaviors may help identify solutions to the under-treatment of perinatal depression. In this mixed methods study, we conducted in-depth interviews with 61 pregnant women, approximately half of whom were experiencing clinical levels of depression. In addition to assessing psychiatric diagnoses, symptoms, and functional impairment, we conducted qualitative interviews addressing women’s preferences for depression treatment, concerns, and decision-making patterns. Consistent with prior reports, women were significantly more likely to voice a preference for non-pharmacologic depression treatments, as opposed to antidepressant medications. Many depressed women reported a great degree of uncertainty regarding how to treat their depression, and those with more severe depression symptoms were more likely to endorse decisional conflict. Analysis of qualitative comments yielded detailed information about the nature of women’s concerns and preferences related to use of antidepressant medications and other aspects of treatment engagement. We discuss findings in the context of improving patient-centered care for perinatal depression. PMID:24241498
Pérez-Zepeda, Mario Ulises; Arango-Lopera, Victoria Eugenia; Wagner, Fernando A.; Gallo, Joseph J.; Sánchez-García, Sergio; Juárez-Cedillo, Teresa; García-Peña, Carmen
Objective Depression in the elderly is associated with multiple adverse outcomes, such as high health service utilization rates, low pharmacological compliance, and synergistic interactions with other comorbidities. Moreover, the help seeking process, which usually starts with the feeling “that something is wrong” and ends with appropriate medical care, is influenced by several factors. The aim of this study was to explore factors associated with the pathway of help seeking among older adults with depressive symptoms. Methods A cross-sectional study of 60-year or older of community dwelling elderly belonging to the largest health and social security system in Mexico was done. A standardized interview explored the process of seeking health care in four dimensions: depressive symptoms, help seeking, help acquisition and specialized mental health. Results A total of 2,322 individuals were studied; from these, 67.14% (n=1,559) were women, and the mean age was 73.18 years (SD=7.02) 57.9% had symptoms of depression, 337 (25.1%) participants sought help, and 271 (80.4%) received help and 103 (38%) received specialized mental health care. In the stepwise model for not seeking help (?2=81.66, p<0.0001), significant variables were female gender (OR=0.07 95% CI 0.511–0.958 p=0.026), health care use (OR 3.26 CI 95% 1.64–6.488, p=0.001). Number of years in school, difficulty in activities, SAST score and depression as a disease belief were also significant. Conclusions Appropriate mental health care is rather complex and is influenced by several factors. The main factors associated with help seeking were gender, education level, recent health service use, and the belief that depression is not a disease. Detection of subjects with these characteristics could improve care of elderly with depressive symptoms. PMID:23585359
Association of American Colleges, Washington, DC. Project on the Status and Education of Women.
This document lists in alphabetical order the addresses, phone numbers, subgroup titles (if applicable), and the names and addresses of directors/ chairpersons of professional women's organizations. An asterisk indicates whether or not a group offers services in the areas of employment opportunities, such as a roster of women for employees seeking…
Kapoor, Garima; Salhan, Sudha; Sarda, Nivedita; Aggarwal, Deepika
The aim of this study is to compare the effectiveness of 100 mg versus 200 mg mifepristone along with misoprostol for medical abortion in gestation upto 56 days. This is a prospective controlled study. Eighty women seeking medical abortion with a gestation up to 56 days were included in the study. The women were randomly allotted into two groups. They received 100 mg/200 mg mifepristone on day 1 followed by 800 mcg misoprostol two days later. Women who had not aborted completely by day 14, received a repeat dose of 400 mcg misoprostol and were evaluated on day 21 for completeness of the procedure. Five women in both the groups had incomplete abortion by day 14 (12.5%), while one woman in the test group had to undergo dilatation and evacuation on day 3 due to excessive bleeding. By repeating a second dose of misoprostol, all of them aborted completely and the complete abortion rates were markedly improved from 85% and 87.5% in the test and the control group, respectively to 97.5% and 100%, respectively. It may be concluded that 100 mg mifepristone is as effective as 200 mg and appears to be the lowest effective dose for medical abortion. PMID:25935963
Nathan (Robert R.) Associates, Inc., Washington, DC.
This manual is intended to encourage policy makers, administrators, and personnel officers in hospitals and other health facilities to recruit and hire the thousands of well-trained, experienced men and women who leave the military medical services each year. The document lists the advantages to the medical institution when employing medically…
Seeking Explanations: Abduction in Logic, Philosophy of Science and Artifical Intelligence Atocha AlisedaLLera #12; Seeking Explanations: Abduction in Logic, Philosophy of Science and Artificalmail: firstname.lastname@example.org #12; SEEKING EXPLANATIONS: ABDUCTION IN LOGIC, PHILOSOPHY OF SCIENCE AND ARTIFICIAL
The author argues that the college textbook market provides a clear example of monopoly seeking as described by Tullock (1967, 1980). This behavior is also known as rent seeking. Because this market is important to students, this example of rent seeking will be of particular interest to them. (Contains 24 notes.)
Puustinen, Minna; Kokkonen, Marja; Tolvanen, Asko; Pulkkinen, Lea
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…
Is Earth unique in the universe? What is a habitable planet? How abundant are habitable planets? NASA's Kepler Mission team seeks answers to these questions. Launching in 2009, Kepler is NASA's 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 "Earth and Space Sciences" and "Science as Inquiry." 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.
Murdoch, Maureen; Bradley, Arlene; Mather, Susan H; Klein, Robert E; Turner, Carole L; Yano, Elizabeth M
Most of today's 1.7 million women veterans obtain all or most of their medical care outside the VA health care system, where their veteran status is rarely recognized or acknowledged. Several aspects of women's military service have been associated with adverse psychologic and physical outcomes, and failure to assess women's veteran status, their deployment status, and military trauma history could delay identifying or treating such conditions. Yet few clinicians know of women's military history—or of military service's impact on women's subsequent health and well being. Because an individual's military service may be best understood within the historical context in which it occurred, we provide a focused historical overview of women's military contributions and their steady integration into the Armed Forces since the War for Independence. We then describe some of the medical and psychiatric conditions associated with military service. PMID:16637946
Ganatra, Bela; Sorhaindo, Annik; Karver, Tahilin S; Seuc, Armando; Villalobos, Aremis; García, Sandra G; Pérez, Martha; Bousieguez, Manuel; Sanhueza, Patricio
Abstract Objective To examine the effectiveness, safety, and acceptability of nurse provision of early medical abortion compared to physicians at three facilities in Mexico City. Methods We conducted a randomized non-inferiority trial on the provision of medical abortion and contraceptive counselling by physicians or nurses. The participants were pregnant women seeking abortion at a gestational duration of 70 days or less. The medical abortion regimen was 200 mg of oral mifepristone taken on-site followed by 800 ?g of misoprostol self–administered buccally at home 24 hours later. Women were instructed to return to the clinic for follow-up 7–15 days later. We did an intention-to-treat analysis for risk differences between physicians’ and nurses’ provision for completion and the need for surgical intervention. Findings Of 1017 eligible women, 884 women were included in the intention-to-treat analysis, 450 in the physician-provision arm and 434 in the nurse-provision arm. Women who completed medical abortion, without the need for surgical intervention, were 98.4% (443/450) for physicians’ provision and 97.9% (425/434) for nurses’ provision. The risk difference between the group was 0.5% (95% confidence interval, CI: ?1.2% to 2.3%). There were no differences between providers for examined gestational duration or women’s contraceptive method uptake. Both types of providers were rated by the women as highly acceptable. Conclusion Nurses’ provision of medical abortion is as safe, acceptable and effective as provision by physicians in this setting. Authorizing nurses to provide medical abortion can help to meet the demand for safe abortion services. PMID:26229189
Chandra, Prabha S; Kommu, John Vijay Sagar; Rudhran, Vidyendran
Women and children with psychotic disorders in developing countries may be vulnerable and have considerable social disadvantages. Gender disadvantage has implications for all health outcomes including mental illnesses. In the more relevant gender-related context we discuss several important issues which affect women with schizophrenia, namely stigma, caregiver burden, functional outcome, marriage, victimization and help-seeking. The findings indicate that there are variations in clinical and functional outcomes and age of onset of illness between different regions. Drug side effects, such as metabolic syndrome appear to be quite common, adding to disease burden in women from developing countries. Victimization and coercion may contribute to poor quality of life and health concerns such as STIs and HIV. Stigma among women with schizophrenia appears to play a major role in help-seeking, caregiver burden and issues such as marriage and parenting. Gender-sensitive care and practices are few and not well documented. Research in the area of psychoses in children and adolescents from LAMI countries is sparse and is mainly restricted to a few clinic-based studies. More research is needed on organic and medical factors contributing to childhood psychoses, pathways to care, help-seeking, and impact of early detection and community care. PMID:23057983
Scholz, Nelle Tumlin; And Others
Designed to meet the changing needs of women by increasing their decision-making ability, this book provides practical exercises and activities which develop and clarify decision-making skills. In addition, it seeks to develop a broader concept of women's roles and emerging life patterns, to awaken women to the spectrum of new possibilities…
The struggle for sex equity by U.S. academic women in higher education during the early years of the women's movement, based on the experiences of 470 academic women, is addressed in a book suitable for sociology courses. All aspects of the academic employment process are covered, including acquiring degrees, job seeking, promotion, salary,…
Girard, Kathryn L.
This paper presents some of the findings of a survey of feminists seeking to answer three basic questions about women's education. The questions guiding the research were: (1) What do feminist women perceive as important aspects of an education for women which promotes the development of their potentials? (2) What aspects of their schooling…
Meyers, Steven D.
MEDICAL OR PSYCHOLOGICAL EMERGENCY Ambulatory Patient (Students): Medical assistance can) with a physician is available for urgent medical concerns. Faculty and Staff can seek medical assistance If the individual needing assistance is not ambulatory, call 911 to request assistance from Emergency Medical
Bipolar affective disorder in women is a challenging disorder to treat. It is unique in its presentation in women and characterized by later age of onset, seasonality, atypical presentation, and a higher degree of mixed episodes. Medical and psychiatric co-morbidity adversely affects recovery from the bipolar disorder (BD) more often in women. Co-morbidity, particularly thyroid disease, migraine, obesity, and anxiety disorders occur more frequently in women while substance use disorders are more common in men. Treatment of women during pregnancy and lactation is challenging. Pregnancy neither protects nor exacerbates BD, and many women require continuation of medication during the pregnancy. The postpartum period is a time of high risk for onset and recurrence of BD in women. Prophylaxis with mood stabilizers might be needed. Individualized risk/benefits assessments of pregnant and postpartum women with BD are required to promote the health of the women and to avoid or limit exposure of the fetus or infant to potential adverse effects of medication. PMID:26330643
Amy K. Taylor; Sharon Larson; Rosaly Correa-de-Araujo
This study examines women's use and expenditures for medical care in the US. In 2000, 91% of women aged 18 years and older used any form of health care services. Overall, 82% of adult women reported an ambulatory care visit, and 11% had an inpatient hospital stay. Mean expense per person with expenses was $3219 for that year. We examined
Brazil has among the highest cesarean section rates in the world, with 36% of women in the country delivering surgically. Women, especially those who deliver in private hospitals with cesarean rates in the 80-90% range, are often portrayed as actively choosing to deliver surgically. Doctors typically promote this view, also common in the popular understanding of the phenomenon, that it is women's demand for a cesarean that is behind the high rates. Academic analyses tend to present a more balanced view with doctors' motives for wanting to perform cesareans included alongside descriptions of women's motives for the procedures. What is typically missing from such analyses is a discussion of the power differences between women and doctors. Doctors clearly have more decision-making power in the hospital birthing situation, and their medical expertise and authority is often marshaled to convince a woman to "choose" a cesarean. Using data collected from a postpartum survey, participant observation in hospital obstetrics wards, and in-depth interviews. I offer evidence which refutes many of the hypotheses associated with why women might prefer to deliver by cesarean. I also show that the majority of women surveyed in two cities in Brazil, particularly first-time mothers, do not seek to deliver by cesarean. Through an analysis of conversations between doctors and women during labor and delivery, and through women's narratives of their delivery experiences, I also show some of the mechanisms that doctors use in order to induce so-called demand for surgical delivery and argue that they are very active participants in the ongoing construction of the culture of cesarean section in Brazil. PMID:10975232
SYMED, Inc., developed a unique electronic medical records and information management system. The S2000 Medical Interactive Care System (MICS) incorporates both a comprehensive and interactive medical care support capability and an extensive array of digital medical reference materials in either text or high resolution graphic form. The system was designed, in cooperation with NASA, to improve the effectiveness and efficiency of physician practices. The S2000 is a MS (Microsoft) Windows based software product which combines electronic forms, medical documents, records management, and features a comprehensive medical information system for medical diagnostic support and treatment. SYMED, Inc. offers access to its medical systems to all companies seeking competitive advantages.
Reid, Inez Smith
Black women in the United States experience a high incidence of serious health problems and, as a group, receive insufficient and inadequate medical care. The death rate for black women suffering from breast cancer has increased substantially since 1950. Also of great concern is the high incidence of cervical cancer in low income black women…
Huong, Nguyen My; Gammeltoft, Tine; Rasch, Vibeke
This paper presents selected findings from a larger study on reproductive tract infections (RTIs) among women seeking abortion in Northern Vietnam. In particular it focuses on women's experience of RTIs within the context of their perceptions of female physiology and what women do to prevent and treat RTIs. The approach used was a combination of the quantitative and the qualitative: 748 structured interviews were undertaken before, and 701 after, abortion; and in-depth interviews were carried out with 20 women and 20 healthcare providers. Both healthcare providers and women believed that RTIs are an essential and normal part of womanhood. Reproductive tract infections were associated with laziness, being unclean and hesitance in using health facilities for help with gynecological problems. Women used various forms of self-treatment, including some that may be medically harmful. Women's preventive and treatment strategies were often supported and sometimes even promoted by healthcare providers. We assess women's strategies for RTI prevention and treatment in the context of the current Vietnamese health system and from a gender perspective. These strategies highlight inadequacies in the public healthcare system, while also pointing to important cultural paradoxes in the understanding of womanhood in contemporary Vietnam. PMID:18446557
Minna Puustinen; Marja Kokkonen; Asko Tolvanen; Lea Pulkkinen
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 needed. Impulsivity was analyzed using the Hyperactivity–Impulsivity Scale
Levison, Sandra P.; Straumanis, Joan
Describes how the Fund for the Improvement of Postsecondary Education (FIPSE) has played a central role in sponsoring innovations in the medical and health sciences, including landmark medical projects to integrate women's health issues into the medical curriculum and to use lay people in the teaching and evaluating of medical students. (EV)
Riters, Lauren V.
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
Animal communication abounds with extravagant displays. These signals are usually interpreted as costly signals of quality. However, there is another important function for these signals: to call the attention of the receiver to the signaller. While there is abundant empirical evidence to show the importance of this stage, it is not yet incorporated into standard signalling theory. Here I investigate a general model of signalling - based on a basic action-response game - that incorporates this searching stage. I show that giving attention-seeking displays and searching for them can be an ESS. This is a very general result and holds regardless whether only the high quality signallers or both high and low types give them. These signals need not be costly at the equilibrium and they need not be honest signals of any quality, as their function is not to signal quality but simply to call the attention of the potential receivers. These kind of displays are probably more common than their current weight in the literature would suggest. PMID:26287489
An Integrated Web-Based Mental Health Intervention of Assessment-Referral-Care to Reduce Stress, Anxiety, and Depression in Hospitalized Pregnant Women With Medically High-Risk Pregnancies: A Feasibility Study Protocol of Hospital-Based Implementation
Janes-Kelley, Selikke; Tyrrell, Janie; Clark, Lorna; Hamza, Deena; Holmes, Penny; Parkes, Cheryl; Moyo, Nomagugu; McDonald, Sheila; Austin, Marie-Paule
Background At prevalence rates of up to 40%, rates of depression and anxiety among women with medically complex pregnancies are 3 times greater than those in community-based samples of pregnant women. However, mental health care is not a component of routine hospital-based antenatal care for medically high-risk pregnant women. Objective The purpose of this study is to evaluate the effectiveness and feasibility of the hospital-based implementation of a Web-based integrated mental health intervention comprising psychosocial assessment, referral, and cognitive behavioral therapy (CBT) for antenatal inpatients. Methods This study is a quasi-experimental design. Pregnant women are eligible to participate if they are (1) <37 weeks gestation, (2) admitted to the antenatal inpatient unit for >72 hours, (3) able to speak and read English or be willing to use a translation service to assist with completion of the questionnaires and intervention, (4) able to complete follow-up email questionnaires, (5) >16 years of age, and (6) not actively suicidal. Women admitted to the unit for induction (eg, <72-hour length of stay) are excluded. A minimum sample of 54 women will be recruited from the antenatal high-risk unit of a large, urban tertiary care hospital. All women will complete a Web-based psychosocial assessment and 6 Web-based CBT modules. Results of the psychosocial assessment will be used by a Web-based clinical decision support system to generate a clinical risk score and clinician prompts to provide recommendations for the best treatment and referral options. The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6-8 weeks postrecruitment. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence at 3-months postpartum; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. All women will complete email questionnaires at 6-8 weeks postrecruitment and 3-months postpartum. Qualitative interviews with 10-15 health care providers and 15-30 women will provide data on feasibility and acceptability of the intervention. Results The study was funded in September, 2014 and ethics was approved in November, 2014. Subject recruitment will begin January, 2015 and results are expected in December, 2015. Results of this study will determine (1) the effectiveness of an integrated Web-based prenatal mental health intervention on maternal and infant outcomes and (2) the feasibility of implementation of the intervention on a high-risk antenatal unit. Conclusions This study will provide evidence and guidance regarding the implementation of a Web-based mental health program into routine hospital-based care for women with medically high-risk pregnancies. PMID:25595167
Karamanis, Georgios; Skalkidou, Alkistis; Tsakonas, Georgios; Brandt, Lena; Ekbom, Anders; Ekselius, Lisa; Papadopoulos, Fotios C
Caloric restriction in animals is an effective way to reduce carcinogenesis. Anorexia nervosa (AN) is considered a model of extreme caloric restriction in humans. The aim of our study was to assess cancer incidence and mortality in women with AN. A total of 6,009 women with at least one inpatient treatment for AN during the period 1973-2003 were included in the study. Standardized incidence ratios (SIR) and standardized mortality ratios (SMR) were calculated. Overall, there was no statistically significant difference in cancer incidence compared to women in the general population. At a statistically significant or borderline significant level, a higher incidence for lung cancer and cancer of lymphoid, hematopoietic and related tissue was observed along with a reduced breast cancer incidence. Women with AN had twice as high mortality from cancer in general, and more specifically from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites. The increased lung cancer incidence may be due to smoking habits among women with AN. The worse prognosis with higher mortality from melanoma, cancers of genital organs and cancers of ill-defined, secondary and unspecified sites may be explained by AN-specific attitudes toward seeking medical care, adherence to treatment or worse biological precondition due to starvation and cachexia. PMID:24114497
Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Glozier, Nicholas; Saini, Bandana
Timely access to appropriate treatment is important for optimizing insomnia management. To date, little is known about insomnia patients' treatment experiences or how they access and engage with the available health care resources. This study sought to capture the help-seeking experiences and behavioral patterns of patients with insomnia who are seeking or receiving specialist care. A purposive sample of 26 insomnia patients from specialist sleep and mental health clinics located in metropolitan New South Wales, Australia was recruited. Participants completed a brief questionnaire, followed by an in-depth, semi-structured interview. Interviews were digitally recorded, transcribed verbatim, and analyzed using framework analysis. Three key themes emerged from the data: patients' sleep beliefs, treatment beliefs, and accessing specialized care. The findings show that daytime symptoms arising from insomnia serve as important illness cues for patients to seek medical help. In addition, participants' treatment pathways highlight factors that prevent the widespread use of cognitive behavioral therapy for insomnia (CBT-I), including limited awareness about CBT-I, tentative referral mechanisms, limited service providers, and the high cost of CBT-I. PMID:23514322
Fu, Wai-Tat; Gray, Wayne D.
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…
Meredith Ringel Morris; Gene Golovchinsky; Jeremy Pickens
Although most digital information-seeking tools are designed for solo use, studies have shown that groups of many types (e.g., students, families, and knowledge workers) have shared information needs that are not adequately served by status quo technologies. This workshop seeks to bring together researchers with backgrounds in CSCW, social computing, information retrieval, library sciences, and HCI to discuss the research
George Buchanan; Sally Jo Cunningham; Ann Blandford; Jon Rimmer; Claire Warwick
This paper investigates the information seeking of humanities academics and scholars using digital libraries. It furthers existing work by updating our knowledge of the information seeking techniques used by humanities scholars, where the current work predates the wide availability of the Internet. We also report some of the patterns observed in query and term usage by humanities scholars, and relate
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…
Assessment of completion of early medical abortion using a text questionnaire on mobile phones compared to a self-administered paper questionnaire among women attending four clinics, Cape Town, South Africa.
Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon
In-clinic follow-up to assess completion of medical abortion is no longer a requirement according to World Health Organization guidance, provided adequate counselling is given. However, timely recognition of ongoing pregnancy, complications or incomplete abortion, which require treatment, is important. As part of a larger trial, this study aimed to establish whether women having a medical abortion could self-assess whether their abortion was complete using an automated, interactive questionnaire on their mobile phones. All 469 participants received standard abortion care and all returnees filled in a self-assessment on paper at clinic follow-up 2-3 weeks later. The 234 women allocated to receive the phone messages were also asked to do a mobile phone assessment at home ten days post-misoprostol. Completion of the mobile assessment was tracked by computer and all completed assessments, paper and mobile, were compared to providers' assessments at clinic follow-up. Of the 226 women able to access the mobile phone assessment, 176 (78%) completed it; 161 of them (93%) reported it was easy to do so. Neither mobile nor paper self-assessments predicted all cases needing additional treatment at follow-up. Prediction of complete procedures was good; 71% of mobile assessments and 91% of paper assessments were accurate. We conclude that an interactive questionnaire assessing completion of medical abortion on mobile phones is feasible in the South African setting; however, it should be done later than day 10 and combined with an appropriate pregnancy test to accurately detect incomplete procedures. PMID:25702072
... need to take medication. THE HEART TRUTH® FOR AFRICAN AMERICAN WOMEN: AN ACTION PLAN One good eating plan, ... Learn More.” High Blood Cholesterol. Nearly half of black women have a total cholesterol that’s too high. ...
Novick, Gina; Sadler, Lois S.; Kennedy, Holly Powell; Cohen, Sally S.; Groce, Nora E.; Knafl, Kathleen A.
Group prenatal care (GPNC) is an innovative alternative to individual prenatal care. In this longitudinal study we used ethnographic methods to explore African American and Hispanic women’s experiences of receiving GPNC in two urban clinics. Methods included individual, in-depth, semistructured interviews of women and group leaders in GPNC, participant observation of GPNC sessions, and medical record review. GPNC offered positive experiences and met many of the women’s expressed preferences regarding prenatal care. Six themes were identified, which represented separate aspects of women’s experiences: investment, collaborative venture, a social gathering, relationships with boundaries, learning in the group, and changing self. Taken together, the themes conveyed the overall experience of GPNC. Women were especially enthusiastic about learning in groups, about their relationships with group leaders, and about having their pregnancy-related changes and fears normalized. There were also important boundaries on relationships between participants, and some women wished for greater privacy during physical examinations. PMID:20693516
This information Web site, established and maintained by the Women's Law Initiative (WLI), is an online resource that provides legal information to women and girls living with or escaping domestic violence. Seeking to "empower women and girls to lead independent and productive lives, free from abuse," this site offers step-by-step instructions on filing for and obtaining restraining orders in all 50 US states and Washington, DC. Also, the site contains "plain language translations" of domestic violence statutes, as well as online links to counseling services, shelters, legal assistance, downloadable court documents, locations of courthouses and sheriffs' offices for filing forms and serving court papers, and legislation news regarding domestic violence. The site is not only a valuable resource for women who experience domestic abuse, but also a handy guide for the people who help them.
Background Despite the increased attention on maternal mortality during recent decades, which has resulted in maternal health being defined as a Millennium Development Goal (MDG), the disability and suffering from obstetric fistula remains a neglected issue in global health. Continuous leaking of urine and the physical, emotional and social suffering associated with it, has a profound impact on women's quality of life. This study seeks to explore the physical, cultural and psychological dimensions of living with obstetric fistula, and demonstrate how these experiences shape the identities of women affected by the condition. Methods A cross-sectional study with qualitative and quantitative components was used to explore the experiences of Tanzanian women living with obstetric fistula and those of their husbands. The study was conducted at the Comprehensive Community Based Rehabilitation Tanzania hospital in Dar es Salaam, Bugando Medical Centre in Mwanza, and Mpwapwa district, in Dodoma region. Conveniently selected samples of 16 women were interviewed, and 151 additional women responded to a questionnaire. In addition, 12 women affected by obstetric fistula and six husbands of these affected women participated in a focus group discussions. Data were analysed using content data analysis framework and statistical package for the social sciences (SPSS) version 15 for Microsoft windows. Results The study revealed a deep sense of loss. Loss of body control, loss of the social roles as women and wives, loss of integration in social life, and loss of dignity and self-worth were located at the core of these experiences. Conclusion The women living with obstetric fistula experience a deep sense of loss that had negative impact on their identity and quality of life. Acknowledging affected women's real-life experiences is important in order to understand the occurrence and management of obstetric fistula, as well as prospects after treatment. This knowledge will help to improve women's sense of self-worth and maintain their identity as women, wives, friends and community members. Educational programmes to empower women socially and economically and counselling of families of women living with obstetric fistula may help these women receive medical and social support that is necessary. PMID:22082132
It is natural for humans to collaborate while dealing with complex problems. In this article I consider this process of collaboration in the context of information seeking. The study and discussion presented here are driven by two dissatisfactions: (1) the majority of IR systems today do not facilitate collaboration directly, and (2) the concept of collaboration itself is not well-understood. I begin by probing the notion of collaboration and propose a model that helps us understand the requirements for a successful collaboration. A model of a Collaborative Information Seeking (CIS) environment is then rendered based on an extended model of information seeking.
Blank, Arthur E; Fletcher, Jason; Verdecias, Niko; Garcia, Iliana; Blackstock, Oni; Cunningham, Chinazo
Access to sustained HIV medical care is critical to achieving viral suppression. However, a variety of factors may impede or facilitate retention in care or becoming virally suppressed. Though retention and suppression are often treated separately, this study examined both in a cohort of 921 HIV+ women of color who participated in eight demonstration programs across the US. For women who met the inclusion criteria, 83% (n = 587) were retained and 73% (n = 357) were virally suppressed. Average age of women retained was 40.9, and 41.9 for those virally suppressed. The majority were African American/Black or Hispanic/Latina, single, and had no children less than 18 years of age, had health insurance, a high school degree or higher, were stably housed, and unemployed. Some factors associated with retention in care were indecision about seeking HIV medical care (AOR = 0.42) and having children under the age of 18 (AOR = 0.59). Some factors associated with being virally suppressed were living with others (AOR = 0.58), current substance abuse (AOR = 0.38), and fair/poor health (AOR = 0.40). The findings suggest different processes and social mechanisms may influence retention and viral suppression. Interventions seeking to improve retention in care may require tailored program components and strategies that focus on improving viral suppression. PMID:25458205
Morgan-Haker, Veronica R.
Changes in the role of the physician in today's society have made their career choices risky. Career specialists have an opportunity to assist those who do not normally seek career advice outside their own profession. (JOW)
Timothy Koschmann; Gerry Stahl
Information seeking is typically situated within an interpersonal and problem-solving context. We have examined the process by which a group of medical students engages in collaborative information seeking within a pedagogy known as Problem- Based Learning (PBL). Here, the identity of learning issues (LIs) persists through successive phases of recognition, researching, reporting, and reflection. These explicit learning issues help to
70-90% of Africans still live in rural areas, and 25-30% of rural households are headed by women. Standards of living in rural areas are lower than in urban areas. Rural African women's involvement in development is in its initial stages, and social development for women is likely to be slow. Increasing women's opportunities for education is a means of promoting social justice and fairness. Schools should offer courses of practical value for those not planning on higher education and special programs and career counseling for gifted girls. Women's organizations, African leaders, and other influential parties should aggressively create awareness about the oppressive aspects of traditional attitudes, beliefs, and views about women. Laws on ownership of property, inheritance, access to credit, and employment must be equitable and enforced. Consciousness-raising among rural women is an effective means of encouraging rural women to seek and assume new roles and for questioning unreasonable expectations and norms. Women's professional associations serve important functions and fulfill the need for role models. The quality of rural women's life is effectively improved through formulation of policies relevant to women's needs and problems and improve rural conditions. Women should have fair representation at local and national levels of government. Women's role in agriculture is likely to be enhanced through improved transportation systems, electricity supply, and introduction of intermediate technology. This assessment of rural African women's contributions to economic growth emphasizes women's involvement in farming and the informal sector and their lack of equal remuneration or low wages. Illiteracy places women in a disadvantaged position when competing for employment in the formal sector. Lack of access to credit and limits on credit are other obstacles in the informal sector. The reduced participation of rural women in the formal and informal sector is due to lack of economic power, limited educational opportunities, and policies that place industry in urban areas. Social development that reduces illiteracy and poverty should be encouraged. PMID:12346826
... Dietary Supplements Medical Conditions, Allergies, and Food Intolerances Food Safety For More Information Adults Men and Women Moms/ ... Dietary Supplements Medical Conditions, Allergies, and Food Intolerances Food Safety Older Adults Children Students Professionals Multiple Languages MyPlate ...
Lukas, Scott E.; Penetar, David; Su, Zhaohui; Geaghan, Thomas; Maywalt, Melissa; Tracy, Michael; Rodolico, John; Palmer, Christopher; Ma, Zhongze; Lee, David Y.-W.
OBJECTIVE We previously demonstrated that short-term treatment with a standardized kudzu extract (NPI-031) reduced alcohol drinking by men and women in a natural setting. The present study was conducted in non treatment-seeking heavy drinkers to assess the safety and efficacy of four weeks of kudzu extract in an outpatient setting. METHOD This randomized between-subject, double-blind, placebo-controlled study involved two weeks of baseline, four weeks of treatment and two weeks of follow-up. Seventeen men (21–33 years) who reported drinking 27.6 ± 6.5 drinks/week with a diagnosis of alcohol abuse/dependence took either kudzu extract (250 mg isoflavones, t.i.d.) or matched placebo on a daily basis. They reported alcohol consumption and desire to use alcohol using a wrist actigraphy device; twice weekly laboratory visits were scheduled to monitor medication adherence and adverse events. RESULTS Medication adherence was excellent and there were no adverse events, changes in vital signs, blood chemistry, renal or liver function. There was no effect on alcohol craving, but kudzu extract significantly reduced the number of drinks consumed each week by 34–57%, reduced the number of heavy drinking days and significantly increased the percent of days abstinent and the number of consecutive days of abstinence. CONCLUSIONS A standardized formulation of kudzu extract produced minimal side effects, was well-tolerated and resulted in a modest reduction in alcohol consumption in young non treatment-seeking heavy drinkers. Additional studies using treatment-seeking alcohol-dependent persons will be necessary to determine the usefulness of this herbal preparation in reducing alcohol use in other populations. PMID:23070022
Lucea, Marguerite B; Stockman, Jamila K; Mana-Ay, Margarita; Bertrand, Desiree; Callwood, Gloria B; Coverston, Catherine R; Campbell, Doris W; Campbell, Jacquelyn C
Many victims of intimate partner violence (IPV) do not access services. Education and severity of physical violence have previously been shown to predict resource utilization, but whether these hold true specifically among women of African descent is unknown. This article furthers our understanding of the relationship between IPV and resource use, considering sociodemographics and aspects of IPV by presenting results from a study conducted with African American and African Caribbean women in Baltimore, Maryland, and the U.S. Virgin Islands. Of the 545 women included in this analysis, 95 (18%) reported emotional abuse only, 274 (50%) reported experiencing physical abuse only, and 176 (32%) had experienced both physical and sexual abuse by an intimate partner. Resource utilization was relatively low among these women, with only 57% seeking any help. Among those who did, 13% sought medical, 18% DV, 37% community, and 41% criminal justice resources. Generalized linear model results indicated that older age and severe risk for lethality from IPV and PTSD were predictive of certain types of resource use, while education, insurance status, and depression had no influence. Perceived availability of police and shelter resources varied by site. Results suggest that systems that facilitate resource redress for all abused women are essential, particularly attending to younger clients who are less likely to seek help, while building awareness that women accessing resources may be at severe risk for lethality from the violence and may also be experiencing mental health complications. In addition, greater efforts should be made on the community level to raise awareness among women of available resources. PMID:23295377
Stockman, Jamila K.; Mana-Ay, Margarita; Bertrand, Desiree; Callwood, Gloria B.; Coverston, Catherine R.; Campbell, Doris W.; Campbell, Jacquelyn C.
Many victims of intimate partner violence (IPV) do not access services. Education and severity of physical violence have previously been shown to predict resource utilization, but whether these hold true specifically among women of African descent is unknown. This paper furthers our understanding of the relationship between IPV and resource use, considering socio-demographics and aspects of IPV by presenting results from a study conducted with African American and African Caribbean women in Baltimore, Maryland and the U.S. Virgin Islands. Of the 545 women included in this analysis, 95 (18%) reported emotional abuse only, 274 (50%) reported experiencing physical abuse only, and 176 (32%) had experienced both physical and sexual abuse by an intimate partner. Resource utilization was relatively low among these women, with only 57% seeking any help. Among those who did, 13% sought medical, 18% DV, 37% community and 41% criminal justice resources. Generalized linear model results indicated that older age, severe risk for lethality from IPV and PTSD were predictive of certain types of resource use, while education, insurance status, and depression had no influence. Perceived availability of police and shelter resources varied by site. Results suggest that systems that facilitate resource redress for all abused women are essential, particularly attending to younger clients who are less likely to seek help, while building awareness that women accessing resources may be at severe risk for lethality from the violence and may also be experiencing mental health complications. In addition, greater efforts should be made on the community level to raise awareness among women of available resources. PMID:23295377
Objective The impact of postmenopausal vaginal atrophy and women's coping strategies were evaluated through international focus groups. Methods Three-hour focus groups of three to five postmenopausal women who had symptoms of vaginal atrophy but had not sought treatment were conducted in Canada, Sweden, the United States, and the United Kingdom. Participants were asked about their experience with menopause and vaginal atrophy, including use of non-prescription treatments and their interactions with health-care providers. Women were classified as one of five personality types, based on their interaction with the world (individualism or belonging) and strategies for coping with stress (control or liberation). Results Vaginal atrophy was not recognized as a medical condition by focus group participants, and women had not used treatments for vaginal atrophy apart from non-prescription lubricants. Women who had discussed vaginal atrophy symptoms with their doctor felt their concerns were dismissed as a normal part of aging, and they did not receive counseling about treatment options such as low-dose estrogen therapy. Those whose coping strategy involved dominance, combatting, or individualism were more likely to seek treatment than those whose strategy involved submission, acceptance, or belonging. Women who used control to cope with menopausal changes were more likely to respond to information validated by perceived experts than were those who used a strategy of release. Conclusions Women's reactions to their vaginal atrophy varied according to personality. Use of a personality-based approach to patient counseling may encourage patients to discuss vaginal atrophy with their health-care provider and seek treatment. PMID:24083795
Amar, Angela Frederick; Sutherland, Melissa; Laughon, Kathryn; Bess, Renee; Stockbridge, Jennifer
While partner violence and sexual assault are public health concerns affecting college women, most young women do not seek help after the experience. Limited research explores the interpersonal context of help seeking related to violence in young women. The overall purpose of this research was to understand peer factors within a campus culture associated with seeking help in response to violence within a campus environment. Eight focus groups were held with 64 participants representing a broad spectrum of diversity in race and ethnicity. Narrative analysis was the primary method of analysis. Three themes emerged from the data: victim blaming, fear of direct response, and the alcohol factor. The young women's stories demonstrate the effects of friends and campus culture on perceptions of violence and abuse and help seeking. Findings suggest that peers and the social norms of the campus environment influence help-seeking behavior. An understanding of interpersonal level determinants of help seeking is essential for clinically relevant and effective prevention efforts. Nurse practitioners in campus health settings can use this research to guide assessment, intervention, and prevention strategies. PMID:23061163
Hamel, L; Oberle, K
Cardiovascular disease is the leading cause of death of both men and women in Canada and the United States. The medical and societal emphasis on the occurrence of cardiovascular disease in men has resulted in an inclination to minimize its existence and severity in women. The purpose of this article is to assist clinical nurse specialists in cardiovascular risk-screening of women by providing a review of cardiovascular risk factors specific to women. Current knowledge about lipids, hypertension, diabetes, smoking, menopause, obesity, sedentary lifestyle, stress, and multiple roles are discussed. The clinical presentation for women and the clinical implications are presented. Lastly, implications for future research are described. PMID:9060255
Ainsbury, Liz; Heaney, Libby; Hodges, Vicki; Harkness, Laura; Russell, Laura
In 2007, the Women in Physics Group of the Institute of Physics initiated the Very Early Career Woman Physicist of the Year Award. The award seeks to recognise the outstanding achievements of women physicists who are embarking on a career in physics and to promote the career opportunities open to people with physics qualifications. The prize is…
Aboagye, Emmanuel; Agyemang, Otuo Serebour
This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities. PMID:23985108
Beisecker, Analee E.; And Others
Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…
Prevalence of human herpes virus-8 and hepatitis B virus among HIV seropositive pregnant women enrolled in the Mother-to-Child HIV Transmission Prevention Program at Saint Camille Medical Centre in Burkina Faso.
Ilboudo, Denise; Karou, Damintoti; Nadembega, Wendyame M C; Savadogo, Aly; Djeneba, Ouermi; Pignatelli, Salvatore; Pietra, Virginio; Bere, Augustin; Simpore, Jacques; Traore, Alfred S
The aims of this research are: i) to evaluate the prevalence of HHV-8, HBV and HIV among pregnant women, ii) to determine the percentage of these co-infections and iii) to estimate the frequency of the mother-to-child transmission of HIV among HBV and HHV-8 positive mothers. Thus, 379 pregnant women attending ante-natal consultation in Saint Camille Medical Centre were subject to HIV, HHV-8 antibodies and the viral marker Hepatitis B Surface Antigen (HBsAg) detection. We observed 48/379 (12.66%) HIV seropositive subjects. Among them, HIV-1 type infection was predominant (95.83%), only 2/48 (4.17%) subjects had a dual HIV-1 type and HIV-2 type infection, no single HIV-2 type infection was detected. 38/379 (10.02%) subjects were infected by HHV-8 and 30/379 (7.91%) were HBsAg positive. HHV-8 and HIV Co-infections rates were high within HBV positive patients and we had respectively 20.00 and 16.67%. 10.42% HIV positive women were coinfected by HBV while 12.50% were infected by HHV-8. Then, 15.79% subjects HHV-8 positive were co-infected by HBV or HIV. In spite of the PMTCT protocol application, five (10.42%) HIV positive women transmitted the virus to their children. Two HIV positive mothers were co-infected by HHV-8 and one by HBV. Among the 5 HIV infected, one mother (20.0%) was HBV positive and two (40.0%) HHV-8 positive. Although we did not have a large sample which would show large prélalences of the infections, we could put forward that the Co-infection of the HIV with one of these viruses (HBV or HHV-8) could favorite the mother-to-child transmission. PMID:19090184
Background Studies in K-12 and college students show that their learning preferences have been strongly shaped by new media technologies like video games, virtual reality environments, the Internet, and social networks. However, there is no known research on medical students' game experiences or attitudes towards new media technologies in medical education. This investigation seeks to elucidate medical student experiences and attitudes, to see whether they warrant the development of new media teaching methods in medicine. Methods Medical students from two American universities participated. An anonymous, 30-item, cross-sectional survey addressed demographics, game play experience and attitudes on using new media technologies in medical education. Statistical analysis identified: 1) demographic characteristics; 2) differences between the two universities; 3) how video game play differs across gender, age, degree program and familiarity with computers; and 4) characteristics of students who play most frequently. Results 217 medical students participated. About half were female (53%). Respondents liked the idea of using technology to enhance healthcare education (98%), felt that education should make better use of new media technologies (96%), and believed that video games can have educational value (80%). A majority (77%) would use a multiplayer online healthcare simulation on their own time, provided that it helped them to accomplish an important goal. Men and women agreed that they were most inclined to use multiplayer simulations if they were fun (97%), and if they helped to develop skill in patient interactions (90%). However, there was significant gender dissonance over types of favorite games, the educational value of video games, and the desire to participate in games that realistically replicated the experience of clinical practice. Conclusions Overall, medical student respondents, including many who do not play video games, held highly favorable views about the use of video games and related new media technology in medical education. Significant gender differences in game play experience and attitudes may represent male video game design bias that stresses male cognitive aptitudes; medical educators hoping to create serious games that will appeal to both men and women must avoid this. PMID:20576125
Genuis, Shelagh K
In this article I use Social Positioning Theory to explore the experiences of women as they interact with and make sense of evolving health information mediated by formal and informal sources. I investigate how women position themselves within their accounts of information seeking, and the influence of positioning on interactions with health professionals (HPs). Interviewed women gathered and valued information from a range of sources, and were likely to position themselves as autonomous, rather than collaborative or dependent. Faced with evolving health information, women felt responsible not only for information seeking, but also for making sense of gathered and encountered information. Participants did, however, value information provided by HPs and were likely to view decision making as collaborative when HPs fostered information exchange, appeared to appreciate different types of knowledge and cognitive authority, and supported women in their quests for information. Implications for shared decision making are discussed. PMID:23427080
McLemore, Monica; Levi, Amy
In its first issue in 1972, JOGNN published a review article reporting surveillance data about abortions in the United States (Bourne, Kahn, Conger, & Tyler, 1972). This historical article predated Roe v. Wade, the U.S. Supreme Court decision legalizing abortion. Since this landmark decision, numerous articles have addressed nurses' role in abortion care. We review current literature on nurses and abortion care and use thematic categories to highlight areas of investigation. PMID:22273447
Julie M. Albright
This was an exploratory study of sex and relationship seeking on the Internet, based on a survey of 15,246 respondents in the United States Seventy-five percent of men and 41% of women had intentionally viewed or downloaded porn. Men and gays\\/lesbians were more likely to access porn or engage in other sex-seeking behaviors online compared with straights or women. A
Al-Natour, Sahar H
The media-fuelled obsession with beauty in modern society has led more women to seek elective cosmetic procedures to meet the portrayed ideals of beauty in different cultures. This study gives insights into incentives and desires to undergo cosmetic procedures in a conservative society with strict religious practices where women are veiled. Questionnaire data were obtained from 509 Saudi women who responded to a survey distributed randomly to a sample of Saudi women aged 17 to 72 years. At least 1 elective cosmetic procedure was performed in 42% of the women, of whom 77.8% wore a veil. Another 33% considered having a procedure. The motives for seeking a cosmetic procedure were to improve self-esteem in 83.7%, attract a husband in 63.3%, or prevent a husband from seeking another wife in 36.2%. The decision to seek a procedure was affected by the media, with high peer influence. Motivation for elective cosmetic procedures in Saudi women is influenced by a combination of emotional and cultural factors, level of education, marital status, and religious beliefs. The veil is not an impediment for seeking such procedures. The limitation of the study was missing data analysis as some items in the questionnaire were completed inaccurately or left unanswered. PMID:25134311
Al-Hinai, Saleh S.; Al-Busaidi, Ahmed S.; Al-Busaidi, Ibrahim H.
Objectives: This study aimed to understand why people seek medical advice abroad given the trouble and expense this entails. The types of medical problems for which treatment abroad was sought, preferred destinations and satisfaction with the treatment were explored. A secondary aim was to give feedback to stakeholders in the health care system on how to handle this issue and meet the needs of the community. Methods: 45 patients who had recently travelled abroad for treatment were asked to complete a questionnaire or were interviewed by telephone. Results: 40 questionnaires were received. 68% of the respondents were male. Orthopaedic diseases were the most common conditions leading patients to seek treatment abroad. Thailand was the most popular destination followed by India (50% and 30% respectively). 85% of respondents went abroad for treatment only, 10% for treatment and tourism and 2.5% were healthy, but travelled abroad for a checkup. Interestingly, 15% of the participants went abroad without first seeking medical care locally. Out of those initially treated in Oman, 38.2% had no specific diagnosis and 38.2% had received treatment, but it was not effective. 73% of respondents obtained information on treatment abroad from a friend. The Internet and medical tourism offices were the least used sources of information. 15% of the patients experienced complications after their treatment abroad. Conclusion: Various facts about medical treatment abroad need to be disseminated to the public. This will necessitate greater effort in public health promotion and education. PMID:22087396
It is estimated that 80% of the people involved in grassroots environmental protection advocacy in the US are women. One such self-described "average" woman became an activist upon learning that her drinking water was contaminated with uranium leaking from a US Department of Energy (DOE) facility. When DOE officials tried to brush off her concerns and those of her neighbors at a hearing, she presented them with a jar of water from her kitchen tap and challenged them to drink it. They refused. Thus began a long, but ultimately successful, struggle to shut down the offending facility. The efforts of these US women are mirrored all over the world as women have embraced environmental justice as one of their causes. At recent UN conferences, activists have challenged conventional strategies of economic development as being incompatible with equity and environmental sustainability. They have also established that "women's rights are human rights" and added domestic violence and rape to the human rights agenda. The recent International Conference on Population and Development revolved around women's health and rights issues. Throughout the world, women activists have challenged and changed the social dynamics of families, households, communities, and societies in general. One reason for the increased success of women's groups is that they have adopted the tactics of mass communication, including the use of computers, radio, and film. Although the various efforts are arising from diverse circumstances, they have some things in common such as finding personal experience to be a major impetus for action, realizing the self-reinforcing empowering nature of advocacy work, breaking the silence surrounding culturally taboo topics, and challenging the status quo. Such challenges often lead to political backlash or to counter measures taken by fundamentalist religious groups who link improvements in women's status with societal ills. Despite these challenges, the global women's movement continues to grow and to seek democracy and social justice. PMID:12290007
Hubbard, Ruth E; Rockwood, Kenneth
It is a truth universally acknowledged that although men tend to have better health in old age, women live longer lives. Here, we briefly review the biological, social and behavioural factors that may contribute to women's greater longevity. We consider in particular factors that might result in a greater frailty burden in women, focusing on frailty being measured by a Frailty Index. The Frailty Index represents the burden of health deficits, expressed for an individual as the proportion of deficits present - from 0 (no deficits) to 1.0 (the theoretical maximum, if all deficits were expressed). A greater frailty burden in women might first represent a male "fitness-frailty pleiotropy", resulting in men having lower physiological reserves in old age so that health deficits are more lethal. In short, the price of more optimal physiological functioning during youth is a lower threshold for system failure in old age. Conversely, a female "fertility-frailty pleiotropy" might result in greater physiological reserves in women. Child birth and child rearing necessitate high levels of energetic and nutritional investment: women who have children live shorter lives. Women currently are limiting the number of children they bear and their life expectancies may be longer than predicted by evolutionary design. Third, though the Frailty Index captures physical, cognitive and psychological vulnerability, it may not include all factors that impact life expectancy in older people; these factors may be present more in men than in women. While these hypotheses seek to explain how frailty impacts men and women in different ways, there is clearly much to be done to understand frailty in older people. PMID:21570783
This paper is concerned with aspects of post-secondary education of women in physics in the Caribbean, focusing more specifically on the main university campuses in Trinidad and Tobago, Jamaica, and Barbados. Within this framework, there are three institutions of tertiary education that provide for undergraduate and post-graduate studies in physics. On average, the bachelor-level graduating class is roughly 40% female. A great majority of these students go on to seek master's degrees in engineering. Among those enrolled in graduate programs featuring research in astronomy, materials science, environmental physics, medical physics, and quantum physics, 58% are female. Significant numbers of women from the selected countries and from the Caribbean region are engaged in bachelor and doctoral programs in physics abroad, but no formal survey is available to provide the relevant quantitative information. However, an attempt will be made to quantify this component. Based in part on personal experience, a comparison will be made between domestic and foreign educational pathways, in terms of access to resources, level of research training, and occupational opportunities following graduation.
Fitzgerald, C.; Zimon, A. E.; Jones, E. E.
Reproductive potential in women declines with age. Age-related changes in the ovary account for most of this loss of reproductive function. Oocytes, all of which are present at birth, decline in number and quality with age. The endocrine function of the ovary also declines with age, and the ovary becomes unable to sustain its normal function in the neuroendocrine axis. The neuroendocrine axis may be further affected by primary changes occurring in the hypothalamus and pituitary during aging, although this has not been established in humans. Aging also affects the function of the uterus as the endometrium loses its ability to support implantation and growth of an embryo. Diminished uterine function during aging may be due to changes in the uterine vasculature or to changes in the hormone-dependent development of the endometrium. Finally, aging increases a woman's risk of developing medical, gynecologic or obstetric conditions that may impair her fertility. Knowledge of these affects of aging on a woman's reproductive function is essential to advise and treat the growing number of women seeking pregnancy at advanced reproductive age. PMID:10527364
Guillory, Jamie; Niederdeppe, Jeff; Kim, Hyekung; Pollak, J P; Graham, Meredith; Olson, Christine; Gay, Geri
We examine how social support (perceived support and support from a spouse, or committed partner) may influence pregnant women's information seeking behaviors on a pregnancy website. We assess information seeking behavior among participants in a trial testing the effectiveness of a web-based intervention for appropriate gestational weight gain. Participants were pregnant women (N = 1,329) recruited from clinics and private practices in one county in the Northeast United States. We used logistic regression models to estimate the likelihood of viewing articles, blogs, frequently asked questions (FAQs), and resources on the website as a function of perceived social support, and support from a spouse or relationship partner. All models included socio-demographic controls (income, education, number of adults and children living at home, home Internet use, and race/ethnicity). Compared to single women, women who were married or in a committed relationship were more likely to information seek online by viewing articles (OR 1.95, 95 % CI [1.26-3.03]), FAQs (OR 1.64 [1.00-2.67]), and blogs (OR 1.88 [1.24-2.85]). Women who felt loved and valued (affective support) were more likely to seek information by viewing articles on the website (OR 1.19 [1.00-1.42]). While the Internet provides a space for people who have less social support to access health information, findings from this study suggest that for pregnant women, women who already had social support were most likely to seek information online. This finding has important implications for designing online systems and content to encourage pregnant women with fewer support resources to engage with content. PMID:24671467
Background There are limited data on perceptions of health professionals on challenges faced by cervical cancer patients seeking healthcare in the developing countries. We explored the views of operational level health professionals on perceived barriers to cervical screening and early help–seeking for symptomatic cervical cancer and the proposed remedies to the challenges. Methods Fifteen key informant interviews were held with health professionals including medical directors, gynecologists, medical officers, nurses and midwives in the gynecology and obstetrics departments of two hospitals in northern Uganda during August 2012 to April 2013. We used content analysis techniques to analyze the data. Results Health professionals’ perceived barriers to cervical cancer care included: (i) patients and community related barriers e.g. lack of awareness on cervical cancer and available services, discomfort with exposure of women’s genitals and perceived pain during pelvic examinations, and men’s lack of emotional support to women (ii) individual healthcare professional’s challenges e.g. inadequate knowledge and skills about cervical cancer management; (iii) health facility related barriers e.g. long distances and lack of transport to cervical cancer screening and care centers, few gynecologists and lack of pathologists, delayed histology results, lack of established palliative care services and inadequate pain control; and (iv) health policy challenges e.g. lack of specialized cancer treatment services, and lack of vaccination for human papilloma virus. Other challenges included increased number of cervical cancer patients and late stage of cervical cancer at presentations. Conclusions Operational level healthcare professionals in northern Uganda reported several practical challenges facing cervical cancer care that influence their decisions, management goals and practices. The challenges and proposed remedies can inform targeted interventions for early detection, management, and control of cervical cancer in Uganda. PMID:24341601
Much of the existing information seeking literature only considers information seeking when performed by an individual information seeker. This paper describes a study that explicitly considers information seeking from a collaborative perspective. The study used a grounded theory approach of a complex, real world, example of collaborative information seeking activity, drawn from the military domain.
McDoom, M Maya; Bokhour, Barbara; Sullivan, Meg; Drainoni, Mari-Lynn
As black women over age 50 represent a growing share of women living with HIV, understanding what helps them persist and engage in ongoing HIV care will become increasingly important. Delineating the specific roles of social support and stigma on HIV care experiences among this population remains unclear. We qualitatively examined how experiences with stigma and social support either facilitated or inhibited engagement in HIV care, from the perspective of older black women. Semi-structured interviews were conducted with 20 older black women currently receiving HIV care at primary care clinics in the Metropolitan Boston area. Women expressed that experiences with stigma and seeking support played an important role in evaluating the risks and benefits of engaging in care. Social support facilitated their ability to engage in care, while stigma interfered with their ability to engage in care throughout the course of their illness. Providers in particular, can facilitate engagement by understanding the changes in these women's lives as they struggle with stigma and disclosure while engaging in HIV care. The patient's experiences with social support and stigma and their perceptions about engagement are important considerations for medical teams to tailor efforts to engage older black women in regular HIV care. PMID:25494607
Background The purpose of this article was to describe effective strategies for recruitment of Hispanic women into a prospective cohort study of modifiable risk factors for gestational diabetes mellitus (GDM). Although Hispanic women have two to four times the risk of developing GDM compared with non-Hispanic white women, few GDM prevention studies have included Hispanic women. Methods The study was conducted in the ambulatory obstetrical practices of Baystate Medical Center located in a socioeconomically and ethnically diverse city in Massachusetts. The study employed a range of strategies to recruit Hispanic women based on a review of the literature as well as prior experience with the study population. Results Over a period of 32 months, a total of 851 Hispanic prenatal care patients were recruited. Among eligible women, 52.4% agreed to participate. Participants were young (70% <25 years), with low levels of education, and on public health insurance (81.5%); 88% were unmarried. Study design features such as use of bilingual recruiters, a flexible recruitment process, training recruiters to be culturally sensitive, use of culturally tailored materials, prescreening participants, participant compensation, seeking the cooperation of clinic staff, and continuous monitoring of recruitment goals emerged as important issues influencing recruitment. Conclusions Findings suggest that investigators can successfully recruit pregnant women from ethnic minority groups of low socioeconomic status into observational studies. The study provides culturally appropriate recruitment strategies useful for practice-based settings recruiting Hispanic research participation. PMID:20003350
Pregnant women are at increased risk for severe illness and complications from infection with seasonal influenza and 2009 pandemic influenza A (H1N1). To characterize the severity of 2009 H1N1 infection in pregnant women, the New York City Department of Health and Mental Hygiene (DOHMH) conducted active and passive surveillance for cases of 2009 H1N1 infection in pregnant women requiring intensive care. This report summarizes the results of that surveillance, which found that, during 2009, 16 pregnant women and one who was postpartum were admitted to New York City intensive-care units (ICUs). Two women died. Of the 17 women, 12 had no recognized risk factors for severe influenza complications other than pregnancy. All 17 women received antiviral treatment with oseltamivir; however, treatment was initiated
Tee, G H; Kaur, G; Ramanathan, P; Amal, N M; Chinna, K
About 1.8 million people die annually from acute diarrheal disease globally. A nationwide cross-sectional survey was conducted via face-to-face interview with eligible subjects to determine the incidence and health seeking behavior of Malaysians with acute diarrheal disease (ADD). An acute diarrheal episode was defined as having three or more loose stools in any 24 hour period during the four weeks period prior to the interview. The exclusion criteria included pre-existing chronic diarrhea, such as with cancer of the bowel, ulcerative colitis or Chrohn's disease. Forty three point three percent of those with ADD (95% CI 41.3-45.4) sought treatment for the illness. Younger age groups (0-4 years, 67.7%; 95% CI 61.5-73.4; 5-9 years, 56.5%; 95% CI 48.6-64.1) were more likely to seek care for ADD. Seventy-one point eight percent of those seeking treatment, (95% CI 69.0-74.4) did so within 12 hours of the onset of symptoms. Most people with ADD sought treatment at private clinics. The main reasons given for not seeking treatment were the illness was mild and did not warrant treatment and the practice of self-medication (22.4%; 95% CI 20.0-24.9). These findings show self-medication is a major health seeking behavior among Malaysians with ADD. Self-medication of ADD deserves more in-depth study to ensure it is safe. PMID:21710867
This thesis examines fictional representations of Indian women’s responses to trauma in the background of communal violence. It argues that fiction allows for the reimagination of women’s conditions during communal riots, and their responses to trauma as a result of those riots. While ethnographic research seeks answers from traumatized victims, a fictional text can open up spaces for debates about
Jo-Anne Rayner; Helen L McLachlan; Della A Forster; Rhian Cramer
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
Lincoln, Alisa K.; Liebschutz, Jane M.; Chernoff, Miriam; Nguyen, Dana; Amaro, Hortensia
for Women's Alcohol and Drug Addiction Treatment. Alcoholismhistory and addiction treatment outcomes. J Stud Alcoholaddiction severity [1-4]. General data for men and women seeking treatment for alcohol and
...Enhanced Collection of Relevant Data and Statistics Relating to Women Presidential Documents...Enhanced Collection of Relevant Data and Statistics Relating to Women Memorandum for...identify and to seek to fill in gaps in statistics and improve survey methodology...
Fu, Wai-Tat; Gray, Wayne D
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 subjects often stabilize at suboptimal levels of performance. A Bayesian satisficing model (BSM) is proposed and implemented in the ACT-R architecture to predict information-seeking behavior. The BSM uses a local decision rule and a global Bayesian learning mechanism to decide when to stop seeking information. The model matched the human data well, suggesting that adaptation to cost and information structures can be achieved by a simple local decision rule. The local decision rule, however, often limits exploration of the environment and leads to suboptimal performance. We propose that suboptimal performance is an emergent property of the dynamic interactions between cognition and the environment. PMID:16356487
Within the wide expanse of social networking, educators appear to be gravitating to more protected and exclusive spaces. While teachers often use such popular mainstream social networks as Facebook, they are more likely to seek out and return to less-established networks that offer the privacy, peer-to-peer connections, and resource sharing that…
Johnson, J, David
Explores context in information seeking as equivalent to the situation in which a process is immersed. Discusses contingency approaches that detail active ingredients of the situation that have specific, predictable effects. Examines major frameworks for meaning systems. Discusses how a deeper appreciation of context can enhance understanding of…
Elsenberg, Michael B.
A brief overview of one Big6 stage by Mike Eisenberg, followed by articles by two exemplary Big6 teachers, Barbara Jansen and Rob Darrow, offering practical uses of the Big6 in elementary and secondary situations is presented. The two-part nature of information seeking strategies that includes brainstorming and choosing is emphasized.
It is natural for humans to collaborate while dealing with complex problems. In this article I consider this process of collaboration in the context of information seeking. The study and discussion presented here are driven by two dis- satisfactions: (1) the majority of IR systems today do not facilitate collaboration directly, and (2) the concept of col- laboration itself is
's Earthquake Relief As you all might have already heard from news about the damage done in Nepal due/staff members is a part of this organization. If you want to read more news about the Earthquake in Nepal, click SEEK Book Drive Spring 2015 Fundraising for Nepal's Earthquake Relief Student of the Month Bintou
Rowe, Hilary; Baker, Teresa; Hale, Thomas W
This article reviews the necessary skills required for clinicians to make informed decisions about the use of medications in women who are breastfeeding. Even without specific data on certain medications, this review of kinetic principles, mechanisms of medication entry into breast milk, and important infant factors can aid in clinical decision making. In addition, common medical conditions and suitable treatments of depression, hypertension, infections and so forth for women who are breastfeeding are also reviewed. PMID:23178070
Rowe, Hilary; Baker, Teresa; Hale, Thomas W
This article reviews the necessary skills required for clinicians to make informed decisions about the use of medications in breastfeeding women. Even without specific data on certain medications, this review of kinetic principles, mechanisms of medication entry into breast milk, and important infant factors can aid in clinical decision making. In addition, the article reviews common medical conditions (eg, depression, hypertension, infections) in breastfeeding women and their appropriate treatment. PMID:25455573
Background Malaysia has relatively liberal abortion laws in that they permit abortions for both physical and mental health cases. However, abortion remains a taboo subject. The stagnating contraceptive prevalence rate combined with the plunging fertility rate suggests that abortion might be occurring clandestinely. This qualitative study aimed to explore the experiences of women and their needs with regard to abortion. Methods Women from diverse backgrounds were purposively selected from an urban family planning clinic in Penang, Malaysia based on inclusion criteria of being aged 21 and above and having experienced an induced abortion. A semi-structured interview guide consisting of open ended questions eliciting women’s experiences and needs with regard to abortion were utilized to facilitate the interviews. Audio recordings were transcribed verbatim and analyzed thematically. Results Thirty-one women, with ages ranging from 21–43?years (mean 30.16 ±6.41), who had induced surgical/medical abortions were recruited from an urban family planning clinic. Ten women reported only to have had one previous abortion while the remaining had multiple abortions ranging from 2–8 times. The findings revealed that although women had abortions, nevertheless they faced problems in seeking for abortion information and services. They also had fears about the consequences and side effects of abortion and wish to receive more information on abortion. Women with post-abortion feelings ranged from no feelings to not wanting to think about the abortion, relief, feeling of sadness and loss. Abortion decisions were primarily theirs but would seek partner/husband’s agreement. In terms of the women’s needs for abortion, or if they wished for more information on abortion, pre and post abortion counseling and post-abortion follow up. Conclusions The existing abortion laws in Malaysia should enable the government to provide abortion services within the law. Unfortunately, the study findings show that this is generally not so, most probably due to social stigma. There is an urgent need for the government to review its responsibility in providing accessible abortion services within the scope of the law and to look into the regulatory requirements for such services in Malaysia. This study also highlighted the need for educational efforts to make women aware of their reproductive rights and also to increase their reproductive knowledge pertaining to abortion. Besides the government, public education on abortion may also be improved by efforts from abortion providers, advocacy groups and related NGOs. PMID:22950371
The Women's Health Information Center, offered by editors of JAMA: the Journal of the American Medical Association (AMA), provides the latest research and clinical information on women's health issues for physicians and other health professionals. A Newsline section features current stories from Reuters Health Information and special reports from Morbidity, Mortality and Weekly Reports (MMWR) which may be read in HTML or downloaded as .pdf files. The Library section features full text of selected articles on women's health issues and abstracts of articles recently published in medical journals. For the latest information on sexually transmitted diseases or contraceptive issues, visit the STD Information Center or the Contraception Information Center, each of which features the latest news, patient education materials, clinical guidelines for treatment, recommended Internet resources, and abstracts and full-text reports on the latest research.
Background The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. Methods We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. Results We interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n?=?74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. Conclusions This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence. PMID:24552142
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J. B. Antoine Maintz; Petra A. Van Den Elsen; Max A. Viergever
Ridge-like structures in digital images may be extracted by convolving the images with deriva- tives of Gaussians. The choice of the convolution operator and of the parameters involved defines a specific ridge image. In this paper, various ridge measures related to isophote curvature are con- structed, reviewed, and evaluated with respect to their usability in CT\\/MRI matching of human brain
Kannan, Srimathi; Sparks, Arlene V; Webster, J DeWitt; Krishnakumar, Ambika; Lumeng, Julie
The purpose was to develop, implement and evaluate a peer-led nutrition curriculum Healthy Eating and Harambee that addresses established objectives of maternal and infant health and to shift the stage for African American women of childbearing age in Genesee County toward healthier dietary patterns using a socio-cultural and biomedical orientation. The PEN-3 model, which frames culture in the context of health promotion interventions, was integrated with the Transtheoretical Model to guide this 13-week pre-test/post-test curriculum. Materials developed included soul food plate visuals, a micronutrient availability worksheet, a fruit stand, and gardening kits. Learning activities included affirmations, stories, case-scenarios, point-of-purchase product recognition, church health teams, and community health fairs. We investigated health-promoting dietary behaviors (consumption of more fruits and vegetables (F&V), serving more F&V to their families, and moderating dietary sodium and fat intakes), and biomedical behaviors (self-monitoring blood pressure and exercising) across five stages of change. Session attendance and program satisfaction were assessed. N = 102 women participated (mean age = 27.5 years). A majority (77%) reported adopting at least one healthy eating behavior (moderating sodium, serving more F&V to their families), 23% adopted at least two such behaviors (reading food labels for sodium; using culinary herbs/spices; serving more F&V to their families), and 45% adopted both dietary (moderating sodium; eating more fruits) and biomedical behaviors. Participants and facilitators favorably evaluated the curriculum and suggested improvements. A multi-conceptual approach coupled with cultural and biomedical tailoring has potential to promote young African American women's movement to more advanced stages of change and improve self-efficacy for fruit and vegetable intake, dietary sodium moderation, and self-monitoring blood pressure and physical activity. PMID:19655237
Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery. PMID:22013991
Longwe, S H
This article distinguishes between "schooling for subordination," the notion that promotes conventional schooling for women within existing school systems as a possible basis for them to improve their position in society and "education for empowerment," a more radical perspective that links women's advancement with the transformation of the patriarchal social order. The article opens by defining gender training as provision of skills and methods for improved gender-orientation of development programs. The conservative interpretation of gender training holds that it seeks to increase women's access to resources. The radical definition holds that inequality in access to resources is a mere symptom of a deeper problem caused by structural gender inequality and calls for conscientization of this problem. The two definitions of women's empowerment that follow this distinction are 1) a watered-down view of empowerment as self-reliance reflecting the conservative definition and 2) a more robust and pure view of empowerment as enabling women to identify and end the discriminatory practices that block their access to resources. It follows that education may be mere schooling for subordination in systems where patriarchal gatekeepers limit chances for women and where women who do succeed become "honorary males" and "queen bees" intent on repelling the advancement of other women. Education for empowerment can be found in gender training, which holds objectives that are opposite to those found in formal schooling and may be more readily adopted by women with less exposure to formal, patriarchal schools. PMID:12294042
Rolinska, Agnieszka Anna; Tomasz, G?ca; Kwasniewska, Anna; Makara-Studzinska, Marta
The aim of the present study was to determine whether applying obstetric gel, a noninvasive method of pain management that is safe both for the mother and the child, during labor influences delivery satisfaction by facilitating pain management and decreasing exhaustion. Forty-seven primiparous women were included in the study: 23 on whom during the delivery gel was used and 24 whose delivery proceeded without the use of a gel (control group). The following research tools were used for the evaluation of satisfaction with the course of the delivery: Visual Analogue Scale (VAS), self-authorship survey, and the State-Trait Anxiety Inventory. There were no significant differences in intensification of pain in the first and second periods of delivery, exhaustion after delivery and intensification of pain in the second period of delivery, and increased anxiety between the study group and the control group. Our results suggest that application of obstetric gel during the first and second period of delivery does not significantly influence women's satisfaction with the course of delivery. PMID:25515973
The construction of menopause as an estrogen deficiency condition originated primarily in the United States and is being exported to many other countries throughout the world. I have identified specific cultural assumptions and policies in the United States as well as the ubiquitous gender biases that have contributed to the medicalization of menopause. Since medicalized menopause is causing harm to women worldwide, it is imperative that it be addressed by the international community. PMID:14742119
Chuang, Cynthia H; Poole, Erika S; Peyton, Tamara; Blubaugh, Ian; Pauli, Jaimey; Feher, Alyssa; Reddy, Madhu
Background The prenatal care visit structure has changed little over the past century despite the rapid evolution of technology including Internet and mobile phones. Little is known about how pregnant women engage with technologies and the interface between these tools and medical care, especially for women of lower socioeconomic status. Objective We sought to understand how women use technology during pregnancy through a qualitative study with women enrolled in the Women, Infants, and Children (WIC) program. Methods We recruited pregnant women ages 18 and older who owned a smartphone, at a WIC clinic in central Pennsylvania. The focus group guide included questions about women’s current pregnancy, their sources of information, and whether they used technology for pregnancy-related information. Sessions were audiotaped and transcribed. Three members of the research team independently analyzed each transcript, using a thematic analysis approach. Themes related to the topics discussed were identified, for which there was full agreement. Results Four focus groups were conducted with a total of 17 women. Three major themes emerged as follows. First, the prenatal visit structure is not patient-centered, with the first visit perceived as occurring too late and with too few visits early in pregnancy when women have the most questions for their prenatal care providers. Unfortunately, the educational materials women received during prenatal care were viewed as unhelpful. Second, women turn to technology (eg, Google, smartphone applications) to fill their knowledge gaps. Turning to technology was viewed to be a generational approach. Finally, women reported that technology, although frequently used, has limitations. Conclusions The results of this qualitative research suggest that the current prenatal care visit structure is not patient-centered in that it does not allow women to seek advice when they want it most. A generational shift seems to have occurred, resulting in pregnant women in our study turning to the Internet and smartphones to fill this gap, which requires significant skills to navigate for useful information. Future steps may include developing interventions to help health care providers assist patients early in pregnancy to seek the information they want and to become better consumers of Internet-based pregnancy resources. PMID:24892583
Mavis Tsai; Shirley Feldman-Summers; Margaret Edgar
To examine factor contributing to the differential adjustment of women sexually molested as children, 3 groups of 30 women aged 18–65 yrs each were recruited to participate in this study: (a) a clinical group consisting of women seeking therapy for problems associated with childhood molestation, (b) a nonclinical group of women molested as children who had never sought therapy and
O’Neil, Deborah A.; Hopkins, Margaret M.
In this Perspective article we propose that in order to pave the way for women’s career advancement into the senior ranks of organizations, attention must be directed at the systemic norms and structures that drive the gendered nature of the workplace. A focus on individual level issues, i.e., women lacking confidence and women opting out, detracts from the work that must be done at the organizational level in order to dismantle the system of pervasive, structural disadvantage facing women seeking to advance to senior leadership positions. PMID:26175708
Lanre-Abass, Bolatito A
Poverty is often identified as a major barrier to human development. It is also a powerful brake on accelerated progress toward the Millennium Development Goals. Poverty is also a major cause of maternal mortality, as it prevents many women from getting proper and adequate medical attention due to their inability to afford good antenatal care. This Paper thus examines poverty as a threat to human existence, particularly women's health. It highlights the causes of maternal deaths in Nigeria by questioning the practice of medicine in this country, which falls short of the ethical principle of showing care. Since high levels of poverty limit access to quality health care and consequently human development, this paper suggests ways of reducing maternal mortality in Nigeria. It emphasizes the importance of care ethics, an ethical orientation that seeks to rectify the deficiencies of medical practice in Nigeria, notably the problem of poor reproductive health services. Care ethics as an ethical orientation, attends to the important aspects of our shared lives. It portrays the moral agent (in this context the physician) as a self who is embedded in webs of relations with others (pregnant women). Also central to this ethical orientation is responsiveness in an interconnected network of needs, care and prevention of harm. This review concludes by stressing that many human relationships involve persons who are vulnerable, including pregnant women, dependent, ill and or frail, noting that the desirable moral response is that prescribed by care ethics, which thus has implications for the practice of medicine in Nigeria. PMID:18447920
Digital Women strives to be a full-service portal for working women in all varieties of business. The site offers a huge collection of resources, including informative articles, manuals, free software, Web tools, and advice, as well as ten free newsletters and mailing lists. Digital Women also provides a place for business women to network, including information about the Digital Women 2000 Annual International Net-Together, which will take place on Vancouver Island September 29-October 1, 2000.
Mangan, Cheryl; Sanci, Lena
Background Young people regularly use online services to seek help and look for information about mental health problems. Yet little is known about the effects that online services have on mental health and whether these services facilitate help-seeking in young people. Objective This systematic review investigates the effectiveness of online services in facilitating mental health help-seeking in young people. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in PubMed, PsycINFO, and the Cochrane library. Out of 608 publications identified, 18 studies fulfilled the inclusion criteria of investigating online mental health services and help-seeking in young people aged 14-25 years. Results Two qualitative, 12 cross-sectional, one quasi-experimental, and three randomized controlled trials (RCTs) were reviewed. There was no change in help-seeking behavior found in the RCTs, while the quasi-experimental study found a slight but significant increase in help-seeking. The cross-sectional studies reported that online services facilitated seeking help from a professional source for an average of 35% of users. The majority of the studies included small sample sizes and a high proportion of young women. Help-seeking was often a secondary outcome, with only 22% (4/18) of studies using adequate measures of help-seeking. The majority of studies identified in this review were of low quality and likely to be biased. Across all studies, young people regularly used and were generally satisfied with online mental health resources. Facilitators and barriers to help-seeking were also identified. Conclusions Few studies examine the effects of online services on mental health help-seeking. Further research is needed to determine whether online mental health services effectively facilitate help-seeking for young people. PMID:24594922
In September, Human Rights Watch posted five new reports on their Website. The first, Seeking Protection: Addressing Sexual and Domestic Violence in Tanzania's Refugee Camps, is a 151-page indictment of the United Nation's High Commission for Refugees and the Tanzanian host government's failure to address violence against Burundi women refugees in Tanzanian camps in a "timely and effective manner, despite ample evidence that women's lives were in danger in their homes and in the general camp community."
Suka, Machi; Yamauchi, Takashi; Sugimori, Hiroki
Objective Encouraging help-seeking for mental illness is essential for prevention of suicide. This study examined the relationship between individual characteristics, neighbourhood contexts and help-seeking intentions for mental illness for the purpose of elucidating the role of neighbourhood in the help-seeking process. Design, setting and participants A cross-sectional web-based survey was conducted among Japanese adults aged 20–59?years in June 2014. Eligible respondents who did not have a serious health condition were included in this study (n=3308). Main outcome measures Participants were asked how likely they would be to seek help from someone close to them (informal help) and medical professionals (formal help), respectively, if they were suffering from serious mental illness. Path analysis with structural equation modelling was performed to represent plausible connections between individual characteristics, neighbourhood contexts, and informal and formal help-seeking intentions. Results The acceptable fitting model indicated that those who had a tendency to consult about everyday affairs were significantly more likely to express an informal help-seeking intention that was directly associated with a formal help-seeking intention. Those living in a communicative neighbourhood, where neighbours say hello whenever they pass each other, were significantly more likely to express informal and formal help-seeking intentions. Those living in a supportive neighbourhood, where neighbours work together to solve neighbourhood problems, were significantly more likely to express an informal help-seeking intention. Adequate health literacy was directly associated with informal and formal help-seeking intentions, along with having an indirect effect on the formal help-seeking intention through developed positive perception of professional help. Conclusions The results of this study bear out the hypothesis that neighbourhood context contributes to help-seeking intentions for mental illness. Living in a neighbourhood with a communicative atmosphere and having adequate health literacy were acknowledged as possible facilitating factors for informal and formal help-seeking for mental illness. PMID:26264273
Fahmy, Howaida H; Abd El-Rahman, Seham I
Violence against women is a global phenomenon that cuts across all social and economic classes, it has recently drawn attention in the medical field as a leading cause of preventable morbidity and mortality. The present study was carried out to estimate the prevalence of domestic violence, to identify socio-demographic and behavioral risk factors and to investigate the relationship between the women's psychological health status and violence exposure. This is a comparative cross-sectional study using a multistage random sampling technique. The sample comprised 500 women aged 18-50y. Data was collected via a structured interview questionnaire including the socio-demographic characteristics of the women and their husbands, some of the husbands' habits, attitude and history of chronic illnesses. Also, the questionnaire assesses different forms of domestic violence, women's reaction to it and its consequences on psychological well-being of women. A depression anxiety scale was used to assess the women's psychological status. The study revealed that the overall prevalence of domestic violence among the studied group was (62.2%); the commonest form (74.0%) was psychological abuse, followed by social (26.8%) one, then the physical (22.4%) and lastly sexual abuse (19.6%). On studying the socio-demographic variables, a significantly higher percentage of younger ( pound 30 years) non-educated, low income and those having any property ownership were more exposed to violence. Also exposure to abuse was more prevalent among women whose husbands were young, non-educated, skilled workers, drug abuser, with positive history of family troubles and chronic illness. The majority of women reported that they react to violence by crying loudly or screaming, while a minority may seek medical care or call the police. Regarding the psychological effect of violence exposure, the most common effects were anxiety (69.2%) and depression (52.2%), with a highly statistically significant difference with exposure in every form of domestic violence. Conclusion & Recommendations: The overall prevalence of domestic violence was relatively high and was predominantly of the psychological form. Women abuse had serious health effects on the women's health mainly her psychological well being. The study recommends practicing compulsory pre-marital counseling and offering health educational sessions in schools, universities and health units to all expected couples about marital and family life and provision of routine screening for domestic violence in primary care. PMID:18992205
Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis. PMID:24400630
Albright, Julie M
This was an exploratory study of sex and relationship seeking on the Internet, based on a survey of 15,246 respondents in the United States Seventy-five percent of men and 41% of women had intentionally viewed or downloaded porn. Men and gays/lesbians were more likely to access porn or engage in other sex-seeking behaviors online compared with straights or women. A symmetrical relationship was revealed between men and women as a result of viewing pornography, with women reporting more negative consequences, including lowered body image, partner critical of their body, increased pressure to perform acts seen in pornographic films, and less actual sex, while men reported being more critical of their partners' body and less interested in actual sex. Married and divorced were more likely than singles to go online seeking a serious relationship. Only 2% of users met the threshold of compulsive use established by previous studies. PMID:18569538
Maki, K C; Geohas, J G; Dicklin, M R; Huebner, M; Udani, J K
This randomized, double-blind, placebo-controlled multi-center trial investigated the lipid-altering effects of a medical food (PDL-0101) providing 1.8g/d eicosapentaenoic acid; 12mg/d astaxanthin, a marine algae-derived carotenoid; and 100mg/d tocopherol-free gamma/delta tocotrienols enriched with geranylgeraniol, extracted from annatto, on triacylglycerols (TAG), other lipoprotein lipids, and oxidized low-density lipoprotein (LDL) in 102 subjects with TAG 150-499mg/dL (1.69-5.63mmol/L) and LDL cholesterol (LDL-C) ?70mg/dL (1.81mmol/L). Compared to placebo, after eight weeks of treatment, PDL-0101 significantly reduced median TAG (-9.5% vs. 10.6%, p<0.001), while not significantly altering mean LDL-C (-3.0% vs. -8.0% for PDL-0101 and placebo, respectively, p=0.071), mean high-density lipoprotein cholesterol (~3% decrease in both groups, p=0.732), or median oxidized LDL concentrations (5% vs. -5% for PDL-0101 and placebo, respectively, p=0.112). These results demonstrate that PDL-0101 is an effective medical food for the management of elevated TAG. PMID:26076828
Frederick W Kron; Craig L Gjerde; Ananda Sen; Michael D Fetters
BACKGROUND: Studies in K-12 and college students show that their learning preferences have been strongly shaped by new media technologies like video games, virtual reality environments, the Internet, and social networks. However, there is no known research on medical students' game experiences or attitudes towards new media technologies in medical education. This investigation seeks to elucidate medical student experiences and
Patel, Jaya; Gupta, Sweta
Introduction: Symptomatic vaginal discharge is the most frequent symptom in women of reproductive age group. Owing to social stigma majority of affected women hesitate to seek medical consultation. Therefore the actual incidence of vaginal discharge is much more than what is reported. The aim of the study is to determine the microbiological profile of symptomatic vaginal discharge in rural area and its utility in the management of genital tract infection. Materials and Methods: This was a descriptive type of observational study, conducted in sexually active women of reproductive age group (18-45 years) attending the OPD/IPD of Obstetrics and Gynaecology Department of National Institute of Medical Sciences, Shobhanagar, Jaipur (Rajasthan), over a period of 18 months from June 2012 to December 2013. Hundred sexually active non pregnant women of reproductive age group (18-45 years) were included in the study. After taking consent general physical examination along with pelvic examination was performed. Two high vaginal swabs and blood sample were collected for various tests. Hanging drop preparation was immediately made. This was followed by gram staining and culture. Chlamydia trachomatis IgM antibody was detected by ELISA method. Results: Out of 100 women with symptomatic vaginal discharge, specific diagnosis was obtained in 89% of cases whereas no specific aetiology was found in 11% cases. Mean age was 32.60 years. Fifty-three percent patient had Bacterial vaginosis, candidiasis was found in 14% cases, 16% had Chlamydia trachomatis infection while Trichomonas vaginalis infection was detected in 6% cases. Homogenous discharge was most prevalent (52%), followed by mucopurulant discharge in 23% of women. Conclusion: Patient with symptomatic vaginal discharge need to be actively managed with appropriate antimicrobial agents. Judicious management may be helpful in prevention of HIV, HPV, CIN and post infection sequelae. PMID:25954668
Hendry, David G.; Harper, David J.
Investigates how an informal computerized environment, or workspace, can support information seeking. Outlines the design space for information-seeking environments and presents a prototype, SketchTrieve, a graphic editor. Discusses how this environment might support information-seeking in ways not available in other more overdetermined systems.…
Paul, Sharoda A.
In recent years researchers have found that people often collaborate during information seeking activities. Collaborative information seeking (CIS) is composed of multiple different activities like seeking, sharing, understanding, and using information together. However, most studies of CIS have focused on how people find and retrieve information…
Swan, Suzanne C.; Sullivan, Tami P.
Studies have found high rates of help seeking among domestic violence victims. However, little research has investigated the help-seeking patterns of women who use violence (many of whom are also abused). Understanding the resources utilized by women who are violent toward their partners may aid in designing interventions that will reduce the…
The mission of CEDPA (Center for Development and Population Activities) is to empower women to be full partners in development. Empowerment starts with the development of women as leaders and managers through leadership training. There are now 4000 CEDPA alumnae worldwide who have participated in training programs. USAID-funded integrated service programs are geared toward women-managed health services seeking out nongovernmental organizations (NGOs) based in the community that have women as part of their services. Another approach is building the capacity of institutions to broaden their programs to fully utilize external funding and also establish a foundation for sustainability. Another strategy is advocacy and policy. Recently a group of women leaders attended all the preparatory meetings for the International Conference on Population and Development (ICPD) to be sure that input into the Cairo Document came from women who were representatives of family planning programs in their communities. The ICPD document itself is favorable to women's development, women leaders, and training for women, but the challenge is to find financial resources to make the commitment to women's programs on a large scale. The test of the Program of Action is how it is implemented. NGOs do not have enough resources, but women's NGOs have even less resources than other NGOs. The Global Issues Initiative is a significant commitment on the part of the Japanese government. CEDPA's mission is to ensure that women participate in these programs that will be developed and managed by women and NGOs. PMID:12288955
... lead researcher Dr. Leslie Cho, director of the Cleveland Clinic Women's Cardiovascular Center. The bottom line: "It ... Leslie Cho, M.D., director, Women's Cardiovascular Center, Cleveland Clinic, Ohio; Carl Lavie, M.D., medical director, ...
Park, Hyejin; Park, Min Sook
Linguistically and culturally isolated Korean Americans have less access to health service and cancer screening tests than all U.S population. Lack of adequate cancer information is one of the barriers to undergoing cancer screening tests. It is necessary to understand their current cancer information-seeking behaviors and information needs if we are to more effectively provide adequate cancer information. The purpose of the study was to identify cancer information seeking behaviors and information needs among Korean Americans. Data were collected from one of the biggest websites for the Korean community in the USA. A total of 273 free-texts from January to June 2013 were reviewed and analyzed for this study. The extracted terms were categorized based on the coding system. The primary reason for asking questions was inquiry followed by sharing experiences. The main topics of the postings were categorized as medical or non-medical. In relation to types of cancer, breast cancer was the greatest concern. The findings from this study can help in establishing more effective strategies to provide better cancer information among Korean Americans by assessing their current cancer information seeking trends and information needs. PMID:24943573
The consistent 2:1 ratio of women to men in the receipt of prescriptions for psychotropic drugs is reflected in the higher rates for women of neurotic illness, symptoms of both physical and mental discomfort, and help-seeking and drug-taking behaviour. Physicians' perceptions of the problems presented by their male and female patients influence their prescribing of these drugs. Recent statistics in Ontario indicate that greater use of physicians' services by women is an inadequate explanation of the higher rate of prescribing of psychotropic drugs to women. A longitudinal study of a large insured population in Ontario showed that almost twice the proportion of females, compared with males, received a prescription for psychotropic drugs in 1970-71 and in 1973-74, a higher proportion of females received multiple prescriptions for each drug class, and males were more likely than females to have received only one prescription in a year. PMID:10075
Boot, Cécile R L; Meijman, Frans J
The aim of this study was to gain insight into people's drives, or motives, for seeking health information on the Internet. A systematic literature review, restricted to handbooks and reviews, was conducted by searching the databases of various disciplines. Each drive was translated into the context of health information. Five drives were retrieved from the fields of psychology, mass communication, library and information science, and medical science: drives regarding the retrieval of knowledge, social contact or support, tempering uncertainty, entertainment, and self-actualization. Based on these results, three hypotheses were generated for future research: (1) drives are interconnected and may be present simultaneously in the process of seeking information; (2) they not only serve as antecedents for the need for information, but are present throughout the entire information-seeking process; (3) they are subject to change throughout the information-seeking process. Various drives play a role in the health information-seeking process. PMID:20573646
Since common ground is pivotal to collaboration, this paper proposes to define collaborative information seeking as the combined activity of information seeking and collaborative grounding. While information-seeking activities are necessary for collaborating actors to acquire new information, the activities involved in information seeking are often performed by varying subgroups of actors. Consequently, collaborative grounding is necessary to share information among
Hacker, Randi; Tsutsui, William
Broadcast Transcript: There's marital duplicity going on here in South Korea. Namely, secret bank accounts. Put together by women. Unbeknownst to their husbands. Apparently, more than 65% of married Korean women are salting away money that they save...
Leone, Janel M.; Johnson, Michael P.; Cohan, Catherine L.
Research indicates that two major forms of partner violence exist, intimate terrorism (IT) and situational couple violence (SCV). The current study (N=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…
Sancho, J J; González, J C; Patak, A; Sanz, F; Sitges-Serra, A
Medical informatics (MI) has been introduced to medical students in several countries. Before outlining a course plan it was necessary to conduct a survey on students' computer literacy. A questionnaire was designed for students, focusing on knowledge and previous computer experience. The questions reproduced a similar questionnaire submitted to medical students from North Carolina University in Chapel Hill (NCU). From the results it is clear that although almost 80% of students used computers, less than 30% used general purpose applications, and utilization of computer-aided search of databases or use in the laboratory was exceptional. Men reported more computer experience than women in each area investigated by our questionnaire but this did not appear to be related to academic performance, age or course. Our main objectives when planning an MI course were to give students a general overview of the medical applications of computers and instruct them in the use of computers in future medical practice. As our medical school uses both Apple Macintosh and IBM compatibles, we decided to provide students with basic knowledge of both. The programme was structured with a mix of theoretico-practical lectures and personalized practical sessions in the computer laboratory. As well as providing a basic overview of medical informatics, the course and computer laboratory were intended to encourage other areas of medicine to incorporate the computer into their teaching programmes. PMID:8208154
The WLRN, provided by Ginny Daley, Women's Archivist of Duke University Libraries, is a group of "students, teachers, activists, librarians, and archivists who have an interest in some aspect of the U.S. Women's Liberation Movement." Their website features a member directory, information on special library and archival collections, research and documentation projects, and publishers seeking manuscripts. In general, the site is envisioned as a point of departure for professional contacts, publication projects, or ideas for dissertation topics. Membership information is also provided.
Provides an historic overview of the conditions and obstacles encountered by women in pursuing careers in astronomy. Highlights the accomplishments and contributions made by successful women in the field. Reviews the current status and climate associated with women in astronomy and the sciences in general. (ML)
Bogren, M A; Hvarfwén, E; Fridlund, B
Urinary incontinence (UI) is a disability caused by an impairment, which can lead to a handicap of importance for nursing care. This means that UI is not only a practical-medical concern but also a socio-economic problem. The purpose of the study was to determine the prevalence of UI among 65 year-olds in a Swedish Health Care District and to compare gender differences concerning medical history and psychosocial consequences. In a Primary Health Care District, a questionnaire pertaining to UI was mailed to all women and men 65 years of age (N = 458). A total of 91% (n = 419) was sufficient for data analysis, which was performed by descriptive and inferential statistics. It was found that 28% (n = 61) of the women and 9% (n = 21) of the men were afflicted with UI. Women reported significantly more urge incontinence (p < .05) as well as stress incontinence (p < .05). Information from the health service about UI had been given to 46% (n = 28) of the women and 33% (n = 7) of the men. The strongest reason reported, both in women (42%, n = 26) and men (40%, n = 8), for not seeking help from the health service was that UI was a normal condition for people of their age. Most of the women had to urinate at least twice per night (42%) compared to once per night (44%) for the men. It is important to establish a UI clinic at every main Primary Health Care Centre which builds on nursing care and whose aim is to inform the general public that UI is a common problem, that it leads to psychosocial consequences, and that the health service can offer active rehabilitation interventions. PMID:9393125
Bogren, M A; Hvarfwén, E; Fridlund, B
Urinary incontinence (UI) is a disability caused by an impairment, which can lead to a handicap of importance for nursing care. This means that UI is not only a practical-medical concern but also a socio-economic problem. The purpose of the study was to determine the prevalence of UI among 65 year-olds in a Swedish Health Care District and to compare gender differences concerning medical history and psychosocial consequences. In a Primary Health Care District, a questionnaire pertaining to UI was mailed to all women and men 65 years of age (N = 458). A total of 91% (n = 419) was sufficient for data analysis, which was performed by descriptive and inferential statistics. It was found that 28% (n = 61) of the women and 9% (n = 21) of the men were afflicted with UI. Women reported significantly more urge incontinence (p < .05) as well as stress incontinence (p < .05). Information from the health service about UI had been given to 46% (n = 28) of the women and 33% (n = 7) of the men. The strongest reason reported, both in women (42%, n = 26) and men (40%, n = 8), for not seeking help from the health service was that UI was a normal condition for people of their age. Most of the women had to urinate at least twice per night (42%) compared to once per night (44%) for the men. It is important to establish a UI clinic at every main Primary Health Care Centre which builds on nursing care and whose aim is to inform the general public that UI is a common problem, that it leads to psychosocial consequences, and that the health service can offer active rehabilitation interventions. PMID:9464154
Belinda F. Morrison; Arthur L. Burnett
\\u000a Priapism is a rare disorder, typified by a persistent penile erection, which is usually painful. Though rare, it is seen commonly\\u000a in certain patient populations, e.g. sickle-cell disease. Priapism is a true urological emergency. Unfortunately, due to the\\u000a general rarity of the disorder, many patients delay in seeking medical attention and medical practitioners may also be delayed\\u000a in initiation of
Wolinsky, F D; Stump, T E
The authors assess the factorial validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for use in a clinical sample of disadvantaged, older adults with significant comorbidities. Confirmatory factor analysis was performed using LISREL VIII on data obtained from baseline face-to-face interviews with a clinical sample of 1,051 patients who were at risk for acute deterioration of their clinical condition due either to their age alone (75 years or older), or to their age (50 to 74 years old) and major comorbid conditions. An acceptable eight-factor measurement model reflecting the original specification (ie, subscales) of the SF-36 was obtained (chi-square to degrees of freedom ratio = 2.14; root mean squared residual = .055; adjusted goodness of fit index = .90). That model, however, required relaxing the assumptions associated with seven correlated error terms. Moreover, an alternative nine-factor model that allowed the ¿getting sick¿ and ¿getting worse¿ items to form their own factor, labeled ¿health optimism,¿ fit the data significantly better (8 degrees of freedom chi-square improvement = 61; P< 0.0001). Although continued use of the SF-36 in older, disadvantaged, clinical samples is appropriate, further assessment of the underlying measurement model in other samples using confirmatory factor analytic techniques is needed to resolve the issue of correlated error structures and the existence of the health optimism factor. PMID:8656720
Ayers, Stephanie L; Kronenfeld, Jennie Jacobs
By using the theories of help-seeking behavior and health-information seeking, this article demonstrates the relationship between chronic illness, retrieving health information from the Internet and changing health behavior. Research on the impact of health information on the Internet and changing health behavior is fairly new, given the growth of the Internet in recent years. Using US data on Internet use within the US population, multiple regression analysis was performed to explore the relationships between chronic medical conditions and frequency of Internet use, as well as changes in health behavior due to frequency of Internet use. The findings suggest that it is not merely the presence of a particular chronic illness, but rather the total number of chronic conditions that determine Internet use. Also, the more frequently a person uses the Internet as a source of health information, the more likely they are to change their health behavior. PMID:17606698
The civil war in the former Yugoslavia has taken a toll on the women's movement which has disintegrated across male-defined nationalist borders. The women's movement in this area got its start during the Second World War but was disbanded under communism until women's groups began to form in the 1970s. Today the women's movement has lost the power to oppose the war and has been unable to prevent widespread violence perpetuated against women. Some feminists who have refused to embrace nationalism and patriotism have been vilified and have had to seek refuge abroad. Recently, however, hundreds of nongovernmental organizations have been formed to provide support to women and children victimized by the war. Women have been raped and impregnated as a strategy of male warfare, and raped women who refused an abortion were ostracized. War-related rape has yet to be fully recognized as an international human rights violation, and the issue is being used as political propaganda in the former Yugoslavia while it is ignored elsewhere. Sensationalist reporting of these rapes has further victimized women and made them unable to give voice to their trauma. War also increases women's suffering by destroying economic and social welfare systems. Oxfam is helping women record their testimonies of war and reconstruct the fabric of their societies through programs which provide income-generation and training in micro-enterprises. In addition, Oxfam is strengthening electronic communication and networking among women's groups throughout the region. PMID:12347863
Satterlund, Travis D; Lee, Juliet P; Moore, Roland S
The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This article examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends, and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all. PMID:25715067
Saint Arnault, Denise; Roles, Deborah J
Asian immigrant women have the lowest utilization of mental health services of any ethnic minority (Garland, Lau, Yeh & McCabe 2005). Because help seeking for distress occurs within social networks, we examined how social networks supported or disabled help seeking for Japanese sojourners living in the US. Unfortunately, most of the literature about Japanese social relationships focuses on men in organizational settings. This study used intensive ethnographic interviewing with 49 Japanese expatriate women to examine how social relationships influenced psychosocial distress and help seeking. We found that the women in these samples engaged in complex, highly regulated, complicated and obligatory relationships through their primary affiliation with other "company wives." Like many immigrant women, increased traditional cultural norms (referred to in Japanese as ryoosai kenbo, or good wives and wise mothers), were expected from these modern women, and the enactment of these roles was enforced through scrutiny, gossip and the possibility of ostracism. Fears of scrutiny was described by the women as a primary barrier to their self-disclosure and ultimate help seeking. Understanding the social organization and support within the Japanese women's community is central to understanding how culturally specific social networks can both give support, as well as create social constraints to help seeking. Health oriented prevention programs must consider these social factors when evaluating the immigration stressors faced by these families. PMID:23162609
Millar, J.D.; Morris, G.K.; Shelton, B.G. [PathCon Labs., Norcross, GA (United States)
During the Bicentennial summer of 1976, American Legion Conventioneers in Philadelphia suffered a dramatic epidemic that left 34 dead. Near the end of 1976, scientists at the Centers for Disease Control (CDC) in Atlanta discovered the bacterium that caused Legionnaires` disease and named it Legionella. Nearly two decades later, a wealth of scientific information exists about the organism, its health effects, epidemiology, microbiology, aquatic ecology, molecular biology, immunology, pathophysiology, etc. Fortunately, for the engineer seeking to prevent Legionnaires` disease, it is unnecessary to master this complexity; the practice of prevention requires understanding a few, straightforward facts. The purpose of this paper is to present four messages about Legionnaires` disease that provide a conceptual framework to guide the crucial role of practical prevention. Those messages are: Legionnaires` disease is important; Legionnaires` disease is an environmental disease; Legionnaires` disease is preventable; and Legionnaires` disease prevention requires the right strategy.
Flórez, Gerardo; López-Durán, Ana; Triñanes, Yolanda; Osorio, Jesús; Fraga, Jaime; Fernández, José Manuel; Becoña, Elisardo; Arrojo, Manuel
Background The purpose of this study was to gain an understanding of the profiles of the new treatment demands posed by opioid addicts between 2005 and 2010 at the addictive disorders assistance units in Galicia, Spain. Methods A cluster analysis was performed using data from 1,655 treatment entrants. Clusters were constructed using sociodemographic and medicolegal variables. A cluster analysis was also conducted according to age. Once clusters were defined, their association with the following variables was analyzed: age at first use of opioids, years of use, frequency of opioid use in the previous month, psychiatric treatment, cocaine use, existence of a drug-dependent partner, and source of referral. Results Four clusters were obtained in the main analysis. Cluster 1 (34.01%) consisted of young males, cluster 2 (16.19%) consisted of not-so-young males, cluster 3 (32.62%) consisted mainly of older males and a small group of females, and cluster 4 (17.18%) was made up entirely of women. With regard to age-related clusters, two clusters were obtained in those under the age of 30 years: cluster 1 (73%) without medicolegal complications and cluster 2 (27%) with medicolegal complications. For those over the age of 30 years, two clusters were obtained: cluster 1 (53.92%) with hardly any medicolegal complications and cluster 2 (46.08%) with medicolegal complications. Conclusion Cluster analysis suggests that there have been no substantial changes in variables indicating greater severity in this new group of patients. Women are likely to seek help earlier, which reduces their duration of opioid use. The younger the patient, the shorter the duration of opioid use and the greater the likelihood of cessation of intravenous use. Public health systems should use a two-pronged treatment strategy of short but intense cessation therapies for women and younger treatment entrants and longer maintenance and replacement therapies for older treatment entrants with more psychosocial and medical complications.
and research methods. They experience and participate in the making of women's history in Washington, D.C. Part of public policy with a concentration in women's studies (http://bulletin.gwu.edu/arts-sciences/ womens-studies/ma-public-policy
Boath, E; Bradley, E; Henshaw, C
Little research has been carried out on the treatment of postnatal depression and clinicians must currently rely on general recommendations for the use of antidepressants. Antidepressant medication as the main treatment for depression in general practice has been shown to be effective when used as prescribed. However, research has shown that depressed patients consistently receive either no medication or consistently low doses of medication. This study will investigate women's experiences of taking antidepressant medication for postnatal depression. Thirty-five women with a clinical diagnosis of postnatal depression who had been prescribed antidepressant medication completed a questionnaire detailing their experiences of taking medication. Four open-ended questions and responses were discussed with the women. Of the 35 women who were prescribed medication, 4 chose not to take it because they were breast-feeding. Twenty of the women described finding medication helpful. Although only 4 women directly reported not taking antidepressants as prescribed, the comments made by a further 9 women suggest that compliance may have been poor. This study suggests a need to improve information about medication for postnatal depression. If this information is not provided, women are likely to continue to self-manage medication at a dosage that may be clinically ineffective. PMID:15715021
...Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN The STOP (Services â¢ Training â¢ Officers â¢ Prosecutors) Violence Against Women Formula Grant Program § 90.14 Forensic medical examination payment...
...Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN The STOP (Services â¢ Training â¢ Officers â¢ Prosecutors) Violence Against Women Formula Grant Program § 90.14 Forensic medical examination payment...
...Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN The STOP (Services â¢ Training â¢ Officers â¢ Prosecutors) Violence Against Women Formula Grant Program § 90.14 Forensic medical examination payment...
Background Uncertainty is regarded as a central dimension in the experience of illness and in the processes of alleviating it. Few studies from resource-poor settings have investigated this and how it interacts with other factors. This study aims to shed light on how healthcare-seeking develops in the context of multiple medical alternatives and to understand what bearing uncertainty has on this process. Methods The study was conducted in six purposively selected rural communities in Lao PDR. In each community, two focus group discussions were held: first with mothers and then with fathers of children younger than five years old. Eleven in-depth interviews with caregivers of severely sick children were conducted. Subsequently, traditional healers, drug vendors, community health workers, nurses and medical doctors were recruited for interviews or group discussions. The data were transcribed and key themes and similarities were identified. Additional readings were conducted to better understand the interactions of factors during which uncertainty was identified as one of several factors mentioned during interviews and focus group discussions. Results Care-seekers expressed a strong preference for initially seeking local providers. Subsequently, multiple providers were consulted to increase the chances of recovery. This resulted in patients leaving the health facilities before recovery and in ending the recommended treatment regime prematurely. These healthcare-seeking decisions reflect the social significance of being a responsible caregiver and of showing respect for household norms. In general, healthcare-seeking was shrouded in uncertainty when it came to selecting the right provider, the likelihood of finding the real cause of the illness, spending savings on treatments and ultimately the likelihood of recovery. Conclusions Care-seekers’ initial strong preference for local providers irrespective of the providers’ legitimacy indicates the need for a robust primary healthcare system. Care-seekers’ subsequent consultations must be understood in the light of their uncertainty regarding the skills of the available providers. The social connotations of seeking healthcare including the vulnerability of poor households in public health facilities were taken into account to only a limited extent by health workers. Health workers should have greater awareness of the social and cultural aspects of seeking care. PMID:23777408
Kalousova, Lucie; Burgard, Sarah A.
Most American households carry debt, yet we have little understanding of how debt influences health behavior, especially health care seeking. We examined associations between foregone medical care and debt using a population-based sample of 914 southeastern Michigan residents surveyed in the wake of the late-2000s recession. Overall debt and…
Brazier, Ellen; Fiorentino, Renée; Barry, Saidou; Kasse, Yaya; Millimono, Sita
This article presents findings from a study on women's delivery care-seeking in two regions of Guinea. We explored exposure to interventions promoting birth preparedness and complication readiness among women with recent live births and stillbirths. Using multivariate regression models, we identified factors associated with women's knowledge and practices related to birth preparedness, as well as their use of health facilities during childbirth. We found that women's knowledge about preparations for any birth (normal or complicated) was positively associated with increased preparation for birth, which itself was associated with institutional delivery. Knowledge about complication readiness, obstetric risks, and danger signs was not associated with birth preparation or with institutional delivery. The study findings highlight the importance of focusing on preparation for all births--and not simply obstetric emergencies--in interventions aimed at increasing women's use of skilled maternity care. PMID:24821280
Zhu, S?H; Nguyen, Q B; Cummins, S; Wong, S; Wightman, V
Objectives To examine the phenomenon of non?smokers spontaneously taking action to seek help for smokers; to provide profiles of non?smoking helpers by language and ethnic groups. Setting A large, statewide tobacco quitline (California Smokers' Helpline) in operation since 1992 in California, providing free cessation services in English, Spanish, Mandarin, Cantonese, Korean, and Vietnamese. Subjects Callers between August 1992 and September 2005 who identified themselves as either white, black, Hispanic, American Indian, or Asian (n??=??349?110). A subset of these were “proxies”: callers seeking help for someone else. For more detailed analysis, n??=??2143 non?smoking proxies calling from October 2004 through September 2005. Main outcome measures Proportions of proxies among all callers in each of seven language/ethnic groups; demographics of proxies; and proxies' relationships to smokers on whose behalf they called. Results Over 22 000 non?smoking proxies called. Proportions differed dramatically across language/ethnic groups, from mean (±95% confidence interval) 2.7 (0.3)% among English?speaking American Indians through 9.3 (0.3)% among English?speaking Hispanics to 35.3 (0.7)% among Asian?speaking Asians. Beyond the differences in proportion, however, remarkable similarities emerged across all groups. Proxies were primarily women (79.2 (1.7)%), living in the same household as the smokers (65.0 (2.1)%), and having either explicit or implicit understandings with the smokers that calling on their behalf was acceptable (90.0 (1.3)%). Conclusions The willingness of non?smokers to seek help for smokers holds promise for tobacco cessation and may help address ethnic and language disparities. Non?smoking women in smokers' households may be the first group to target. PMID:16565458
Created by Congress on June 5, 1920, to "promote the welfare of wage earning women," the US Department of Labor Women's Bureau (DOLWB) seeks to inform the public of women's work rights and employment issues. Bureau publications include Fact Sheets on Women in the Workplace, the legally informative Know Your Rights Series, survey results, and special reports on the history of the Equal Pay Act, child care, and financial success stories, among others (.pdf format). A Statistics and Data Library will be of particular use to educators, offering current and historical employment totals and earnings estimates in graphical, presentation formats. Male to Female wage and employment comparisons are also included on site, and some DOLWB studies delineate employment totals by occupation. Links to relevant DOL agencies and reports, as well as other women's labor organizations are also useful in researching the long history of women's labor struggles in the US.
Amer, Marwa R; Cipriano, Gabriela C; Venci, Jineane V; Gandhi, Mona A
The increasing popularity and use of dietary supplements has required health care professionals to become more knowledgeable of their properties, interactions, and adverse effects. The objectives of this review were to evaluate the safety of popular dietary supplements in breastfeeding mothers and the effects on the infants. Nine of the most popular herbal dietary supplements were identified based on the 2011 US market report of the top 10 selling botanicals and the most frequently received inquiries by the Ruth A. Lawrence Lactation Study Center at the University of Rochester Medical Center. Relevant publications were identified through June 2014 using PubMed and EMBASE; tertiary references, including the Drugs and Lactation Database and Natural Medicine Comprehensive Database, were also reviewed. These herbals include black cohosh, cranberry, echinacea, evening primrose, garlic, ginseng, melatonin, milk thistle, and St John's wort. Studies varied greatly with regard to study design, herbal intervention, and outcome measures. Findings suggested that dietary/herbal supplements have not been evaluated in high-quality clinical trials, and there is limited evidence supporting safety of use, particularly among lactating women. Therefore, it is essential for physicians to provide counseling for nursing mothers seeking information on dietary supplements, highlighting reliable safety profiles, inquiring about the potential benefits the patient is seeking, and assessing the patient's perception of this supplement during breastfeeding. More research and clinical trials are required in this area to guide the recommendations and expand our current knowledge of these products. PMID:25881578
Tribble, David B.
Recent data on medical school admissions are analyzed, and it is shown that they support the contention that the medical profession actively seeks liberally educated individuals, at least in the sense that "liberally educated" implies a reasonable breadth rather than a narrowly specialized education. (Author/LBH)
C. A. Tony Buffington
Background: Medically unexplained (or ‘functional’) symptoms (MUS) are physical symptoms that prompt the sufferer to seek healthcare but remain unexplained after an appropriate medical evaluation. Examples of MUS also occur in veterinary medicine. For example, domestic cats suffer a syndrome comparable to interstitial cystitis, a chronic pelvic pain syndrome of humans. Method: Review of current evidence suggests the hypothesis that
Godoy, Leandra; Mian, Nicholas D; Eisenhower, Abbey S; Carter, Alice S
Understanding parent appraisals of child behavior problems and parental help-seeking can reduce unmet mental health needs. Research has examined individual contributors to help-seeking and service receipt, but use of structural equation modeling (SEM) is rare. SEM was used to examine parents' appraisal of child behavior, thoughts about seeking help, and receipt of professional services in a diverse, urban sample (N = 189) recruited from women infant and children offices. Parents of children 11-60 months completed questionnaires about child behavior and development, parent well-being, help-seeking experiences, and service receipt. Child internalizing, externalizing, and dysregulation problems, language delay, and parent worry about child behavior loaded onto parent appraisal of child behavior. Parent stress and depression were positively associated with parent appraisal (and help-seeking). Parent appraisal and help-seeking were similar across child sex and age. In a final model, parent appraisals were significantly associated with parent thoughts about seeking help, which was significantly associated with service receipt. PMID:23504296
Morrison, Joanna; Basnet, Machhindra; Budhathoki, Bharat; Adhikari, Dhruba; Tumbahangphe, Kirti; Manandhar, Dharma; Costello, Anthony; Groce, Nora
Objective there is little evidence about disabled women?s access to maternal and newborn health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and care seeking. Our study explores disabled women?s experiences of maternal and newborn care in rural Nepal. Design we used a qualitative methodology, using semi-structured interviews. Setting rural Makwanpur District of central Nepal. Participants we purposively sampled married women with different impairments who had delivered a baby in the past 10 years from different topographical areas of the district. We also interviewed maternal health workers. We compared our findings with a recent qualitative study of non-disabled women in the same district to explore the differences between disabled and non-disabled women. Findings married disabled women considered pregnancy and childbirth to be normal and preferred to deliver at home. Issues of quality, cost and lack of family support were as pertinent for disabled women as they were for their non-disabled peers. Health workers felt unprepared to meet the maternal health needs of disabled women. Key conclusions and implications for practice integration of disability into existing Skilled Birth Attendant training curricula may improve maternal health care for disabled women. There is a need to monitor progress of interventions that encourage institutional delivery through the use of disaggregated data, to check that disabled women are benefiting equally in efforts to improve access to maternal health care. PMID:24768318
Wick, Laura; Hassan, Sahar
Women seek to give birth in a place where they feel safe, protected and secure. However, in conflict settings, many are forced to give birth in dangerous and frightening situations, where even the most rudimentary help and protection is unavailable. This study, based on interviews with women who gave birth and midwives during the 22-day Israeli attack on Gaza in December 2008 - January 2009, illustrates the vulnerability and trauma women experience when there is no safe place for childbirth. They recounted their overwhelming fear of not knowing when they would go into labour, not reaching a hospital or skilled attendant during the bombing, complications in labour without emergency care, and fear for the safety of their families and being separated from them. Most of the midwives were unprepared both materially and psychologically to attend births outside a hospital setting, while physicians were overwhelmed with severely injured patients. The capacity of midwifery care to keep birth normal whenever possible is particularly crucial in situations of political instability, conflict, poverty and disaster. Planning for emergency care by mapping the location of midwives, supplying them with basic equipment and medications, and legitimizing their profession with an appropriate scope of practice, licensing, back-up, and incentives would facilitate their ability to respond to birthing women's needs. PMID:23245403
Barr, B. J.
A cluster seeking technique is defined as a method of dividing data into subsets, called clusters. These clusters contain data points that are similar to each other and different from the elements of other clusters. Various cluster seeking techniques were broken down into seven categories: (1) probabilistic, (2) signal detection, (3) clustering, (4) clumping, (5) eigenvalue, (6) minimal mode seeking, and (7) miscellaneous. Each category is described and one or more algorithms of that type are presented.
Thompson, I. E.
In this paper, Mr Thompson, one of the research fellows appointed to the Edinburgh Medical Group research project, seeks to define medical ethics in relation to traditional ethics in the philosophical sense of enquiring into right and wrong modes of thought and conduct, and to carry that study further into the field of moral decisions made by doctors and other professional people who care for the sick. Until very recently the Victorian definition of medical ethics - medical etiquette - served the doctor well but the complexity of modern medicine and the involvement of other professional workers in medical care appears to have swept away the old framework and left a vacuum. A new medical ethic must be evolved to fill that vacuum, taking account not only of technological advances but also of relationships between doctors and other professionals associated with them and of the role in caring for the sick. PMID:781252
Madison Area Technical Coll., WI.
This guide is intended for use by trainers presenting the Tools for Tomorrow program, a technical college program to train women for employment in 13 skilled trades. Discussed in the first two sections are these topics: the program's purposes, barriers encountered by women seeking to enter trades, and various aspects of implementing the Tools for…
Renn, Kristen A.; Lytle, Jesse H.
The single-sex higher education sector is growing worldwide as more women seek access to postsecondary education. Although positive learning outcomes--including leadership development--of women's colleges are well documented in the United States, less is known internationally. We conducted an exploratory qualitative study of 46 student leaders…
Argues that the Spanish educational system does not discriminate between men and women in access to administrative positions, and that women in Spain are neither interested in nor motivated to seek positions in educational administration because they do not identify with the traditional hierarchical model of administration. Organizational reforms…
Maloch, Janelle K.; Bieschke, Kathleen J.; McAleavey, Andrew A.; Locke, Benjamin D.
This study found that treatment-seeking sexual minority college women evidenced serious eating concerns. Regardless of sexual orientation and compared with those with low levels of eating concerns, women with high levels of eating concerns evidenced increased depression, increased generalized anxiety, and a greater likelihood of experiencing…
Weissman, Myrna M.
Women more frequently report depressive symptoms, are diagnosed as depressed, and in far greater proportion than men, seek outpatient treatment for depression. Therefore, the ambulatory treatment of depression is of particular importance when reviewing the mental health of women. This paper reviews the data on sex differences in rates and…
Brunner, C. Cryss
This paper uses the seven principles of "stalking," the cultural wisdom for training Yaqui Indian warriors as described by Carlos Castenada, as a framework for organizing insights shared by successful women superintendents. "Stalking" is a metaphor for the process through which women seek success as superintendents. The research used a modified…
McLemore, Elisabeth C; Ramamoorthy, Sonia; Peterson, Carrie Y; Bass, Barbara L
Women make up an increasing proportion of students entering the medical profession. Before 1970, women represented 6% or less of the medical student population. In drastic contrast, nearly half of first-time applicants to medical schools in 2011 were women. However, the ratio of women to men is less balanced among graduates from surgical residencies and among leadership positions in surgery. Less than 20% of full professor, tenured faculty, and departmental head positions are currently held by women. However, this disparity may resolve with time as more women who entered the field in the 1980s emerge as mature surgeons and leaders. The aim of this article is to review the history of women in surgery and to highlight individual and institutional creative modifications that can promote the advancement of women in surgery. A secondary aim of the article is to add some levity to the discussion with personal anecdotes representing the primary author's (ECM) personal opinions, biases, and reflections. PMID:23012600
Bennett, Heather A; Boon, Heather S; Romans, Sarah E; Grootendorst, Paul
Background The purpose of this constructivist grounded theory study was to develop a theoretical model that explains women's processes of managing diagnosed depression when pregnant. Methods We explored the experiences of 19 women in Ontario who were diagnosed with depression during their pregnancy. Results The model that emerged from the analysis was becoming the best mom that I can. Becoming the best mom that I can explains the complex process of the women's journey as they travel from the depths of despair, where the depression is perceived to threaten their pregnancy and their ability to care for the coming baby, to arrive at knowing the self and being in a better place. In order to reground the self and regain control of their lives, the women had to recognize the problem, overcome shame and embarrassment, identify an understanding healthcare provider, and consider the consequences of the depression and its management. When confronting and confining the threat of depression, the women employed strategies of overcoming barriers, gaining knowledge, and taking control. As a result of counseling, medication, or a combination of both, women felt that they had arrived at a better place. Conclusion For many women, the idea that depression could occur during pregnancy was antithetical to their vision of the pregnant self. The challenge for a pregnant woman who is diagnosed with depression, is that effective care for her may jeopardize her baby's future health. This provides a dilemma for about-to-be parents and their healthcare providers. Improved awareness of depression during pregnancy on the part of healthcare professionals is needed to improve the women's understanding of this disorder and their ability to recognize and seek help with depression should it occur during the prenatal period. Further qualitative research is needed to determine the specific aspects that need to be addressed in such classes. PMID:17848199
Background The use of complementary and alternative medicine (CAM) has increased significantly in Australia over the past decade. Back pain represents a common context for CAM use, with increasing utilisation of a wide range of therapies provided within and outside conventional medical facilities. We examine the relationship between back pain and use of CAM and conventional medicine in a national cohort of mid-aged Australian women. Methods Data is taken from a cross-sectional survey (n?=?10492) of the mid-aged cohort of the Australian Longitudinal Study on Women’s Health, surveyed in 2007. The main outcome measures were: incidence of back pain the previous 12?months, and frequency of use of conventional or CAM treatments in the previous 12?months. Results Back pain was experienced by 77% (n?=?8063) of the cohort in the previous twelve month period. The majority of women with back pain only consulted with a conventional care provider (51.3%), 44.2% of women with back pain consulted with both a conventional care provider and a CAM practitioner. Women with more frequent back pain were more likely to consult a CAM practitioner, as well as seek conventional care. The most commonly utilised CAM practitioners were massage therapy (26.5% of those with back pain) and chiropractic (16.1% of those with back pain). Only 1.7% of women with back pain consulted with a CAM practitioner exclusively. Conclusions Mid-aged women with back pain utilise a range of conventional and CAM treatments. Consultation with CAM practitioners or self-prescribed CAM was predominantly in addition to, rather than a replacement for, conventional care. It is important that health professionals are aware of potential multiple practitioner usage in the context of back pain and are prepared to discuss such behaviours and practices with their patients. PMID:22809262
Shiquina L. Andrews; James Tres Stefurak; Sheila Mehta
Drawing on a college and community sample, this study utilised hierarchical multiple regression to examine the relative contributions of demographic variables, psychological treatment experience, religious service attendance, locus of control, and religious problem-solving style in predicting attitudes towards psychological help-seeking. Women, those holding a graduate degree, and those with treatment experience held more positive attitudes towards psychological help-seeking. While neither
Orme, John S.
The Performance Seeking Control (PSC) program evolved from a series of integrated propulsion-flight control research programs flown at NASA Dryden Flight Research Center (DFRC) on an F-15. The first of these was the Digital Electronic Engine Control (DEEC) program and provided digital engine controls suitable for integration. The DEEC and digital electronic flight control system of the NASA F-15 were ideally suited for integrated controls research. The Advanced Engine Control System (ADECS) program proved that integrated engine and aircraft control could improve overall system performance. The objective of the PSC program was to advance the technology for a fully integrated propulsion flight control system. Whereas ADECS provided single variable control for an average engine, PSC controlled multiple propulsion system variables while adapting to the measured engine performance. PSC was developed as a model-based, adaptive control algorithm and included four optimization modes: minimum fuel flow at constant thrust, minimum turbine temperature at constant thrust, maximum thrust, and minimum thrust. Subsonic and supersonic flight testing were conducted at NASA Dryden covering the four PSC optimization modes and over the full throttle range. Flight testing of the PSC algorithm, conducted in a series of five flight test phases, has been concluded at NASA Dryden covering all four of the PSC optimization modes. Over a three year period and five flight test phases 72 research flights were conducted. The primary objective of flight testing was to exercise each PSC optimization mode and quantify the resulting performance improvements.
Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios
Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide. PMID:25798383
Manoloudakis, Nikolaos; Labiris, Georgios; Karakitsou, Nefeli; Kim, Jong B; Sheena, Yezen; Niakas, Dimitrios
Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide. PMID:25798383
Horowitz, Michael D.; Rosensweig, Jeffrey A.; Jones, Christopher A.
The citizens of many countries have long traveled to the United States and to the developed countries of Europe to seek the expertise and advanced technology available in leading medical centers. In the recent past, a trend known as medical tourism has emerged wherein citizens of highly developed countries choose to bypass care offered in their own communities and travel to less developed areas of the world to receive a wide variety of medical services. Medical tourism is becoming increasingly popular, and it is projected that as many as 750,000 Americans will seek offshore medical care in 2007. This phenomenon is driven by marketplace forces and occurs outside of the view and control of the organized healthcare system. Medical tourism presents important concerns and challenges as well as potential opportunities. This trend will have increasing impact on the healthcare landscape in industrialized and developing countries around the world. PMID:18311383
Jejeebhoy, Shireen J; Santhya, K G; Acharya, Rajib
Intimate partner violence is pervasive in South Asia, yet married women's experiences regarding seeking help when faced with intimate partner violence and the health sector response remain largely unexplored. This commentary reviews the available published and unpublished literature and summarises what is known about the prevalence of marital violence against women and violence-related care-seeking experienced by women in this region. The commentary highlights that between one-fifth and one-half of married women are affected by violence perpetrated by their husband in South Asia, violence starts early in a marriage and the health consequences are wide ranging and long lasting. Yet, very few women seek support from the health sector, and the health system is not proactive in identifying and supporting women at risk. A greater commitment to making the health system responsive to women in distress is essential and should be undertaken with the same level of commitment given to prevention programmes. PMID:24842297
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Owens, Christabel; Lambert, Helen; Donovan, Jenny; Lloyd, Keith R
Background Many suicides may be preventable through medical intervention, but many people do not seek help from a medical practitioner prior to suicide. Little is known about how consulting decisions are made at this time. Aim To explore how distressed individuals and members of their lay networks had made decisions to seek or not to seek help from a medical practitioner in the period leading up to suicide. Design of study Qualitative analysis of psychological autopsy data. Setting One large English county. Method Semi-structured interviews with close relatives or friends of suicide victims were conducted as part of a psychological autopsy study. Sixty-six interviews were transcribed verbatim and analysed using a thematic approach. Results Relatives and friends often played a key role in determining whether or not suicidal individuals sought medical help. Half the sample had consulted in their final month and many were persuaded to do so by a relative or friend. Of those who did not consult, some were characterised as help-resisters but many others had omitted to do so because no-one around them was aware of the seriousness of their distress or considered it to be medically significant. A range of lay interventions and coping strategies was identified, including seeking non-medical help. Conclusion Greater attention needs to be given to the potential role of lay networks in managing psychological distress and preventing suicide. A balanced approach to suicide prevention is recommended that builds on lay knowledge and combines medical and non-medical strategies. PMID:16004734
Ngunjiri, Faith Wambura
Purpose: The purpose of this paper is to explicate spiritual leadership lessons of beneficence, courage, hope and ubuntu/humanness that are derived from the experiences of women leaders in Kenya. The paper seeks to connect African data with existing literature on spiritual leadership, to demonstrate where African spiritual leadership is similar…
McQuillan, Julia; Stone, Rosalie A. Torres; Greil, Arthur L.
Using data from a random sample of 580 midwestern women, the authors explore the association between lifetime infertility and life satisfaction. Past research shows lower life satisfaction among those seeking help for infertility. The authors find no direct effects of lifetime infertility, regardless of perception of a problem, on life…
This preliminary report of a research project in progress briefly outlines Zimbabwe's historical, geographic, and cultural heritage and describes the methodology being used. Traditionally, Zimbabwean women are viewed as inferior and subordinate in a patriarchal society. They perform much of the work but have no political power. This study seeks to…
Agampodi, Suneth Buddhika; Wickramasinghe, Nuwan Dharshana; Horton, Jennifer; Agampodi, Thilini Chanchala
Background Although maternal mortality has become a major focus on global public health agenda, maternal morbidity is a neglected area of research. The purpose of this paper is to present the burden of acute maternal illness during pregnancy. Methods A cross sectional study was carried out in Anuradhapura district, Sri Lanka. Pregnant women residing in the Anuradhapura district with a gestational age more than 24 weeks through 36 weeks were recruited to the study using a two-stage cluster sampling technique. All pregnant women who consented participated in a detailed interview using a structured questionnaire. Self reported episodes of acute illness during pregnancy were the main outcome measures. Secondary outcomes were utilization of medical services and frequency of hospitalizations. Results Nausea and vomiting during pregnancy (NVP) was experienced by 325 (69.7%) of the 466 pregnant women studied. Other common symptoms were backache (152, 32.6%), dizziness (112, 24.0%) and heartburn/regurgitation (107, 23.0%). Of the 421 pregnant women who reported ill health conditions 260 (61.8%) women sought medical treatment for these illnesses. Total number of episodes that needed treatment seeking were 373. Hospitalizations were reported by 83 (17.8%) pregnant women and the total number of hospitalizations was 109. The leading cause of hospitalization was NVP which accounted for 43.1% of total admissions and 49.1% of total days spent in hospitals. Conclusions Minor maternal ill health conditions affecting day-to-day life have a major burden on pregnancy period. Evidence based management guidelines and health promotion strategies are needed to control and prevent these conditions, in order to provide comprehensive, good quality maternal health care. PMID:23675528
Razali, S M; Najib, M A
The aim of this study is to explore the help-seeking behaviour of Malay psychiatric patients. A semi-structured interview based on a standard proforma was conducted to assess help seeking process and delays for Malay psychiatric patients attending the psychiatric clinic for the first time. Help-seeking process and delays were defined. Among 134 patients evaluated in the study, 69% had visited traditional healers (bomoh) for the present illness before consulting psychiatrists. The second popular choice of treatment was medical practitioner and only a small percentage of them had consulted homeopathic practitioners and herbalists. Patients who had consulted bomohs were significantly delayed in getting psychiatric treatment compared with those who had not consulted them. Consultation of bomohs was significantly higher among married patients, those with major psychiatric illnesses and in family who believed in supernatural causes of mental illness. However, there was no significant difference in age, gender, educational status and occupation between patients who had consulted and not consulted bomoh. We concluded that majority of the Malay psychiatric patients had sought the traditional treatment prior to psychiatric consultation. The strength of social support and the belief of the patients, friends, and/or relatives in supernatural causes of mental illness were strongly associated with the rate of traditional treatment. Deep-seated cultural beliefs were major barrier to psychiatric treatment. PMID:11201349