Background: Patients with cancer often delay seeking medical advice in developing countries. It can adversely influence the outcome of disease. Objectives: The present study was performed to determine the stage at diagnosis and delay in seeking medical care among women with breast cancer in Delhi, India. Patients and Methods: This was a cross-sectional study based on a census (case series) approach to reach all women (172) diagnosed with primary breast cancer “detected in surgery Out Patient Department (OPD) from January 2007 to December 2009” at Lok Nayak Hospital, Delhi, India. Patients were interviewed using a self-structure questionnaire. Seeking behavior variables were awareness of problem, first consultation, followed physician's advice, detection of problem, system of medicine and gap between knowing the problem and consultation (patient delay). Statistical Analysis was performed using the Microsoft SPSS-pc version 14.0 statistical program. The analytic methods were used (mean, standard deviation, X2, Fisher's Exact Test, K-S, Kruskal-Wallis) for variables. All statistical tests were performed at a significance level of 5% (P < 0.05). Results: the mean age of women was 46.99 years. 38.4% of women were ? 40 years. 61% of women were in stage IV of cancer at the time of diagnosis. The mean duration of gap between knowing the problem and consulting a physician (patients delay) was 10.90 months. There was no significant association between stage of cancer and consultation gap. A significant association was found between the stage of breast cancer and income; women with lower income had a higher stage of breast cancer (P < 005). Conclusions: A significant association was found between ages of women with their delays in consultation. Delay is still prevalent amongst women with breast cancer. It seems necessary to design educating programs for women in both clinical and community settings, about breast cancer and early detection practices.
Pakseresht, Sedigheh; Ingle, Gopal Krishna; Garg, Suneela; Sarafraz, Nahid
Background Menstrual symptoms are associated with various health problems in women of reproductive age, and this may impact their quality of life. Despite this, Japanese women are likely to hesitate seeking a specialist’s medical help for their menstrual symptoms. Purpose To study subject parameters including symptom severity, gynecological disorders, and treatments in medical care-seeking women (outpatient) and women opting for self-care (nonvisit), to identify reasons why Japanese women do not see a gynecologist, and to document the benefit of gynecologist visits by assessing the impact on women’s daily lives. Methods Two online surveys were conducted among women aged 15–49 years. Sampling was structured to approximate the age and geographic distribution in Japan. Results of the first survey and part of the second survey on the overall current burden of menstrual symptoms are reported in a separate publication. Further outcomes from the second survey reported in this paper included data from the outpatient (n=274) and nonvisit (n=500) groups on symptom severity, gynecological disorders, medical treatment use, reasons for not seeking medical care, and the improvement of daily life. Results The outpatient group tended to have greater symptom severity compared to the nonvisit group. Uterine fibroids, dysmenorrhea, endometriosis, and premenstrual syndrome were the most commonly self-reported diagnoses, and oral contraceptives were frequently prescribed at gynecologist visits. Nonvisit group subjects felt that gynecologist consultations were unnecessary or felt resistant to them. Daily life was significantly improved after medical treatment from a gynecologist visit with associated economic savings, whilst the nonvisit group had no change after taking over-the-counter drugs to relieve their menstrual symptoms. Conclusion The present study results indicate that Japanese women who were suffering from menstrual symptoms could benefit from visiting a gynecologist for easing their symptoms, hence improving their daily life. PMID:24368891
Tanaka, Erika; Momoeda, Mikio; Osuga, Yutaka; Rossi, Bruno; Nomoto, Ken; Hayakawa, Masakane; Kokubo, Kinya; Wang, Edward CY
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
Tiihonen Möller, Anna; Bäckström, Torbjörn; Söndergaard, Hans Peter; Helström, Lotti
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
Sarah Horton; Stephanie Cole
In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted. PMID:1483530
Objective To map the knowledge about and attitudes toward birth control methods among women in Kathmandu, Nepal, and to compare the results between women seeking an induced abortion and a control group. Method This was a cross-sectional cohort study with matched controls. Women aged 15–49 years seeking medical care at the Department of Gynecology and Obstetrics at Kathmandu Medical College were included and interviewed. A case was defined as a woman who sought an elective medical or surgical abortion. A control was defined as a woman who sought medical care at the outpatient department or had already been admitted to the ward for reasons other than elective abortion. A questionnaire developed for the study – dealing with different demographic characteristics as well as knowledge about and attitudes toward contraceptives – was filled out based on the interview. Results A total of 153 women were included: 64 women seeking an abortion and 89 controls. Women seeking an abortion had been pregnant more times than the control group and were more likely to have been informed about contraceptives. Women with higher education were less likely to seek an abortion than women with lower education. There was no significant difference in knowledge about and attitudes toward contraceptives between cases and controls. The women considered highest possible effectiveness to be the most important feature when deciding on a birth control method. Conclusion Women seeking abortion in Kathmandu had shorter education and a history of more pregnancies and deliveries than women in the control group. Education and counseling on sex and reproduction as well as on contraceptive methods probably need to be improved in Nepal to avoid unwanted pregnancies. Attitudes about contraceptives need to be further investigated to develop better and more effective methods to educate women about family planning in order to increase reproductive health. PMID:24672261
Berin, Emilia; Sundell, Micaela; Karki, Chanda; Brynhildsen, Jan; Hammar, Mats
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
Brown-Bowers, Amy; McShane, Kelly; Wilson-Mitchell, Karline; Gurevich, Maria
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
SusanS Glander; MaryLou Moore; Robert Michielutte; LinnH Parsons
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
The presence in the West of women physicians with degrees from regular medical schools spans a period of approximately 130 years. Women's Medical College of Pennsylvania graduated many of these early women physicians. The first woman medical graduate of a western school was Lucy M. Field Wanzer, who finished in 1876 at the Department of Medicine, University of California in San Francisco. Soon thereafter, schools that would become Stanford University and the Oregon Health Sciences University schools of medicine, as well as the newly founded University of Southern California, were contributing to the pool of women physicians. The University of Michigan Medical School, the first coeducational state medical school, also educated some of the western women physicians, who by 1910 numbered about 155. This regional account of the progress of women physicians as they strove to become an integral part of the profession emphasizes the familiar themes of altruism, ingenuity, and perseverance that characterized their efforts. Images PMID:3074578
Scully, A L
As opposed to studies focused on the role of reconstruction in the rehabilitation of cancer patients, the aim of this study is to define what kind of women undergo post-mastectomy reconstruction. The social, cultural and psychological variables influencing women in this choice were assessed using a questionnaire administered to 45 women who had breast reconstruction and 51 who did not. An univariate analysis shows significant differences between the two groups regarding age, education, socioeconomic status, leisure activities, sexual intercourse, information about breast reconstruction and fear of recurrence. These results show that social status is a deciding factor in a woman's access to information about reconstruction. If every women undergoing mastectomy is to be given the opportunity of plastic surgery, we think that information must be adapted to psychosocial profile. PMID:9243198
Charavel, M; Brémond, A; Courtial, I
Introduction and hypothesis The Autonomy Preference Index (API) and Control Preferences Scale (CPS) measure information-seeking and decision-making preferences. Our objective was to validate these scales in women with pelvic floor disorders (PFDs) and identify variables associated with decision-making preferences. Methods Women seeking care for PFDs completed the API and the CPS. Psychometric properties were determined. Multivariable analyses were used to identify correlates of information-seeking and decision-making preferences. Results One hundred ten women were recruited. Both scales demonstrated good psychometric properties (intraclass correlation coefficient=0.5 to 0.7; Cronbach’s alpha = 0.8 for the API, and r=?0.3 between the API and CPS). Based on scores, women had strong preferences to be well informed, but were more neutral in their decision-making preferences. In multivariable analyses, higher education levels were associated with a stronger desire for seeking medical information. Conclusions Women seeking care for PFDs vary in their preferences for participating in treatment decisions. PMID:20424822
Raker, Christina A.; Myers, Deborah L.; Clark, Melissa A.
This interpretive phenomenological study explored the health care-seeking experiences of undocumented Mexican immigrant women. Interviews and observations were conducted with 26 uninsured Mexican immigrant women with a chronic illness residing in California. Participant narratives revealed that their health care seeking experiences were often characterized by a lack of recognition of their human plight and devaluation of their personhood. Both structural and social barriers to care exist for immigrant women. Modifying current policies to allow undocumented immigrants more options to access care could help reduce stigma, reduce suffering, and encourage clinicians to recognize their humanity and their legitimate medical needs. PMID:22565795
Chandler, Juliet T; Malone, Ruth E; Thompson, Lisa M; Rehm, Roberta S
Objective: To assess how English language use by Hispanic women affects their preferences for participating in decision making and information seeking regarding medical care. Methods: The study included 235 Hispanic women aged 35-61 years participating in a larger multicenter study, the Ethnicity, Needs, and Decisions of Women (ENDOW) Project. Participants were recruited from community settings and primary care public health
Guillermo Tortolero-Luna; Theresa Byrd; Janet Y. Groff; Adriana C. Linares; Patricia D. Mullen; Scott B. Cantor
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.
Janine Farrell; Thea Cacchioni
To determine the images of women in picture advertisements, a stratified random sample of 32 medical journals, representing approximately 12% of medical journals published in the United States that are directed toward physicians in clinical practice, was subjected to content analysis. The sample consists of 209 different ads. The subjects of the ads included men, women, and children representing a
Joellen W. Hawkins; Cynthia S. Aber
In ancient Egypt, at least one woman carried the title of physician. University education for women started in 1930. Today, women are practicing in all disciplines and are effective in health care. Egyptian medical women represent 35% to 45% of the staff of faculties of medicine and about one-third of all medical graduates. They have contributed to the improvement of health, particularly in maternal and child health, and are role models for young girls in rural areas. PMID:10680407
Nasser, S; Baligh, R
By the Banal edict of 28 June 1903, while the country was part of the Austrian-Hungarian monarchy, women physicians in Croatia were granted permission to carry out medical practice. In the memory of that occasion a historical overview of the women's role in medical science and practice is presented. The evidence of women's medical skills dates back to 2500 BC in Ancient Egypt. The 11th and 12th centuries saw first women gain access to medical schools in Europe. Women doctors practiced mainly gynaecology, obstetrics, cosmetics, skin and eye diseases. It took another seven centuries for them to be treated as men's equals as far as medical training and permission to work were concerned. In the 18th and 19th centuries the number of female physicians greatly increased in Europe, USA, and Canada. In Croatia the first woman medical doctor was Milica Sviglin Cavov, who graduated from the Medical School in Zürich in 1893, but was not allowed to work in the home country. The first woman to practice medicine in Croatia was Karola Maier Milobar in 1906. The first woman to have graduated from the Medical School in Zagreb, capital of Croatia, following its opening in 1917, was Kornelija Sertic The paper concludes with a view of the present-day role of women in medical practice, education and science. PMID:16808102
Zuskin, Eugenija; Piasek, Martina; Piasek, Gustav; Sari?, Marko; Mustajbegovi?, Jadranka; Susec, Tanja
This survey of individuals seeking methadone maintenance treatment was pursued to document the parenting status of drug-dependent men and clarify ways their status as parents differs from that of drug-dependent women. Data concerning demographic characteristics, drug abuse history, and parenting status were systematically coded from the medical records of 362 men and 162 women seeking methadone maintenance treatment during a 12-month period. Analysis of parenting status by gender indicated that, although a greater proportion of women were the parent of at least one biological child, there were actually more fathers than mothers within the cohort. Among the parents, fathers were more likely to have been abusing opioids when they first became a parent, and they were more likely to be living away from their children. There were no significant gender differences in the number of children or the average age of children. The results suggested that fathering may be an important, but largely neglected, treatment issue for drug-abusing men. PMID:15768572
McMahon, Thomas J; Winkel, Justin D; Luthar, Suniya S; Rounsaville, Bruce J
Seeks to identify the perceptions of African American women toward a study abroad program in West Africa and to make recommendations to increase their participation. Argues that study abroad programs provide opportunities for Black women and African women to learn about each other and share experiences that empower Black women who question their…
Morgan, Rose M.; Mwegelo, Desideria T.; Turner, Laura N.
Background: Women as active health information seekers play a key role in determining lifestyle and possible implementation of preventive measures, thereby improving the health of individuals, families and society. Although studies indicate that equipping people with adequate health information leads to optimal health outcomes, sometimes the complexity of human behavior and presence of barriers and limitations expose them to challenges. Objectives: This study was designed to explore women's experiences of health information seeking barriers. Patients and Methods: In this qualitative content analysis study, data collection was conducted regarding inclusion criteria, through purposive sampling and semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was performed constantly and simultaneously with data collection. Results: Five central themes were emerged to explain women's experiences of barriers to health information seeking as inadequate support from health care system, shame and embarrassment, costs, wrong ideas and beliefs and inadequate health literacy. Conclusions: It seems the accurate and evidence-based review of the current health system is crucial to support the health informative requirements in a community-based approach, respecting the community cultural-religious beliefs and client participation in health care and according to local resources. PMID:25834743
Nikbakht Nasrabadi, Alireza; Sabzevari, Sakineh; Negahban Bonabi, Tayebeh
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
Prata, Ndola; Holston, Martine; Fraser, Ashley; Melkamu, Yilma
This multimethod study explored women's information seeking behaviour and decision making regarding menopause, hormone replacement therapy (HRT), and use of complementary and alternative medicines (CAM) during menopause. This research was underway during the mass media release of the Women's Health Initiative (WHI) estrogen–progestin trial results, allowing an examination of the impact of this news on women's decisions. There were two
C. Nadine Wathen
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
Gwee, Kok Ann; Setia, Sajita
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
041 (a) 1-WH 06/2012 MEDICAL HISTORY--WOMEN'S HEALTH Page 1 of 1 MEDICAL HISTORY Â WOMEN'S HEALTH: _______________________ DOB: / / Mo. Day Year Please complete for your first Women's Health visit at University Health
Research consistently reports that older people tend not to seek medical help for sexual concerns or difficulties. This article reviews the literature to examine help-seeking for, and doctor–patient interactions about, sexual problems in the middle and later life age groups. Twenty-five articles from 1999 to 2010 were identified and analyzed. Significant barriers to seeking medical help included psychosocial factors relating
Sharron Hinchliff; Merryn Gott
The importance of pets in families, especially during major life stressors, is well documented. Research suggests links between pet ownership and intimate partner violence (IPV). This study explored abused women's decisions about pets when seeking help from a shelter. Interviews were conducted with 19 women who were pet owners. Using grounded theory methods, two patterns emerged surrounding abusers' treatment of pets, bonds to pets, women's decisions about pets upon seeking shelter, and future plans for pets. The presence of coercive control was central to these patterns. Women also discussed their experiences with and needs from shelter professionals and veterinarians with implications for practice. PMID:23670287
Hardesty, Jennifer L; Khaw, Lyndal; Ridgway, Marcella D; Weber, Cheryl; Miles, Teresa
In the breast cancer literature, "delayed presentation" is defined as a period of 3 months or more between the self-detection of a new breast symptom and the decision to seek help for it. Delay studies have overlooked the relevance of dominant medical discourses such as those concerning "proper" health. In this paper we use a critical discursive method to analyze interviews with 14 women about their symptom appraisal process to demonstrate how many inhabited a liminal space comprised of both "knowing and not knowing" about the symptom, and "acting and not acting" on it (interviews took place from January 2006 to April 2007). We describe three discursive themes that arose in the transcripts including "Doing the right thing", "Deliberate ignorance", and "Passive resistance." These women's narratives are juxtaposed with two commonly accepted medical discourses in relation to self-detected breast symptoms: That of the woman who was unaware of her symptom, or interpreted it as being insignificant, and therefore, not requiring medical attention; or that of the woman who noticed the symptom, interpreted it as threatening, and immediately sought medical attention. We suggest that such discourses are constricting and fail to account for the sizeable number of women who do not fit this mold (i.e., those who are both aware of the concerning change and delay presentation). We conclude that these constricting medical discourses effectively have a role to play in the contradictory reasoning or perceived irrationality of women's delay behavior when it occurs. PMID:22884943
Granek, Leeat; Fergus, Karen
Do men base their self-worth on relationships less than do women? In an assessment of lay beliefs, men and women alike indicated that men are less reliant on relationships as a source of self-worth than are women (Study 1). Yet relationships may make a different important contribution to the self-esteem of men. Men reported basing their self-esteem on their own relationship status (whether or not they were in a relationship) more than did women, and this link was statistically mediated by the perceived importance of relationships as a source of social standing (Studies 1 and 2). Finally, when relationship status was threatened, men displayed increased social-standing concerns, whereas women displayed increased interdependence concerns (Study 3). Together, these findings demonstrate that both men and women rely on relationships for self-worth, but that they derive self-esteem from relationships in different ways. PMID:23658253
Kwang, Tracy; Crockett, Erin E; Sanchez, Diana T; Swann, William B
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
Khakbazan, Zohreh; Taghipour, Ali; Latifnejad Roudsari, Robab; Mohammadi, Eesa
Purpose/Objectives To examine relationships among demographic variables, healthcare system distrust, lung cancer stigma, smoking status, and timing of medical help–seeking behavior in individuals with symptoms suggestive of lung cancer after controlling for ethnicity, socioeconomic status, and social desirability. Design Descriptive, cross-sectional, correlational study. Setting Outpatient oncology clinics in Louisville, KY. Sample 94 patients diagnosed in the past three weeks to six years with all stages of lung cancer. Methods Self-report, written survey packets were administered in person followed by a semistructured interview to assess symptoms and timing characteristics of practice-identified patients with lung cancer. Main Research Variables Timing of medical help–seeking behavior, healthcare system distrust, lung cancer stigma, and smoking status. Findings Lung cancer stigma was independently associated with timing of medical help–seeking behavior in patients with lung cancer. Healthcare system distrust and smoking status were not independently associated with timing of medical help–seeking behavior. Conclusions Findings suggest that stigma influences medical help–seeking behavior for lung cancer symptoms, serving as a barrier to prompt medical help–seeking behavior. Implications for Nursing When designing interventions to promote early medical help–seeking behavior in individuals with symptoms suggestive of lung cancer, methods that consider lung cancer stigma as a barrier that can be addressed through public awareness and patient-targeted interventions should be included. PMID:24769603
Carter-Harris, Lisa; Hermann, Carla P.; Schreiber, Judy; Weaver, Michael T.; Rawl, Susan M.
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
Jerry Ingram; Robin D. Rawls; H. Dean Moberly
Women seeking shelter from intimate partner violence are at an increased risk for suicide ideation and attempts compared to women in the general population. Control-based violence, which is common among shelter-seeking women, may play a pivotal role in the development of suicide ideation and attempts. Current risk assessment and management practices for shelter-seeking women are limited by the lack of an empirically grounded understanding of increased risk in this population. We argue that in order to more effectively promote risk assessment and management, an empirically supported theory that is sensitive to the experiences of shelter-seeking women is needed. Such a theory-driven approach has the benefits of identifying and prioritizing targetable areas for intervention. Here, we review the evidence for the link between coercive control and suicide ideation and attempts from the perspective of Baumeister's escape theory of suicide. This theory has the potential to explain the role of coercive control in the development of suicide ideation and eventual attempts in shelter-seeking women. Implications for suicide risk assessment and prevention in domestic violence shelters are discussed. PMID:24415137
Wolford-Clevenger, Caitlin; Smith, Phillip N
Information behavior includes activities of active information seeking, passive acquisition of information, and information use. Guided by the Elaboration Likelihood Model, this study explored elderly Singaporean women's health information behavior to understand how they sought, evaluated, and used health information in everyday lives. Twenty-two in-depth interviews were conducted with elderly Chinese women aged 61 to 79. Qualitative analysis of the interview data yielded three meta-themes: information-seeking patterns, trustworthiness of health information, and peripheral route of decision making. Results revealed that elderly women took both systematic and heuristic approaches to processing information but relied on interpersonal networks to negotiate health choices. PMID:24919105
Chang, Leanne; Basnyat, Iccha; Teo, Daniel
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 intervention or the standard chemical dependence intervention. The Seeking Safety participants
Anna Cash Ghee; Lanny C. Bolling; Candace S. Johnson
Women who seek medical care following sexual assault are usually evaluated and treated in an emergency department (ED). Therefore, EDs can be an important source of sexual assault surveillance data. The authors compared the incidence of sexual assault presenting for emergency care in a single county during July to November of 1974 and 1991.…
Magid, David J.; Houry, Debra; Koepsell, Thomas D.; Ziller, Andrew; Soules, Michael R.; Jenny, Carole
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
Kostick, Kristin M; Schensul, Stephen L; Jadhav, Kalpita; Singh, Rajendra; Bavadekar, Amruta; Saggurti, Niranjan
We examined male partners' influence on the decision to seek medical help for infertility using the National Study of Fertility Barriers. Building upon an existing help-seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we…
Johnson, Katherine M.; Johnson, David R.
This grounded theory study in California, United States was an inquiry into the perceptions of health of Cambodian women in resettlement. The sequelae of significant life trauma on the health of women who escaped political conflict have received little attention in the nursing literature. Thirty-nine Cambodian women were recruited through a social service organization and verbal referrals. Open-ended questions and a conversational approach to dialogue and data gathering facilitated the interview process. Women were interviewed at home or the local temple. Seeking life balance emerged as the core perspective of this study. The relationships between thematic categories of seeking life balance, patterns of knowing, and caring for self were salient. Outcomes of these interrelationships further moved women's health toward disharmony or harmony. The findings of this study are limited by sampling participants in a tightly networked community and may serve as a pilot for future research. PMID:23545697
Late adolescent college women (N=578) were surveyed regarding eating disorders. Participants found to have eating disorders were younger and more likely to be white, in a sorority, and Christian. Additionally, they were most likely to say that they would prefer a close friend to support them when dealing with disordered eating, followed by their…
Prouty, Anne M.; Protinsky, Howard O.; Canady, Donna
Psychometric properties of the Eating Disorders Inventory-2 (EDI-2) when used for women with Binge Eating Disorder (BED) are assessed. The EDI-2 was administered to 144 outpatients seeking treatment for BED and 152 outpatients seeking treatment for Bulimia Nervosa (BN). Most EDI-2 scales had acceptable internal consistence for both the BED and BN samples. EDI-2 scales demonstrated adequate stability within a
Giorgio A. Tasca; Vanessa Illing; Vanessa Lybanon-Daigle; Hany Bissada; Louise Balfour
For women who experience abuse in childhood or adulthood, the assumptions are that surviving includes seeking help. This article presents an exploratory study on the prevalence of victimization in the lives of Caucasian, African American, and Latina women, if and to whom they disclosed their victimization, and where they turned for services and support. The results indicate Caucasian women turn more to traditional, therapeutic sources compared with African American women, who tend to use tangible supports. However, when controlling for a number of key variables, the ethnic differences disappear. Implications for further research and practice conclude this article. PMID:25680802
Postmus, Judy L
... to medical care, National Health Interview Survey Does health insurance coverage differ by race and ethnicity for young ... having health insurance coverage. Definitions Terms related to health insurance Health insurance coverage: Health insurance is broadly defined ...
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…
Olatokun, Wole Michael; Ajagbe, Enitan
Introduction and hypothesis To compare depressive symptoms in women with and without prolapse and evaluate impact on quality of life.\\u000a \\u000a \\u000a \\u000a Methods This is a secondary analysis of a case–control study assessing the effect of prolapse on body image. Cases had prolapse and\\u000a sought surgery (Pelvic Organ Prolapse Quantification stage ?2). Controls had stage ?1. Subjects completed the Pelvic Floor\\u000a Impact Questionnaire (PFIQ),
Chiara Ghetti; Jerry L. Lowder; Rennique Ellison; M. A. Krohn; Pamela Moalli
A new study by Johns Hopkins researchers shows that obese white women may be less likely than normal-weight counterparts and African-Americans of any weight or gender to seek potentially lifesaving colon cancer screening tests. Results of this study follow the same Johns Hopkins group’s previous research suggesting that obese white women also are less likely to arrange for mammograms, which screen for breast cancer, and Pap smears, which search for early signs of cervical cancer.
The authors examined the relationship among trauma, coping, depression, and mental health service seeking in a probability sample of sheltered homeless and low-income housed women. Results highlight the diversity of trauma. In a longitudinal analysis, women who lived in shelters or experienced major violence had a twofold increase in their risk of depression over the 6-month follow-up. In a cross-sectional
Nadine Recker Rayburn; Suzanne L. Wenzel; Marc N. Elliott; Katrin Hambarsoomians; Grant N. Marshall; Joan S. Tucker
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…
The objective of this study was to investigate the health-seeking practices of pregnant women in a periurban area in Cape Town, South Africa. This qualitative study was based on 103 minimally structured in-depth interviews of 32 pregnant women. Most women were interviewed on several occasions, and a group discussion was held with women. The interviews were taped, transcribed, analyzed ethnographically,
Naeemah Abrahams; Rachel Jewkes; Zodumo Mvo
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…
Kim, Jae Yop; Lee, Ji Hyeon
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"…
Cash Ghee, Anna; Bolling, Lanny C.; Johnson, Candace S.
Studies suggest that the experiences of unmarried young women seeking abortion in India differ from those of their married counterparts, but the evidence is limited. Research was undertaken among nulliparous young women aged 15-24 who had abortions at the clinics of a leading NGO in Bihar and Jharkhand. Over a 14-month period in 2007-08, 246 married and 549 unmarried young abortion seekers were surveyed and 26 who were unmarried were interviewed in depth. Those who were unmarried were far more likely to report non-consensual sexual relations. As many as 25% of unmarried young women, compared to only 9% of married young women, had had a second trimester abortion. The unmarried were far more likely to report non-consensual sexual relations leading to pregnancy. They were also more likely to report such obstacles to timely abortion as failure to recognise the pregnancy promptly, exclusion from abortion-related decision-making, seeking confidentiality as paramount in selection of abortion facility, unsuccessful previous attempts to terminate the pregnancy, and lack of partner support. After controlling for background factors, findings suggest that unmarried young women who also experienced these obstacles were, compared to married young women, most likely to experience second trimester abortion. Programmes need to take steps to improve access to safe and timely abortion for unmarried young women. PMID:20541095
Jejeebhoy, Shireen J; Kalyanwala, Shveta; Zavier, A J Francis; Kumar, Rajesh; Jha, Nita
This article draws on legal arguments made by civil society organisations to challenge the legal reasoning that apparently produced the decision in the Ms Y case in Ireland in August 2014. I show how legal standards of reasonableness and practicality ought to be interpreted in ways that are respectful of the patient's wishes and rights. The case concerned a decision by the Health Service Executive, the Irish public health authority, to refuse an abortion to a pregnant asylum seeker and rape survivor on the grounds that a caesarean section and early live delivery were practicable and reasonable alternatives justified by the need to protect fetal life. I argue that the abortion refusal may not have been a reasonable decision, as required by the terms of relevant legislation, for four different reasons. First, the alternative of a caesarean section and early live delivery was not likely to avert the risk of suicide, and in fact did not do so. Second, the consent to the caesarean section alternative may not have been a real consent in the legal sense if it was not voluntary. Third, an abortion refusal and forcible treatment fall below the norms of good medical practice as interpreted through a patient-centred perspective. Fourth, an abortion refusal that entails forms of cruel, inhumane and degrading treatment ought not to be a reasonable action under the legislation. PMID:25555759
Discusses curriculum reform in medical education to ensure that women's health issues receive adequate attention. There has been remarkable progress in this area, but the reforms have not yet been translated into equitable care for women patients. (SLD)
Donoghue, Glenda D.
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
Das, Ashavaree; Sarkar, Madhurima
Objectives: Quantitative review and categorization of available endocrinology related mobile apps for the iOS platform (Apple®) and outline of search strategies to identify appropriate mobile apps for this field. Methods: A total of 80 endocrinology related search terms were collected and grouped into 8 main categories covering different areas of endocrinology. These terms were then used to perform comprehensive searches in three categories of Apple’s app store, namely ‘Medicine’, ‘Health and Fitness’, and ‘Reference’. Results: Altogether, matches were found for only 33 of the 80 collected endocrinology related search terms; the majority of matches were found in the medical category, followed by matches for the health and fitness (27/33), and reference (16/33) categories. Restricting the search to these categories significantly helped in discriminating between health related apps and those having another purpose. The distribution of apps per category roughly matches what one can expect considering available data for incidence and prevalence of corresponding endocrinological conditions. Apps matching terms belonging to the spectrum of glucose homeostasis disorders are the most common. For conditions where patients do not have to constantly monitor their condition, apps tend to have a reference or educational character, while for conditions that require a high level of involvement from patients, there are proportionally more apps for self-management. With a single exception, the identified apps had not undergone regulation, and information about the data sources, professional backgrounds, and reliability of the content and integrated information sources was rare. Conclusions: While applying a good search strategy is important for finding apps for endocrinology related problems, users also need to consider whether the app they have found respects all necessary criteria regarding reliability, privacy and data protection before they place their trust in it. PMID:25152809
von Jan, Ute
The objectives of the present paper were to determine the rate and factors associated with seeking readmission among the clients admitted to an inpatient medical withdrawal management program, Vancouver Detox (VD). All clients who were admitted to VD between July 1, 2003, and June 30, 2004, were included in the study, and were followed up for 1 year. Multinomial logistic
Xin Li; Huiying Sun; David C. Marsh; Aslam H. Anis
Objective: To examine the factors that influenced African American men's medical help seeking. Method: Thematic analysis of 14 focus groups with 105 older, urban African American men. Results: African American men described normative expectations that they did not go to the doctor and that they were afraid to go, with little explanation. When they…
Griffith, Derek M.; Allen, Julie Ober; Gunter, Katie
This paper develops an analysis of women's perceptions of medical technology and the elements which shape them, and then draws out the implications for medicine and the medicalization thesis. In the first part of the paper we outline the macro-theoretical debates about medicalization and the role of medical technology in this process, and the consequences for those who use health
Jonathan Gabe; Michael Calnan
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
Cheng, Tyrone C; Lo, Celia C
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
Zamani, Maryam; Soleymani, Mohammad Reza; Afshar, Mina; Shahrzadi, Leila; Zadeh, Akbar Hasan
FOCUS Medical Student Fellowship in Women's Health Research Website: www and 5 awards annually Â Range of study in women's health, defined broadly; 1 award may be specific to CV completing 3rd year- some flexibility Â· Funding for 6 months of mentored, intensive women's health research
Studies on infertility in the Netherlands have little information on migrant Ghanaian women, even though Ghanaians are the third largest migrant group in Amsterdam. An exploratory study on the unmet needs, attitudes, and beliefs of migrant Ghanaian women with infertility problems living in the Netherlands, and the kinds of treatment they sought was undertaken in 1999. Qualitative data were collected from 12 women with primary or secondary infertility through narratives and 20 key informant interviews. The women described seeking treatment for infertility in Ghana, the Netherlands and other European countries, included use of infertility drugs, surgery, donor insemination and in vitro fertilisation. Illegal migrant women are not entitled to treatment paid by the national health system, and being of low income they cannot afford to pay directly for this or to obtain private health insurance. Herbalists and spiritual healers in both Amsterdam and Ghana were regularly consulted, especially for their willingness to address the social and spiritual aspects of infertility. To produce a pregnancy where male infertility was suspected, transfer of sexual rights to another man in the husband/partner's family, or a healer or priest, was a practical remedy that kept male infertility hidden. This study revealed difficulties experienced in clinical settings due to language barriers and cultural differences. Ghanaian women living in the Netherlands need much more information on the causes of infertility and their options. PMID:11424241
Yebei, V N
Background There is limited understanding of the factors that influence decisions to seek HIV care and treatment services in community settings. The aim of this study was to explore the socio-cultural and health system factors affecting health-seeking behaviour among deceased women in Kenya who were living with HIV at the time of death. Methods Out of a total of 796 deaths for which a caregiver was available to provide information, retrospective data were drawn from verbal and social autopsies administered to caregivers of 218 women who had died of AIDS-related illnesses aged 15 to 49 years. Information was collected on essential elements of the care-seeking process from the onset of severe illness episodes and analysed using qualitative and quantitative techniques. Results Results from the quantitative data showed that poor women were less likely to access formal health services (OR?=?0.2; p?0.001) compared to non-poor women. The qualitative data showed that socioeconomic status, poor knowledge and understanding of AIDS-related illness, distance to facility and transportation costs, medical pluralism, stigma, low HIV risk perception, lack of family support and health care system barriers contributed to delays/constraints in seeking care. Conclusions The findings highlight important issues that have implications for addressing challenges faced by women living with HIV, including non-adherence to treatment regimen and late diagnosis of HIV. Provision of transportation subsidies as part of the national social safety-net strategy can help in addressing financial constraints associated with transportation costs among poor women living with HIV. PMID:24968717
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…
Fanslow, Janet L.; Robinson, Elizabeth M.
This paper seeks to contribute to an understanding of the changing nature of support and information-seeking practices for women in the transition to first-time motherhood. In the context of increasing digitalisation, the significance of new virtual spaces for parenting is discussed. The paper demonstrates how women seek out alternative forms of expertise (specifically, non-medical expertise) and social support. The author argues for the importance of 'intimate mothering publics' through which women gather experiential information and practical support. These publics can act as a space for women to 'test' or legitimise their new identity as a mother. Intimate mothering publics are particularly useful for thinking about the meaning-making practices and learning experiences that occur during intimate online and face-to-face interactions. A variety of types of online support may be used during pregnancy. Surreptitious support in particular involves users invisibly receiving advice, information and reassurance that might otherwise be lacking. Access to intimate mothering publics is motivated by a number of factors, including feelings of community or acceptance, the desire to be a good mother or parent, emotional support and the need for practical and experiential advice. PMID:25339096
Johnson, Sophia Alice
OBJECTIVE: To investigate among young people the relation between the number of sexual partners and use of medical services in order to guide planning of sexually transmitted disease screening. DESIGN: Cross sectional study within a birth cohort using a questionnaire presented by computer. SETTING: Dunedin, New Zealand in 1993-4. SUBJECTS: 477 men and 458 women aged 21 enrolled in the
N. Dickson; C. Paul; P. Herbison
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
Tobin, Carolyn L; Murphy-Lawless, Jo
Growing evidence suggests intimate partner violence (IPV) and substance misuse are co-occurring problems that disproportionately affect low income urban women seeking care in emergency departments (EDs) and represent leading causes of injuries that result in ED visits. This paper examines temporal bidirectional associations between different types of drug and alcohol use and different types of IPV in a longitudinal study of a representative sample of 241 low-income urban women receiving emergency care from an ED in the Bronx, New York. After adjusting and matching for sociodemographics and potentially confounding multilevel risk and protective covariates, women who reported using heroin in the prior 6 months at Wave 1 were twice as likely as nonheroin-using women to indicate any physical, injurious, or sexual IPV at subsequent waves and were 2.7 times more likely to indicate experiencing an injury from IPV at subsequent waves. Crack or cocaine use in the past 6 months at Wave 1 was associated with an increased likelihood of injurious IPV and severe verbal abuse at subsequent waves. Findings also suggested that sexual IPV was significantly associated with subsequent use of crack or cocaine. The multiple bidirectional associations found linking these problems underscore the need for conducting routine screening for IPV and substance misuse among women in low-income urban EDs, and for improving linkages to services that will ultimately reduce the risk of morbidity, disability, and mortality related to these co-occurring problems. PMID:22023020
Gilbert, Louisa; El-Bassel, Nabila; Chang, Mingway; Wu, Elwin; Roy, Lolita
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
Machado, Carolina Leme; Fernandes, Arlete Maria Dos Santos; Osis, Maria José Duarte; Makuch, Maria Yolanda
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…
Moradi, Bonnie; Funderburk, Jamie R.
The aims of this study were to (1) assess the level of depression among women seeking cancer genetic counseling and risk assessment and to (2) identify and describe the demographic, health history, and health behavior correlates of clinically significant depression. Participants were 280 women presenting for an intake appointment at a university cancer risk clinic. During intake, participants completed questionnaires
Molly Middlecamp Kodl; Judith W. Lee; Alicia K. Matthews; Shelly A. Cummings; Olufunmilayo I. Olopade
Objective: To determine the prevalence of intimate partner violence (IPV) among women and teenagers seeking termination of pregnancy compared with those continuing with pregnancy. Methods: All women who presented for elective termination of pregnancy at a family planning clinic between June 2001 and January 2003 were invited to participate. This study was conducted by means of face-to-face interviews with clinic
Dominique Bourassa; Jocelyn Bérubé
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
Unipolar depression occurs twice as frequently among women as among men, and the pharmacological industry maintains a massive advertising campaign that encourages psychiatric professionals to rely on antidepressant medication as the solution to this problem. The pictorial content of drug advertisements shows women as victims of depression. The social problems and situational stresses associated with unipolar depression are never shown,
Arthur G. Nikelly
Background: Psychosocial factor is considered as intermediate social determinant of health, because it has powerful effects on health especially in women. Hence deeper understanding of the mental-health process needed for its promotion. The aim of this study was to explore women's experience of the mental-health problem and related action-interactions activities to design the appropriate interventions. Methods: In-depth interviews with women 18-65 years were analyzed according to the grounded theory method. The selection of Participants was based on purposeful and theoretical sampling. Results: In this study, a substantive theory was generated; explaining how female with the mental-health problem handled their main concern, which was identified as their effort to achieve comfort (core variable). The other six categories are elements in this process. Daily stress as a trigger, satisfaction is the end point, marriage is the key point and action - interaction activities in this process are strengthening human essence, Developing life skills and help seeking. Conclusions: Better understanding the mental-health process might be useful to design the interventional program among women with mental-health problems. PMID:24627750
Mohammadi, Farahnaz; Eftekhari, Monir Baradaran; Dejman, Masoumeh; Forouzan, Ameneh Setareh; Mirabzadeh, Arash
Background This qualitative study sets to fill a gap in knowledge by exploring the health seeking behaviour of rural women living in the occupied Palestinian territories (oPt). The existing literature on the oPt has so far focused on unravelling the country’s epidemiological and health system profile, but has largely neglected the assessment of factors shaping people’s decisions on health care use. Methods Based on a conceptual framework rooted in the Anderson behavioural model, we conducted 30 semi-structured interviews with purposely selected women and seven key informant interviews in three purposely selected villages in Ramallah district. Results Our findings indicate that women delay seeking professional care, use self-prescribed medications and home treatment, and do not use preventive and educational health services. Their health seeking behaviour is the result of the interplay of several factors: their gendered socio-cultural role; their health beliefs; financial affordability and geographical accessibility; their perceptions of the quality of care; and their perceived health needs. Conclusions Findings are discussed in the light of their policy implications, suggesting that adequate health policy planning ought to take into considerations socio-cultural dimensions beyond those directly pertinent to the health care system. PMID:23705933
Family health history (FHH) is a valuable health promotion tool that can be used to assess disease risk and make lifestyle\\u000a and screening recommendations. However, few FHH resources exist for medically underserved populations such as the urban Appalachian\\u000a community in Cincinnati Ohio. Women of Appalachian heritage with less than a college education who did and did not participate\\u000a in a
Robyn A. Cree; John Lynch; Margaret G. Au; Melanie F. Myers
This essay explores different views on the female body articulated within Hebrew medieval texts on women's health care. It also investigates whether texts also integrate women's own perceptions of their bodies, and of their needs and care. I have analysed how this genre of Hebrew literature understood two key issues in the construction of sexed bodies: menstruation and cosmetics. PMID:19847971
Navas, Carmen Caballero
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
Maternowska, M Catherine; Mashu, Alexio; Moyo, Precious; Withers, Mellissa; Chipato, Tsungai
Reproductive health has emerged as an organizational framework that incorporates men into maternal and child health (MCH) programs. For several decades, medical anthropologists have conducted reproductive health research that explores male partners’ effects on women's health and the health of children. This article summarizes exemplary research in this area, showing how ethnographic studies by medical anthropologists contribute new insights to
Matthew R. Dudgeon; Marcia C. Inhorn
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
Zamberlin, Nina; Romero, Mariana; Ramos, Silvina
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
Sheridan, Jennifer T.; Fine, Eve; Pribbenow, Christine Maidl; Handelsman, Jo; Carnes, Molly
We sought to examine characteristics of HIV-positive women with varying levels of engagement in care and care-seeking behaviors. From 2010 to 2013, in a multi-site US-based study of engagement in care among HIV-positive women, we conducted baseline interviews, which included socio-demographic, clinical, and risk behavior characteristics, and barriers to care. We used multinomial logistic regression to compare differences among three distinct categories of 748 women: engaged in care; not engaged in care, but seeking care ("seekers"); and not engaged in care and not seeking care ("non-seekers"). Compared with women in care, seekers were more likely to be uninsured and to report fair or poor health status. In contrast, non-seekers were not only more likely to be uninsured, but, also, to report current high-risk drug use and sexual behaviors, and less likely to report transportation as a barrier to care. Examining care-seeking behaviors among HIV-positive women not engaged in care revealed important differences in high-risk behaviors. Because non-seekers represent a particularly vulnerable population of women who are not engaged in care, interventions targeting this population likely need to address drug use and be community-based given their limited interaction with the health care system. PMID:25561307
Blackstock, Oni J; Blank, Arthur E; Fletcher, Jason J; Verdecias, Niko; Cunningham, Chinazo O
The objectives of the present paper were to determine the rate and factors associated with seeking readmission among the clients admitted to an inpatient medical withdrawal management program, Vancouver Detox (VD). All clients who were admitted to VD between July 1, 2003, and June 30, 2004, were included in the study, and were followed up for 1 year. Multinomial logistic regression was performed to investigate the potential risk factors associated with short-term (1 month) and long-term (2 to 12 months) requests for readmission simultaneously. The risk factor associated with short-term request for readmission was leaving VD against medical advice (AMA) during the index admission. Clients who reported to have hepatitis C virus (HCV) infection, whose primary preferred substance was alcohol, and those who were poly-drug users were more likely to request readmission in long-term. Clients with no fixed address were less likely to seek readmission between months 2 and 12.PMID:19042200
Li, Xin; Sun, Huiying; Marsh, David C; Anis, Aslam H
Factors affecting delay were studied in patients seeking treatment for the first time for a particular symptom at clinics in a major, innercity hospital. On the basis of the patients' retrospective report, the total time from first noticing a symptom to the seeking of treatment was divided into three sequential stages: 1) appraisal delay--the time the patient takes to appraise a symptom as a sign of illness; 2) illness delay--the time taken from deciding one is ill until deciding to seek professional medical care; and 3) utilization delay--the time from the decision to seek care until the patient goes to the clinic and uses its services. The variables used to predict the length of delay for each of the three stages and for total delay included reports on concrete, sensory perceptions and abstract, conceptual beliefs about one's symptoms, behavioral factors such as strategies for self-appraisal and techniques for coping with illness, emotional reactions, negative imagery elicited by the illness threat, situational barriers, and socio-demographic factors. Patients experiencing a very painful symptom and patients who did not read about their symptom had a short appraisal delay. Patients with old symptoms and those who imagined possible, severe consequences of their illness had long illness delays. Utilization delay was shortest for persons who were not concerned about the cost of treatment, who had a painful symptom, and who were certain that their symptom could be cured. Patients who had short total delays were persons who did not have a competing personal problem and who had a painful symptom. All of these predictors were significantly correlated with the measure of delay at or beyond the p = .01 level. It was concluded that different factors mediate delay in each of the three stages and that studies which use only a single measure of total delay are likely to be of limited value in understanding delay. PMID:759741
Safer, M A; Tharps, Q J; Jackson, T C; Leventhal, H
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
The library facilities, resource materials, training of librarians and so on are described at first. The library collection is that of middle sized medical library. However, since the facilities are not enough to handle it, it is necessary for the library to be supplemented by information services. Then primary information services such as reading of materials, interlibrary loan and journal acquisition system of the recent issues for each laboratory is outlined. Secondary information services centered around on-line information retrieval service, contents sheet service and preparation of index cards are also described. What a medical library should be is considered in terms of its relation to information services.
Few with eating disorders (EDs) access evidence-based treatments. We conducted a prospective exploration of help-seeking by 57 community women with bulimic-type EDs using the Framework approach of familiarization, identifying themes, indexing, charting and mapping and interpretation. The mean age of the sample was 33 years. Results found women sought help for concerns regarding perceived (over) weight rather than for eating,
Elizabeth J. Evans; Phillipa J. Hay; Jonathan Mond; Susan J. Paxton; Frances Quirk; Bryan Rodgers; Atiranjan K. Jhajj; Marta A. Sawoniewska
Male cancer patients' use of a national cancer information service, their requests and key predictors of these over the period April 1996 to March 1998 are presented, in comparison with women. The most frequent requests of 411 prostate, 162 male and 217 female colorectal cancer patients were similar: site-specific information, emotional support, publications, specific therapies. Research or clinical trials (P< 0.05), diet and nutrition (P< 0.001) requests differed between men with prostate and colorectal cancers; complementary therapies (P< 0.05), prognosis (P< 0.05) requests differed between male and female colorectal cancer patients. Among prostate cancer patients, employed men aged 60+ were more likely to need emotional support than retired men aged 70?+; men 59 years old were more likely to request publications, but less likely to enquire about specific therapies than others. Among male colorectal cancer patients, employed men were less likely to request site-specific information, but more likely to need emotional support than retired men; patients from geographical areas other than Thames were more likely to request publications; patients from manual classes were less likely to enquire about specific therapies than those from non-manual classes. The complexity of information and support seeking behaviour is demonstrated; no pattern was found among men or in comparison with women. Further research is needed to enable development of services that are appropriate to individual needs and concerns. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11531244
Boudioni, M; McPherson, K; Moynihan, C; Melia, J; Boulton, M; Leydon, G; Mossman, J
In this paper, we propose a system which aims at verifying integrity of medical images. It not only detects and localizes alterations, but also seeks into the details of the image modification to understand what occurred. For that latter purpose, we developed an image signature which allows our system to approximate modifications by a simple model, a door function of similar dimensions. This signature is partly based on a linear combination of the DCT coefficients of pixel blocks. Protection data is attached to the image by watermarking. Whence, image integrity verification is conducted by comparing this embedded data to the recomputed one from the observed image. Experimental results with malicious image modification illustrate the overall performances of our system. PMID:19162681
Huang, H; Coatrieux, G; Montagner, J; Shu, H Z; Luo, L M; Roux, Ch
Dalhousie Medical School Cancer Researcher Seeks Biomarkers of Treatment Success HALIFAX,NOVA Seeks Biomarkers of Treatment Success Wednesday, May 30, 2007: Halifax, Nova Scotia - A Dalhousie. Founded in 2001 by Dalhousie Medical School, Dalhousie Medical Research Foundation, and Cancer Care Nova
Objective: To ascertain the proportion of employed pregnant women who receive medical advice to stop working during pregnancy and to describe their characteristics.Methods: Data were analyzed from the Georgia Pregnancy Risk Assessment Monitoring System, a surveillance system that surveys new mothers about pregnancy risk factors, health behaviors, and birth-related outcomes. Employment during pregnancy was defined as work for pay for
Linda M Frazier; Amanda L Golbeck; Leslie Lipscomb
Objectives Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo. Methods Stratified two-stage cluster sampling was used to select women ?18 years old who had been pregnant within the prior three years. Participants were interviewed about their reproductive healthcare utilization and impressions of services received. Results We interviewed 1221 women, 98% of whom sought antenatal care (ANC). 78% of women began ANC after the first trimester and 22% reported <4 visits. Reasons for choosing an ANC facility included reputation (51%), friendly/accessible staff (39%), availability of comprehensive services (29%), medication access (26%), location (26%), and cost (21%). Most women reported satisfactory treatment by staff, but 47% reported that the ANC provider ignored their complaints, 23% had difficulty understanding responses to their questions, 22% wanted more time with the provider, 21% wanted more privacy, and 12% felt uncomfortable asking questions. Only 56% reported someone talked to them about HIV/AIDS. Strongest predictors of seeking inadequate ANC included low participant and partner education and lack of certain assets. Only 32% of women sought postnatal care. Some results varied by health zone. Conclusions Scaling-up interventions to improve reproductive health services should include broad-based health systems strengthening and promote equitable access to quality ANC, delivery, and postnatal services. Personal and structural-level barriers to seeking ANC need to be addressed, with consideration given to local contexts. PMID:23964667
Feinstein, Lydia; Mupenda, Bavon; Duvall, Sandra; Chalachala, Jean Lambert; Edmonds, Andrew; Behets, Frieda
Background Migrant 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 Chinese women were over-represented among abortion clinic attendees. Methods Retrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n?=?277) and Maori women (n?=?128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups. Results Chinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05). Conclusions Following contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about contraception and where to access it, so women can be better prepared to avoid unplanned pregnancy. PMID:22768231
Rose, Sally B.; Wei, Zhang; Cooper, Annette J.; Lawton, Beverley A.
The purpose of this study was to evaluate whether antihypertensive medication use, including long-term use, is associated with increased breast cancer incidence in women. We studied 210,641 U.S. registered nurses participating in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHS II). Information on antihypertensive medication use was collected on biennial questionnaires in both cohorts, and breast cancer cases were ascertained during this period. Multivariable-adjusted Cox proportional hazard models were used to estimate relative risks of invasive breast cancer over follow-up (1988-2012 in NHS, 1989-2011 in NHS II) across categories of overall antihypertensive medication use and use of specific classes (diuretics, beta blockers, calcium channel blockers, and angiotensin-converting enzyme inhibitors). During follow-up, 10,012 cases of invasive breast cancer developed (6718 cases in NHS and 3294 in the NHS II). Overall, current use of any antihypertensive medication was not associated with breast cancer risk compared with past/never use in NHS (multivariable-adjusted relative risk = 1.00, 95 % CI = 0.95-1.06) or NHS II (multivariable-adjusted relative risk = 0.94, 95 % CI = 0.86-1.03). Furthermore, no specific class of antihypertensive medication was consistently associated with breast cancer risk. Results were similar when we considered hypertensive women only, and when we evaluated consistency and duration of medication use over time. Overall, antihypertensive medication use was largely unrelated to the risk of invasive breast cancer among women in the NHS cohorts. PMID:25701121
Devore, Elizabeth E; Kim, Sung; Ramin, Cody A; Wegrzyn, Lani R; Massa, Jennifer; Holmes, Michelle D; Michels, Karin B; Tamimi, Rulla M; Forman, John P; Schernhammer, Eva S
Background: To examine ethnic groups differences in (a) prevalence of depressive disorders and (b) health related quality of life in fee-for-service and managed care patients (n=21?504) seeking care in general medical settings. Methods: Data are from the Medical Outcomes Study, a multi-site observational study of outpatient practices. The study screened patients of clinicians (family practice, internal medicine, cardiology, diabetology and
Maga E. Jackson-Triche; J. Greer Sullivan; Kenneth B. Wells; William Rogers; Patti Camp; Rebecca Mazel
More inquiry is needed into how Mexican immigrant survivors of intimate partner violence (IPV) are seeking help, to improve interventions designed to reach this isolated and vulnerable population. This grounded theory study, using a sample of 29 Mexican immigrant survivors of IPV and 15 key informants, examines the help-seeking process. Findings indicate that informal networks, particularly family and female friends, play a critical role in providing assistance and linking women to formal services. These findings have implications for the delivery of formal domestic violence services to this community as well as the response of police and other formal service systems. PMID:25234812
Background: Although women make up nearly half of medical school classes in the United States, just over 20% of residents in surgery are women (excluding obstetrics\\/gynecology). The objective of this study was to identify whether the proportion of women surgeons on the faculty who have frequent encounters with medical students during their surgery rotation influences the student’s perceptions about women
Leigh Neumayer; Susan Kaiser; Kimberly Anderson; Linda Barney; Myriam Curet; Donald Jacobs; Thomas Lynch; Christine Gazak
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
Elaine Scallan; Timothy F. Jones; Alicia Cronquist; Stepy Thomas; Paul Frenzen; Dina Hoefer; Carlota Medus; Fredrick J. Angulo
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
Ramos, Silvina; Romero, Mariana; Aizenberg, Lila
Intimate partner violence (IPV) has a detrimental effect on the wellbeing of victims and their children. Situational as well\\u000a as individual factors shape victims’ responses to the experiences of IPV in many ways. This study uses a quantitative approach\\u000a to examine the factors that influence victims’ decisions on whether and where to seek help. The role of (unborn) children\\u000a has
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
Mc Sharry, Jennifer; Baxter, Alison; Wallace, Louise M.; Kenton, Anthony; Turner, Andrew; French, David P.
Background: Critiques of the validity of the DSM diagnostic criteria for depressive disorder argue that it fails to differentiate between abnormal sadness due to internal dysfunction or depression (sadness without an identifiable cause), and normal sadness (sadness with a clear cause). Aims and Methods: A population survey was undertaken in adult education centres in Spain aiming to explore beliefs about depression and normal sadness. Two hypothetical case vignettes portrayed individuals experiencing deep sadness, both fulfilling criteria for major depressive disorder (DSM-IV), one with a clear cause, the other without an identifiable cause. Three hundred and forty-four (344) questionnaires were obtained (95% response rate). Results: Participants statistically significantly differentiated between the sadness-with-cause vignette, seen more frequently as a normal response, while the one without a cause was seen as pathological. Help-seeking behaviour recommendations followed this distinction: a medical option was statistically significantly more common when there was no cause for sadness. Socio-cultural variation in how people understand and deal with sadness was also found. Conclusions: This study emphasizes the importance of taking into account the context in which depressive symptoms occur as it seems that the absence of an appropriate context is what makes people conceptualize them as abnormal. It also raises questions about the lack of face validity of the current diagnostic classification for depressive disorder that exclusively uses descriptive criteria. PMID:22187003
Littlewood, Roland; Leavey, Gerard
This article reports a study of the possible impact of sociodemographic and interactional aspects of intimate partner violence\\u000a (IPV) on help-seeking behavior. Do different sociodemographic groups of IPV survivors use different professional supports\\u000a and treatments? Do different professional support and treatment agencies come predominantly in contact with women who have\\u000a been subjected to different characteristics of IPV? Do different interactional
Solveig Karin Bř Vatnar; Stĺl Bjřrkly
At present, the public image of the medical profession is changing as more women enter the medical field. Despite this dramatic surge in the number of women physicians, they are proportionately under and over represented in specific subfields of the medical profession. This study investigates the relationship between physician's gender (male or female), medical subfield specialty (OB\\/GYN or surgeon), and
The safe and effective use of medication is a concern for both older women patients and older women as caregivers. In 1989, twice as many antidepressants were prescribed for women as for men, and older women are more likely to have such drugs prescribed for them. According to studies, older women who live alone have the highest use of both…
Regina Univ. (Saskatchewan). Univ. Extension. Seniors Education Centre.
Objective: This study aims to provide a rich analysis of particular women’s medical education experiences.\\u000aDesign: One-on-one interviews and self-administered questionnaires Participants: 25 practicing women physicians who had graduated from U.S. medical schools.\\u000aResults: The author identified the following themes: 1) societal gender role assumptions significantly impact women physicians’ experiences as medical students, in practice, and as primary care givers.
Katherine M Butler; Julia Mason
We used data derived from two independent studies to examine the psychometric properties of a new scale to measure adolescents’ willingness to engage in sexual sensation-seeking behavior. In Study 1, the Sexual Sensation-Seeking Scale for Adolescents (SSSA) was administered to a sample of 715 African American adolescents ranging in age from 15 to 21 years. The SSSA demonstrated strong internal
Ralph DiClemente; Robin R. Milhausen; Laura F. Salazar; Joshua Spitalnick; Jessica McDermott Sales; Richard A. Crosby; Sinead N. Younge; Gina M. Wingood
IntroductionSocio-economic inequalities in basic maternal health interventions exist in Egypt, yet little is known about health-seeking of poor households. This paper assesses levels of maternal health-seeking behaviours in women living in poor households in rural Upper Egypt, and compares these to national averages. Secondly, we construct innovative measures of socio-economic resourcefulness among the rural poor in order to examine the association between the resulting variables and the four dimensions of maternal health-seeking behaviour.MethodsWe analysed a cross-sectional survey conducted in Assiut and Sohag governorates in 2010ż2011 of 2,242 women in households below the poverty line in 65 poorest villages in Egypt. The associations between four latent socio-economic constructs (socio-cultural resourcefulness, economic resourcefulness, dwelling quality and womanżs status) and receipt of any antenatal care (ANC), regular ANC (four or more visits), facility delivery and private sector delivery for womenżs most recent pregnancy in five years preceding survey were assessed using multivariate logistic regression.ResultsIn the sample, 58.5% of women reported using any ANC and 51.1% facility delivery, lower than national coverage (74.2% and 72.4%, respectively). The proportion of ANC users receiving regular ANC was lower (67%) than nationally (91%). Among women delivering in facilities, 18% of women in the poor Upper Egypt sample used private providers (63% nationally). In multivariate analysis, higher economic resourcefulness was associated with higher odds of receiving ANC but with lower odds of facility delivery. Socio-cultural resourcefulness was positively associated with receiving any ANC, regular ANC and facility delivery, whereas it was not associated with private delivery care. Dwelling quality was positively associated with private delivery facility use. Womanżs status was not independently associated with any of the four behaviours.ConclusionsCoverage of basic maternal health interventions and utilisation of private providers are lower among rural poor women in Upper Egypt than nationally. Variables capturing socio-cultural resourcefulness and economic resourcefulness were useful predictors of ANC and facility delivery. Further understanding of issues surrounding availability, affordability and quality of maternal health services among the poor is crucial to eliminating inequalities in maternal health coverage in Egypt. PMID:25424200
Benova, Lenka; Campbell, Oona; Sholkamy, Hania; Ploubidis, George B
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
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
Webber, Gail C.; Chirangi, Bwire
Recommendations for women with a deleterious BRCA1 or BRCA2 gene mutation include complex medical approaches related to cancer risk reduction and detection. Current science has not yet fully elucidated decision support needs that women face when living with medical consequences associated with known hereditary cancer risk. The purpose of this study was to describe health communication and decision support needs in healthy women with BRCA1/2 gene mutations. The original researchers completed an interpretive secondary qualitative data analysis of 23 phenomenological narratives collected between 2008 and 2010. The Ottawa Decision Support and Patient Centered Communication frameworks guided the study design and analysis. Women described a pattern wherein breast and ovarian cancer risk, health related recommendations and decisions, and personal values were prioritized over time based on life contexts. Knowing versus acting on cancer risk was not a static process but an ongoing balancing act of considering current and future personal and medical values, further compounded by the complexity of recommendations. Women shared stories of anticipatory, physical and psychosocial consequences of the decision making experience. The findings have potential to generate future research questions and guide intervention development. Importantly, findings indicate a need for ongoing, long-term, support from genetics professionals and decision support interventions, which challenges the current practice paradigm. PMID:24271037
Underhill, Meghan L; Crotser, Cheryl B
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 200 mg/day of sertraline or 0.5 mg/day of ondansetron for 3 weeks followed by an alcohol self-administration experiment (ASAE), then placebo for 3 weeks followed by a second ASAE, then receive the alternate drug, in a counterbalanced order, for 3 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 genotype 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 3-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 libitum 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
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
Molested women who completed a series of 16 weekly group psychotherapy sessions conducted by social workers improved substantially regarding various aspects of psychological functioning, including self-image, coping techniques, relationship issues, and mothering. In addition, there was significant improvement in all psychological symptom scales and all global indices of symptomatic distress measured by the SCL-90-R. Furthermore, the improvement was present immediately after therapy and, with the exception of the hostility score, persisted 1 year later. Although the somatization score was reduced, the number of visits for physical symptoms did not change. The patients studied manifested characteristics typical of previously surveyed women with a history of childhood abuse, including a frequent history of major surgery (Drossman et al., 1996; Longstreth & Wolde-Tsadik, 1993; Springs & Friedrich, 1992) and, in some, a previous problem with alcohol (Springs & Friedrich, 1992; Walker et al., 1995) or drugs (Longstreth & Wolde-Tsadik, 1993; Miller & McCluskey-Fawcett, 1993; Springs & Friedrich, 1992). Also, nearly one half of the subjects had irritable bowel syndrome, the prototypical functional bowel disorder (Drossman et al., 1995; Longstreth & Wolde-Tsadik, 1993; Scarinci et al., 1994; Walker et al., 1995). Most of their baseline SCL-90-R scores were > 1 SD above the nonpatient norms. A problem inherent in assessing the long-term benefit of this study and other group psychotherapy studies is the tendency for some patients to continue similar or different forms of therapy after completing the group sessions. More than one half of patients received subsequent therapy that could have influenced their status at 1-year follow-up. However, most of the symptom dimensions and all global indices were similar 1 year posttherapy in the women who did not receive more treatment as compared to results in the women who did. Patients who received additional therapy had higher somatization scores before, immediately after, and 1 year posttherapy; scores in the other group increased 1 year posttherapy. Although the indications for subsequent therapy were not surveyed, there was an association between additional psychological care seeking and somatization. Furthermore, improvement in psychological status reflected by the phobic-anxiety score immediately posttherapy may have contributed to the decision of some patients to seek subsequent therapy. In the group without additional treatment, the loss of some of the initial somatization improvement at 1 year may have contributed to the lack of reduction in medical care visits in the combined groups. We speculate that provision of additional therapy to more patients might have had a long-term effect on somatization and reduced medical visits. We obtained complete psychological data and nearly complete medical-visit data on our patients, and our survey included 1-year follow-up. Our survey did not meet rigorous methodological standards for an outcome study, however. We surveyed only a small number of patients and did not collect similar data on an untreated control group. It was not possible to distinguish health care visits for organic versus functional disorders, but such a distinction may be artificial, because psychological factors may influence health care seeking for "organic" illness. Because our measurements came from a subset of our patients who were willing to complete the survey questionnaires, we do not know how generalizable the findings are. There is increasing awareness among health care professionals that childhood sexual abuse is common and that it may have serious and long-term psychological and medical sequelae. Our data suggest that group psychotherapy by social workers for women victims may have long-lasting psychological and somatic symptom benefits. Reduction in health care usage was not found, and this outcome may require the identification and treatment of patients who need additi PMID:9766093
Longstreth, G F; Mason, C; Schreiber, I G; Tsao-Wei, D
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
Godin, G.; Naccache, H.; Pelletier, R.
Predictors of ever having sought adoption are evaluated for Hispanic and non-Hispanic White women. Analysis of the 2002 National Survey of Family Growth, a nationally representative study of reproductive health of 7,643 women aged 15 to 44 years, is employed. These include Hispanic and non-Hispanic White women aged 18 to 44 who are currently married and cohabiting (n = 3,118)
Kathleen A. Lamb
According to a recent Mexican survey, 10.72% of women have at some point experienced sexual partner violence, and 23.71% physical violence at the hands of their current or last partner. Using this survey and a series of semi-structured interviews with experts, this study used a mixed-methods approach to examine, first, whether women who experienced violence turned to law enforcement agencies for help, and the characteristics of these women. Second, the research examined what type of service and treatment they reported receiving from these agencies. Finally, the research examined reasons women did not request help from police and law enforcement agencies. PMID:23404245
Frías, Sonia M
Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy. PMID:22410271
A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (military sexual trauma [MST]). Associations between MST and trading sex were examined in 200 women enrolled in a crosssectional study of HIV risks
Jennifer L. Strauss; Christine E. Marx; Julie C. Weitlauf; Karen M. Stechuchak; Kristy Straits-Tröster; Ayaba W. Worjoloh; Christina B. Sherrod; Maren K. Olsen; Marian I. Butterfield; Patrick S. Calhoun
Estimating the causal effect of a first child on female labor supply is complicated by the endogeneity of fertility. This paper addresses this problem by focusing on a sample of women from the National Survey of Family Growth (NSFG) who sought help to become pregnant. After a certain period, only some of these women gave birth. Results using this…
Cristia, Julian P.
Using data from Wave 1 (2004-2006) of the National Survey of Fertility Barriers (NSFB), a national probability sample of women ages 25-45, we examine online information-seeking among ever-infertile women. Of the 1352 women who met criteria for infertility, 459 (34%) neither talked to a doctor nor went online for information, 9% went online only for information, 32% talked to a doctor but did not go online, and 25% did both. Guided by Chrisman's Health-Seeking Model and previous research on Internet use to obtain health information, we employ multinomial logistic regression to compare these four groups of ever-infertile women. Findings generally support Chrisman's model. Infertile women tend to seek information online as a complement to, rather than as a substitute for, in-person health-seeking. Greater faith in the ability of medical science to treat infertility and greater perceived stigma were associated with higher odds of using the Internet to obtain information about infertility. In general, women who perceived the symptoms of infertility as more salient had higher odds of using both online and in-person or only in-person health-seeking compared to online health-seeking. Women with greater resources had higher odds of using online sources of information. Strong network encouragement to seek treatment was associated with higher odds of in-person health-seeking and combining in-person and online health-seeking compared to only going online or doing nothing. PMID:24355477
Slauson-Blevins, Kathleen S; McQuillan, Julia; Greil, Arthur L
... 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 ...
Background Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic. Methods 200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010. Results Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner’s refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage. Discussion High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment. PMID:25811849
Haddad, Lisa B.; Feldacker, Caryl; Jamieson, Denise J.; Tweya, Hannock; Cwiak, Carrie; Chaweza, Thomas; Mlundira, Linly; Chiwoko, Jane; Samala, Bernadette; Kachale, Fanny; Bryant, Amy G.; Hosseinipour, Mina C.; Stuart, Gretchen S.; Hoffman, Irving; Phiri, Sam
This research aimed to investigate the extent to which women in Southern Ghana seeking infertility treatment perceived themselves as stigmatised in order to investigate the relationship between perceived stigma and infertility-related stress. A survey was conducted using face-to-face interviews in three languages with 615 women receiving infertility treatment on three health sites in Southern Ghana. The majority (64%) of women
Ernestina S. Donkor; Jane Sandall
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
Wright, Steve; Twardzicki, Maya; Gomez, Fabio; Henderson, Claire
The oral hormonal agent anastrozole improves clinical outcomes for women with breast cancer, but women have difficulty taking it for the five-year course. The unique medication-taking experiences related to self-management of anastrozole therapy for women with early stage breast cancer are not known. Our purpose was to describe the medication-taking experiences for postmenopausal women with early stage breast cancer who were prescribed a course of anastrozole therapy. Twelve women aged 58 to 67 years, midway through therapy, participated in audio-recorded interviews. Women's medication-taking experiences involved a belief in their importance and an imperative to take anastrozole. We found that women's side effect experiences, particularly menopausal symptoms, were significant, but only one woman stopped anastrozole due to side effects. Medication-taking included routinization interconnected with remembering/forgetting and a storage strategy. Some women noted a mutual medication-taking experience with their spouse, but most felt taking anastrozole was something they had to do alone. Our results provide insight into the way some women with early stage breast cancer manage their hormonal therapy at approximately the midpoint of treatment. Next steps should include examinations of patient-provider communication, potential medication-taking differences between pre- and postmenopausal women, and the effects of medication-taking on clinical outcomes. PMID:23326655
Wickersham, Karen; Happ, Mary Beth; Bender, Catherine M.
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
Grotegut, Chad A.; Chisholm, Christian A.; Johnson, Lauren N. C.; Brown, Haywood L.; Heine, R. Phillips; James, Andra H.
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
Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali
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
Xinyi Hu; Robert A. Bell; Richard L. Kravitz; Sharon Orrange
To what extent do MeSH (Medical Subject Headings) terms improve search effectiveness of different kinds of users? We observed four different kinds of searchers using an experimental information retrieval (IR) system: (1) search novices; (2) domain experts; (3) search experts and (4) medical librarians. The information needs were a subset of the relatively difficult topics originally created for the Text
The objective of this study was to verify factors associated with the use of medication by adults, with emphasis on the differences between men and women. It was a population-based, cross-sectional study with cluster sampling conducted in two stages in Campinas in the state of Săo Paulo in 2008. Among the 2,413 individuals aged 20 or older, the prevalence of use of at least one drug in the three days before the research was 45.4% (95% CI: 41.3 - 49.4) in men and 64.6% (95% CI: 59.8 - 69.2) in women. For adult men over 40 years old who were not working, former smokers, with one or more chronic diseases, with two or more health problems and who sought health care or a health professional in the two weeks preceding the research showed higher prevalence of medication use. Among women, a higher prevalence of use was observed in females over 40, obese, former smokers, who reported a short sleep pattern, with one or more chronic diseases and two or more health problems, and who reported seeking a health care service or professional in the past 15 days. The findings showed some differences in the determinants of drug use in relation to gender, revealing the greater importance of health-related behavior among women. PMID:25388199
Francisco, Priscila Maria Stolses Bergamo; Bastos, Tássia Fraga; Costa, Karen Sarmento; do Prado, Maria Aparecida Medeiros Barros; Barros, Marilisa Berti de Azevedo
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.
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
Bowen, Shelly-Ann; Williams, Edith M.; Stoneberg-Cooper, Chayah M.; Glover, Saundra H.; Williams, Michelle S.; Byrd, Michael D.
This paper provides an analysis of the potential impact of changes in recruitment and hiring processes in Portuguese higher education institutions – under the New Public Management framework – on the representation of women in academia. Based on official data from the Portuguese Ministry of Science, Technology and Higher Education, two major conclusions emerge. First, Portuguese higher education institutions reproduce
Teresa Carvalho; Rui Santiago
The island province of Samar, the third largest in the Philippines, was classified in 1996 as a third-class province. At the same time, its newly established city of Catbalogan is categorized as first class. This study presents the factors affecting Catbalogan women before they join the labour force. The female labour force participation rate of Catbalogan is at almost eighty
This paper provides an analysis of the potential impact of changes in recruitment and hiring processes in Portuguese higher education institutions--under the New Public Management framework--on the representation of women in academia. Based on official data from the Portuguese Ministry of Science, Technology and Higher Education, two major…
Carvalho, Teresa; Santiago, Rui
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…
Johnson, Emily; Lahey, Joanna
Medical Student Fellowship in Women's Health Research Perelman School of Medicine at the University in academic medicine Â· To promote research and education in women's health Dual Mission To support in women's health: 1 award may be specific to CV research Â Clinical, basic science or community Â· Open
Little is known about the cancer information seeking experiences of Chinese immigrants despite reported disparities in cancer\\u000a burden and use of cancer screening. This research used semi-structured interviews to the explore cancer information seeking\\u000a preferences and experiences of 50 English-as-a-second-language older Chinese immigrant women to Canada with different levels\\u000a of health literacy. Directed content analysis was used to identify three
Laura Todd; Laurie Hoffman-Goetz
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
Bailey, Genie L; Herman, Debra S; Stein, Michael D
This article draws upon letters to a colonial physician, contemporary printed medical advice and published medical texts to confirm that formal medical assistance and information about treatment options were available in late colonial New Spain. Publications approved and supervised by the government, doctors, and pharmacies provided up-to-date medical treatments, and individuals actively sought health care from physicians and pharmacists, and expected relief from their ailments. A tradition of government participation in public health in Spain supported structures in New Spain where the latest European advances joined local traditions and experimentation. Although historians may question the effectiveness of any particular cure or treatment, they must accept that individuals in late colonial New Spain participated in their own health care and expected relief from their ailments. PMID:17153157
Samayoa, Marianne B
Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313
This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs). The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002. Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification
Lena M. Lundgren; Hortensia Amaro; Linsey Ben-Ami
The current research is a pilot study that included 87 single women who responded to an announcement placed in one of the national newspapers and then filled out interview questionnaires. The study hypothesized three groups of variables for predicting elderly single women's appeals for help from health and welfare services: (a) demographic variables, (b) intrapersonal variables, and (c) interpersonal variables. The research tools were (a) a demographics questionnaire constructed specifically for this study; (b) a personal assessment of single life: chosen or unchosen, including a question regarding what single people think about bachelorhood/spinsterhood; (c) an approach to the institution of bachelorhood/spinsterhood; (d) self-evaluation questionnaire; (e) a sense of mastery over life questionnaire; (f) informal support networks questionnaire; and (g) an assessment of the appeal to health and welfare services for help. A special questionnaire was constructed, which included a list of health and welfare services. The research findings indicate connections among all the research variables. All the research hypotheses were confirmed. Special attention should be given to this one tenth and more of the elder population. It might improve the lives of those women and save Western governments a lot of money. PMID:20183153
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
Kratzke, Cynthia; Amatya, Anup; Vilchis, Hugo
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…
Casebeer, Linda; Bennett, Nancy; Kristofco, Robert; Carillo, Anna; Centor, Robert
BACKGROUND: In the Dominican Republic, a Latin American country with filariasis-endemic areas, more than 63,000 people have lymphatic filariasis and more than 400,000 people are at risk of future infection. In this paper, we explore the health beliefs, health-seeking behaviors and self-care practices of women with lymphoedema in filariasis-endemic areas to better understand the needs of women when developing lymphoedema
Bobbie Person; David G Addiss; L Kay Bartholomew; Cecilia Meijer; Victor Pou; Bart van den Borne
Background: Breast reconstruction (BR) may improve psychosocial and cosmetic outcomes after mastectomy for breast cancer but currently, few women opt for surgery. Reasons for this are unclear. The aim of this qualitative study was to explore access to care and the provision of procedure choice to women seeking reconstructive surgery. Methods: Semi-structured interviews with a purposive sample of patients who had undergone BR and professionals providing specialist care explored participants' experiences of information provision before BR. Interviews were transcribed verbatim and analysed using the constant comparative technique of grounded theory. Sampling, data collection and analysis were performed concurrently and iteratively until data saturation was achieved. Results: Both patients and professionals expressed concerns about the provision of adequate procedure choice and access to care. Lack of information and/or time, involvement in decision making and issues relating to the evolution and organisation of reconstructive services, emerged as potential explanations for the inequalities seen. Interventions to improve cross-speciality collaboration were proposed to address these issues. Conclusion: Inequalities in the provision of choice in BR exist, which may be explained by a lack of integration between surgical specialities. Pathway restructuring, service reorganisation and standardisation of training may enhance cross-speciality collaboration and improve the patient experience. PMID:23928662
Potter, S; Mills, N; Cawthorn, S; Wilson, S; Blazeby, J
The Women's Health Interschool Curriculum Committee of Ontario has developed goals and objectives for medical education based on a definition of women's health that includes emotional, social, cultural, spiritual and physical well-being. The author presents background information on how women have been treated as "other" and sex-role stereotypes have been reinforced by some of the assumptions, terminology and attitudes used in medical practice and research. The objectives address the biologic and social context of women's health, the effect of power differentials (particularly the imbalance in power between physicians and patients), sex-role stereotyping in medical practice and teaching, and the effect of individual physicians' attitudes toward women on the care they provide. These objectives are the first published effort to define what physicians should know about the social context of women's health. The committee encourages readers to debate, discuss and use these objectives. PMID:7859198
Title1 The individual determinants of care-seeking among middle-aged women reporting2 urinary, Poitiers, France.10 2. INSERM, CESP Centre for Research in Epidemiology and Population Health,11 U1018,Gender, Sexual and Reproductive Health Team, Univ Paris-Sud, UMRS12 1018, Kremlin-BicĂŞtre, France
Objective This study assessed knowledge of neurotic disorders, and attitudes and preferences toward professional help and treatment for them, among general medical outpatients in general hospitals in Xi’an, China. Methods General medical outpatients (N=372) from general hospitals in China were recruited by using a stratified cluster sampling method between June and September 2010. In face-to-face interviews, participants age 16 years or older were assessed for their knowledge, attitudes, and help-seeking preferences in regard to neurotic disorders (obsessive-compulsive disorder, social phobia, and panic disorder). Demographic data were also collected. Results Lack of insight into neurotic disorders was common among medical outpatients in general hospitals of Xi’an, China. Twenty-four percent to 58% of the outpatients had some knowledge of the symptoms and treatment of neurotic disorders. Only 11% of the outpatients would reveal to others that they or a family member suffered from neurotic disorders. When faced with the problem of neurotic disorders, the preference of the respondents was to visit a psychiatrist in a general hospital (44%), and only 17% would visit a physician in a psychiatric hospital. Major ways for the outpatients to obtain knowledge regarding neurotic disorders were via radio and television (36%), and only 18%223% of outpatients obtained knowledge about neurotic disorders through printed public health materials and by attending lectures. Conclusions Study results underscore the need for information campaigns aimed at improving the mental health literacy of general medical outpatients. Such campaigns must consider culturally relevant beliefs to facilitate the development of specific educational programs. PMID:24733481
Ni, Chunping; Ma, Lihua; Wang, Bo; Yan, Yongping; Huang, Yueqin; Wallen, Gwenyth R.; Li, Lu; Lang, Hongjuan; Hua, Qianzhen
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.
Verma, Anjana; Kumar Meena, Jitendra; Banerjee, Bratati
Many prescription medications have limited information regarding safety for use during pregnancy. In order to inform research on safer medication use during pregnancy, we examined prescription medication use among women in the United States. We analyzed data from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) to estimate the prevalence of prescription medication use in the past 30 days among pregnant women and non-pregnant women of childbearing age (15-44 years) and to ascertain the most commonly reported prescription medications by women in these groups. We assessed how the most commonly reported medications differed among groups defined by selected demographic characteristics, including age, race/ethnicity, and markers of socioeconomic status. Prescription medication use in the past 30 days was reported by 22 % of pregnant women and 47 % of non-pregnant women of childbearing age. The most commonly reported prescription medications by NHANES participants differed somewhat by pregnancy status; allergy and anti-infective medications were more common among pregnant women, while oral contraceptives were more common among non-pregnant women. Use of prescription medication for asthma and thyroid disorders was reported by both groups. Although prescription medication use in the previous 30 days was less common among pregnant women than non-pregnant women, its use was reported among almost 1 in 4 pregnant women. Many of the most common medications reported were for the treatment of chronic medical conditions. Given the potential impact of medications on the developing fetus, our data underscore the importance of understanding the safety of these medications during pregnancy. PMID:25287251
Tinker, Sarah C; Broussard, Cheryl S; Frey, Meghan T; Gilboa, Suzanne M
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
Tao, Donghua; Demiris, George; Graves, Rebecca S; Sievert, MaryEllen
U.S. Army Combat Medic serves as both Soldier and provider of combat casualty care, often in the heat of battle and with limited resources. Yet little is known about their help-seeking behavior and perceived stigma and barriers to care. Participants were three groups of U.S. Army Combat Medics surveyed at 3- and 12-months postdeployment from assignment with line units vs. those Medics who had never deployed to combat. The primary data source was surveys of mental health service utilization, perceived stigma and barriers to care, and depression and post-traumatic stress disorder screens. Medics who received help in the past year from a mental health professional ranged from 18% to 30%, with 18% to 30% seeking mental health assistance from other sources. Previously deployed Medics were more likely to obtain assistance than those who never deployed. Those meeting a mental health screening criteria were more likely to report associated stigma and barriers to care. Findings indicate that Medics in need of assistance report greater perceived barriers to mental health care, as well as stigma from seeking treatment, and that depression may be a salient issue for Medics. The longitudinal nature of the ongoing study will help determine the actual trajectory and onset of depression and post-traumatic stress disorder. PMID:25102550
Chapman, Paula L; Elnitsky, Christine; Pitts, Barbara; Figley, Charles; Thurman, Ryan M; Unwin, Brian
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
R C Henshaw; S A Naji; I T Russell; A A Templeton
Women's health topics of interest for continuing medical education were identified by 91 primary care physicians. Most felt that more knowledge of these topics would reduce the number of referrals to specialists. A more comprehensive, rather than reproductive, perspective of women's health was called for. (SK)
Kwolek, Deborah S.; Donnelly, Michael B.; Carr, Ellen; Sloan, David A.; Haist, Steven A.
Background: Although numerous studies have documented the psychiatric and physiological effects of anabolic-androgenic steroids (AAS) in males, virtually no studies have investigated the effects of illicit AAS use in women. Methods: We performed psychiatric and medical evaluations of 75 dedicated women athletes, recruited by advertisement primarily from gymnasiums in the Boston, Mass., area. Results: Twenty-five (33%) of the women reported
Amanda J. Gruber; Harrison G. Pope Jr.
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
Behets, F. M.; Miller, W. C.; Cohen, M. S.
Introduction There is increasing evidence that self-medications among pregnant women are common in many developing countries. Despite the adverse impact on pregnancy, there are few programs available for their control. The objective of this study was to assess the level of self-medication amongst Nigerian pregnant women in order to determine possible harmful effects on fetus. Methods Five hundred and eighteen 518 pregnant women, aged between 18 and 40 years, drawn from three General hospitals in Akwa Ibom State were assessed for self-medication and substance abuse using an instrument, adapted from a modified form of 117-item self-report questionnaire based on the WHO guidelines for students’ substance use survey. Results Of the 518 pregnant women assessed, 375 (72.4%) indulged in one form of self-medication or the other; 143 (27.6%) used only drugs prescribed from the antenatal clinic. A total of 157 (41.9%) pregnant women self-medicate fever/pain relievers; 47 (9.1%) mixture of herbs and other drugs; 15 (4.0%) sedatives; 13 (3.5%) alcohol; while 5 (1.3%) used kolanuts. Reasons for using these substances range from protection from witches and witchcrafts, preventing pregnancy from coming out, for blood; poor sleep, fever and vomiting and infections. There was a significant difference in the rate of using analgesics (X2=9.43, p=0.001); and antibiotic (X2=4.43, p=0.001) among pregnant women who were highly educated compared to those with little or no education. However, the level of education has no impact in the usage of native herbs. Conclusion This study shows that self-medication is common among pregnant women in our environment. There is need for adequate education of pregnant women during antenatal clinics on the potential danger of self-medication so as to prevent child and maternal morbidity and mortality. PMID:23308320
Abasiubong, Festus; Bassey, Emem Abasi; Udobang, John Akpan; Akinbami, Oluyinka Samuel; Udoh, Sunday Bassey; Idung, Alphonsus Udo
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…
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…
Albright, Brittany; Skipper, Betty; Riley, Shawne; Wilhelm, Peggy; Rayburn, William F.
The UCONN Medical Anthropology Forum, the Women's Studies Department, and the Middle East Studies in the Middle East" Marcia Inhorn, PhD, MPH, is a professor of anthropology and international affairs at Yale Life in Egypt" and "Quest for Conception: Gender, Infertility, and Egyptian Medical Traditions." Her
Health behavior plays an important role in the development, detection and course of cancer of the head and neck. Relevant health behavior includes prompt medical care seeking, and smoking and drinking cessation after diagnosis. This study examines the relationship between these health behaviors and health value and control beliefs, as well as psychological distress. Two hundred and sixty-four recently diagnosed
D. M. Tromp; X. D. R. Brouha; G. J. Hordijk; J. A. M. Winnubst; W. A. Gebhardt; M. P. van der Doef; J. R. J. De Leeuw
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
This study provides national prevalence estimates for complementary and alternative (CAM) use, visits to doctors for health\\u000a problems, and the effects of acculturation on health practices in Chinese women living in the United States. A national telephone\\u000a survey of 3,172 women on their use of complementary and alternative medicine was conducted in 2001. This study focuses on\\u000a a subsample of
Christine Wade; Maria T. Chao; Fredi Kronenberg
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
Fogel, Joshua; Teichman, Chaim
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
De Jesus, Maria
In response to the growing HIV epidemic in Africa in the 1990s, microbicide technologies emerged from discourses of empowerment and imaginings of the sexual lives and agency of African women. This draws on an anthropological enquiry which explored narratives from Tanzanian women who participated in a microbicide clinical trial. In the context of the HIV epidemic in Tanzania, women's lives were full of uncertainty and insecurity and their sexual lives were situated in a wider discourse of urban women's sexuality linked to morality and power. Their narratives revealed that women participated in the trial to seek knowledge as well as to 'try' the gel. In relation to their concerns about sexual health, the gel was experienced as cleansing as well as enhancing sexual desire and pleasure. The idea of empowerment imbued in the gel and transported to the women through the clinical trial was meaningful to the women, and this and ideas of sexual health and pleasure suggest future and hopeful possibilities for such HIV prevention technologies. However, if made widely available the potential for enhanced inequalities and further intensified surveillance of women's sexual lives must be considered. PMID:25317758
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
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.
Garman, Jamie L.
Background: Abortion in Iran, like other Islamic countries is severely restricted except in a few exceptions. However, some women who have an unwanted or mistimed pregnancy are seeking abortion. Objectives: This study aimed to compare the contraceptive use and its related factors among repeat and first- time induced abortion seekers in Iran. Patients and Methods: In this cross-sectional study, 417 married women (age range, 15-49 years) seeking abortion services at either a hospital or private office in Maku City, the northwest of Iran, were selected through convenience sampling between December 2010 and March 2011. All the subjects were asked about the contraceptive methods used during the three months before the current pregnancy and the use of any emergency contraception and forced sex. Women who mentioned reasons except than completing family size for their applying for abortion were excluded from the analysis. Characteristics of women were examined using chi-square and t test. T test and Mann-Whitney U test were used to compare contraceptive methods and the regularity of contraceptive use between repeat and first-time abortion seekers, respectively. Results: About 33.8% of the repeat abortion-seekers and 76.8% of first-time abortion seekers were using male methods (withdrawal and condom). Utilization of an intrauterine device for birth control was higher among women seeking repeat abortion than in first-time abortion seekers (P = 0.003). All of 31 pill users in the repeat abortion-seeking group missed three or more pills per month for three times during the three months before contraception. The repeat abortion seekers had used condom more regularly than those in the first-time abortion seekers. Forced sex was more prevalent in the abortion seekers who had used male method. Conclusions: Using male methods are prevalent in abortion-seeker women. An increased focus is needed on training the regular use of pills and using the emergency contraception for all of the couples who are first-time abortion-seekers. Moreover, information about the role of forced sex might be efficacious in decreasing illegally induced repeat abortion in couples who use condom or withdrawal methods. PMID:25830153
Bayrami, Roghieh; Javadnoori, Mojgan
This study examined the effects of socioeconomic status, knowledge and Health Belief Model variables on ever use of hormone therapy and other osteoporosis medications among older African–American women. One-hundred and two African–American women, 60 years old or older, randomly selected from Registers of Voters and a list of participants in educational activities of a university hospital, were interviewed in their
Christine G. Unson; Richard Fortinsky; Karen Prestwood; Susan Reisine
The literature has demonstrated that the continuity of diabetes care can lower medical service utilization and expenses. However, few studies have examined the effects of patients' medical care-seeking behaviors in the early stage after the diagnosis of diabetes on their long-term prognoses.This study aimed to examine the association of medical care-seeking behavior in the first year following diabetes diagnosis on the occurrence of diabetes-related complications among patients in Taiwan. This is a retrospective data collection with follow-up analysis and a nationwide population-based dataset in Taiwan. A total of 89,428 newly diagnosed type 2 diabetes mellitus patients during the period from 2000 to 2006 were followed up until 2010. The patients' medical care-seeking behaviors were classified as follows: high consistency to a physician, high consistency to a medical setting, medium consistency to providers, and low consistency to providers. The occurrence of diabetes-related complications and all-cause mortality were the primary outcomes of this study. Chi-square tests, ANOVAs, and Cox proportional hazard models were applied to examine the relationships between the predictors and medical outcomes.Compared to the patients with high medical care-seeking consistency to a physician, the multivariate-adjusted hazard ratios of diabetes-related complications occurrence among patients in the high consistency to a medical setting, medium consistency, and low consistency categories were 1.112 (95% CI 1.089-1.136, P?0.001), 1.226 (95% CI 1.205-1.248, P?0.001), and 1.536 (95% CI 1.504-1.567, P?0.001) in outpatient visits and 1.032 (95% CI 0.992-1.074, P?=?0.121), 1.056 (95% CI 1.022-1.092, P?=?0.001), and 1.208 (95% CI 1.164-1.254, P?0.001) in complication-incurred hospitalizations, respectively. The monotonic trend was sustained across different strata of age, gender, and disease complexity.The findings of this study suggest that the incentives of continuity of care and physician-patient relationship management should be reinforced during the early stage of diabetes care in future medical care systems. PMID:25700326
Liao, Pei-Ju; Lin, Zu-Yu; Huang, Jui-Chu; Hsu, Kuang-Hung
This paper presents results from a qualitative analysis of the perceptions Australian young women cigarette smokers have of the medical health messages espoused through anti-smoking campaigns. The study aims to show that the deployment of medico-scientific knowledges in the most recent series of anti-smoking campaigns disseminated in New South Wales Australia (those which emerged in the 1990s under the auspices
This research aimed to investigate the extent to which women in Southern Ghana seeking infertility treatment perceived themselves as stigmatised in order to investigate the relationship between perceived stigma and infertility-related stress. A survey was conducted using face-to-face interviews in three languages with 615 women receiving infertility treatment on three health sites in Southern Ghana. The majority (64%) of women in this sample felt stigmatised. Sequential multiple regression analyses indicated that higher levels of perceived stigma were associated with increased infertility-related stress. Also women with higher levels of education felt less infertility-related stress. The presence of an existing child/children, the number of years spent in infertility treatment and the type of marriage (monogamous/polygamous union) were less important in predicting stress. The findings suggest that the social status of infertile women derived from other factors can be of importance in minimising the impact of stigmatisation and stress related to infertility. These findings highlight the wider beneficial effects of improved educational opportunities for girls and women. PMID:17673344
Donkor, Ernestina S; Sandall, Jane
The stereotype that women are dependent on men is a commonly verbalized, potentially damaging aspect of benevolent sexism. We investigated how women may use behavioral disconfirmation of the personal applicability of the stereotype to negotiate such sexism. In an experiment (N = 86), we manipulated female college students' awareness that women may…
Wakefield, Juliet R. H.; Hopkins, Nick; Greenwood, Ronni M.
Background There is limited documentation of non-medical methods of labor induction and pain management during childbirth in the U.S. We estimated the prevalence of non-medical interventions for induction and pain management and examined the association between medical and non-medical care during labor. Methods We used a nationally-representative survey of U.S. women who gave birth in 2005 (N=1,382) to examine use of non-medical methods of labor induction and pain management. Using logistic regression, we calculated odds of non-medical and medical interventions to induce labor or mitigate pain, and the odds of medical induction and obstetric analgesia by whether non-medical methods were used. Results Nearly 30% of women used non-medical methods to start labor, and over 70% of women used non-medical pain management. Doula support was the strongest predictor of non-medical methods of labor induction (Adjusted Odds Ratio (AOR) = 3.0) and labor pain management (AOR = 5.7). Use of non-medical pain management was significantly associated with decreased odds of medical pain management (OR = 0.65); this relationship was attenuated with covariate adjustment. Conclusions Non-medical methods to induce labor and manage pain during childbirth are commonly used by U.S. women. Future research should examine effectiveness of these strategies and their influence on medical services use. PMID:24344703
Kozhimanil, Katy Backes; Johnson, Pamela Jo; Attanasio, Laura B.; Gjerdingen, Dwenda K.; McGovern, Patricia M.
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
Liu, Honghu; Longshore, Doug; Williams, John K.; Rivkin, Inna; Loeb, Tamra; Warda, Umme S.; Carmona, Jennifer; Wyatt, Gail
?unique? stressors. This research examines stress in Hispanic women students (all four years) at Texas A&M University System ? Health Science Center ? College of Medicine (TAMUS-HSC) at College Station and at the University of Texas Medical Branch (UTMB... the probability of success over a demand (Ramos & Mormede, 1998). TAMUS ? HSC-COM: Texas A&M University System ? Health Science Center ? College of Medicine at College Station, Texas. UTMB: The University of Texas Medical Branch at Galveston, Texas. ULAMS...
Anita, Connelly Nicholson
Use of antidepressant medications has been associated with increased risk of fracture, but prior studies have been limited\\u000a by incomplete control of confounders or a limited number of fractures. Use of antidepressant medications by 8,217 community-dwelling\\u000a women aged 69 and older from a population-based prospective cohort study at four US clinical centers was assessed by interview\\u000a at four examinations over
Susan J. Diem; Terri L. Blackwell; Katie L. Stone; Jane A. Cauley; Teresa A. Hillier; Elizabeth M. Haney; Kristine E. Ensrud
on ongoing studies of adults with and without mental illness, focused on the roles of hormones and genes in understanding sex differences in brain circuitry implicated in psychiatric disorders, disorders of aging of the brain, and their comorbidity with general medical disorders. RAs will work within a team approach
Patel, Aniruddh D.
Describes a collaboration to analyze and integrate elements of women's health into the core curriculum in internal medicine for a medical school's third year clerkship. Illustrates the new curriculum by describing the new module in pulmonary medicine and discusses the use of the process to integrate curricula in other interdisciplinary fields.…
Nicolette, JoDean; Jacobs, Michael D.
Mentoring for Women Mentoring Program of the Medical Faculty of the University of Bern and NCCR TransCure The mentoring program provides support to a successful academic and clinical career and how: Â· Mentors and mentees are from a related discipline Â· The relationship is individual one-to-one mentoring
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
Ramakrishnan, Aditi; Sambuco, Dana; Jagsi, Reshma
This article looks at the relationship between depression and other medical conditions in women. Depression is a major healthcare issue in its own right, but is also known to be related to many physical conditions which are routinely seen in a primary care provider's office and not thought of as \\
Marghani M. Reever
Women with current posttraumatic stress disorder (PTSD) comprise 30–59% of substance abuse treatment samples and experience a more severe course than women with either disorder alone. As yet, no effective treatment for this population has been identified. This paper reports outcome results on 17 women who completed a new manual-based 24-session cognitive behavioral group therapy protocol treatment, based on assessments
Lisa M. Najavits; Roger D. Weiss; Sarah R. Shaw; Larry R. Muenz
This article describes the challenges Sub-Saharan African women, including the author, have experienced in their pursuit of graduate studies in the United States and successful strategies that have been adopted. The author begins with a brief overview of the education of girls and women in Sub-Saharan African countries. She then explores the…
Gatua, Mary Wairimu
Individuals with eating disorders often exhibit profound ambivalence towards taking prescribed medications. They may actively restrict their intake of medications, take them and then purge them, or hoard them and 'binge' on them. Such behaviors are often labeled clinically as 'treatment resistance,' and power struggles over medication adherence between clinicians and clients often ensue. This paper advances an alternative perspective. Based on extensive ethnographic and clinical engagements with women with eating disorders who restrict their medication intake, the analytical focus is pivoted to consider medication refusal not only as communicative in the interpersonal realm, but also as a powerful means of self-communication within the context of a larger ethical and moral project. This larger project makes visible the underside of what Lakoff (2008) calls the logic of pharmaceutical reason, which presumes that people naturally strive for optimal health. For these clients, by contrast, the optimal state is not health, but deprivation, which is experienced as a moral imperative extending well beyond issues related to body weight and shape. Within a broader cultural context where medication use is increasingly viewed as a legitimate and even superior means of self-management, medication restriction among people with eating disorders signals layers of meaning far beyond 'treatment resistance.' Refusing needed or useful medication can become a private and personally meaningful practice, largely independent of the material or interpersonal effects of the drugs. This suggests that the symbolic significance of medications must in some cases be discerned by their selective absence. PMID:25082373
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…
Ragusa, Angela T.
This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM—III—R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates
Christy F. Telch
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…
Background: Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain. Methods: All women born in 1960–79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individual's changes on study variables over time. Data were retrieved from national administrative registers. Results: Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20–25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children. Conclusion: Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women. PMID:21450840
Hagman, Maud; Aronsson, Gunnar; Marklund, Staffan; Wikman, Anders
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…
van Zanten, Marta
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
Golden, Annis G; Pomerantz, Anita
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
Abate, Meskerem; Assefa, Nega; Alemayehu, Tadesse
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
De la Cruz-Sánchez, Ernesto; Aguirre-Gómez, Loli
Objective: To determine the validity of adult body weights and heights recorded in electronic medical records (EMRs) in the course of routine medical care. Background: EMRs allow the potential use of data collected in the course of routine medical care for a variety of research applications in many fields including epidemiology and comparative effectiveness studies. However, researchers familiar with carefully controlled measurement protocols typically used in clinical trials may question the validity of data collected in the course of routine clinical care. Methods: Weights and heights collected during a research project that focused on weight gain during pregnancy were compared to weight and height measurements coincidently recorded in the research participant’s medical records. For weight measures (N=102), data recorded within ±14 days were compared, and for height measures (N=114), data recorded within ±5 years were compared. We assessed agreement between medical and research measurements using the concordance and intraclass correlation coefficients, and Bland and Altman’s limits of agreement. Findings: The mean research and medical record weight measurements were 99.3 kg and 99.2 kg, respectively. The concordance and intraclass correlation coefficients for weight had similar estimates of .999 and 95 percent confidence intervals [.998, .999]. The 95 percent limits of agreement were ?1.5 kg and +1.7 kg. The mean research and medical height measurements were 1.646 m and 1.654 m, respectively, and the concordance and intraclass correlation coefficients for height were .941 and .942, respectively. The 95 percent limits of agreement were ?.031 m and +.047 m. Conclusions: For pregnant women, body weights documented in the medical record are exchangeable with body weights recorded in a research setting. Height measurements recorded in the medical records were not in as close agreement as weights, but concordance between medical record and research height measurements are high enough to allow them to be used epidemiological and comparative effectiveness research.
Leo, Michael C.; Lindberg, Nangel M.; Vesco, Kimberly K.; Stevens, Victor J.
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
Derbyshire, Emma; Dancey, Darren
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
Bentley, Kia J; Price, Sarah Kye; Cummings, Cory R
Objective: We examined 4 separate dimensions of functional social support (tangible, appraisal, self-esteem, and belonging) as predictors of change in depression over 4.5 years in a sample of women reporting intimate partner violence. Method: Participants were recruited as they sought help for violence perpetrated by a current or former male…
Suvak, Michael K.; Taft, Casey T.; Goodman, Lisa A.; Dutton, Mary Ann
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…
Price, Sarah Kye; Proctor, Enola 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…
McCoy, Shannon K.; Newell, Ellen E.; Gardner, Susan K.
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
The Todhunter/Castelhano and Boyko laboratories seek qualified applicants interested in medical genetics research and training as part of the Clinical Fellows Program in the Cornell College of Veterinary Medicine
research, we maintain a clinical presence for medical genetic consultation and phenotype screeningThe Todhunter/Castelhano and Boyko laboratories seek qualified applicants interested in medical genetics research and training as part of the Clinical Fellows Program in the Cornell College of Veterinary
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
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
Ilboudo, Patrick GC; Somda, Serge MA; Sundby, Johanne
Hispanics of Mexican origin constitute the largest minority population in the Southwestern United States, yet little is known about their reproductive health. This study assessed ethnic differentials in fetal mortality at 20 or more weeks gestation and identified the social and behavioral predictors associated with this outcome among low-income Hispanic, black non-Hispanic and white non-Hispanic women. Records were used of
Sylvia Guendelman; Gilberto Chavez; Roberta Christianson
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
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.
Abstract Background Although there has been much research examining the relationship between pregnancy and abuse, this study is one of the few to investigate whether perinatal status (defined as pregnancy or early postpartum) impacts the help seeking of abused women. Methods We retrospectively reviewed 3 years of prosecutor administrative records, police incident reports, and hospital medical records for a countywide population of adult females (n?=?964) assaulted by an intimate partner in 2000. Perinatal and nonperinatal victims were compared using chi-square and a series of logistic regression models, controlling for all demographic and incident-related factors. Results Compared with women across the county, abused women were twice as likely to become pregnant (p?0.001). Perinatal status did not change the rate of help seeking from police (OR 1.1, p?=?0.67) or emergency departments (ED) (OR 1.1, p?=?0.94), but it did change the pattern of help seeking with higher ED use in the 6 months prior to the assault (p?0.01) and a trend toward seeking help with fewer injuries (p?=?0.10). Conclusions Abused women are more likely to become pregnant. Perinatal status impacts how victims seek help from criminal justice agencies and EDs. PMID:19788343
Cerulli, Catherine; Marcus, Steven; Rhodes, Karin V.
of papers and articles, always willing to edit my work with a smile on his face, and talking me through every stress or self-doubt I had through this process (and there were many)! I am so grateful to have so many people that believe in me in my corner... instead of raise their own children. Choices men and women have for dealing with society’s prescribed sex roles are numerous. The degree of importance placed on each of the roles within marital, familial, and 19 occupational realms determines...
Gripka, Abbey Alyssa Campbell
Context: Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. Objective: The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. Design and Setting: We conducted a prospective cohort study at five clinical centers in the United States. Participants: The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). Exposure: The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. Main Outcome Measures: BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. Results: BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ?16). Conclusions: In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck. PMID:24001746
Ruppert, Kristine; Cauley, Jane A.; Lian, YinJuan; Bromberger, Joyce T.; Finkelstein, Joel S.; Greendale, Gail A.; Solomon, Daniel H.
Abstract Aim To describe long-term prescribing patterns of osteoporosis therapy before and after the Women's Health Initiative (WHI) publication. Methods We conducted a time-series analysis from 1997 to 2005 using nationally representative data based on office-based physician and hospital ambulatory clinic visits. Bivariate and multivariable analyses were conducted using chi-square tests and logistic regression, respectively, and trends in the prevalence of osteoporosis therapies were evaluated per 6-month (semiannual) intervals. Linear regression and graphic techniques were used to determine statistical differences in the prevalence trends between the two periods. Results Overall prevalence of therapeutic or preventive osteoporosis therapy was similar between the WHI periods. However, a significant decrease in estrogen therapy and increases in bisphosphonates, calcium/vitamin D were observed in the period after the WHI publication (p 0.05). Multiple logistic regression analysis showed older age and white race were associated with a higher likelihood of antiosteoporosis medication (AOM) prescription, and Medicaid insurance type was associated with a lower likelihood of an AOM prescription. Excluding calcium/vitamin D, nonestrogen therapy was more likely to be prescribed in the after-WHI period (office-based physician clinic: [adjusted OR, aOR] 2.49 [2.04–4.04]; hospital-based clinic: aOR 2.42 [1.67–7.50]) Nonestrogen therapy was more prevalent in visits made by older women, women of white race, women with contraindicated conditions for estrogen therapy, and women from the Northeast region. Conclusions After the WHI publication, the overall prevalence of osteoporosis therapy did not change; however, a shift from estrogen to nonestrogen therapy was observed after the WHI publication. Black women were less likely to receive nonestrogen antiosteoporosis therapy in hospital-based clinics. PMID:20459329
Maneno, Mary K.; Wutoh, Anthony K.; Zuckerman, Ilene H.
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
Sinclair, R; Patel, M; Dawson, T L; Yazdabadi, A; Yip, L; Perez, A; Rufaut, N W
Background Sexual and reproductive health (SRH), a basic right for women worldwide, is infrequently researched in countries in the Middle East and North Africa (MENA). No empirical studies of SRH among Saudi women exist. This protocol describes a study to explore the SRH knowledge, information-seeking behaviour and attitudes of Saudi female university students. Methods/Design This study will administer a questionnaire survey to female students at 13 universities in Riyadh, Saudi Arabia. The questionnaire was developed following a literature search to identify relevant content, with psychometrically tested tools used when available. The content layout and the wording and order of the questions were designed to minimize the risk of bias. The questionnaire has been translated into Arabic and piloted in preparation for administration to the study sample. Ethical approval for the study has been granted (reference no. QMREC2012/54). After questionnaire administration, the data will be collated, analysed and reported anonymously. The findings will be published in compliance with reporting guidelines for survey research. Discussion This study will be the first to provide fundamental information concerning Saudi females university students SRH knowledge and information needs. PMID:24885041
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
The apathy encountered by battered women when they seek help from medical and other professions has been attributed to patriarchal norms and victim?blaming. Because of their place in the medical hierarchy this study hypothesized that: a) nurses would have more sympathetic attitudes toward battered women than physicians; and b) professional roles and not gender would explain the differences. The findings
Karla Rose; Daniel G. Saunders
Across many jurisdictions, a key institutional response to sexual assault is centred on the collection of medico-legal evidence through a medical forensic examination (MFE). Despite the increased routinization of this practice, such evidence often is not related to positive criminal justice outcomes. As there has been little systematic investigation of the perspectives of victims regarding the MFE, we conducted semi-structured, face-to-face interviews with 19 women aged 17-46 years who had been sexually assaulted and had undergone an MFE in the previous six months at one of four specialized hospital-based sexual assault centres in Ontario, Canada. Extracts from the transcribed interviews were coded into two broad themes, 'Expectations' and 'Experiences', from which a series of lower order constructs were derived. We found that most women went to a centre to have their physical and emotional needs addressed rather than medico-legal evidence collected and were overwhelmingly satisfied with their interactions with specially trained nurse examiners. However, some women were confused about the purpose of the MFE, believing that their access to treatment hinged upon undergoing this process. Moreover, though optional, several indicated that they had been instructed to have an MFE by the police and/or nurse examiner. Most women who chose to have evidence collected did so with the hope that it would hold the assailant accountable and generate social recognition of the harm done to them. While many stated that they were distressed during the MFE, some reported feeling simultaneously empowered by the fact that the experience fostered a "sense of doing something". These findings point to the value of collecting medico-legal evidence in settings staffed with supportive practitioners who also attend to women's health related concerns. Implications with respect to issues of informed consent, revictimization, and empowerment, as well as the relative weight given to the MFE in the post-sexual assault care encounter, are discussed. PMID:19095341
Du Mont, Janice; White, Deborah; McGregor, Margaret J
Intimate partner abuse is world-wide much more prevalent than often suspected. Three female patients consulted their family doctor with a variety of complaints. A 53-year-old woman, mother of three grown-up children, and divorced a year ago, sought help after four days, for a large infected wound of her right hand. A 32-year-old single mother of a 2-year-old girl asked the practice assistant for an iteration of a tranquillizer because of tension headache. A 36-year-old divorced mother of three sons was sent by her company doctor to ask for a referral to a psychiatrist because of chronic fatigue. All three women appeared to have been severely abused by their partners, recently or in the past, and were reluctant to disclose the abuse. Two women were regular visitors of doctor's offices with diverse unspecific complaints. The third woman was a victim of sexual abuse as a child and was severely depressed. Active asking about experiences of intimate partner abuse helped these women to disclose the real nature of their problem. Important effect is that abused women can accept help and experience support to improve their situation. Doctors should suspect intimate partner abuse more often in patients who are heavy medical consumers, depressed or victims of sexual abuse in childhood. Single and divorced mothers can hide a history of abuse. Doctors should ask clear and specific questions about relationships and listen without passing judgement so as to help women to disclose abuse. PMID:15651495
Lo Fo Wong, S H; Lagro-Janssen, A L M
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
Hernández-Díaz, Sonia; Su, Yung-Cheng; Mitchell, Allen A.; Kelley, Katherine E.; Calafat, Antonia M.; Hauser, Russ
Objective We examined four separate dimensions of functional social support (tangible, appraisal, self-esteem support, and belonging) as predictors of change in depression over a four and a half year period 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 partner. Three hundred eighty-eight participants completed the Interpersonal Support Evaluation List (ISEL; Cohen, Mermelstein, Kamarack, & Hoberman, 1985), the Conflict Tactics Scale-2 (Straus et al. 1996), and the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) at the baseline assessment. Participants were re-evaluated on 9 follow-up assessment occasions over an approximately four and a half year period during which they completed the CES-D. Results Growth curve analyses revealed that belonging, or the perceived availability of people one can do things with, was the only dimension that predicted changes in depressive symptoms when controlling for initial depressive symptom levels. Higher levels of belonging support reported at the baseline assessment were associated with larger decreases in depression. Conclusions The findings of the current study suggest that interventions should consider ways to get survivors connected to informal social networks. Neither perceived availability of material aid, nor availability of someone to talk about one’s problems, or availability of a positive comparison when comparing one’s self to others was associated with decreased depression over time. Only perceived availability of people one can do things with (i.e., belonging support) exhibited salutary effects. PMID:23398492
Suvak, Michael K.; Taft, Casey T.; Goodman, Lisa A.; Dutton, Mary Ann
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
Michel, Joanna; Duarte, Reinel Eduardo; Yao, Ping; Bolton, Judy L.; Huang, Yue; Cáceres, Armando; Veliz, Mario; Soejarto, Djaja Doel; Mahady, Gail B.
Classical myeloproliferative neoplasms (MPN) are comprised 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 (BMI) (RR=1.52 for >29.3 vs. <23.4 kg/m2; 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
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.
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.
Naqvi, Syed Mansoor; Hasnain, Aziz Fatima
Most autoimmune diseases predominantly affect females. Many of these diseases occur in women who have the potential to become pregnant or wish to plan a pregnancy. The potential for fetotoxic effects of immunosuppressive medications that are commonly used to treat systemic autoimmune diseases must be weighed against the need for control of disease activity during pregnancy and the postpartum period, since active disease can be an independent risk factor for adverse pregnancy outcomes. Although far from conclusive, most data concerning the safety of medications for use during pregnancy come from case series and observational studies. It is often necessary to continue treating patients throughout pregnancy and lactation in order to control the activity of the underlying disease. The aim of this paper is to review the evidence regarding the safety of the most commonly used medications in rheumatic disease during pregnancy or lactation and to enable practitioners and patients to make informed decisions regarding treatment during this period in a woman's life. PMID:20426608
Elliott, Amy B; Chakravarty, Eliza F
The Department of Biosystems Engineering at Auburn University is seeking candidates for the position of Assistant Professor in Biological Engineering. The expected start date is August 16, 2014. Women and minorities are
such as food or fiber processing, pharmaceutical engineering, medical engineering, and similar topicsThe Department of Biosystems Engineering at Auburn University is seeking candidates for the position of Assistant Professor in Biological Engineering. The expected start date is August 16, 2014
Clinical evidence supports the value of BRCA1/2 genetic counseling and testing (GC/T) for managing hereditary breast and ovarian cancer risk; however, BRCA1/2 GC/T is underutilized among Black women and reasons for low use remain elusive. We examined the potential influence of socio-cultural factors (medical mistrust, concerns about genetic discrimination) on GC/T engagement in a sample of 100 Black women at increased risk for carrying a BRCA1/2 mutation. Eligible participants fell into one of three groups: 1) healthy women with ? 1 first-degree relative (FDR) affected by breast and/or ovarian cancer, 2) women diagnosed with breast cancer at age ? 50, and 3) women diagnosed with breast and/or ovarian cancer at age ? 50 with either one FDR or two second degree relatives with breast and/or ovarian cancer. Participants were recruited from clinical and community settings and completed a semi-structured interview. Study variable relationships were examined using bivariate tests and multivariate regression analysis. Forty-three percent of participants were aware of GC/T services. Yet referral and receipt of GC/T services in this sample was low (28%). After accounting for sociodemographic factors, women with higher self-efficacy had greater GC/T engagement (B = 0.37, p < .001), while those with higher medical mistrust had lower GC/T engagement (B = ?0.26, p <. 01). Interventions targeted towards increasing provider referrals may facilitate higher levels of engagement in GC/T services. Individual interventions that enhance women’s personal confidence in obtaining GC/T may also be useful in promoting GC/T engagement. PMID:23862292
Sheppard, Vanessa B.; Mays, Darren; LaVeist, Thomas; Tercyak, Kenneth P.
Background There is significant morbidity and mortality caused by the complications of osteoporosis, for which ageing is the greatest epidemiological risk factor. Preventive medications to delay osteoporosis are available, but little is known about motivators to adhere to these in the context of a symptomless condition with evidence based on screening results. Aim To describe key perceptions that influence older women's adherence and persistence with prescribed medication when identified to be at a higher than average risk of fracture. Design of Study A longitudinal qualitative study embedded within a multi-centre trial exploring the effectiveness of screening for prevention of fractures. Setting Primary care, Norfolk. United Kingdom Methods Thirty older women aged 70–85 years of age who were offered preventive medication for osteoporosis and agreed to undertake two interviews at 6 and 24 months post-first prescription. Results There were no overall predictors of adherence which varied markedly over time. Participants' perceptions and motivations to persist with medication were influenced by six core themes: understanding adherence and non-adherence, motivations and self-care, appraising and prioritising risk, anticipating and managing side effects, problems of understanding, and decision making around medication. Those engaged with supportive professionals could better tolerate and overcome barriers such as side-effects. Conclusions Many issues are raised following screening in a cohort of women who have not previously sought advice about their bone health. Adherence to preventive medication for osteoporosis is complex and multifaceted. Individual participant understanding, choice, risk and perceived need all interact to produce unpredictable patterns of usage and acceptability. There are clear implications for practice and health professionals should not assume adherence in any older women prescribed medication for the prevention of osteoporosis. The beliefs and motivations of participants and their healthcare providers regarding the need to establish acceptable medication regimes is key to promoting and sustaining adherence. PMID:24392086
Salter, Charlotte; McDaid, Lisa; Bhattacharya, Debi; Holland, Richard; Marshall, Tarnya; Howe, Amanda
Africa's distribution of specialized private health services is severely disproportionate. Mismatch between South Africa's excess supply and a huge demand potential in an under-serviced continent represents an entrepreneurial opportunity to attract patients to South Africa for treatment and recuperative holidays. However, effective demand for intra-African medical tourism could be constrained by sub-Saharan poverty. Results from interviewing 320 patients and five staff at the Johannesburg Breast care Centre of Excellence, however, reject this proposition, Africa's middle class women being the target market estimated to grow annually by one million while breast cancer incidence increases with middle-class lifestyles. Uncovering this potential involves an extensive marketing strategy. PMID:22392794
Ahwireng-Obeng, Frederick; van Loggerenberg, Charl
Background Frequent reporting of cases of hysterical conversion reaction (HCR) among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address psychosocial needs of HCR patients, assist with triage in a system where both medical inpatient beds and psychiatric services are scarce commodities, and help ensure appropriate follow up. PMID:23088583
Background Precompetition screening was implemented for male referees during the 2010 Fédération Internationale de Football Association (FIFA) Word Cup. In contrast, female football referees have been neglected in this respect although they experience similar physical work loads compared to male referees. Methods The standardised football-specific Pre-Competition Medical Assessment (PCMA) was performed in 51 referees and assistant referees selected for the 2011 FIFA Women's World Cup. Results Family history for sudden cardiac death (SCD) was positive in four referees (7.8%), but cardiac examinations did not reveal any pathological findings. Training-unrelated ECG changes were identified in three referees (5.9%), all without correlates in echocardiography or clinical examination. Most common echocardiography findings (66.6%, n=34) were asymptomatic tricuspid and mitral regurgitations. Conclusions During the present screening, no elite female referee was identified being at risk for SCD, and no referee had to be excluded from participating in the 2011 FIFA Women's World Cup. PMID:22976906
Keller, Dagmar I; Bizzini, Mario; Feddermann, Nina; Junge, Astrid; Dvorak, Jiri
SEED GRANTS for Biological/Medical Research on Sex Differences and/or Women's Health The Stanford, and population health research on sex differences and women's health at Stanford University School of Medicine/or in women's health. This year, we are particularly eager for School of Medicine faculty to collaborate
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…
Mack, Yvette E.
An Institute of Medical Ethics working party supports the view that explicit permission should normally be sought in the case of testing for HIV antibody. It discusses this in relation to anonymised HIV testing for epidemiological purposes, concluding that this is to be welcomed, given certain safeguards. It next argues that pregnant women may have a greater and more immediate
K M Boyd
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
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 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
Correia, Katharine F.; Ginsburg, Elizabeth S.
Numerous studies show that changes occurring in a woman’s organism during menopause may lower her quality of life. This study involved 630 healthy postmenopausal women from Poland. Its purpose was to assess their quality of life in relation to socio-demographic variables, medical data and personality profiles. The authors used the Short Form Health Survey (SF-36) to assess quality of life, the NEO-Five Factor Inventory to measure personality traits, and the Blatt-Kupperman Menopausal Index to estimate severity of climacteric symptoms. The study demonstrated significant relationships between quality of life and variables such as: age, education, employment status, and the use of menopausal hormone therapy. An analysis of personality traits revealed correlations between the openness to experience scores and the quality of life within physical functioning, vitality, and mental health. Neuroticism, agreeableness and extroversion significantly correlated with all quality of life domains. Conclusions: (1) Age, education and employment status have significant effects on the selected quality of life domains after menopause. (2) Quality of life within the general health domain was assessed lower by MHT-users (Menopausal hormone theraphy (MHT)). (3) Health-related quality of life is also influenced by personality traits, which are relatively stable throughout life. PMID:24972032
Wieder-Huszla, Sylwia; Szkup, Ma?gorzata; Jurczak, Anna; Samochowiec, Agnieszka; Samochowiec, Jerzy; Stanis?awska, Marzanna; Rotter, Iwona; Karakiewicz, Beata; Grochans, El?bieta
international agencies. "TransNational Women's Health Stories: Beyond the Hippocratic Oath" Carol Ritter, MD without means. Dr. Ritter's focus on humanitarian work was sharpened by her training in women's health as the president of the Continental Gynecological Society and the Society for Humanism in Medicine. "Women's Health
Background Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world. Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking and symptom interpretation process among Danish women, who have a very high mortality rate. Methods The health seeking and symptom interpretation process was analysed via combining study methods. The material consisted of registry data dealing with the use of public health care and hospital services of Danish women, newly diagnosed with ovarian cancer. These results were combined with findings from semi-structured qualitative research interviews on women's bodily experiences with symptom development. Results A number of 663 Danish women with ovarian cancer attended 27 different kinds of primary health care providers in a total of 14,009 visits during 2007. The women also had 6,214 contacts with various hospitals, and obtained 562 different diagnoses. From the main theme "Women's experiences with the onset of symptoms" three sub-themes were identified: "Bodily sensations", "From bodily sensation to symptom", and "Health seeking and treatment start". In all cases the General Practitioner represented the first contact to public health care, acting as gate-keeper to specialist and hospital referral. The women were major users of public health care throughout the diagnostic process and subsequent treatment. All women held personal knowledge concerning the onset of their symptoms. The early symptoms of ovarian cancer might be uncharacteristic and non-disease-specific when interpreted as personal experiences, but they had similarities when analysed together. Conclusions Diagnostic delay in ovarian cancer seems far from being exclusively a medical problem, as the delay proved to be influenced by organisational, cultural, and social factors, too. Initiatives facilitating the diagnostic process and research concerning the selection of individuals for further investigation are indicated. The way in which the women interpreted their symptoms was influenced by their personal experiences, their cultural, and their social background. This became crucial to the diagnostic process. These issues need to be explored through further research on women's experiences during the diagnostic process. PMID:21699682
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.
Susan Markens; C. H. Browner
The prevalence of cardiovascular disease (CVD) in American women is staggering. In 2008, the American Heart Association reported\\u000a that one in three women had some form of CVD. An estimated 7.3 million women alive today have had a heart attack or are living\\u000a with angina pectoris. This year, almost 500,000 new and recurrent myocardial infarctions are expected in women. Education
Kathy Berra; Linda Klieman; Anna Hinohara
Objectives to evaluate clinical and functional long-term outcomes following pregnancy-related medically treated iliofemoral deep venous thrombosis (DVT). Design retrospective follow-up of patients identified through a registry search. Material and methods twenty-five women underwent clinical examination, colour duplex ultrasound and computerised strain-gauge plethysmography on two occasions a mean of nine and 16 years after DVT. Results 40% of the patients were
S Rosfors; A Norén; R Hjertberg; L Persson; K Lillthors; S Törngren
Objective: To assess clinical competency of third-year medical students completing a problem-oriented, primary care emphasis clerkship in obstetrics and gynecology using an objective structured clinical examination, and to determine the feasibility of implementing the objective structured clinical examination in the curriculum.Methods: Sixteen groups of third-year medical students were evaluated prospectively on their exit performances with a six-station objective structured clinical
George J Gilson; Karen E George; Clifford M Qualls; Gloria E Sarto; S. Scott Obenshain; Jack Boulet
Smoking is associated with adverse effects on pregnancy and fetal development, yet 88-95% of pregnant women in medication-assisted treatment for an opioid use disorder smoke cigarettes. This review summarizes existing knowledge about smoking cessation treatments for pregnant women on buprenorphine or methadone, the two forms of medication-assisted treatment for opioid use disorder indicated for prenatal use. We performed a systematic review of the literature using indexed terms and key words to capture the concepts of smoking, pregnancy, and opioid substitution and found that only three studies met search criteria. Contingency management, an incentive based treatment, was the most promising intervention: 31% of participants achieved abstinence within the 12-week study period, compared to 0% in a non-contingent behavior incentive group and a group receiving usual care. Two studies of brief behavioral interventions resulted in reductions in smoking but not cessation. Given the growing number of pregnant women in medication-assisted treatment for an opioid use disorder and the negative consequences of smoking on pregnancy, further research is needed to develop and test effective cessation strategies for this group. PMID:25592332
Akerman, Sarah C; Brunette, Mary F; Green, Alan I; Goodman, Daisy J; Blunt, Heather B; Heil, Sarah H
When alcoholic women seek medical assistance, it is more likely to be because of distress over interpersonal or family problems, and their complaints of anxiety, depression and insomnia will be treated with prescription drugs. The alcoholism, which presents differently in women than men, is often left undiagnosed and untreated. However, even when women seek help for a drinking problem, traditional and male-dominated support groups may not meet their unique needs. When it comes to alcoholism, men and women are certainly not created equal. PMID:7728702
The purposes of this study were to assess direct medical resource utilization related to the treatment of nonvertebral osteoporotic fractures within 1 year postfracture and to evaluate whether age impacts resource utilization. A previously-validated algorithm for physician claims databases identified 15,327 women aged 50 years or older with incident fracture at nonvertebral osteoporotic sites between January 1, 2004 and December 31, 2005. Administrative databases of the health services available to all residents in Quebec served to study fracture-related health resource utilization in the year after fracture. Data were linked by a unique personal identifier, creating a longitudinal cohort of all fracture cases for health resource utilization. The proportions of fractures treated by open reduction, closed reduction, immobilization or follow-up by an orthopedic surgeon (OS) were evaluated. The mean number of claims for consultation with an OS or other clinicians in inpatient and outpatient visits, the hospitalization rate and length of stay (LOS) were assessed. Hip/femur fractures represented the highest rate of resource utilization because the majority of them required surgery (91.1%) and hospitalization (94.5%) with a mean (median) LOS of 39.2 (31) days. However, other nonvertebral fracture types needed significant clinical care related to surgery (27.9%), follow-up consultation with an OS (77.6%), and hospitalization (27.3% of total LOS). Even pelvic fractures, which often do not require surgical treatment, commanded high resource utilization due to the high hospitalization rate (67.4%) with mean (median) LOS of 34.2 (26) days. Moreover, age was an important determinant of health resource utilization, being associated with an increased number of visits to other physicians, hospitalization, and length of hospitalization (LOS), admissions to long term care (LTC), and death. Osteoporosis-related fractures accounted for substantial healthcare resource utilization. With an aging population and increased prevalence of fractures, strategies for osteoporosis management need to be introduced to reduce the healthcare burden. PMID:22991183
Jean, Sonia; Bessette, Louis; Belzile, Etienne L; Davison, K Shawn; Candas, Bernard; Morin, Suzanne; Dodin, Sylvie; Brown, Jacques P
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.
BACKGROUND: The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid to investigate the ability of pregnant women to access and effectively utilize these services. OBJECTIVES: To describe the experience and perceptions of pregnant
Godfrey M Mubyazi; Paul Bloch; Pascal Magnussen; Řystein E Olsen; Jens Byskov; Kristian S Hansen; Ib C Bygbjerg
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…
Calizo, Lee Scherer Hawthorne
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 is a study of the physical performance and injury rate for seven classes of women midshipmen at the United States Naval Academy. Women comprise only 6.2% of the brigade of midshipmen, but men and women live in the same dormitory, undergo the same physical training and fitness tests, study the same academic curriculum, and live in an environment where performance and activities can be constantly monitored. The required number of hours of physical education are the same for men and women. The conclusions from this study are: (1) women midshipmen continue to improve their fitness level more rapidly than men; (2) while some disparities in performance are correctly attributed to physiological differences, many of the present disparities should be attributed to societal conditions; (3) should physical performance requirements ever become the same, women will have to work harder than men to achieve the same standards because of the physiological differences; (4) women continue to seek medical attention for stress-related problems (i.e., shin splints, stress fractures) more often than men, but do so less often as they become acclimated to the active life of the Naval Academy; (5) women midshipmen have the same number of serious injuries as men, and in some sports are more susceptible to certain types of injuries. PMID:6742310
Cox, J S; Lenz, H W
OBJECTIVESThe goal of our study was to determine whether hormone therapy alters markers of inflammation in postmenopausal women with chronic stable coronary artery disease (CAD) on appropriate medical management.BACKGROUNDHormone therapy reduces some markers of inflammation associated with atherosclerosis risk (cell adhesion molecules) but increases levels of another marker of inflammation—C-reactive protein—in healthy postmenopausal women.METHODSTen women (average age 66 years; range
Diane Zanger; Benjamin K Yang; Jeanette Ardans; Myron A Waclawiw; Gyorgy Csako; Larry M Wahl; Richard O Cannon
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,
FRED MOLITOR; JUAN D. RUIZ; JEFFREY D. KLAUSNER; WILLIAM McFarland
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
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
Severe, Linda; Fitzgerald, Daniel W.; Deschamps, Marie M.; Reif, Lindsey; Post, Kendall; Johnson, Warren D.; Pape, Jean W.; Boutin-Foster, Carla
Examined whether early divorce would affect job satisfaction of professional or clerical/technical women (N=88) working in hospitals and explored differences among married, divorced, and single working women in their perceptions of different areas of their work. Results revealed significant positive relationship between job level and job…
Lottinville, Elinor; Scherman, Avraham
Objective: Graduating learners from Oregon Health and Sciences University programs and from the National College of Naturopathic Medicine were surveyed about their attitudes toward their training in women's health. Study design: The survey addressed learner satisfaction with training in women's health, their preferred learning methods, and their clinical comfort in managing 17 clinical problems. The survey addressed knowledge of complementary
Sandra Emmons; C. Wayne Sells; M. Patrice Eiff
The relation of criminal victimization to health perceptions (self-rated current health) was determined among women health maintenance organization patients. Data were survey responses from 2,291 women (45% response rate), 57% of whom had experienced crime. Reliability was evaluated by assessing 241 respondents both by survey and by interview. Data were analyzed by hierarchical multiple regression, which indicated that criminal victimization
Mary P. Koss; W. Joy Woodruff; Paul G. Koss
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
Yu, Foo Qing; Murugiah, Muthu Kumar; Khan, Amer Hayat; Mehmood, Tahir
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
Main Objective The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion. Methods This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis. Most Important Findings Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion. Conclusions The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective for the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the indication is for the abortion. PMID:25546416
Andersson, Inga-Maj; Christensson, Kyllike; Gemzell-Danielsson, Kristina
ObjectivesTo determine the prevalence of stress urinary incontinence (SUI) symptoms in women and to evaluate the severity of these symptoms and resulting functional impairment with regard to urinary symptoms, quality of life (QoL) impairment, medical care seeking, and care facilities.
Isabelle Gasquet; Stéphanie Tcherny-Lessenot; Pierre Gaudebout; Brigitte Bosio Le Goux; Patrick Klein; François Haab
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
Pereira, Ana Rita; Vieira, Duarte Nuno; Magalhăes, Teresa
Patients with low-trauma fractures are at risk of future fractures and so should be evaluated and treated for osteoporosis. This study was conducted to assess and compare bone medication use and calcium and vitamin D intake at the time of and after an acute fracture. One hundred and six patients, mean age 66.7±10.3 years, were administered medical history and diet
Alejandra Pro-Risquez; Susan S. Harris; Lingyi Song; Sally Rudicel; Brien Barnewolt; Bess Dawson-Hughes
Intimate partner violence (IPV) and suicidal behavior are major public health problems in the African American community.\\u000a This study investigated whether or not IPV and suicidal ideation are correlated in urban African American women, and if the\\u000a IPV–suicidal ideation link is explained by symptoms of depression and posttraumatic stress disorder (PTSD). With 323 abused\\u000a African American females, path analysis revealed
Amy S. Leiner; Michael T. Compton; Debra Houry; Nadine J. Kaslow
Mifepristone (RU486), which is used for early medical abortion, can only be obtained in Australia under the Authorised Prescriber legislation (Section 19 of the Therapeutic Goods Act 1989 [Cwlth]); two of the authors have permission to obtain, prescribe and administer this drug in Cairns, Queensland. From July 2006 to April 2007, 10 women who fulfilled the Therapeutic Goods Administration (TGA) criteria of "life-threatening or otherwise serious" indications underwent medical abortion with mifepristone/misoprostol, and 12 women conforming with abortion requirements of Queensland law, but not TGA legislation for mifepristone administration, had medical abortions with the less preferable methotrexate/misoprostol combination. Although it is now more than a year since the cross-party vote in federal Parliament in February 2006 confirmed wide support for the right of Australian women to a medical abortion, we believe we are at present the only medical practitioners in Australia with permission to use mifepristone. Obtaining Authorised Prescriber status from the TGA is of necessity a complex and protracted process, involving ethics committee approval and auditing, and regular reporting to the TGA. Because of the current restrictions, we believe that women seeking medical abortion in Australia face barriers not experienced by women in other comparable countries, and that drug manufacturing and distributing companies may be discouraged from seeking to market mifepristone in Australia. PMID:17680745
de Costa, Caroline M; Russell, Darren B; de Costa, Naomi R; Carrette, Michael; McNamee, Heather M
In the framework of an increasing feminization of the medical profession in Mexico, this article explores the characteristics of this process in the obstetrics and gynecology specialty. Understanding feminization as a process of change to be analyzed both quantitatively and qualitatively, the article focuses special attention on the experiences of female obstetrician-gynecologists within a medical specialty that has since its origins functioned as a mechanism of control over women's bodies. Based on ethnographic research, the article combines statistical and archival sources and field observation. The interviews reveal the experiences and tensions women obstetrician-gynecologists encounter in this context. PMID:25522102
BACKGROUND: Cannabis (marijuana) had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of
Thomas J O'Connell; Ché B Bou-Matar
The prevalence of chronic non-communicable disease, such as type 2 diabetes mellitus (T2DM), is rising worldwide. In Africa, T2DM is primarily affecting those living in urban areas and increasingly affecting the poor. Diabetes management among urban poor is an area of research that has received little attention. Based on ethnographic fieldwork in Dar es Salam, the causes and conditions for diabetes management in Tanzania have been examined. In this paper, we focus on the structural context of diabetes services in Tanzania; the current status of biomedical and ethnomedical health care; and health-seeking among people with T2DM. We demonstrate that although Tanzania is actively developing its diabetes services, many people with diabetes and low socioeconomic status are unable to engage continuously in treatment. There are many challenges to be addressed to support people accessing diabetes health care services and improve diabetes management. PMID:20441575
The officer-in-charge of information and motivation with the Family Planning Association of Hong Kong (FPAHK) granted an interview to JOICFP News during JOICFP's IEC Workshop for the Production of Video Script for Women's Health in Tokyo, Japan. FPAHK does a checkup of every woman who seeks services at its family planning clinics. These clinics also provide medical services for women not using contraceptives and postmenopausal women. They provide family planning services to betrothed women. FPAHK promotes the self health care concept. It has education programs and primary screening services. FHAPK has recently done a survey of the general health conditions of women. It shows that even though most women are familiar with gynecological problems and the importance of taking care of themselves, they do not act on this knowledge. Women tend to know about and use contraceptives, but many contraception failures occur. Most women do not seek family planning services during their first 6 months of sexual activity. During this period, they use safe as well as unsafe contraceptives. These behaviors result in many women undergoing an abortion. The FPAHK officer claimed that the IEC workshop informed her about the major issues of women's health in other countries and women's needs. PMID:12318570
Introduction: Diabetes is increasingly becoming prevalent worldwide. Pregnancy with diabetes is prone to maternal and fetal complications. Preconception care (PCC) is an important factor in alleviating gestational complications in those women who suffer from diabetes. This study seeks to gain insight into experiences of diabetic women and providers about PCC. Subjects and Methods: The present research was a qualitative research conducted on eight women with diabetes during the reproductive age and 15 health care providers of the public and private medical centers, which provide health care for women with diabetes in Isfahan (Iran), with a qualitative approach. Based on the aims of research, purposive sampling was done through semi-structuralized individual interview. Data were analyzed using conventional qualitative content analysis method. Results: Data analysis revealed three major categories: (1) Health centers weakness in providing PCC for diabetic women, (2) lack of a comprehensive PCC plan for diabetic women and (3) diabetic women's negligence about having planned pregnancy. Conclusion: In order to improve diabetic women's health, precise training of students, health care providers and patients themselves with respect to PCCs should be taken into account. Designing diabetic PCC system is an essential factor to succeed in this trend.
Nekuei, Nafisehsadat; Kohan, Shahnaz; Kazemi, Ashraf
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
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
Objective The aim of the present study was to analyse gender differences in self-reported non-adherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA. Methods A questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA. Results Use of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR=0.77 (95%CI 0.65:0.92)], changing the dosage [OR=0.64 (95%CI 0.52:0.79)] and that they had recovered [14.3%, (OR=0.71 (95%CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR=1.25 (95%CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR=1.89 (95%CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs. Conclusions Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes. PMID:24155839
Thunander Sundbom, Lena; Bingefors, Kerstin
Objective: There are various elements affecting the healthy family such as marital satisfaction. Various factors such as sexual satisfaction have an important impact on satisfaction of marital relationship. The present study aimed to determine the association of marital satisfaction with sexual satisfaction among sexually active employee women. Methods: This analytical descriptive study was carried on 140 married women employed at educational and medical centers of Golestan University of Medical Sciences. Questionnaires for data collection included Enrich Marital Satisfaction Questionnaire and self-constructed questionnaire (demographic characteristic and sexual satisfaction). Data were analyzed using descriptive statistics, ?2 and Spearman statistical test. Statistical significant level was set as 0.05. Results: The findings showed that in marital satisfaction scale, the majority of the participants (63.6%) were very satisfied and none of them were very unsatisfied. In sexual satisfaction scale, most of the participants (56.4%) expressed extremely satisfaction rate and only 0.7% were not satisfied with their sexual relationship. Marital satisfaction was significantly associated with sexual satisfaction (p ? 0.001). So with the increase of sexual satisfaction, there was an increase in marital satisfaction accordingly. The findings indicated that there was a significant association between sexual satisfaction and age (p = 0.086). Level of education was associated significantly with the marital satisfaction (p = 0.038). The effects of sexual satisfaction on marital satisfaction were moderated by number of children and the level of education. Conclusion: The findings have implications for improving of couples' marital satisfaction by highlighting the need for awareness of sexual quality. According to the findings, it seems that development of educational programs and pre-marriage counseling is necessary. Continuous education would be helpful after marriage in addressing couples' unique transitional needs in marital life. PMID:25053956
Ziaee, Tayebe; Jannati, Yadollah; Mobasheri, Elham; Taghavi, Taraneh; Abdollahi, Habib; Modanloo, Mahnaz; Behnampour, Naser
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
Janjua, Naveed Z; Mahmood, Bushra; Imran Khan, M
Rationale Many studies have reported medication effects on alcohol cue-elicited brain activation or associations between such activation and subsequent drinking. However, few have combined the methodological rigor of a randomized clinical trial (RCT) with follow-up assessments to determine whether cue-elicited activation predicts relapse during treatment, the crux of alcoholism. Objectives This study analyzed functional magnetic resonance imaging (fMRI) data from 48 alcohol-dependent subjects enrolled in a six-week RCT of an investigational pharmacotherapy. Methods Subjects were randomized, based on their level of alcohol withdrawal (AW) at study entry, to receive either a combination of gabapentin (up to 1200 mg for 39 days) and flumazenil infusions (two days) or two placebos. Midway through the RCT, subjects were administered an fMRI alcohol cue reactivity task. Results There were no main effects of medication or initial AW status on cue-elicited activation, but these factors interacted, such that the gabapentin-flumazenil/higher AW and placebo/lower AW groups, which had previously been shown to have relatively reduced drinking, demonstrated greater dorsal anterior cingulate cortex (dACC) activation to alcohol cues. Further analysis suggested that this finding represented differences in task-related deactivation and was associated with greater control over alcohol-related thoughts. Among study completers, regardless of medication or AW status, greater left dorsolateral prefrontal cortex (DLPFC) activation predicted more post-scan heavy drinking. Conclusions These data suggest that alterations in task-related deactivation of dACC, a component of the default mode network, may predict better alcohol treatment response, while activation of DLPFC, an area associated with selective attention, may predict relapse drinking. PMID:23389755
Schacht, Joseph P.; Anton, Raymond F.; Randall, Patrick K.; Li, Xingbao; Henderson, Scott; Myrick, Hugh
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 Uniăo 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
Labate, Beatriz Caiuby
Objective: To examine whether there are latent trajectory classes in response to treatment and whether they moderate the effects of medication versus psychotherapy. Method: Data come from a 1-year randomized controlled trial of 267 low-income, young (M = 29 years), minority (44% Black, 50% Latina, 6% White) women with current major depression…
Siddique, Juned; Chung, Joyce Y.; Brown, C. Hendricks; Miranda, Jeanne
In May 2011, the Ministry of Unification of the Republic of Korea (Korea) announced that 21,165 defectors from Democratic People’s Republic of Korea (North Korea) had settled in Korea. Since healthcare workers are counted among these defectors, it is necessary to provide them with a pathway to certification to work in Korea. This report summarizes the vetting and approval process defectors from North Korea must pass through to be eligible to take the national medical licensing examination. Defectors must pass an oral test conducted by the National Health Personnel Licensing Examination Board to be eligible to sit for the exam. From 2002 to August 2011, 41 North Korean defectors applied for the approval process to take the exam. Twenty-nine were approved (70.7%): 23 physicians, 1 dentist, 2 oriental medical doctor, 1 nurse, and 2 pharmacists. Out of 29 approved, 11 passed the licensing examination (39.3%). This report also highlights the difficulty in assessing North Korean defectors’ eligibility by oral test, and suggests that adequate competency should be emphasized to recognize their unique abilities as healthcare personnel. PMID:23330055
Kim, Yoon Hee
In May 2011, the Ministry of Unification of the Republic of Korea (Korea) announced that 21,165 defectors from Democratic People's Republic of Korea (North Korea) had settled in Korea. Since healthcare workers are counted among these defectors, it is necessary to provide them with a pathway to certification to work in Korea. This report summarizes the vetting and approval process defectors from North Korea must pass through to be eligible to take the national medical licensing examination. Defectors must pass an oral test conducted by the National Health Personnel Licensing Examination Board to be eligible to sit for the exam. From 2002 to August 2011, 41 North Korean defectors applied for the approval process to take the exam. Twenty-nine were approved (70.7%): 23 physicians, 1 dentist, 2 oriental medical doctor, 1 nurse, and 2 pharmacists. Out of 29 approved, 11 passed the licensing examination (39.3%). This report also highlights the difficulty in assessing North Korean defectors' eligibility by oral test, and suggests that adequate competency should be emphasized to recognize their unique abilities as healthcare personnel. PMID:23330055
Kim, Yoon Hee
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 women draw upon; and how...
This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American women seeking medical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more
Martie P. Thompson; Nadine J. Kaslow; J. B. Kingree; Akil Rashid; Robin Puett; Diana Jacobs; Alex Matthews
Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs). A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit) or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90). Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared to individual visits. If GMCs prove to be effective and efficient, implementation of GMCs in regular care for BRCA mutation carriers will be recommended. Trial registration The study is registered at ClinicalTrials.gov (NCT01329068) PMID:21864353
In six villages in the Kathmandu valley of Nepal, an intensive health and nutrition study was conducted on 26 lactating women and their 2--6-month-old infants. Analysis of 24-h duplicate diet composites indicated that the mothers were consuming approximately 2100 kcal energy/d. The diets contained approximately 62 g protein (11.6% of the calories), 392 g carbohydrate (73.3% of the calories), and 20.9 g fat (8.6% of the calories) and a mean of 24 g neutral detergent fiber. Although anthropometric measurements indicated that the mothers had mild protein malnutrition and inadequate energy reserves, their infants exhibited low-normal weight and length for age. All the mothers had hepatitis A antibodies; 92% had tropical eosinophilia, indicating intestinal parasites; 16% had cheilosis and angular stomatitis, indicating a possible B-vitamin deficiency; and 8% had elevated urinary nitrite, indicating urinary tract infection. There were no unusual physical findings on the infants. Although the children appeared healthy, the mothers showed evidence of multiple infections and possible nutrient deficiencies. PMID:3354497
Reynolds, R D; Moser, P B; Acharya, S; McConnell, W; Andon, M B; Howard, M P
Abstract Background: Disease presentation, prevalence, and treatment effects vary by sex, thus it is important to ensure adequate participation of both sexes in medical device post-approval studies (PAS). Methods: The goals of this study were to determine the participation rate of women in PAS mandated by the Food and Drug Administration (FDA) and if participation varied by clinical area. The study also evaluated the frequency in which enrollment by sex is reported by applicant reports and FDA reviews, as well as the frequency in which final study reports analyze whether outcomes differ by sex. Results: Of 89 studies with enrollment completed, data on sex of participants were available in 93% of submitted reports, while data on enrollment by sex was evaluated and noted in 43% of FDA review memos. Study participation varied by clinical area, with female participation ranging from 32% in cardiovascular PAS to 90% in PAS for reconstructive devices. Of 53 completed studies, data on enrollment by sex was provided in 49 of the final reports. Of these 14% included a multivariate analysis that included sex as a covariate and 4% included a subgroup analysis for female participants. Conclusions: Data on sex was not routinely assessed in FDA reviews. Based on these findings, FDA implemented new procedures to ensure participation by sex is evaluated in PAS reviews. FDA will continue working with applicants to develop PAS that enroll and retain proportions of women consistent with the sex-specific prevalence for the disease or condition the device is used to treat. PMID:24405314
Herz, Naomi; Loyo-Berrios, Nilsa; Tarver, Michelle
This study examined medical and psychosocial characteristics of 440 patients (mean age 58 years, 21% women) with coronary artery disease at baseline and at 3-month and 12-month follow-ups. All patients were participants in the Multicenter Lifestyle Demonstration Project, aimed at improving diet (low fat, whole foods, plant-based), exercise, stress management, and social support. Spousal participation was encouraged. Both genders evidenced significant improvements in their diet, exercise, and stress management practices, which they maintained over the course of the study. Both women and men also showed significant medical (e.g., plasma lipids, blood pressure, body weight, exercise capacity) and psychosocial (e.g., quality of life) improvement. Despite their worse medical, psychosocial, and sociodemographic status at baseline, women's improvement was similar to that of men's. These results demonstrate that a multi-component lifestyle change program focusing on diet, exercise, stress management, and social support can be successfully implemented at hospitals in diverse regions of the United States. Furthermore, this program may be particularly beneficial for women with coronary artery disease who generally have higher mortality and morbidity than men after a heart attack, angioplasty, or bypass surgery. PMID:12767423
Koertge, Jenny; Weidner, Gerdi; Elliott-Eller, Melanie; Scherwitz, Larry; Merritt-Worden, Terri A; Marlin, Ruth; Lipsenthal, Lee; Guarneri, Mimi; Finkel, Robert; Saunders Jr, Donald E; McCormac, Patty; Scheer, Judith M; Collins, Richard E; Ornish, Dean
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.
Analyzing the Relationship of Geographic Mobility and Institutional Prestige to Career Advancement of Women in Academic Medicine Pursuing Midcareer-, Senior-, or Executive-Level Administrative Positions: Implications for Career Advancement Strategies
The purpose of this study was to explore the relationship of geographic mobility and institutional prestige to career advancement defined as administrative promotions of women seeking midcareer-, senior-, or executive-level positions at academic health centers (AHCs) and their medical schools or in non-AHC related medical schools in the United…
McLean, Marsha Renee
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
Wilson, Erin C; Chen, Yea-Hung; Arayasirikul, Sean; Wenzel, Conrad; Raymond, H Fisher
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.
Background Stigma shapes the lives of people living with HIV and may affect their willingness to seek medical care. But treatment delays can compromise health and increase the risk of transmission to others. Purpose To examine whether four stigma manifestations—enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma’s prevalence) and internalized (personal endorsement of stigma beliefs)—were linked with delays in seeking care among HIV-infected people in India. Methods A cross-sectional survey was conducted with 961 HIV-positive men and women in Mumbai and Bengaluru. Results Enacted and internalized stigmas were correlated with delays in seeking care after testing HIV-positive. Depression symptoms mediated the associations of enacted and internalized stigmas with care seeking delays, whereas efforts to avoiding disclosing HIV status mediated only the association between internalized stigma and care seeking delays. Conclusions It is vital to develop stigma reduction interventions to ensure timely receipt of care. PMID:22282878
Steward, Wayne T.; Bharat, Shalini; Ramakrishna, Jayashree; Heylen, Elsa; Ekstrand, Maria L.
This study examined medical and psychosocial characteristics of 440 patients (mean age 58 years, 21% women) with coronary artery disease at baseline and at 3-month and 12-month follow-ups. All patients were participants in the Multicenter Lifestyle Demonstration Project, aimed at improving diet (low fat, whole foods, plant-based), exercise, stress management, and social support. Spousal participation was encouraged. Both genders evidenced
Jenny Koertge; Gerdi Weidner; Melanie Elliott-Eller; Larry Scherwitz; Terri A. Merritt-Worden; Ruth Marlin; Lee Lipsenthal; Mimi Guarneri; Robert Finkel; Donald E. Saunders; Patty McCormac; Judith M. Scheer; Richard E. Collins; Dean Ornish
This study examined medical and psychosocial character- istics of 440 patients (mean age 58 years, 21% women) with coronary artery disease at baseline and at 3-month and 12-month follow-ups. All patients were participants in the Multicenter Lifestyle Demonstration Project, aimed at improving diet (low fat, whole foods, plant-based), exer- cise, stress management, and social support. Spousal par- ticipation was encouraged.
Jenny Koertge; Gerdi Weidner; Melanie Elliott-Eller; Larry Scherwitz; Terri A. Merritt-Worden; Ruth Marlin; Lee Lipsenthal; Mimi Guarneri; Robert Finkel; Donald E. Saunders; Patty McCormac; Judith M. Scheer; Richard E. Collins; Dean Ornish
Examines relationships between Sensation-Seeking Scale (SSS) and vocational interests measured by the Kuder and Strong Vocational Interest Blank, among alcoholics and undergraduates. Results support construct validity of the SSS and provide further evidence of modes of expression of stimulus-seeking needs in personality. (Author/CJ)
Kish, George B.; Donnenwerth, Gregory V.
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
Deanna L. Novak; Mara Mather
Tested 63 new items for the Sensation Seeking Scale (SSS) in an attempt to develop new scales representative of hypothesized dimensions of sensation seeking. An experimental form was given to 332 and 92 undergraduates at 2 universities. Data from the 1st university was factor analyzed separately for males and females. Besides the general factor running through diverse items, 4 factors
This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis. PMID:25715292
Tejada-Tayabas, Luz María; Salcedo, Liseth Amell; Espino, Joel Monárrez
The ‘woman doctor question’ was a title given to the public debates that erupted in early twentieth-century New South Wales (Australia) over the employment of women doctors in general hospitals. Two wellqualified women, Drs Susie O'Reilly and Jessie Aspinall, were rejected from hospital residencies in Sydney, which led a wide variety of groups and individuals to mobilise in print, not
Introduction Skilled attendance is one of the major strategies to curtail maternal mortality, specifically in developing countries. Despite the low level of equipment, it is only in health facilities that skilled care are provided during pregnancy and childbirth; but there are some barriers which prevent women to use health facilities for good care. Methods This study was carried out in Ouargaye where a skilled care initiative was implemented by Family care International with the aim to increase the skilled attendance at delivery and Diapaga, the control district. Thirty (30) In-depth interviews, 8 Focus group discussions and 6 non participant observations were carried out. Participants were women from 15-49 years. All the interviews were tape-recorded, transcribed and analysed line by line. NVIVO was used to manage the interviews. Results Four types of barriers have been described by women; 1) the cultural barriers concern the low status of women in the two districts and some traditional beliefs which mean that women can not always decide to use health facility by themselves. 2) The geographical barrier is about the distance to reach health facility and the lack of transport means. 3) The financial barrier to pay care and drugs. 4) Bad organization of care and poor quality of care provided to women. Conclusion To minimize the risk of complications during pregnancy and childbirth, it is important that women use health facilities. The barriers described by women are not insurmountable but needed to be integrated in a global comprehensive health policy. PMID:25368732
Somé, Donmozoun Télesphore; Sombie, Issiaka; Meda, Nicolas
Through the true story of Fatma, the author reveals and examines the underlying cause and effect of violence against women in Palestinian society in Israel. By following a path of abuse and violence that lasted for 10 years and several desperate attempts to seek help, we get a clearer view of the true problems and obstacles facing these women today.
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
Blume, S B
's Hospital is designed to treat the whole woman, not just her symptoms, with compassion, innovation imbalances. Exceptional Features: Â· Onsite helipad to transport pregnant women, babies and children
With the advent of thrombolytic therapy and other coronary reperfusion strategies, rapid identification and treatment of acute myocardial infarction greatly reduces mortality. Unfortunately, many patients delay seeking medical care and miss the benefits afforded by recent advances in treatment. Studies have shown that the median time from onset of symptoms to seeking care ranges from 2 to 61\\/2 hours, while
Kathleen Dracup; Debra K. Moser; Mickey Eisenberg; Hendrika Meischke; Angelo A. Alonzo; Allan Braslow
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
Dale, Sannisha; Cohen, Mardge; Weber, Kathleen; Cruise, Ruth; Kelso, Gwendolyn; Brody, Leslie
Abstract 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
Cohen, Mardge; Weber, Kathleen; Cruise, Ruth; Kelso, Gwendolyn
A 2-year investigation was conducted of Connecticut's high school medical careers programs and the career opportunities available to students, particularly females, who have graduated from them. Research conducted in two phases in four communities involved the following activities: site visits of high school medical careers programs and student…
Silverman, Suzanne; Pritchard, Alice
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
Blomberg, Marie; Birch Tyrberg, Rasmus; Kjřlhede, Preben
The current study examined prevalence and correlates of non-medical use of prescription drugs (NMUPD), with particular emphasis on lifetime history of rape and PTSD as risk associates. Interviews conducted via telephone using Computer-Assisted Telephone Interviewing technology, resulting in a nationally representative sample of 3,001 non-institutionalized, civilian, English or Spanish speaking women (aged 18–86 years) residing in households with a telephone. Demographic characteristics, rape history, general health/mental health, and substance abuse variables were assessed. NMUPD was assessed by asking if, in the past year, participants had misused a prescription drug. Multivariable logistic regressions were conducted for each theoretically derived predictor set. Significant predictors from each set then entered into final multivariable logistic regression to determine significant predictors of past-year NMUPD. NMUPD was endorsed by 5.5% of the sample (n=164). Final multivariable model showed that lifetime posttraumatic stress disorder, other forms of substance use/abuse, and a history of drug or alcohol facilitated rape were significantly associated with increased likelihood of NMUPD. Risk reduction efforts targeting non-medical prescription drug use among women who have experienced traumatic events and/or abuse substances are warranted. Trauma-focused interventions for drug or alcohol facilitated rape victims should include treatment or prevention modules that specifically address NMUPD. PMID:19375238
McCauley, Jenna L.; Amstadter, Ananda B.; Danielson, Carla Kmett; Ruggiero, Kenneth J.; Kilpatrick, Dean G.; Resnick, Heidi S.
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
Miller, Stephania T.; Oates, Veronica J.; Brooks, Malinda A.; Shintani, Ayumi; Jenkins, Darlene M.
Transcultural nursing, psychiatry, and medical anthropology have theorized that practitioners and researchers need more flexible instruments to gather culturally relevant illness experience, meaning, and help seeking. The state of the science is sufficiently developed to allow standardized yet ethnographically sound protocols for assessment. However, vigorous calls for culturally adapted assessment models have yielded little real change in routine practice. This paper describes the conversion of the Diagnostic and Statistical Manual IV, Appendix I Outline for Cultural Formulation into a user-friendly Clinical Ethnographic Interview (CEI), and provides clinical examples of its use in a sample of highly distressed Japanese women. PMID:22194348
Arnault, Denise Saint; Shimabukuro, Shizuka
Female corporate leaders are becoming more common, but that does not mean it was a snap for them to get there. Much has been said about the hard road faced by women who seek top spots in corporate America. Many point out, for instance, that women executives still often are paid less than their male counterparts, and that they face stereotypes,…
Background Predictors of adverse events (AE) associated with nevirapine use are needed to better understand reports of severe rash or liver enzyme elevation (LEE) in HIV+ women. Methodology AE rates following ART initiation were retrospectively assessed in a multi-site cohort of 612 women. Predictors of onset of rash or LEE were determined using univariate and multivariate analyses. Principal Findings Of 612 subjects, 152 (24.8%) initiated NVP-based regimens with 86 (56.6%) pregnant; 460 (75.2%) initiated non-NVP regimens with 67 (14.6%) pregnant. LEE No significant difference was found between regimens in the development of new grade ?2 LEE (p?=?0.885). Multivariate logistic regression demonstrated an increased likelihood of LEE with HCV co-infection (OR 2.502, 95% CI: 1.04 to 6, p?=?0.040); pregnancy, NVP-based regimen, and baseline CD4 >250 cells/mm3 were not associated with this toxicity. Rash NVP initiation was associated with rash after controlling for CD4 and pregnancy (OR 2.78; 95%CI: 1.14–6.76), as was baseline CD4 >250 cells/mm3 when controlling for pregnancy and type of regimen (OR 2.68; 95% CI: 1.19–6.02 p?=?0.017). Conclusions CD4 at initiation of therapy was a predictor of rash but not LEE with NVP use in HIV+ women. Pregnancy was not an independent risk factor for the development of AEs assessed. The findings from this study have significant implications for women of child-bearing age initiating NVP-based ART particularly in resource limited settings. This study sheds more confidence on the lack of LEE risk and the need to monitor rash with the use of this medication. PMID:20838641
Aaron, Erika; Kempf, Mirjam-Colette; Criniti, Shannon; Tedaldi, Ellen; Gracely, Ed; Warriner, Amy; Kumar, Ritu; Bachmann, Laura H.
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
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
Harrow, Alison; Dryden, Ruth; McCowan, Colin; Radley, Andrew; Parsons, Mark; Thompson, Alastair M; Wells, Mary
...MEDICAL CLEARANCE PROCESS FOR DEPLOYMENT TO ANTARCTICA § 675.2 Medical examinations. (a) Any individual seeking to travel to Antarctica under sponsorship of the United...physically qualified for deployment to Antarctica. (b) The medical and...
...MEDICAL CLEARANCE PROCESS FOR DEPLOYMENT TO ANTARCTICA § 675.2 Medical examinations. (a) Any individual seeking to travel to Antarctica under sponsorship of the United...physically qualified for deployment to Antarctica. (b) The medical and...
...MEDICAL CLEARANCE PROCESS FOR DEPLOYMENT TO ANTARCTICA § 675.2 Medical examinations. (a) Any individual seeking to travel to Antarctica under sponsorship of the United...physically qualified for deployment to Antarctica. (b) The medical and...
Few rape survivors seek help from formal social systems after their assault. The purpose of this study was to examine factors that prevent survivors from seeking help from the legal, medical, and mental health systems and rape crisis centers. In this study, 29 female rape survivors who did not seek any postassault formal help were interviewed…
Patterson, Debra; Greeson, Megan; Campbell, Rebecca
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
Powell-Jackson, Timothy; Acharya, Rajib; Filippi, Veronique; Ronsmans, Carine
AUTHORIZATION FORM FOR MEDICAL TREATMENT* Injured Employee's Name Department Date of Injury. If you need medical treatment due to a work related injury or illness, seek treatment at either: HENRY-related injury or illness (or any treatment that should not wait until clinic hours the next day) seek treatment
Background The continuing contribution of dengue fever to the hospitalization and deaths in hospital of infants and small children in Cambodia is associated with delays in presentation for medical attention, diagnosis and appropriate care. It is important to identify the reasons that influence these delays, in order to develop appropriate interventions to redress the impact of dengue. Methods Data on health seeking were collected during an ethnographic study conducted in two villages in the eastern province of Kampong Cham, Cambodia in 2004. Interviews were conducted with mothers whose children had been infected with suspected dengue fever, or who had been sick for other reasons, in 2003 and 2004. Results Women selected a therapeutic option based on perceptions of the severity of the child's condition, confidence in the particular modality, service or practitioner, and affordability of the therapy. While they knew what type of health care was required, poverty in combination with limited availability and perceptions of the poor quality of care at village health centers and public referral hospitals deterred them from doing so. Women initially used home remedies, then sought advice from public and private providers, shifting from one sector to another in a pragmatic response to the child's illness. Conclusion The lack of availability of financial resources for poor people and their continuing lack of confidence in the care provided by government centres combine to delay help seeking and inappropriate treatment of children sick with dengue. PMID:17892564
Khun, Sokrin; Manderson, Lenore
Director of Clinical Virology Laboratory at Stanford University Medical Center (SUMC Diseases, or who has a Ph.D. in virology or a related field, to direct the Clinical Virology Laboratory at Stanford. Certification by the American Board of Medical Microbiology is desirable. The Clinical Virology
Background Depressive Disorders (DD) are a great financial and social burden. Females display 70% higher rate of depression than males and more than 30% of these patients do not respond to conventional medications. Thus medication-refractory female patients are a large, under-served, group where new biological targets for intervention are greatly needed. Methods We used real-time quantitative polymerase chain reaction (qPCR) to evaluate mRNA gene expression from peripheral blood leukocytes for 27 genes, including immune, HPA-axis, ion channels, and growth and transcription factors. Our sample included 23 females with medication refractory DD: 13 with major depressive disorder (MDD), 10 with bipolar disorder (BPD). Our comparison group was 19 healthy, non-depressed female controls. We examined differences in mRNA expression in DD vs. controls, in MDD vs. BPD, and in patients with greater vs. lesser depression severity. Results DD patients showed increased expression for IL-10, IL-6, OXTR, P2RX7, P2RY1, and TRPV1. BPD patients showed increased APP, CREB1, NFKB1, NR3C1, and SPARC and decreased TNF expression. Depression severity was related to increased IL-10, P2RY1, P2RX1, and TRPV4 expression. Conclusions These results support prior findings of dysregulation in immune genes, and provide preliminary evidence of dysregulation in purinergic and other ion channels in females with medication-refractory depression, and in transcription and growth factors in those with BPD. If replicated in future research examining protein levels as well as mRNA, these pathways could potentially be used to explore biological mechanisms of depression and to develop new drug targets. PMID:24143878
Abstract Aims Asian American women's health has been understudied while the Asian American population is increasing. The purpose of this study was to examine the physical, behavioral, and mental health of Asian American women. Methods Using a nationally representative sample (n=1097) from the National Latino Asian American Study (NLAAS), the first comprehensive epidemiologic survey in the United States, we examined the annual rates of behavioral, physical, and mental healthcare service use, including general medical, specialty mental health, and any medical services, in three major subgroups of Asian American women. Results Health problems varied with three major subgroups of Asian American women. In physical health, Chinese American women reported the highest rates of headache, other pain, hypertension, heart diseases, heart attacks, chronic lung diseases, and asthma. Vietnamese American women reported the highest rates of ulcer, stroke, and diabetes. Filipino American women had the highest rates of cancers and epilepsy. In behavioral health, Filipino women ranked highest on all types of drug use and cigarette smoking, compared with their counterparts. In mental health, Filipino American women reported significantly better mental health self-rating compared with their Chinese and Vietnamese American counterparts. Asian American women from each ethnic group sought health services at distinct rates. However, the help-seeking patterns of health services are similar. Conclusions Asian American women encountered various physical, behavioral, and mental health problems, yet they had low rates of seeking healthcare services. Hence, it is critical to further examine factors associated with the underestimation of physical and mental health problems and underuse of health services by Asian American women. PMID:21777144
Huang, Bu; Ai, Amy L.; Lin, Chyongchiou Jeng
This study compared levels of violence, social support, and post-traumatic stress between battered women charged with a violent crime against an abusive partner and those seeking help from a mental health clinic. Results indicated that forensic battered women were more likely than clinical battered women to report experiencing severe violence, including sexual abuse, in their relationships. Women in the forensic
Mary Ann Dutton; Laura C. Hohnecker; Paulin M. Halle; Kimberly J. Burghardt
The common north-seeking gyro (NSG) is a free gyro with damped precession such that it will align itself parallel to the earth's spin axis. The author presents an improved NSG which still uses the earth's spin to sense north but, instead of physical displacement, the orientation to north is determined by sensing the earth spin rate vector through scanning horizontally with an angular rate sensor and using electronic filtering with digital signal processing to then refine the accuracy. Underlying theoretical limits of accuracy and a discussion of the primary applications are presented.
Watson, William S.
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.
Background College students who consume caffeinated alcoholic beverages (CaffAlc) are at increased injury risk. This study examines the extent to which a sensation-seeking personality accounts for the relationship between consumption of CaffAlc and negative outcomes. Methods A Web-based survey was administered to stratified random samples of 4907 college students from eight North Carolina universities in Fall 2009. Sensation seeking was assessed using the Brief Sensation-Seeking Scale (BSSS) (?=0.81). Data were analyzed using linear and logistic regression. Results 3390 students (71.2%) reported past 30-day drinking, of whom 786 (23.2%) consumed CaffAlc. CaffAlc past 30-day drinkers had higher BSSS scores (3.8 vs. 3.4; p<0.001), compared to non-CaffAlc drinkers. Consumption of CaffAlc was associated with more frequent binge drinking (p<0.001) and drunken days in a typical week (p<0.001), even after adjusting for the BSSS score. CaffAlc students were more likely to be taken advantage of sexually (adjusted odds ratio [AOR]=1.70, p=0.012), drive under the influence of alcohol (AOR=2.00, p<0.001), and ride with a driver under the influence of alcohol (AOR=1.87, p<0.001). Injury requiring medical treatment was more prevalent among CaffAlc students with higher BSSS-8 scores (interaction p=0.024), even after adjustment for drinking levels and student characteristics. Conclusions Sensation seeking does not fully account for the increase in risky drinking among college students who consume CaffAlc, nor does it moderate the relationship between CaffAlc and drinking behaviors. Sensation seeking moderates the risk of alcohol-associated injury requiring medical treatment among college students who consume CaffAlc. Those with strong sensation-seeking dispositions are at the highest risk of alcohol-associated injury requiring medical treatment. PMID:24761275
McCoy, Thomas P.; Egan, Kathleen L.; Goldin, Shoshanna; Rhodes, Scott D.; Wolfson, Mark
According to many reports, time in the United States negatively affects the health of Hispanic immigrants. However, little is known about the role of traditional health beliefs and practices in immigrants' underutilization of the US health care system. This descriptive, qualitative study utilized narrative interviews with 20 foreign-born Hispanic women of childbearing age to gain a better understanding of their existing health beliefs, health promotion practices, past health care experiences, and transition into a new society and health care system. Demographic data and scores on the short acculturation scale for Hispanics were also analyzed. Results highlight the importance of female social support for Hispanic women in making health care decisions; their dual use of US medical intervention and home and herbal remedies; and perceived racial discrimination on their health-care seeking behaviors and adherence to treatment modalities. Recommendations are included for professionals who provide health care to immigrant Hispanic women and their families. PMID:20607608
Sanchez-Birkhead, Ana C; Kennedy, Holly Powell; Callister, Lynn Clark; Miyamoto, Teresa Paredes
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
Pérez-Zepeda, Mario Ulises; Arango-Lopera, Victoria Eugenia; Wagner, Fernando A.; Gallo, Joseph J.; Sánchez-García, Sergio; Juárez-Cedillo, Teresa; García-Peńa, Carmen
GEOS-A, associated with the Soviet Union's Institute of Earth Physics, is seeking to promote exchange between Soviet and Western geophysicists. GEOS-A is a nonprofit, private organization formed by specialists from the U.S.S.R. Academy of Scientists.GEOS-A aims to promote the transfer of academic research results to industry and education. It also seeks to stimulate international scientific exchange and to support independent nongovernmental programs and expertise in geophysics and ecology. The organization would like to cooperate with Western universities in exchanging students and young scientists and in building scientific relationships between the two countries. This would include inviting students and young specialists for collaborative scientific research, consultations, language practice, and graduate study in any institute of the U.S.S.R. Academy of Sciences. Participants would live in rented private apartments in downtown Moscow for approximately one week to several months. All living expenses would be covered at a rate higher than the academy's standard one (unfortunately travel to and from the Soviet Union cannot be covered).
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
Otiashvili, David; Kirtadze, Irma; O’Grady, Kevin E.; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M.; Jones, Hendrée E.
to prescribe hormone therapy prior to the release of the Women's Health Initiative trial: a survey of general for Medical Research U149, Epidemiological Research Unit on Perinatal Health and Women's Health, 16, ave Paul
... What is CDC Doing? Sudden Infant Death Syndrome Teen Pregnancy Unintended Pregnancy Contraception Contraceptive Guidance for Providers Medical ... Services Training for Providers US MEC US SPR Teen Pregnancy Prevention Women's Reproductive Health Common Reproductive Health Concerns ...
Objective To determine the efficacy of a peer-led social support intervention involving support groups and telephone contacts compared with standard clinical care to enhance antiretroviral medication adherence. Design Randomized controlled trial with follow-up. Participants were 136 HIV-positive indigent mainly African American and Puerto Rican men and women recruited from an outpatient clinic in the Bronx, New York. The 3-month intervention was delivered by other HIV-positive clinic patients trained in addressing barriers to adherence and sensitively providing appraisal, spiritual, emotional, and informational adherence-related social support. Main outcome measures Medical chart-abstracted HIV–1 RNA viral load, antiretroviral adherence according to electronic drug monitoring and participant self-report, and social support and depressive symptomatology. All assessments conducted at baseline, 3 months, and 6 months. Results Intent-to-treat and as-treated analyses indicated no between-conditions intervention effects on the primary outcome of HIV–1 RNA viral load or any of the secondary outcomes at immediate postintervention or follow-up. Post hoc analyses within the intervention condition indicated greater intervention exposure was associated with higher self-reported adherence, higher social support, and lower depressive symptomatology at follow-up, even after controlling for baseline adherence. Conclusion Null findings, consistent with the limited literature on efficacious highly active antiretroviral therapy (HAART) adherence interventions, may be due to insufficient exposure to the intervention, its low intensity, or the nature of the sample—a heterogeneous HAART-experienced group of patients with high levels of substance use and multiple other competing stressors. Overall, findings highlight the need for more comprehensive and intensive efforts to battle nonadherence. PMID:17605569
Simoni, Jane M.; Pantalone, David W.; Plummer, Mary D.; Huang, Bu
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
Diniz, Debora; Madeiro, Alberto
This study examined the factors affecting a women's initial intimate partner violence (IPV)-specific health care seeking event which refers to the first health care seeking as a result of IPV in a lifetime. Data were collected using the Life History Calendar method in the Tokyo metropolitan area from 101 women who had experienced IPV. Discrete-time survival analysis was used to assess the time to initial IPV-specific health care seeking. IPV-related injury was the most significant factor associated with increased likelihood of seeking IPV-specific health care seeking for the first time. In the presence of a strong effect of formal help seeking, physical and sexual IPV were no longer significantly related to initial IPV-specific health care seeking. The results suggest some victims of IPV may not seek health care unless they get injured. The timing of receiving health care would be important to ensure the health and safety of victims. PMID:24470569
Kamimura, Akiko; Bybee, Deborah; Yoshihama, Mieko
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
Hotz, Kendra G
Using the phenomenological perspective provided by the concept of embodiment, this article shows that in Cuenca, Ecuador, knowledge about the body is fluid and during illness women can seek reassurance and explanations from multiple knowledge systems, including locally understood subordinate ones. Employing the concept of `character', as described by Ricoeur, as an explanation for why some women are more vulnerable
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
Riters, Lauren V.
Objectives: To determine the influence of health-seeking behavior of urban women in South-West Nigeria on the incidence and perinatal outcome of umbilical cord prolapse (UCP). Methods: A retrospective study comparing two groups of urban women using information extracted from medical records of patients who had UCP, and were managed at the University College Hospital Ibadan, Nigeria from January1st 1995 to December 31st 2005. The data was analyzed using SPSS software (version 15). Analysis included simple tabulation, proportion and comparison of incidence, perinatal morbidity, and mortality of UCP between the two groups of women using Chi-square or Fisher’s exact test. Odds ratio (OR) and 95% confidence intervals (CI) were calculated whenever necessary. P-value of 0.05 or less was statistically significant. Results: Women without prenatal care were more likely to have fetuses with UCP (54, 75%), than in women who had prenatal care (18, 25%). The risk of perinatal death from UCP was higher in women without prenatal care, as compared with those who received prenatal care (OR 3.02, 95% CI: 0.879 to 10.356; P-value = 0.061). The risk of perinatal morbidity and neonatal intensive care admission was also higher among women without prenatal care as compared with women who received prenatal care (OR 4.09, 95% CI: 1.03 to 16.30; P-value = 0.041). The overall perinatal mortality rate in the study population was 403 per 1000 total births, and this was five times more than that of the hospital perinatal mortality rate of 80 per 1000 total births during the study period. The perinatal mortality rate was higher among women without prenatal care, 463 per 1000 total births, as compared with 222 per 1000 total births in women who received prenatal care. Perinatal death before arrival at the hospital is less likely to occur in women with prenatal care when compared with women without prenatal care (OR 0.0635; 95% CI: 0.0052 to 0.776; P-value = 0.03). Conclusion: A high index of suspicion and an identification of risk factors, with early diagnosis, prompt intervention, and provision of health care facilities can reduce the incidence and poor outcome of UCP in developing countries. PMID:21072310
Enakpene, Christopher A; Odukogbe, Akin-Tunde O; Morhason-Bello, Imran O; Omigbodun, Akinyinka O; Arowojolu, Ayo O
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.
Joslyn Yudenfreund Kravitz, Ph.D., Editor Office of Research on Women's Health Office Meeting to Seek New Dimensions and Strategies for Women's Health Research and Advancing Women's Biomedical Will Hold Fifth Regional Meeting to Seek New Dimensions and Strategies for Women's Health Research
Bandettini, Peter A.
The model is based on the highly successful first Women's Bureau sponsored Colorado Education and Employment Conference for Hispanic Women ("Adelante, Mujer Hispana") held in January 1980 for low-income women seeking employment and employed women seeking better jobs and upward mobility. It is intended for use by groups and individuals in planning…
Women's Bureau (DOL), Washington, DC.
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.
Nearly one fourth of women diagnosed with breast cancer are aged 50 and younger. Little is known about the impact of diagnosis or treatment on younger women and their relationships with their spouse or partner. The purpose of this paper is to (a) describe the issues younger women with breast cancer face, (b) identify how these issues impact the relationship
Stephanie R. Burwell; Bowden Templeton; Kelly S. Kennedy; Lisa Zak-Hunter
The purpose was to present the new scale of novelty seeking in the context of wilderness. A study of the psychometric properties of the Wilderness Novelty Seeking Scale was conducted, with an exploratory and a confirmatory factor analysis being carried out and the coefficients of the scale's reliability and stability over time being tested. The convergent validity of the WNSS scale was indicated by positive correlations with sensation seeking, openness to experience, and need for cognition. The divergent validity of the WNSS scale was indicated by non-significant correlations with state-trait anxiety and depression. The correlation between the Wilderness Novelty Seeking Scale and psychological well-being was analyzed. The Wilderness Novelty Seeking Scale seems to be a reliable and valid tool. PMID:25202995
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…
Background The present study describes Complementary and Alternative Medicine (CAM) use amongst Italian women transitioning through menopause. Popularity and perceived effectiveness of CAM treatments, use of pharmaceutical medications, characteristics of CAM users, the extent of communication between medical practitioners and women about their use of CAM, and variables associated with CAM use were also investigated. Methods Women, aged 45-65 years attending Family Planning and Women's Health clinics or Menopause Centres in Bologna were invited to complete a voluntary, anonymous, self administered questionnaire, which was used in a previous study in Sydney. The questionnaire was translated and adapted for use amongst Italian women. Data on general demographic and health characteristics, menopause related symptoms and the use of CAM and pharmaceutical treatments during the previous 12 months were collected. Results In total, 1,203 women completed the survey, of which 1,106 were included in the final sample. Of women who had symptoms linked with menopause and/or used remedies to alleviate symptoms, 33.5% reported to have used CAM. Among these, 23.5% had consulted one or more practitioners and 24% had used at least one CAM product. Approximately nine out of ten respondents reported medical practitioners did not seek information about their use of CAM; while one third of CAM users did not disclose the use of CAM to their physician. Nevertheless, medical practitioners were the most popular source of information. From the multivariate analysis, variables associated with CAM use were: professional employment, time since the last natural menses, use of CAM for conditions other than menopause, and presence of some severe symptoms. Conclusions The relatively high prevalence of CAM use by women transitioning through menopause should encourage research initiatives into determining which CAM treatments are the safest and effective. The increasing and likely concomitant use of CAM with HRT and other pharmaceuticals underlines the need for the implementation of a surveillance system to report and monitor possible drug-herb adverse events. The discrepancy between women preferring to seek information about CAM from their medical doctor and the difficulties noted in communication between doctor and patient should encourage educational initiatives on CAM by health-care agencies and institutions. PMID:20187964
characteristics of communicators and context of communication including communication topic and setting. The women use strategies, boundaries and rules to negotiate communication privacy and engage in comfortable communication. Additionally, the women seek...
Hernandez, Rachael A.
Background Women having experienced several consecutive failing IVF cycles constitute a critical and particular subset of patients, for which growing perception of irremediable failure, increasing costs and IVF treatment related risks necessitate appropriate decision making when starting or not a new cycle. Predicting chances of LB might constitute a useful tool for discussion between the patient and the clinician. Our essential objective was to dispose of a simple and accurate prediction model for use in routine medical practice. The currently available predictive models applicable to general populations cannot be considered as accurate enough for this purpose. Methods Patients with at least four consecutive Failing cycles (CFCs) were selected. We constructed a predictive model of LB occurrence during the last cycle, by using a stepwise logistic regression, using all the baseline patient characteristics and intermediate stage variables during the four first cycles. Results On as set of 151 patients, we identified five determinant predictors: the number of previous cycles with at least one gestational sac (NGS), the mean number of good-quality embryos, age, male infertility (MI) aetiology and basal FSH. Our model was characterized by a much higher discrimination as the existing models (C-statistics=0.76), and an excellent calibration. Conclusions Couples having experienced multiple IVF failures need precise and appropriate information to decide to resume or interrupt their fertility project. Our essential objective was to dispose of a simple and accurate prediction model to allow a routine practice use. Our model is adapted to this purpose: It is very simple, combines five easily collected variables in a short calculation; it is more accurate than existing models, with a fair discrimination and a well calibrated prediction. PMID:23302328
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)
Levison, Sandra P.; Straumanis, Joan
STUDY OBJECTIVE—To describe the responses of women in León, Nicaragua to partner abuse and identify contextual factors associated with the use of certain coping mechanisms and the likelihood of permanent separation.?DESIGN—Cross sectional population-based survey.?SETTING—León, Nicaragua.?PARTICIPANTS—188 women 15-49 years of age who had experienced physical partner abuse, out of 488 women interviewed.?MAIN RESULTS—66% of women defended themselves effectively from abuse either physically or verbally. Forty one per cent of women had left home temporarily because of violence and 20% had sought help outside the home. Women experiencing severe abuse were more likely to leave or seek help, whereas women with less severe abuse were more able to defend themselves effectively. Seventy per cent of women eventually left abusive relationships. Help seeking and temporary separations increased the likelihood of a permanent separation, whereas women who defended themselves and were able to stop the violence, at least temporarily, were more likely to remain in abusive relationships.?CONCLUSIONS—Women in Nicaragua use a variety of methods in order to overcome physical partner abuse. Temporary leaving and help seeking are critical steps in the process of leaving a violent relationship. However, many women indicated that they did not receive support for their situation. More interventions are needed to help women recognise and deal with violence, as well as strengthening the community support networks available to abused women.???Keywords: partner abuse; violence; women PMID:11449011
Ellsberg, M; Winkvist, A; Pena, R; Stenlund, H
For nurses and other health care professionals who seek to distinguish the habitus from the humerus, this online medical dictionary provided by MedicineNet will be a place to bookmark for repeat visits. The dictionary contains well-written explanations for over 16,000 medical terms, and users can go ahead and browse around, or enter keywords or phrases into the search engine that resides on the page. The site also features a â??Word of the Dayâ?ť, and visitors can also look through recent news items that address different health issues and also look over the latest entries to the dictionary. The site is rounded out by a list of the â??Top 10 Medtermsâ?ť, which is also a good way to start exploring the materials here.
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
Amy K. Taylor; Sharon Larson; Rosaly Correa-de-Araujo
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)
Morgan-Haker, Veronica R.
Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender. PMID:21174496
Drapalski, Amy; Bennett, Melanie; Bellack, Alan
Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender. PMID:21174496
Drapalski, Amy; Bennett, Melanie; Bellack, Alan
pramipexole and ropinirole and healthy controls. The never-medicated patients were also re-evaluated after 12: Parkinson's disease; reward; novelty seeking; dopamine; pramipexole; ropinirole doi:10.1093/brain/awp094
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…
Reid, Inez Smith
2015 Summer Ethics Fellowships for Medical Students The Fellowships at Auschwitz for the Study of Professional Ethics (FASPE) seeks appli- cations for its 2015 medical fellowships. FASPE Medical, a component of study on medical ethics. FASPE is predicated upon the power of place, and in particular the first
Medication error is a major source of iatrogenic injuries in children. Dosing errors are the most common type of medication errors in pediatrics. Sicker patients in intensive care units and emergency departments are more often harmed by such errors. Strategies that have been found to be effective in reducing medication errors include the use of computerized physician order entry systems, preprinted order forms, and color-coded systems. Adopting the "systems approach" to medication errors is crucial to every health system where practitioners seek to enhance patient safety. PMID:17126688
Kozer, Eran; Berkovitch, Matitiahu; Koren, Gideon
Many women seek treatment for substance abuse problems during their child-bearing years. Evaluations of interventions for these women need to take into account other problems that women may have when they enter treatment. The effectiveness of residential treatment for women, some of whom reported a history of abuse and psychological problems, is…
Cosden, Merith A.; Peerson, Stacey
Purpose: In this population-based, random-digit-dial, cross-sectional survey, we assessed the lifetime victimization of intimate partner violence (IPV) and forced or coerced sex among 556 women and men in South Carolina, and the help-seeking behaviors of victims.Results: Among women, 25.3% experienced IPV (sexual, physical, or emotional violence) compared with 13.2% of men. Although women were significantly more likely to report physical
Ann L. Coker; Christina Derrick; Julia L. Lumpkin; Timothy E. Aldrich; Robert Oldendick
OBJECTIVES: To understand the prevalence of postpartum morbidities and factors associated with treatment-seeking behaviour among currently married women aged 15-49 residing in rural India. METHODS: We used data from the nationally representative District Level Household Survey from 2007-2008. Cross-tabulation was used to understand the differentials for the prevalence of postpartum morbidities and treatment-seeking behaviours across selected background characteristics. Two-level binary logistic regression was applied to understand the factors associated with treatment-seeking behaviour. RESULTS: Approximately 39.8% of rural women suffered from at least one of the six postpartum morbidities including high fever, lower abdominal pain, foul-smelling vaginal discharge, excessive bleeding, convulsions, and severe headache. Morbidities were more prevalent among poor, illiterate, Muslim, and high-parity women. About 55.1% of these rural women sought treatment/consultation for their problems. The odds of seeking treatment/consultation increased as economic status and years of schooling among both the woman and her husband increased. Poor, uneducated, unemployed, Hindu, and tribal women were less likely to seek treatment/consultation for postpartum morbidities than their counterparts were. The odds of seeking treatment/consultation decreased as the distance to the nearest private health facility increased. Most women visited a private hospital (46.3%) or a friend/family member’s home (20.8%) for treatment/consultation. Only a small percentage visited publicly funded health institutions such as a primary health centre (8.8%), community health centre (6.5%), health sub-centre (2.8%), or district hospital (13.1%). Rural women from the northeast region of India were 50% less likely to seek treatment/consultation than women from the central region were. CONCLUSIONS: Providing antenatal and delivery care, and ensuring nearby government healthcare facilities are available to serve rural women might increase the likelihood of care-seeking for postpartum morbidities. Targeted interventions for vulnerable groups should be considered in future policies to increase the likelihood women will seek treatment or advice postpartum. PMID:25358467
Singh, Aditya; Kumar, Abhishek
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
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
Janes-Kelley, Selikke; Tyrrell, Janie; Clark, Lorna; Hamza, Deena; Holmes, Penny; Parkes, Cheryl; Moyo, Nomagugu; McDonald, Sheila; Austin, Marie-Paule
This study aimed to examine the gender-related differences in demographics, gambling measures, psychological functioning,\\u000a and motivation for therapy in an outpatient sample of pathological gamblers seeking treatment. Participants in this multisite\\u000a study included 103 adult outpatients (51 women and 52 men) meeting current DSM-IV-TR criteria for PG. Logistic regression\\u000a was used to examine if gender was related together to categorical
Enrique Echeburúa; Itxaso González-Ortega; Paz de Corral; Rocío Polo-López
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
Karamanis, Georgios; Skalkidou, Alkistis; Tsakonas, Georgios; Brandt, Lena; Ekbom, Anders; Ekselius, Lisa; Papadopoulos, Fotios C
This article summarizes research pertinent to the clinical care of women with bipolar disorder. With bipolar disorder, female gender correlates with more depressive symptoms and different comorbidities. There is a high risk of symptom recurrence postpartum and possibly during perimenopause. Women with bipolar disorder have increased risk of sexually transmitted diseases, unplanned pregnancies, excessive weight gain, metabolic syndrome, and cardiovascular disease. Mood stabilizing medications, specific psychotherapies, and lifestyle changes can stabilize mood and improve functioning. Pharmacologic considerations include understanding interactions between mood stabilizing medications and contraceptive agents and risks and benefits of mood stabilizing medication during pregnancy and lactation. PMID:25315819
Miller, Laura J; Ghadiali, Nafisa Y; Larusso, Elizabeth M; Wahlen, Kelly J; Avni-Barron, Orit; Mittal, Leena; Greene, Judy A
Introduction Acne and hirsutism are common manifestations of hyperandrogenism. Aim To investigate whether or not acne is present in women with hirsutism, associated with different clinical, endocrine and ultrasonographic features. Material and methods The prospective study included 135 women with hirsutism, aged 14–46 years. We measured the levels of hormones with radioimmunoassay/immunoradiometric assay methods. Results Acne were present in 63 (47.6%) women with hirsutism. Sixty women had mild forms of acne, including: whiteheads, blackheads, papules and pustules. Only 3 women had moderate to severe acne, including nodules. In a group of women with hirsutism and acne, 6 (9.5%) were obese. In our study we found a high prevalence of androgen excess among hirsute women with acne: total testosterone was increased in 79%, free testosterone in 20.6%, androstenedione in 69.8%, dehydroepiandrosterone sulfate (DHEAS) in 30.1%, 17-OH-progesterone 68.2% and sex hormone-binding globulin (SHBG) was decreased in 33.3% of women. Women with hirsutism and acne have received oral contraceptives for a year, without or in a combination with other medication. Thirty-four (53.9%) women have shown improvement in hirsutism and acne. Conclusions In this study we found a high prevalence of acne in hirsute women. The prevalence of acne was higher in polycystic ovarian syndrome. Since these women have associated endocrine changes it is important to correct them with hormonal therapy. PMID:25610349
Pupovci, Hatixhe Latifi; Berisha, Violeta Lokaj; Goçi, Aferdita Uka; Gerqari, Antigona
... Medical Liability Reform GME and Workforce Trauma and EMS Cancer and Research Health Information Technology Patient Safety ... Medical Liability Reform GME and Workforce Trauma and EMS Cancer and Research More in Federal Legislation Regulatory ...
A community-based cross-sectional study was conducted in Paschim Midnapur district of West Bengal during March 2009 to August 2009 to find out the prevalence of reproductive tract infection and the health seeking behaviour. The respondents were 2000 currently married women (15-49 years age group) selected by stratified multistage random sampling. House to house visit and data collection by interview technique was done by faculty members of community medicine of Calcutta National Medical College and other medical colleges through predesigned and pretested schedule. The prevalence of reproductive tract infection was 11.7%, which was higher in 30-35 years age group (19.4%). Reproductive tract infection was indirectly proportional to literacy status. Prevalence of reproductive tract infection was significantly higher among those who did not use sanitary napkin / clean sun-dried domestic clothes. The occurrence of reproductive tract infection was lower who used to practise barrier method of contraception. Majority of symptomatic females complained about vaginal discharge (29.2%). Information, education, communication regarding small family norms, reproductive hygiene and contraceptive practice to be enhanced in the community through intervention (interpersonal communication and mass media) in future to reduce the reproductive tract infection morbidities. PMID:23360037
Baur, Baijayanti; Haldar, Anima; Jha, Sankar Nath; Bal, Runa; Kundu, Mrinal Kanti; Biswas, Arati; Bandyopadhyay, Lina
Objective: This study examined barriers to treatment in an ethnically diverse com- munity sample of women with eating disorders. Method: Participants were 61 women (22 Hispanics, 8 Asians, 12 Blacks, 19 Whites) with eating disorders. Diagnosis was determined using the Eating Disorder Examination. Treatment-seeking history, barriers to treatment seek- ing, ethnic identity, and acculturation were assessed. Results: Although 85% of
Fary M. Cachelin; Ramona Rebeck; Catherine Veisel; Ruth H. Striegel-Moore
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
Lukas, Scott E.; Penetar, David; Su, Zhaohui; Geaghan, Thomas; Maywalt, Melissa; Tracy, Michael; Rodolico, John; Palmer, Christopher; Ma, Zhongze; Lee, David Y.-W.
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.
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
Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon
Objectives To explore how women with negative mammography screening results, but who were later diagnosed with interval breast cancer, reacted when they observed breast symptoms that could indicate malignancy in-between screening rounds. Design Semistructured individual interviews with women who have been diagnosed with breast cancer during mammography screening intervals. Setting Two breast diagnostic units covering two counties in Norway. Participants 26 women diagnosed with interval breast cancer. Results Women with a screening negative result react in two ways when experiencing a possible symptom of breast cancer. Among 24 women with a self-detected palpable lesion, 14 sought medical advice immediately. Their argument was to dispose of potential cancer as soon as possible. Ten women delayed seeking medical advice, explaining their delay as a result of practical difficulties such as holidays, uncertainty about the symptom, and previous experiences of healthcare services’ ability to handle diffuse symptoms. Also, a recent negative mammography scan led some women to assume that the palpable lesion was benign and wait for the next screening round. Conclusions Participating in mammography screening may contribute to a postponed reaction to breast cancer symptoms, although most women acted rapidly when detecting a palpable breast lesion. Furthermore, screening participation does not necessarily increase awareness of breast cancer symptoms. PMID:23148341
Solbjřr, Marit; Skolbekken, John-Arne; Sćtnan, Ann Rudinow; Hagen, Anne Irene; Forsmo, Siri
People fearful of being stigmatized by a health-related condition often do not embrace prevention behaviors or seek medical help. They may adhere poorly to treatment regimes for disease and abruptly terminate much needed treatment. Globally, 120 million--many poor women--suffer consequences of lymphatic filariasis that include stigmatizing lymphedema or elephantiasis of the leg. We investigated how women with lymphedema from two different cultures experience stigma and its consequences. Our qualitative data were collected from 56 Dominican women and 48 Ghanaian women with lymphedema. A lymphedema-related stigma framework was developed from constructs derived from the literature and emergent themes from the data. Women described a spectrum of enacted, perceived, and internalized stigma experiences, such as being criticized and isolated by the community, health providers, and even by friends and relatives; they were often denied access to education and meaningful work roles. Some antecedents, consequences, coping strategies, and outcomes of these experiences varied across cultures, with Dominican women faring somewhat better than Ghanaians. Poverty, poor access to health care resources, limited education, and diminished social support challenged the coping strategies of many women and exacerbated negative consequences of lymphedema-related stigma. PMID:18992982
Person, Bobbie; Bartholomew, L Kay; Gyapong, Margaret; Addiss, David G; van den Borne, Bart
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
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
Blank, Arthur E; Fletcher, Jason; Verdecias, Niko; Garcia, Iliana; Blackstock, Oni; Cunningham, Chinazo
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.
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…
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
Julie M. Albright
This paper presents and discusses selected findings from a study of health-seeking strategies in relation to sexual health among a group of female sex workers in Calcutta, India. Background information on sex work and sexually transmitted disease in Calcutta is followed by the presentation of findings pertaining to women's understandings of (sexual) health, treatment-seeking and service utilisation. In the urban
Catrin Evans; Helen Lambert
Today, phallocentrism is perpetuated by a flourishing medical construction that focuses exclusively on penile erections as the essence of men's sexual function and satisfaction. This article describes how this medicalization is promoted by urologists, medical industries, mass media, and various entrepreneurs. Many men and women provide a ready audience for this construction because of masculine ideology and gender socialization. While
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
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
Failure to recognize symptoms which signal cancer may delay contact with the medical care system, thus decreasing the chances of diagnosis at an early stage of disease. We investigated the determinants of cancer symptom recognition and delay in seeking medical care in a population-based sample of 625 newly diagnosed lung, breast and colorectal cancer patients. Although the majority (79.5%) of
Vincent Mor; Susan Masterson-Allen; Richard Goldberg; Edward Guadagnoli; Margaret S. Wool
Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia). Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24%) were female and 57 (76%) were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%), 41–55 years = 46 participants (61.3%) and >55 years = 13 participants (17.3%). Most participants (n = 48, 64%) were staff specialists and 27 (36%) were visiting medical officers. Half of the participants were internists (n = 39, 52%), 12 (16%) were surgeons, and 24 (32%) were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce. PMID:16022738
Dahlstrom, Jane; Dorai-Raj, Anna; McGill, Darryl; Owen, Cathy; Tymms, Kathleen; Watson, D Ashley R
Women make up 54% of voters in South Africa. A delegation of 80 groups representing 2 million women under the Women' National Coalition delivered many research reports on women's issues (e.g., rape, violence, women's status, women workers' rights) to the Transitional Executive Council. If political parties want women to support them, they need to address the inequalities and discrimination women encounter at work, in their homes, and in society. The research findings were a result of 23 focus groups and will be used to draft a Women's Charter. The Coalition will use the Charter to bring about maximum equality within the constitutional framework. The research revealed that sexual harassment at work was more common than was recognized. Black women reported that men of all races in responsible positions seek sex for jobs or for promotion. 50% of women are raped. 1 of 6 women are beaten by their partner. In the past, women's groups were not well supported because White women tended to be satisfied with the status quo. Specifically, they had a servant, leisure time, and a high standard of living. Women are starting to understand that they can be forces of change. A common thread among the diversity of women in the research was a desire for control of their lives. Other issues emerging from the research were women and law, women at work, women and violence, and political awareness among women. The women call for changes in marital law to make sure that women are considered as majors. For example, they should be able to buy property and sign contracts. Women want equal pay for work of equal value, equal treatment when applying for a job. Women want society, including family members, not to ignore domestic violence. They also call on authorities and police to respond more vigorously to domestic violence. Women are becoming more involved in politics, locally, regionally, and nationally. PMID:12287660
, economic, and national divides. We seek to create new knowledge about women, gender, race, and sexuality, and creatively. We prepare them to ask tough questions about the way society functions and to understand how
Edwards, Paul N.
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
... Diagnosis Diagnosis in animals and humans Direct fluorescent antibody test Histologic examination Immunohistochemistry Electron microscopy Amplification methods Accuracy of the tests Regulation of diagnostic test kits Prevention Prevention in animals Prevention in people Rabies ...
Abnormal vaginal discharge syndrome (AVDS) is a commonly observed gynaecological complaint for which women seek medical attention. The present study was conducted in six Indian Council of Medical Research centres with Praneem polyherbal tablets (PPT), to determine their efficacy in the treatment of symptomatic women with AVDS. Data are given on 141 subjects investigated. In total, 137 women (97%) reported complete (n=62, 44%) and partial (n=75, 53%) relief from symptoms after use of PPT for seven consecutive days. On speculum examination, 71 (74%) women were confirmed to be cured of AVDS. Microbiological tests could only be conducted microscopically for Trichomonas vaginalis, Candida albicans and bacterial vaginosis. It was observed that all women with T. vaginalis had this infection cured by PPT, and the cure rate was 77% for C. albicans and 68% for bacterial vaginosis. Seventy-eight women (55%) reported a transient burning sensation, mostly on the first 2 d of intake of PPT; however, they continued to use the tablets for the prescribed 7 d. This study lays the basis for an extended Phase II/III clinical trial, preferably randomized and comparing a larger number of women to confirm the safety and efficacy of PPT. PMID:18990416
Sharma, R S; Mathur, A K; Chandhiok, N; Datey, S; Saxena, N C; Gopalan, S; Sharma, S; Mittal, S; Sehgal, R; Sumandal, B K; Chanda, A; Salvi, V; Mutalik, N; Coyaji, K J; Gibsson, A; Hazari, K; Kalgutkar, S; Talwar, G P
Increasing the regular use of Pap testing by underserved populations has been identified as a national research priority. Southeast Asian immigrants to the United States have high rates of invasive cervical cancer and demonstrate low use of Pap testing compared to other groups. However, there is little information concerning the control of cancer in Southeast Asian populations. Harborview Medical Center and Fred Hutchinson Cancer Research Center are working together on the Cambodian Women’s Health Project.
The Medical Electronics Center of the Rockefeller Institute seeks to advance the application of electronic techniques in the life sciences and medicine through conferences on specialized topics, by the publication of the Bibliography of Medical Electronics and by acting as a clearing house of ideas and facilities in the field of medical electronics. However, a much greater effort is needed
V. K. Zworykin
Purpose: This study aims to assess whether differences exist in the barriers reported by, and in the person- and situation-centred factors related to the managerial advancement of, women with and without children. The study also seeks to examine whether having children influences womens advancement, by affecting person-situation factors such as…
and social media sites (twitter and facebook). Partner with program areas to maintain site includingPosition Announcement Publicist, Women's Resource Center Women's Resource Center is seeking member of publicity committee). Develop an effective communication program to both support and enhance
Bertini, Robert L.
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…
Ainsbury, Liz; Heaney, Libby; Hodges, Vicki; Harkness, Laura; Russell, Laura
No matter their generation or library setting, the women who find technology and libraries a compelling combination share certain qualities. The women interviewed here are confident, skilled communicators and risktakers, people who seek challenges and prefer working in teams. They revel in new gadgetry, but they never forget it is all about a…
This article explores the issue of gender and computer games by looking at the growing population of women in massive multiplayer online role-playing environments (MMORPGs). It explores what are traditionally seen as masculine spaces and seeks to understand the variety of reasons women might participate. Through ethnographic and interview data, the themes of social interaction, mastery and status, team participation,
T. L. Taylor
Information is presented from a clinical study of 65 women and a psychometric study of 85 women. All had had mastectomies because of breast cancer and were reconstruction patients at Duke Hospital. Women seeking breast reconstruction did not exhibit characterological problems. Relatively few were in psychiatric treatment, and previous research had established the presence of positive rather than negative self-images. The marriages of women seeking this surgical procedure were positively and the women viewed their marriages as a chief source of support. Considerable satisfaction was expressed about husbands being supportive, although husbands were also viewed as poor listeners and, at times, as unable to communicate effectively. Most women were satisfied with various aspects of their sexual lives. A small percentage of the women reported problematic marriages. Various factors, related to the presence of conflict in the marriage and the ability of the husband to understand his wife, may account for the distress evidenced in these marriages. Such factors, of course, are present in any problematic marriage; it remains to be demonstrated whether these problems were caused or exacerbated by the woman's mastectomy and decision to seek breast reconstruction. PMID:7458173
Clifford, E; Clifford, M; Georgiade, N G
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…
Beisecker, Analee E.; And Others
Gynecological care is vital to women’s health but utilization of gynecological care has been seldom addressed. We applied the population-based “ecology model” to demonstrate the utilization of gynecological care of women, with examples from Taiwan. We analyzed the claims data from the cohort datasets within the National Health Insurance Research Database in Taiwan. Women’s utilization of gynecological care in 2009 was computed. Of 1000 women, 319 utilized gynecological care at least once, 277 visited Western medicine clinics, 193 visited physician clinics, 118 visited hospital-based outpatient clinics, 73 visited traditional Chinese medicine clinics, eight were hospitalized, four were hospitalized in an academic medical center, and four visited emergency departments. More than 90% of young and middle-aged women who sought gynecological care visited gynecologist clinics. Elderly women were less likely to utilize gynecological care in all settings of medical care, but were more likely to be attended by non-gynecologists. Young women tended to visit emergency departments. The ecology model highlighted age disparities in women’s utilization of gynecological care in various settings of medical care. Since gynecological conditions were common among women, more attention should be paid on the availability of gynecologists and continuing medical education in gynecological care for non-gynecologists to guarantee women’s health. PMID:25089773
Chang, Chia-Pei; Chou, Chia-Lin; Chou, Yueh-Ching; Shao, Chun-Chih; Su, Irene H.; Chen, Tzeng-Ji; Chou, Li-Fang; Yu, Hann-Chin
Technical books written for women in the English Renaissance are shown to provide a rich source for furthering knowledge of the literacy of women, particularly middle-class women, and the roles these women assumed. These show that Renaissance women assumed active roles, were generally as literate as men, and needed books to help them execute major responsibilities in home medical care,
Elizabeth Tebeaux; Mary Lay
... Results of these studies give women and their healthcare providers better information on the safety or risk of using specific medications during pregnancy. This information supports their ability to make informed decisions about treatment options. Learning the Effects of Medication ...
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
Hamel, L; Oberle, K
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
Mangan, Cheryl; Sanci, Lena
concerning the characteristics of users' information seeking behavior under different moods. Our study will contribute to affective search systems design. Keywords Mood, emotion, affect, information seeking behavior): Miscellaneous. Introduction Our affective feelings can shape our perceptions, cognitions, and behaviors
...demonstration seeks to compensate medical homes for additional services not...evidence-based medicine; use of electronic medical records; care coordination; care transition...Quality Assurance Patient Centered Medical Home (PPC-PCMH)...
Medical literature in colonial India, written mainly for the guidance of colonial personnel, became an important tool for dissemination of western medical knowledge and information but also reinforced wider colonial agendas. Focused mainly on men's health, only few books or sections in this genre of literature addressed white middle class women's health issues. This article examines several medical manuals within the wider parameters of race, class, gender and imperialism, seeking to understand their construction of women, health and empire with a focus on the social history of health management in the colonial home. The medical guidance that these manuals offered as well as the various health issues they touched upon are tested in relation to the racialised gender ideologies underpinning these medical narratives. A careful re-reading of these sources suggests that both the memsahib and her native support staff, specifically the "native" Indian wet nurse as a virtual milch cow, were put into the service of the Empire by the reinforced colonial agenda of such writing. PMID:21128370
Community colleges have a high percentage of women students and a higher percentage of women faculty and administrators than do four-year colleges. Yet the extent to which the community college offers an equitable work and study site for women is not clear. The authors seek to determine this by applying to existing literature an adaptation of…
Townsend, Barbara K.; Twombly, Susan B.
Recent evidence suggests that women are receptive, albeit less than men, to offers of sex. It has also been established that women's preference for attractiveness increases when they seek brief, sexual relationships compared to longer forms of relationship. Here we further explore women's receptivity with respect to romantic relationship type and length, and investigate how male attractiveness influences this receptivity.
Maryanne Fisher; Anthony Cox
The history of the education of women from prehistory through the 1960s reveals constant themes. In every period, obstacles reflecting the prevalent social attitudes were placed in the paths of women seeking education. Economic conditions directly affected the status and scope of women's education, although certain disciplines such as religion and…
Zuelow, Margo J.
Screened 290 men and 92 women for participation in study on marijuana cessation. Indices of severity of marijuana abuse and general psychopathology were in clinical range for majority of subjects. Subjects who did not report evidence of alcohol or other drug abuse (n=144) reported less severe consequences of marijuana use and experienced less…
Stephens, Robert S.; And Others
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\\u000a childbearing age in Genesee County toward healthier dietary patterns using a socio-cultural and biomedical orientation. The\\u000a PEN-3 model, which frames culture in the context of
Srimathi Kannan; Arlene V. Sparks; J. DeWitt Webster; Ambika Krishnakumar; Julie Lumeng
The Arthur and Elisabeth Schlesinger Library on the History of Women in America is seeking to archive the papers of distinguished women geophysicists. That library is at Radcliffe College (Cambridge, Mass.) and is a leading repository for books, manuscripts, and other materials documenting the history of women in the United States. Members of AGU who know of anyone whose papers, in their view, should be archived by the library, or know of some distinguished deceased woman geophysicist whose papers have not yet found a proper repository, should contact Eva Moseley, Curator of Manuscripts, Schelsinger Library, Radcliffe College, 10 Garden Street, Cambridge, MA 02138. The letter of nomination should contain as much pertinent information as possible and a copy of the vitae should also be sent, if available.
Seeking contact with extraterrestrial intelligence is a species enterprise that should be conducted with our shared interests in mind. We must reflect on the full range of possible outcomes; we cannot opt out of the potential consequences of actions taken by small numbers of our fellow humans. Until we have empirical evidence about alien technological civilizations, we can reason about them only by analogy with our own history and behaviour. Given that record, some degree of prudence is in order. To conduct this debate more rationally, we must free our thinking of excessively binary stereotypes.
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."