Journal of women's health最新文献

{"title":"Strategies and Resources for Academic Success in Neurology.","authors":"Alexis N Simpkins","doi":"10.1089/jwh.2024.0609","DOIUrl":"10.1089/jwh.2024.0609","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1429-1430"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Fibroids: A Changing Landscape.","authors":"Lulu Yu, Regina Huang, Chioma Okuagu, Elise Bardawil, Joyce Balls-Berry, Whitney Trotter Ross","doi":"10.1089/jwh.2024.0131","DOIUrl":"10.1089/jwh.2024.0131","url":null,"abstract":"<p><p><b><i>Background:</i></b> Uterine fibroids affect patients' quality of life and contribute significantly to health care costs. Studies from 2009 to 2011 demonstrated that fibroids disproportionately affect Black women, with lower odds of uterine preservation and minimally invasive approaches. <b><i>Objective:</i></b> This is a retrospective cohort study of data abstracted from the National Surgical Quality Improvement Program database from 2015 to 2019 examining trends in surgical management of uterine fibroids and exploring disparities in surgical approach in a modern cohort. <b><i>Results:</i></b> In total, 52,909 women underwent hysterectomy and 15,485 women underwent myomectomy between 2015 and 2019. Over the study period, the overall number of surgeries for fibroids increased by 44.2% with minimally invasive hysterectomy responsible for the majority of this increase. The proportion of patients who underwent myomectomy significantly increased (20.85% to 24.62%, <i>p</i> value <0.0001), whereas hysterectomy significantly decreased (79.15% to 75.38%, <i>p</i> value <0.0001). Bivariate analysis identified younger age, non-White race, and body mass index (BMI) <25 as significantly associated with performance of myomectomy. Non-Hispanic Black (adjusted odds ratio [aOR]: 3.55, 95% confidence interval [CI]: 3.23-3.89), Asian (aOR: 3.26, 95% CI: 2.80-3.80), and Hispanic Black (aOR: 5.50, 95% CI: 3.29-9.25) women were more likely to undergo myomectomy than non-Hispanic White women. <b><i>Conclusion:</i></b> Surgical treatment for fibroids increased over time, shifting toward uterine preservation. Myomectomy performance is associated with lower age and BMI and identifying as a racial and/or ethnic minority. These trends may represent improved access to surgical treatment of fibroids, resulting from the growth of minimally invasive gynecological surgery as a specialty and advocacy for equitable health care for all patients.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1528-1535"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Barriers to Pap Screening Influence Adherence to Screening Recommendations Among Black Women.","authors":"Adebola Adegboyega, JungHee Kang, Adaeze Aroh, Lovoria B Williams","doi":"10.1089/jwh.2023.1024","DOIUrl":"10.1089/jwh.2023.1024","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The aim of this study was to determine the Health Belief Model (HBM) constructs associated with Pap screening adherence among a sample of African American and sub-Saharan African immigrant women in the United States. <b><i>Methods:</i></b> A descriptive cross-sectional study was conducted <i>via</i> an online survey. Participants were recruited from central Kentucky counties. Ninety-one eligible women participated (mean age 38 ± 12 years), 49.5% identified as African American. Twenty-nine percent indicated never being screened or not being up-to-date. Self-reported demographic data, HBM constructs for Pap screening, and Pap screening history were collected. Bivariate and logistic regressions were performed. <b><i>Results:</i></b> There was a significant negative association between perceived barriers and being up-to-date. For every one-point increase in perceived barriers, the odds of being up-to-date decreased by 81%, (<i>p</i> = 0.004; CI: 0.06-0.60), findings from further evaluation of the barrier construct showed that barriers significantly associated with screening include items related to lack of knowledge about where to get a Pap screening, lack of time to attend the screening, screening-associated shame and pain, negligence, and age. There were no other significant HBM constructs associated with up-to-date Pap screening status. There was no difference in perceived barriers between African American and sub-Saharan African women. <b><i>Conclusions:</i></b> Despite public health efforts to decrease screening barriers, a perception of barriers exists among Black women. Continued efforts to address screening barriers as well as the perception of barriers are warranted among Black women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1482-1491"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiation of Oral Endocrine Therapy and Survival Benefit Among Women with Early-Stage Breast Cancer.","authors":"Jingjing Qian, Bang Truong","doi":"10.1089/jwh.2023.0971","DOIUrl":"10.1089/jwh.2023.0971","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Endocrine therapy (ET) is the cornerstone of systemic treatment for patients with estrogen receptor positive breast cancer, but its uptake and adherence need further improvement. This observational study assessed ET initiation and 1-year adherence and its survival benefit among female Medicare beneficiaries with early-stage breast cancer. <b><i>Materials and Methods:</i></b> This retrospective cohort study analyzed the linked 2011-2019 Surveillance, Epidemiology, and End Results-Medicare data. Female beneficiaries newly diagnosed with hormone receptor positive, stage I-III breast cancer were included. Beneficiaries who initiated tamoxifen, anastrozole, letrozole, or exemestane within 3 months after cancer diagnosis were defined as initiators (<i>n</i> = 24,289), and those who never initiated these treatments were noninitiators (<i>n</i> = 8,899). Adherence was measured using proportion of days covered (PDC) in the continuous 12 months follow-up period. Multivariable logistic regression models were used to assess factors associated with ET initiation and adherence (PDC ≥ 80%), controlling for covariates. Weighted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause and breast cancer related mortality between initiators and noninitiators and by adherence status. <b><i>Results:</i></b> Among eligible female beneficiaries (<i>n</i> = 55,893), 43% initiated ET within 3 months of cancer diagnosis. Among initiators, 77% had PDC ≥ 80% during the first year. Patient's demographics (e.g., older age, race/ethnicity) and baseline health services utilization (e.g., mammography) were associated with ET initiation and adherence. ET initiation and adherence was associated with reduced risk of all-cause (adjusted HR = 0.62, 0.59-0.66; HR = 0.55, 0.53-0.59; respectively) and breast cancer related (adjusted HR = 0.57, 0.50-0.64; HR = 0.41, 0.36-0.47; respectively) mortality compared with noninitiators. <b><i>Conclusion:</i></b> Women with early-stage breast cancer who initiate ET and are adherent to treatment may achieve survival benefits compared with noninitiators.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1509-1517"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Colonoscopy Indications and Findings: Results from a Large Multicenter Database.","authors":"Naim Abu-Freha, Revital Guterman, Ruhama Elhayany, Daniel L Cohen, Daniela Munteanu, Vitaly Dizengof, Avraham Yitzhak, Rawi Hazzan, Alexander Fich","doi":"10.1089/jwh.2024.0301","DOIUrl":"10.1089/jwh.2024.0301","url":null,"abstract":"<p><p><b><i>Background:</i></b> Sex-based differences are common among diseases. We aimed to investigate the differences in colonoscopy indications and its findings between males and females. <b><i>Methods:</i></b> A large, multi-center, cross-sectional, retrospective study included all colonoscopies performed between 2016 and 2021 in seven endoscopy departments. The indications and findings of the procedures were compared between males and females. <b><i>Results:</i></b> A total of 151,411 (52.6%) women and 136,519 (47.4%) men were included, aged 56.54 ± 12.9 years and 56.59 ± 12.7. Cecal intubation was similar (95.6% vs 95.5%, <i>p</i> = 0.251). More females had excellent or good bowel preparation compared to males (71.4% vs 65.6%). Colonoscopy due to abdominal pain, constipation, diarrhea, and anemia was higher in females compared to males (15% vs 9.9%, 3.9% vs 2.2%, and 7.6% vs 4.9%, <i>p</i> < 0.001, respectively), while positive FOBT, rectal bleeding and post-polypectomy surveillance and screening were more common indications among males (9.5% vs 7.8%, 10.7% vs 7.8%, and 10.8% vs 7.1%, respectively). On colonoscopy, males were found to have significantly higher colorectal cancer and polyps (0.5% vs 0.4% and 35.1% vs 24.6%). Polyp detection rates were lower in females across all indications, whereas diverticulosis rates were higher in males. However, a clinically significant difference regarding diverticulosis was observed only in patients with anemia as the indication. <b><i>Conclusions:</i></b> Notable differences exist between males and females in terms of the indications and findings on colonoscopy. This highlights the need for identifying the factors contributing to these differences and the developing sex-specific approaches for the diagnosis and management of gastrointestinal diseases.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1442-1448"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Pregnancy Outcomes in People with Sickle Cell Disease and Medicaid Insurance (2006-2018).","authors":"Sarah H O'Brien, Joseph R Stanek, Andrea House, Robert M Cronin, Susan E Creary, Andrea H Roe, Sara K Vesely","doi":"10.1089/jwh.2023.1109","DOIUrl":"https://doi.org/10.1089/jwh.2023.1109","url":null,"abstract":"<p><p><b><i>Background:</i></b> Although the risk of pregnancy-related morbidity and mortality in people with sickle cell disease (SCD) is well established, limitations in data sources and heterogeneity in outcome reporting hinder the ability to make meaningful comparisons between historical and contemporary populations. This study used a national administrative claims database to compare pregnancy outcomes in people with SCD between 2006-2011 and 2012-2018. <b><i>Materials and Methods:</i></b> Pregnant females aged 16-44 years with SCD were identified from the Centers for Medicare and Medicaid Service Analytic eXtract, along with a control cohort of pregnant people. People were followed from first identified pregnancy until one year postpartum. Outcomes of interest were identified with ICD-9 or 10 codes. <b><i>Results:</i></b> We included 6,388 people with SCD and 17,278 controls in analyses. Preeclampsia/eclampsia, hypertension, thrombosis, poor fetal growth, preterm delivery, and postpartum hemorrhage were all more common in people with SCD compared with controls. Maternal death occurred in 0.5% of people with SCD versus <0.1% in those without SCD (<i>p</i> < 0.001). When comparing infant deliveries in 2006-2011 to those occurring in 2012-2018, all pregnancy-related complications except preterm delivery, including maternal death, occurred at similar or higher frequencies in more recent years. <b><i>Conclusions:</i></b> Between 2006 and 2018, maternal death occurred in approximately 1 out of every 200 publicly insured people with SCD in the year following infant delivery. Our work confirms, on a national-level, that pregnancy-related outcomes in people with SCD in the United States have not improved with time, and that some complications have in fact increased in frequency.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Lactation Experience Among Neurology Faculty and Impact of Lactation Time on Academic Achievement at U.S. Academic Medical Centers.","authors":"Sarah R Durica, Jesse Miller, Cynthia Zheng, Parneet Grewal, Chen Zhao, Halley B Alexander, Suma Shah, Sarah Isis R Delima, Annie He, Ailing Yang, Christa O'hana S Nobleza, Padmaja Sudhakar, Kamala Rodrigues, Myriam Abennadher, Doris H Kung, Neishay Ayub, Natasha Frost, Seema Nagpal, Katherine Zarroli, Sol De Jesus, Nicole Brescia, Nancy Foldvary-Schaefer, Laura Tormoehlen, June Yoshii-Contreras, Deborah Bradshaw, Jane B Allendorfer, Alyssa F Westring, Julie K Silver, Sasha Alick-Lindstrom, Sima I Patel","doi":"10.1089/jwh.2024.0363","DOIUrl":"https://doi.org/10.1089/jwh.2024.0363","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To investigate the perceptions of lactation experiences of neurology faculty and the impact of lactation time on academic achievement. <b><i>Materials and Methods:</i></b> This was a cross-sectional study utilizing a survey administered across 19 academic neurology centers in the United States. Respondents self-identified as having children and answered questions about lactation at work. Demographic information; academic achievement including publications, guest speakerships, awards, leadership roles, and funding; and perception of lactation experience were analyzed. <b><i>Results:</i></b> Among 162 respondents, 83% took lactation time at work. Thirty-seven percent reported lack of employer support for lactation, 46% were dissatisfied with their lactation experience, 59% did not receive compensation for lactation time, 62% did not have blocked clinical time, 73% reported relative value units were not adjusted to accommodate lactation, and 43% reported lack of access to private lactation space. Women spent on average 9.5 months lactating per child and desired 2.4 further months of lactation. There was no difference in all measures of self-reported academic achievement between women who did and did not take lactation time when measured across all career stages. <b><i>Conclusions:</i></b> Although a majority of respondents took lactation time at work, perceptions of employer support for lactation were low, and expectations for work productivity were not adjusted to accommodate lactation time. Taking lactation time at work did not decrease self-reported academic achievement. System-level best practices designed to support lactating faculty should be developed to guide academic institutions.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Utilization for Postpartum Behavioral Health Problems and Assault Injury During the COVID-19 Pandemic.","authors":"Sidra Goldman-Mellor, Alison Gemmill, Mark Olfson, Claire Margerison","doi":"10.1089/jwh.2024.0758","DOIUrl":"https://doi.org/10.1089/jwh.2024.0758","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Distinctive stressors facing pregnant and postpartum individuals during the COVID-19 pandemic may have affected their emergency department (ED) care-seeking for behavioral health concerns and violence victimization. We tested whether the incidence of postpartum behavioral health and assault injury ED visits differed for individuals according to their months of postpartum pandemic exposure. <b><i>Methods:</i></b> We used statewide, longitudinally linked hospital and ED administrative claims data from California to classify all individuals with hospital deliveries between January 1, 2016, and December 31, 2020, according to their months of postpartum pandemic exposure. Outcomes comprised 12-month incidence of any ED visit for a psychiatric disorder, drug use disorder/overdose, alcohol use disorder/intoxication, or assault injury, defined using International Classification of Diseases-Clinical Modification, version 10 codes. Risk ratios compared the incidence of each outcome among people with 1-12 months of postpartum pandemic exposure to those with 0 months of exposure. <b><i>Results:</i></b> Compared to people with 0 months of postpartum pandemic exposure (<i>n</i> = 1,163,215), delivering people with 1-12 month' exposure (range: <i>n</i> = 26,836 to <i>n</i> = 273,561) were approximately equally likely to have a postpartum ED visit for a psychiatric disorder, drug use disorder, or alcohol use disorder, after adjusting for demographic differences (most <i>p</i> > 0.10). The incidence of assault injury was significantly lower among delivering individuals with 11 or 12 months of pandemic exposure (RR_adj = 0.70 and 0.91, respectively; both <i>p</i> < 0.01) compared to those with 0 months. <b><i>Conclusions:</i></b> Contrary to expectations, the pandemic did not appear to have affected ED utilization for most behavioral health conditions among postpartum individuals, but assault injury ED visits declined.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making Progress on Regionalized Maternal Risk-Appropriate Care.","authors":"Jennifer Vanderlaan","doi":"10.1089/jwh.2024.0889","DOIUrl":"https://doi.org/10.1089/jwh.2024.0889","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Risk Conditions and Outcomes by Levels of Maternal Care.","authors":"Carla L DeSisto, Alexander C Ewing, Hafsatou Diop, Sarah Rae Easter, Elizabeth Harvey, Debra J Kane, Miriam Naiman-Sessions, Godwin Osei-Poku, Melanie Riley, Birgit Shanholtzer, Audrey M Stach, Ramya Dronamraju, Andrea Catalano, Elizabeth A Clark, Sabrina A Madni, Lindsay S Womack, Elena V Kuklina, David A Goodman, Sarah J Kilpatrick, M Kathryn Menard","doi":"10.1089/jwh.2024.0547","DOIUrl":"https://doi.org/10.1089/jwh.2024.0547","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). <b><i>Methods:</i></b> We used the 2017-2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. <b><i>Results:</i></b> We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with <Level III facilities. Among patients with cardiac conditions, the magnitudes of the associations with these outcomes, along with stroke, were also lower in Level III/IV compared with <Level III facilities. The proportion of patients with risk conditions that delivered in <Level III facilities was 19.8-46.8%. <b><i>Conclusions:</i></b> Odds of severe adverse outcomes among women with selected risk conditions were lower for births occurring at higher-level facilities, supporting the benefit of risk-appropriate care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}