Journal of women's health最新文献

{"title":"Longitudinal Exposure to Neighborhood Concentrated Poverty Contributes to Differences in Adiposity in Midlife Women.","authors":"Mary D Schiff, Emma Barinas-Mitchell, Maria M Brooks, Christina F Mair, Dara D Méndez, Ashley I Naimi, Monique Hedderson, Imke Janssen, Anthony Fabio","doi":"10.1089/jwh.2023.1156","DOIUrl":"10.1089/jwh.2023.1156","url":null,"abstract":"<p><p><b><i>Background:</i></b> Neighborhood poverty is associated with adiposity in women, though longitudinal designs, annually collected residential histories, objectively collected anthropometric measures, and geographically diverse samples of midlife women remain limited. <b><i>Objective:</i></b> To investigate whether longitudinal exposure to neighborhood concentrated poverty is associated with differences in body mass index (BMI) and waist circumference (WC) among 2,328 midlife women (age 42-52 years at baseline) from 6 U.S. cities enrolled in the Study of Women's Health Across the Nation (SWAN) from 1996 to 2007. <b><i>Methods:</i></b> Residential addresses and adiposity measures were collected at approximately annual intervals from the baseline visit through a 10-year follow-up. We used census poverty data and local spatial statistics to identify hot-spots of high concentrated poverty areas and cold-spots of low concentrated poverty located within each SWAN site region, and used linear mixed-effect models to estimate percentage differences (95% confidence interval [CI]) in average BMI and WC levels between neighborhood concentrated poverty categories. <b><i>Results:</i></b> After adjusting for individual-level sociodemographics, health-related factors, and residential mobility, compared to residents of moderate concentrated poverty communities, women living in site-specific hot-spots of high concentrated poverty had 1.5% higher (95% CI: 0.6, 2.3) BMI and 1.3% higher (95% CI: 0.5, 2.0) WC levels, whereas women living in cold-spots of low concentrated poverty had 0.7% lower (95% CI: -1.2, -0.1) BMI and 0.3% lower (95% CI: -0.8, 0.2) WC. Site-stratified results remained in largely similar directions to overall estimates, despite wide CIs and small sample sizes. <b><i>Conclusions:</i></b> Longitudinal exposure to neighborhood concentrated poverty is associated with slightly higher BMI and WC among women across midlife.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1393-1403"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness of Hysterectomy as Treatment for Benign Gynecological Conditions.","authors":"Maya A Wright, Alan C Kinlaw, Asha B McClurg, Erin Carey, Kemi M Doll, Anissa I Vines, Andrew F Olshan, Whitney R Robinson","doi":"10.1089/jwh.2024.0142","DOIUrl":"10.1089/jwh.2024.0142","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess the appropriateness of hysterectomies performed at a large tertiary health system using the 1997 RAND appropriateness classification system and an updated algorithm. <b><i>Design:</i></b> We abstracted structured and unstructured data from electronic medical records on patient demographics, primary indication(s) for hysterectomy, diagnosis codes associated with the hysterectomy, previous treatments, and laboratory results. <b><i>Subjects:</i></b> Patients aged 18-44 years. <b><i>Exposure:</i></b> Receipt of hysterectomy for benign and nonobstetric conditions from October 2014 to December 2017. <b><i>Main Outcome Measures:</i></b> Using these data, we provided a RAND-based (dichotomous: inappropriate/appropriate) and Wright-based (3-level: inappropriate/ambiguous/appropriate) appropriateness rating and characterized missing information patterns associated with inappropriate ratings. <b><i>Results:</i></b> We analyzed 1,829 hysterectomies across 30 nonmutually exclusive primary indications for surgery. Nearly a third (32.8%) of surgeries had only one primary indication for surgery. Using the RAND-based classifier, 31.3% of hysterectomies were rated as appropriate and 68.7% as inappropriate. Using the Wright-based algorithm, 58.1% of hysterectomies were rated as appropriate, 15.7% as ambiguous, and 26.2% as inappropriate. Missing information on diagnostic procedures was the most common characteristic related to both RAND-based (46.1%) and Wright-based (51.2%) inappropriate ratings. <b><i>Conclusions:</i></b> The 1997 RAND classification lacked guidance for several contemporary indications, including gender-affirming care. RAND also has an outdated requirement for diagnostic surgeries such as laparoscopies, which have decreased in practice as diagnostic imaging has improved. Sensitivity analyses suggest that inappropriate surgeries cannot all be attributed to bias from missing electronic medical record data. Accurately documenting care delivery for benign gynecological conditions is key to ensuring quality and equity in gynecological care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1358-1366"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306190","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 the Blood Metabolome During Acute Response to Ischemic Stroke.","authors":"Layne Dylla, Hannah M Higgins, Daniel Stephenson, Julie A Reisz, Thao Vu, Sharon N Poisson, Paco S Herson, Andrew A Monte","doi":"10.1089/jwh.2023.1133","DOIUrl":"10.1089/jwh.2023.1133","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Females suffer greater lifetime risk of stroke and greater morbidity and mortality from stroke compared with males. This study's objective was to identify differences in metabolomic profiling of females and males with stroke and which differences were associated with neurological outcome. <b><i>Methods:</i></b> Females and males with acute ischemic stroke enrolled in the Emergency Medicine Specimen Bank at a comprehensive stroke center provided whole blood samples upon arrival for mass spectrometry-based metabolomics. We used descriptive statistics to characterize the cohort. A linear regression model was fit for individual metabolites to determine differences in relative abundance between males and females while controlling for covariates (age, race/ethnicity, postmenopausal status, cardiovascular risk factors, depression, time between sample collection and last known well, and initial National Institutes of Health Stroke Scale [NIHSS] score). For each differentially expressed metabolite, a linear regression model was fit to determine the association between the metabolite and NIHSS at 24 hours after admission while controlling for the covariates and acute treatments. <b><i>Results:</i></b> After adjusting for covariates, eight metabolites differed in females and males with a stroke. These included amino acids or their metabolites (proline and tryptophan), nucleotides (guanosine diphosphate [GDP], and inosine-3',5'-cyclic monophosphate), citrate, dehydroascorbate, choline, and acylcarnitine-(5-OH). GDP and dehydroascorbate were significantly associated with 24-hour NIHSS (<i>p</i> = 0.0991). <b><i>Conclusions:</i></b> Few metabolites were differentially abundant in blood after a stroke when comparing females with males and controlling for confounders, but the interactions between biological sex and GDP, as well as biological sex and dehydroascorbate, were associated with 24-hour neurological function. This has important implications for future studies that evaluate the therapeutic potential of these metabolites in ischemic stroke.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1378-1384"},"PeriodicalIF":4.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter to the Editors re:</i> Published Article on The White House initiative on Women's Health Research.","authors":"Ruth Merkatz","doi":"10.1089/jwh.2024.0879","DOIUrl":"10.1089/jwh.2024.0879","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1298"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290207","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":"Premenstrual Dysphoric Disorder Affects Five Times as Many Individuals as Postpartum Depression, But Receives 80% Less NIH Research Funding.","authors":"Liisa Hantsoo, Jennifer L Payne","doi":"10.1089/jwh.2024.0787","DOIUrl":"10.1089/jwh.2024.0787","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1296-1297"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734492","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 Across the Lifespan: A Focus on Cardiometabolism.","authors":"T Rajendra Kumar, Jane E B Reusch, Wendy M Kohrt, Judith G Regensteiner","doi":"10.1089/jwh.2024.0595","DOIUrl":"10.1089/jwh.2024.0595","url":null,"abstract":"<p><p>Women's health and sex differences research remain understudied. In 2022, to address the topic of sex differences, the Ludeman Family Center for Women's Health Research (LFCWHR) at the University of Colorado (LudemanCenter.org) held its third National Conference, \"Sex Differences Across the Lifespan: A Focus on Metabolism.\" The research presentations and discussions from the 2022 conference addressed cardiometabolic sex differences across the lifespan and included sessions focusing on scientific methods with which to study sex differences, effects of estrogen on metabolism, and sex differences in cardiovascular disease-implications for women and policy among others. Over 100 participants, including basic scientists, clinical scientists, policymakers, advocacy group leaders, and federal agency leadership participated. The meeting proceedings reveal that although exciting advances in the area of sex differences have taken place, significant questions and gaps remain about women's health and sex differences in critical areas of health. Identifying these gaps and the subsequent research that will result may lead to important breakthroughs.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1299-1305"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759504","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":"Gender and Professional Title Use in Internal Medicine Resident Narrative Assessments.","authors":"Jaeda Pitlick, Emily Olson, Andrew Halvorsen, Karen Fischer, Ivana T Croghan, Hannah Nordhues","doi":"10.1089/jwh.2023.0730","DOIUrl":"10.1089/jwh.2023.0730","url":null,"abstract":"<p><p><b><i>Background:</i></b> Residency is a time of personal and professional growth. Resident assessment and feedback are an integral part of that process. However, assessment may be influenced by various types of bias, including gender bias. Women are less likely than men to be identified by their professional titles in many settings. The use of professional titles for residents in written assessments is unknown and may be a marker of bias. <b><i>Objective:</i></b> To assess for differences and trends regarding the use of professional and personal titles in formal resident assessments related to gender-based resident-faculty pairs. <b><i>Methods:</i></b> Electronic assessments of postgraduate year 1 (PGY1) internal medicine residents from the 2019-2020 academic year were used. Professional title use was analyzed, as it relates to resident-faculty gendered dyads, among other variables. The primary outcome of professional title usage was split into a binary variable by professional versus other titles and analyzed using logistic regression and random-effects model. <b><i>Results:</i></b> We analyzed 1,363 unique electronic assessments (37.8% from female faculty). Female residents were more likely to be addressed by a professional title than their male colleagues (odds ratio [OR], 1.7; confidence interval [CI], 1.2-2.4; <i>p</i> = 0.02). We found no difference in professional title usage based on resident-faculty gendered dyads. After adjusting for repeated faculty and resident encounters with random-effects model, secondary analysis found no significant difference in evaluation of word count between gendered dyads. <b><i>Conclusions:</i></b> The analysis found no significant difference in professional title usage based on resident-faculty dyads. In our analysis, female residents were significantly more likely to have their professional title used on assessments than male residents.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1404-1408"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336086","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":"Racial and Ethnic Disparities in Postpartum Depressive Symptoms Before and During the COVID-19 Pandemic.","authors":"Ibitein N Okeafor, Nicole L Hair, Brian Chen, Peiyin Hung","doi":"10.1089/jwh.2023.0908","DOIUrl":"10.1089/jwh.2023.0908","url":null,"abstract":"<p><p><b><i>Background:</i></b> Existing evidence regarding the impact of the COVID-19 pandemic on postpartum mental health is mixed, with disparate studies showing increased, stable, or even reduced risk of postpartum depression (PPD) amid the pandemic. Furthermore, although it is plausible that the pandemic impacted the mental health of mothers from vulnerable and underserved communities differentially, few studies have characterized racial and ethnic differences in the impact of the COVID-19 pandemic on PPD. <b><i>Materials and Methods:</i></b> Pregnancy Risk Assessment Monitoring System data for 2018-2019 (pre-pandemic period) and 2020 (peri-pandemic period) from 40 sites (<i>n</i> = 110,779, representing 5,485,137 postpartum women) were used to determine whether rates of PPD changed during the first year of the pandemic. Postpartum depressive symptoms were assessed using the Patient Health Questionnaire 2-item. Average marginal effects and contrasts of predictive margins derived from a multivariable logistic regression model were used to compare the risk of PPD before and during the pandemic in the overall sample and across racial/ethnic subgroups. <b><i>Results:</i></b> Adjusting for sociodemographic and clinical characteristics, we found that the overall risk for PPD remained stable (0.0 percentage points [pp]; 95% confidence interval [CI]: -0.7, 0.6 pp) in the first year of the pandemic. We detected no statistically significant changes in risk for PPD across seven of eight racial/ethnic groups considered; however, the risk of PPD among non-Hispanic Black women fell by 2.0 pp (95% CI: -3.5, -0.4 pp) relative to the pre-pandemic period. <b><i>Conclusion:</i></b> We identified important subgroup differences in pandemic-related changes in risk for PPD.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1318-1326"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958437","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":"Associations between Historical Redlining and the Risk of Pregnancy Complications and Adverse Birth Outcomes in Massachusetts, 1995-2015.","authors":"Marissa Chan, Shivani Parikh, Emma Willcocks, Jennie Lytel-Sternberg, Edgar Castro, Loni Philip Tabb, Joel Schwartz, Tamarra James-Todd","doi":"10.1089/jwh.2024.0031","DOIUrl":"10.1089/jwh.2024.0031","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess the impact of historical redlining on the risk of pregnancy complications and adverse birth outcomes in Massachusetts (MA) from 1995 to 2015. <b><i>Methods:</i></b> In total, 288,787 pregnant people from the MA Birth Registry had information on parental characteristics, pregnancy factors, and redlining data at parental residences at the time of delivery. Historic redlining data were based on MA Home Owners' Loan Corporation (HOLC) security maps, with grades assigned (A \"best,\" B \"still desirable,\" C \"definitely declining,\" and D \"hazardous\"). We used covariate-adjusted binomial regression models to examine associations between HOLC grade and each chronic condition and pregnancy/birth outcome. <b><i>Results:</i></b> Living in HOLC grades B through D compared with A was associated with an increased risk of entering pregnancy with chronic conditions and adverse pregnancy/birth outcomes. The strongest associations were seen with pregestational diabetes (adjusted risk ratio [RR] Grade D: 1.7, 95% confidence interval [CI]: 1.3, 2.4) and chronic hypertension (adjusted RR Grade D: 1.5, 95% CI: 1.1, 1.9). <b><i>Conclusions:</i></b> Historical redlining policies from the 1930s were associated with adverse pregnancy outcomes and chronic conditions; associations were strongest for chronic conditions in pregnancy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1308-1317"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563663","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":"Journal of Women's Health Clinical Update.","authors":"Juliana M Kling, Ekta Kapoor, Stephanie S Faubion","doi":"10.1089/jwh.2024.0882","DOIUrl":"https://doi.org/10.1089/jwh.2024.0882","url":null,"abstract":"<p><p>The Clinical Update series is intended to help busy clinicians stay up-to-date with recently published important and potentially practice-changing articles on topics pertinent to the care of women. In this update on sexual health, we review studies on the sexual health content of healthcare professional curricula, sexual health and intimacy after cancer in women of color, sexual function in women with polycystic ovarian syndrome, as well as the risks associated with the use of testosterone in women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349211","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}