Journal of women's health最新文献

{"title":"Communication, Training, and Debriefing After Stillbirth in U.S. Hospitals: A National Survey.","authors":"Katherine J Gold, Martha E Boggs","doi":"10.1089/jwh.2024.0114","DOIUrl":"10.1089/jwh.2024.0114","url":null,"abstract":"<p><p><b><i>Background:</i></b> Stillbirth is a devastating event for families as well as hospital staff. Hospital practices around internal and external staff communication, debriefing, and training are unknown. <b><i>Methods:</i></b> We systematically sampled U.S. hospitals that provide obstetrical care. Staff knowledgeable of bereavement care on labor and delivery were invited to participate in an anonymous survey linked to hospital descriptors. We evaluated stillbirth communication, debriefing, and training for staff. <b><i>Results:</i></b> We received 289 usable surveys from 429 eligible staff (67% response). Most (94%) noted hospitals' marked rooms housing bereaved families, but only a third (37%) reported a marker on the paper or electronic medical record. Half of the hospitals had no standard debriefings post-loss, and 38% reported no perinatal loss training for labor and delivery nurses. <b><i>Conclusions:</i></b> Hospitals have significant variations and gaps in staff communication, support, and training, which are key aspects of respectful stillbirth care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1205-1210"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260597","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":"Assessing the Correlation between Allostatic Load and False-Positive Image-Guided Breast Biopsies.","authors":"Maxwell Lee, Britney Nguyen, Jinho Jung, Eisa Razzak, Eniola T Oluyemi, Elizabeth S McDonald, Randy C Miles, Gelareh Sadigh, Ruth C Carlos","doi":"10.1089/jwh.2024.0039","DOIUrl":"10.1089/jwh.2024.0039","url":null,"abstract":"<p><p><b><i>Background:</i></b> Allostatic load (AL) is the accumulation of physiological dysregulation attributed to repeated activation of the stress response over a lifetime. We assessed the utility of AL as a prognostic measure for high-risk benign breast biopsy pathology results. <b><i>Method:</i></b> Eligible patients were women 18 years or older, with a false-positive outpatient breast biopsy between January and December 2022 at a tertiary academic health center. AL was calculated using 12 variables representing four physiological systems: cardiovascular (pulse rate, systolic and diastolic blood pressures, total cholesterol, high-density lipoprotein, and low-density lipoprotein); metabolic (body mass index, albumin, and hemoglobin A1C); renal (creatinine and estimated glomerular filtration rate); and immune (white blood cell count). Multivariable logistic regression was used to assess the association between AL before biopsy and breast biopsy outcomes controlling for patients' sociodemographics. <b><i>Results:</i></b> In total, 170 women were included (mean age, 54.1 ± 12.9 years): 89.4% had benign and 10.6% had high-risk pathologies (radial scar/complex sclerosing lesion, atypical ductal or lobular hyperplasia, flat epithelial atypia, intraductal papilloma, or lobular carcinoma in-situ). A total of 56.5% were White, 24.7% Asian, and 17.1% other races. A total of 32.5% identified as Hispanic. The mean breast cancer risk score using the Tyrer-Cuzick model was 11.9 ± 7.0. In multivariable analysis, with every one unit increase in AL, the probability of high-risk pathology increased by 37% (odds ratio, 1.37; 95% confidence interval, 1.03, 1.81; <i>p</i> = 0.03). No significant association was seen between high-risk pathology and age, ethnicity, breast cancer risk, or area deprivation index. <b><i>Conclusion:</i></b> Our findings support that increased AL, a biological marker of stress, is associated with high-risk pathology among patients with false-positive breast biopsy results.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1259-1266"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555061","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 Among Pregnancies with Substance Use Disorder: Impact on Perinatal Outcomes.","authors":"Alexandra S Ragsdale, Noor Al-Hammadi, Sabel Bass, Niraj R Chavan","doi":"10.1089/jwh.2023.0619","DOIUrl":"10.1089/jwh.2023.0619","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To examine racial/ethnic disparities in severe maternal morbidity (SMM) and adverse pregnancy outcomes (APOs) among pregnant patients with substance use disorder (SUD) compared to individuals without SUD. <b><i>Materials and Methods:</i></b> We conducted a cross-sectional analysis of inpatient hospitalizations of pregnant people from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2016 to 2019. ICD-10 codes were used to identify the frequency of SMM and/or APO between those with and without SUD by race/ethnicity. Multilevel logistic regression analyses were performed to identify the effect of race/ethnicity as an independent predictor and as an effect modifier of SMM and APO in patients with SUD. <b><i>Results:</i></b> From 2,508,259 hospitalizations, SUD was identified in 6.7% admissions with the highest rate in White patients (8.2%) followed by Black (7.7%) and Hispanic (2.2%) patients. Rate of SMM and APO were increased in patients with SUD in all racial/ethnic groups compared to those without SUD, increasing by 1% and 10%, respectively. Among all patients, Black race was an independent predictor of SMM (adjusted odds ratio [aOR] 2.09; 95% confidence interval [CI]: 2.05-2.13) and APO (aOR 1.58; 95% CI: 1.56-1.59). Hispanic ethnicity was also an independent risk factor for predicting SMM (aOR 1.40; 95% CI: 1.37-1.43). Among Hispanic patients, SUD was associated with an ∼90% increased likelihood of SMM and APO. <b><i>Conclusion:</i></b> Although higher rates of SMM and APO are seen among hospitalizations of pregnant people with SUD, racial/ethnic disparities also exist among this population. This warrants further attention and presents an opportunity for intervention and for addressing the root causes of racial and ethnic disparities.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1166-1174"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972461","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":"Understanding Women's Transitions from Military to Department of Veterans Affairs Care.","authors":"Kristin M Mattocks, Lisa L Shenette, Lorrie Walker, Nancy Maher, Sally Haskell","doi":"10.1089/jwh.2024.0022","DOIUrl":"10.1089/jwh.2024.0022","url":null,"abstract":"<p><p><b><i>Background:</i></b> Over the past two decades, increasing numbers of women have served in the military, with women now comprising 17.3% of active-duty personnel and 21.4% of National Guard and reserves. During military service, women often incur painful musculoskeletal (MSK) injuries related to carrying heavy loads and wearing ill-fitting gear. While women may receive initial care for these injuries under the auspices of the Department of Defense (DoD), these injuries often linger and further treatment in required as women transition to Department of Veterans Affairs (VA) care. However, little is known about this transition process, and whether women are given adequate information and support regarding how to access VA care after their military service has ended. <b><i>Research Design:</i></b> To better understand these issues, we interviewed 65 women veterans with military service-related MSK injuries about their transition from DoD to VA care. <b><i>Results:</i></b> Six major themes emerged from the interviews. Those themes were: (1) Military injuries are often related to ill-fitting gear or carrying heavy loads; (2) Stigma/discrimination related to military injuries; (3) Limited assistance with transition between DoD and VA to manage ongoing injuries and pain; (4) Women have a difficult time managing perceptions and expectations of their weight after military service; (5) Childcare is a substantial burden for veterans in self-care; and (6) veterans desire peer-support services to help them stay healthy. <b><i>Conclusions:</i></b> Based on these findings, DoD and VA should continue to work together to develop programs to educate and support women as they transition from military to VA care. Furthermore, VA should consider developing peer support programs for women Veterans who may require additional support to maintain health, especially among Veteran mothers who have complex family responsibilities that may limit their ability to focus on their own health.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1185-1197"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247934","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":"The White House Initiative on Women's Health Research: A Presidential Boost.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1089/jwh.2024.0271","DOIUrl":"10.1089/jwh.2024.0271","url":null,"abstract":"<p><p>Women's Health Research, barely 40-year-old in the United States has recently received an all-important boost from First Lady Jill Biden. The $100 million in question are bound to make a meaningful difference in this all-important arena. It was the view of the White House that \"our nation must fundamentally change how we approach and fund women's health research.\" The White House expressed its hope that \"congressional leaders, the private sector, research institutions, and philanthropy\" will answer the call to \"improve the health and lives of women throughout the nation.\"</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1151-1153"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247981","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":"Prevalence of Repeat Prenatal HIV Screening in New York State.","authors":"Mark Rosenthal, Amanda Stolz, Lisa Haskin, Shu-Yin John Leung, Calvin Wong, Thomas O'Grady, Carol-Ann Swain, Suzanne Kaufman","doi":"10.1089/jwh.2023.0835","DOIUrl":"10.1089/jwh.2023.0835","url":null,"abstract":"<p><p><b><i>Description:</i></b> New York State Department of Health (NYSDOH) recommends that all pregnant patients receive human immunodeficiency virus (HIV) screening during pregnancy. This study assessed the prevalence of repeat prenatal HIV testing and factors associated with receipt of the recommended tests. <b><i>Methods:</i></b> Data from the NYSDOH newborn screening program were used to randomly select pregnant persons without HIV who delivered a liveborn infant in 2017. Receipt of repeat testing was defined as an initial HIV test in the first or second trimesters and the final in the third trimester (relaxed); or an initial test in the first trimester and the final in the third trimester (strict). Relative risks (RRs) and 95% confidence intervals were calculated in bivariate analyses. Adjusted RRs were calculated to determine associations between demographic and clinical factors and receipt of repeat HIV testing. <b><i>Results:</i></b> The cohort included 2,225 individuals. Roughly one quarter (24%) received the recommended tests in the first or second and third trimesters and 17% received them in the first and third trimesters. Individuals who reported Hispanic or Asian race/ethnicities, had government-funded insurance, started prenatal care in the first trimester, delivered in New York City, or received prenatal hepatitis C virus screening were significantly more likely to receive repeat testing using either definition. <b><i>Conclusions:</i></b> Despite the benefits and cost-effectiveness, the prevalence of repeat prenatal HIV screening during the third trimester remains persistently low. Improved messaging and targeted education and resources to assist prenatal providers could reinforce the importance of repeat testing and reduce residual perinatal HIV transmission.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1240-1247"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306193","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":"Striving for Best Practice in Care After Stillbirth.","authors":"A Ellwood David, Aleena Wojcieszek, Vicki Flenady","doi":"10.1089/jwh.2024.0477","DOIUrl":"10.1089/jwh.2024.0477","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1154-1155"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260603","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":"Allostatic Load in Breast Cancer Detection: A New Opportunity.","authors":"Jie Shen, Hua Zhao","doi":"10.1089/jwh.2024.0483","DOIUrl":"10.1089/jwh.2024.0483","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1156-1157"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555060","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":"Building Capacity of Community Health Centers to Improve the Provision of Postpartum Care Services Through Data-Driven Health Information Technology and Innovation.","authors":"Lisa Romero, Jennifer Du Mond, Pedro B Carneiro, Raymonde Uy, Jayson Osika, Jena Wallander Gemkow, Ta-Yun Yang, Michele Whitt, AnnMarie Overholser, Seren Karasu, Katherine Curtis, Julia Skapik","doi":"10.1089/jwh.2024.0364","DOIUrl":"10.1089/jwh.2024.0364","url":null,"abstract":"<p><p>Maternal morbidity and mortality remain significant challenges in the United States, with substantial burden during the postpartum period. The Centers for Disease Control and Prevention, in partnership with the National Association of Community Health Centers, began an initiative to build capacity in Federally Qualified Health Centers to (1) improve the infrastructure for perinatal care measures and (2) use perinatal care measures to identify and address gaps in postpartum care. Two partner health center-controlled networks implemented strategies to integrate evidence-based recommendations into the clinic workflow and used data-driven health information technology (HIT) systems to improve data standardization for quality improvement of postpartum care services. Ten measures were created to capture recommended care and services. To support measure capture, a data cleaning algorithm was created to prioritize defining pregnancy episodes and delivery dates and address data inconsistencies. Quality improvement activities targeted postpartum care delivery tailored to patients and care teams. Data limitations, including inconsistencies in electronic health record documentation and data extraction practices, underscored the complexity of integrating HIT solutions into postpartum care workflows. Despite challenges, the project demonstrated continuous quality improvement to support data quality for perinatal care measures. Future solutions emphasize the need for standardized data elements, collaborative care team engagement, and iterative HIT implementation strategies to enhance perinatal care quality. Our findings highlight the potential of HIT-driven interventions to improve postpartum care within health centers, with a focus on the importance of addressing data interoperability and documentation challenges to optimize and monitor initiatives to improve postpartum health outcomes.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1140-1150"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580109","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":"Women in Coal Mining-Radiographic Findings of Women Participants in the Coal Workers' Health Surveillance Program 1970-2022.","authors":"Noemi B Hall, Nirmala T Myers, Laura E Reynolds, David J Blackley, A Scott Laney","doi":"10.1089/jwh.2024.0140","DOIUrl":"10.1089/jwh.2024.0140","url":null,"abstract":"<p><p><b><i>Objective</i></b>: To describe the work experience and respiratory health of women coal miners in the United States using Coal Workers' Health Surveillance Program (CWHSP) data. <b><i>Methods:</i></b> Analysis included CWHSP participants with self-reported sex of female between January 1, 1970, and December 31, 2022, and examined radiographic surveillance, demographics, and job history. National Institute for Occupational Safety and Health-certified physicians classified chest radiographs. <b><i>Results:</i></b> Among 8,182 women participants, most worked <10 years and a majority reported working in non-dusty jobs. Among 3,392 with ≥1 year of coal mining tenure, 18 (0.5%) had evidence of pneumoconiosis, with no cases of progressive massive fibrosis. <b><i>Conclusion:</i></b> Women coal miners participating in the CWSHP had short mining careers and low pneumoconiosis prevalence. Few worked in the most dusty jobs, indicating limited exposure to coal mine dust. This underscores the need to explore women's roles in mining, and for improved gender-specific employment reporting. Such changes can enhance health and work conditions for women in male-dominated industries.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1219-1223"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317599","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}