Journal of women's health (2002)最新文献

{"title":"Cervical Cancer Screening Among Patients with Physical Disability.","authors":"Lior Baruch,&nbsp;Avital Bilitzky-Kopit,&nbsp;Keren Rosen,&nbsp;Limor Adler","doi":"10.1089/jwh.2021.0447","DOIUrl":"https://doi.org/10.1089/jwh.2021.0447","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as recommended by guidelines. The aim of our study was to examine the association between physical disability and Pap smear receipt in Israel. <b><i>Methods:</i></b> This cross-sectional study was conducted using the electronic medical records of the second largest health care maintenance organization in Israel. All female patients during 2012-2017 aged 25-65 were identified. The exposure variable was physical disability, and the outcome variable was Pap smear receipt. We used logistic regression to control for covariates. <b><i>Results:</i></b> A total of 391,259 patients were eligible for this study, 6,720 (1.7%) with physical disability. 56.7% of patients with disabilities had received Pap smear compared to 63.3% of patients without disabilities, odds ratio (OR) 0.76, 95% confidence interval [CI] 0.72-0.80. When adjusting to sociodemographic and clinical covariates, patients with disabilities were less likely to receive Pap smear, adjusted OR 0.83, 95% CI 0.79-0.88. For all patients, older age, lower socioeconomic status, religious minorities, cardiovascular disease, type-2 diabetes mellitus, hypertension, smoking, and obesity were associated with lower odds of receipt of Pap smear. A history of nongynecologic oncologic disease was associated with increased odds of Pap smear receipt. <b><i>Conclusion:</i></b> Our study highlights the disparities between patients with and without physical disability with regard to screening for cervical cancer by receipt of Pap smear. Creating an appropriate practice with adequate access to patients with disability should be a focus for health care providers and policy makers.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1173-1178"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/77/jwh.2021.0447.PMC9419959.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39716550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Subjective, But Not Objective, Cognitive Deficit in New Mothers at 1-Year Postpartum.","authors":"Edwina R Orchard,&nbsp;Phillip G D Ward,&nbsp;Gary F Egan,&nbsp;Sharna D Jamadar","doi":"10.1089/jwh.2021.0441","DOIUrl":"https://doi.org/10.1089/jwh.2021.0441","url":null,"abstract":"<p><p><b><i>Background:</i></b> The experience and even existence of cognitive deficits in the postpartum period is uncertain, with only a few scientific studies, reporting inconsistent results. <b><i>Methods:</i></b> In this study, we investigate cognition in 86 women (43 first-time mothers 1 year postpartum and 43 non-mothers). <b><i>Results:</i></b> Mothers and non-mothers showed no significant differences on measures of objective cognition (verbal memory, working memory, and processing speed or theory of mind). Despite the absence of objective differences, mothers self-reported significantly worse subjective memory than non-mothers. To interpret the difference between objective and subjective measures of memory, we investigated relationships between subjective memory, objective memory, and wellbeing. Mothers, but not non-mothers, showed a positive correlation between subjective and objective measures of memory, indicating mothers are \"in-tune\" with their memory performance. Mothers also demonstrated a positive relationship between subjective memory and wellbeing (sleep, anxiety, and depression), where better wellbeing correlated with higher subjective memory. This relationship was not apparent in non-mothers. The results suggest that poorer sleep, higher anxiety, and higher depression are related to reports of poorer self-reported memory in mothers. <b><i>Conclusion:</i></b> Our results add to our growing understanding of maternal cognition at 1 year postpartum, with no evidence of cognitive differences between mothers and non-mothers.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1087-1096"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Management of Menopause: Symposium Proceedings.","authors":"Susan G Kornstein,&nbsp;JoAnn V Pinkerton,&nbsp;Diane T Pace,&nbsp;Andrea J Singer,&nbsp;Sheryl A Kingsberg,&nbsp;Lisa E Ellis,&nbsp;Phoebe Ashley,&nbsp;Wendy Klein","doi":"10.1089/jwh.2022.0175","DOIUrl":"https://doi.org/10.1089/jwh.2022.0175","url":null,"abstract":"<p><p>This proceeding summarizes a symposium on multidisciplinary management of menopause held on July 30, 2021 as part of the Health of Women 2021 conference. The workshop featured presentations by national experts who provided insights into multidisciplinary approaches to the management of menopause, vasomotor symptoms and genitourinary syndrome of menopause, bone health (including osteoporosis, muscular strength, and mobility), as well as sexual and psychological health during menopause. In this study, we highlight the major points of each presentation and the resultant discussion.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1071-1078"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal Uterine Bleeding in Perimenopausal Women.","authors":"Michelle Y Louie,&nbsp;Suneela Vegunta","doi":"10.1089/jwh.2022.0273","DOIUrl":"https://doi.org/10.1089/jwh.2022.0273","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1084-1086"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deferring Risk: Limitations to the Evidence in Product Labels for Vaccine Use in Pregnancy.","authors":"Terra Anne Manca,&nbsp;Karina A Top,&nbsp;Kirsten Weagle,&nbsp;Janice E Graham","doi":"10.1089/jwh.2021.0609","DOIUrl":"https://doi.org/10.1089/jwh.2021.0609","url":null,"abstract":"<p><p><b><i>Background:</i></b> The gaps in clinical trial evidence about vaccination in pregnancy have serious implications for health care worker and public misunderstandings. Contradictions between National Immunization Technical Advisory Group (NITAG) recommendations and regulatory product labeling information contribute to misinformation about vaccine safety and effectiveness. <b><i>Methods:</i></b> A mixed methods approach that included a stakeholder consensus decision-making workshop and a national survey of Canadian health care providers (HCPs). <b><i>Results:</i></b> We identified knowledge gaps and serious limitations concerning the information in vaccine product labels. Stakeholders were troubled that some HCPs rely on regulatory product labels to inform their decisions without knowing their limitations in content. Our survey showed that HCPs were uncertain about the purpose of product labels and the evidence contained in them. Over a third of respondents incorrectly thought that product labels and NITAG recommendations are based on the same evidence and that the information they contain is regularly updated. <b><i>Conclusions:</i></b> Applying social risk theories, we show how such gaps in information defer responsibility for decisions about disease risk and vaccine safety from regulatory agencies and vaccine manufacturers onto HCPs and their clients. This may be especially relevant for COVID-19 and other emerging vaccines that are initially authorized for conditional or emergency use, and especially in understudied populations such as pregnant people. More frequent updating and alignment of robust, unbiased, and independently reviewed clinical trial and postmarket safety and effectiveness evidence with NITAG recommendations would allay HCP and public misunderstandings.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1103-1112"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40177082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paid Family Leave in Improving Lives of Working Families.","authors":"Veronica Easton,&nbsp;Allison Silverstein","doi":"10.1089/jwh.2022.0220","DOIUrl":"https://doi.org/10.1089/jwh.2022.0220","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1069-1070"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40469751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Professional's Knowledge of Pregnancy Complications and Women's Cardiovascular Health: An International Study Utilizing Social Media.","authors":"Pensée Wu,&nbsp;Mamas A Mamas,&nbsp;Martha Gulati","doi":"10.1089/jwh.2021.0298","DOIUrl":"https://doi.org/10.1089/jwh.2021.0298","url":null,"abstract":"<p><p><b><i>Background:</i></b> Despite guidelines recommending the evaluation of adverse pregnancy outcomes (APOs) as a part of the atherosclerotic cardiovascular disease (ASCVD) risk assessment in women, there is limited awareness of this issue in health care professionals. We sought to evaluate the extent of this gap in knowledge. <b><i>Methods:</i></b> An online study using a standardized questionnaire was advertised through newsletters and websites of professional organizations. After a low response rate, the link to the survey was announced on Twitter and <i>via</i> personal email invitations. Differences between groups of respondents were evaluated with <i>z</i>-tests of proportion. <b><i>Results:</i></b> Out of 446 complete responses, there were 315 cardiologists and 112 obstetricians and gynecologists (OBGyns). There was an >90% awareness of association of adverse maternal outcomes with gestational hypertension and gestational diabetes with ASCVD, but only <60% awareness of association of adverse maternal outcomes with preterm birth. There were significant differences in ASCVD risk assessment and awareness of the association of APOs with adverse outcomes between cardiologists and OBGyns, and between female and male cardiologists. A greater proportion of female cardiologists thought that the guidelines recommended annual follow-up for high-risk women. Conversely, a greater proportion of male cardiologists were unsure of the frequency of follow-up of such women in the relevant guidelines. A higher proportion of U.K. respondents thought that women with high-risk pregnancies should never be screened for cardiovascular disease postpartum compared with U.S. respondents. <b><i>Conclusions:</i></b> In a self-selected group of health care professionals interested in women's cardiovascular health, there remains a large gap in knowledge and awareness of the association of APOs with ASCVD risk, in particular, a lack of awareness of the association of ASCVD risk with preterm delivery. Specific target groups for improving knowledge regarding these sex-specific risk enhancers include male cardiologists and health care professionals practicing in the United Kingdom.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1197-1207"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39679318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Long-Term Mortality of Patients with Hypertensive Crisis Visiting the Emergency Department.","authors":"Byung Sik Kim,&nbsp;Hyun-Jin Kim,&nbsp;Jeong-Hun Shin,&nbsp;Jun Hyeok Lee,&nbsp;Woohyeun Kim,&nbsp;Jin-Kyu Park,&nbsp;Jinho Shin","doi":"10.1089/jwh.2021.0430","DOIUrl":"https://doi.org/10.1089/jwh.2021.0430","url":null,"abstract":"<p><p><b><i>Background:</i></b> There are limited data on sex difference in patients with hypertensive crisis. We investigated sex differences in characteristics and long-term mortality in patients with hypertensive crisis visiting the emergency department (ED). <b><i>Materials and Methods:</i></b> This cross-sectional study at a tertiary referral center included patients ≥18 years of age who were admitted to the ED between 2016 and 2019 with hypertensive crisis, defined as systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. <b><i>Results:</i></b> Among the 6,467 patients who visited the ED with hypertensive crisis, 3,131(48.4%) were women. Women were older and less likely to have acute hypertension-mediated organ damage than men. The 3-year all-cause mortality did not differ between women and men (16.9% in women and 17.2% in men, <i>p</i> = 0.738). After adjusting for age and comorbidities, the 3-year all-cause mortality was significantly higher in men than in women (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.01-1.29; <i>p</i> = 0.031). In particular, among patients ≥50 years of age, the 3-year all-cause mortality was significantly higher in men than in women (HR, 1.14; 95% CI, 1.01-1.29; <i>p</i> = 0.038); however, it was not different according to sex among patients 18-49 years of age. Moreover, the 3-year all-cause mortality was significantly higher in men than in women among patients with hypertensive urgency (HR, 1.59; 95% CI, 1.34-1.90; <i>p</i> < 0.001), which was reversed in patients with hypertensive emergency (HR, 0.71; 95% CI, 0.60-0.84; <i>p</i> < 0.001). <b><i>Conclusions:</i></b> Men ≥50 years of age with hypertensive crisis, men with hypertensive urgencies, and women with hypertensive emergencies have a high risk of all-cause mortality. Thus, it is necessary to consider sex differences when predicting subsequent prognosis and determining the appropriate treatment for patients with hypertensive crisis.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1137-1144"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39689578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual Cycle Parameters Are Not Significantly Different After COVID-19 Vaccination.","authors":"Thomas P Bouchard,&nbsp;Mary Schneider,&nbsp;Madeline Schmidt,&nbsp;Michael Manhart,&nbsp;Richard J Fehring","doi":"10.1089/jwh.2022.0097","DOIUrl":"https://doi.org/10.1089/jwh.2022.0097","url":null,"abstract":"<p><p><b><i>Background:</i></b> Some studies have suggested minor changes in the menstrual cycle after COVID-19 vaccination, but more detailed analyses of the menstrual cycle are needed to evaluate more specific changes in the menstrual cycle that are not affected by survey-based recall bias. <b><i>Materials and Methods:</i></b> Using a pretest-post-test quasi-experimental evaluation of menstrual cycle parameters before and after COVID-19 vaccination, we conducted an anonymous online survey of two groups of North American women who prospectively monitor their menstrual cycle parameters daily including bleeding patterns, urinary hormone levels using the ClearBlue Fertility Monitor, or cervical mucus observations. The primary outcome measures were cycle length, length of menses, menstrual volume, estimated day of ovulation (EDO), luteal phase length, and signs of ovulation. Perceived (subjective) menstrual cycle changes and stressors were also evaluated in this study as secondary outcome measures. <b><i>Results:</i></b> Of the 279 women who initiated the survey, 76 met the inclusion criteria and provided 588 cycles for analysis (227 pre-vaccine cycles, 145 vaccine cycles, 216 post-vaccine cycles). Although 22% of women subjectively identified changes in their menstrual cycle, there were no significant differences in menstrual cycle parameters (cycle length, length of menses, EOD, and luteal phase length) between the pre-vaccine, vaccine, and post-vaccine cycles. <b><i>Conclusions:</i></b> COVID-19 vaccines were not associated with significant changes in menstrual cycle parameters. Perceived changes by an individual woman must be compared with statistical changes to avoid confirmation bias.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"1097-1102"},"PeriodicalIF":3.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40070050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-Residencies to Improve Care for Women Veterans: A Decade of Re-Educating Veterans Health Administration Primary Care Providers.","authors":"Linda Baier Manwell,&nbsp;Melissa McNeil,&nbsp;Megan R Gerber,&nbsp;Samina Iqbal,&nbsp;Sarina Schrager,&nbsp;Catherine Staropoli,&nbsp;Roger Brown,&nbsp;Laure Veet,&nbsp;Sally Haskell,&nbsp;Patricia Hayes,&nbsp;Molly Carnes","doi":"10.1089/jwh.2021.0033","DOIUrl":"https://doi.org/10.1089/jwh.2021.0033","url":null,"abstract":"<p><p><b><i>Background:</i></b> Many primary care providers (PCPs) in the Veterans Health Administration need updated clinical training in women's health. The objective was to design, implement, and evaluate a training program to increase participants' comfort with and provision of care to women Veterans, and foster practice changes in women's health care at their local institutions. <b><i>Methods:</i></b> The Women's Health Mini-Residency was developed as a multi-day training program, based on principles of adult learning, wherein knowledge gleaned through didactic presentations was solidified during small-group case study discussions and further enhanced by hands-on training and creation of a facility-specific action plan to improve women Veterans' care. Pre, post, and 6-month surveys assessed attendees' comfort with and provision of care to women. The 6-month survey also queried changes in practice, promulgation of program content, and action plan progress. <b><i>Results:</i></b> From 2008 to 2019, 2912 PCPs attended 26 programs. A total of 2423 (83.2%) completed pretraining and 2324 (79.3%) completed post-training surveys. The 6-month survey was sent to the 645 attendees from the first 14 programs; 297 (46.1%) responded. Comparison of pre-post responses indicated significant gains in comfort managing all 19 content areas. Six-month data showed some degradation, but comfort remained significantly improved from baseline. At 6 months, participants also reported increases in providing care to women, including performing more breast and pelvic examinations, dissemination of program content to colleagues, and progress on action plans. <b><i>Conclusions:</i></b> This interactive program appears to have been successful in improving PCPs' comfort in providing care for women Veterans and empowering them to implement institutional change.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"991-1002"},"PeriodicalIF":3.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}