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101.
《The Journal for Nurse Practitioners》2019,15(4):306-310
Although substance use has negative health effects on women, especially during the reproductive years, family planning practices in which nurse practitioners are key care providers, generally do not adequately screen and intervene for alcohol and drugs. Screening, brief intervention, and referral to treatment (SBIRT) can limit the effects of substance use on women and families. This study explored barriers and facilitators to SBIRT through qualitative analysis of focus groups with family planning providers. Results suggest family planning providers are favorable to implementation. Barriers include training and organizational support; facilitators include use of electronic health records and setting patient expectations. 相似文献
102.
103.
《Vaccine》2022,40(48):6931-6938
BackgroundInfluenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica.MethodsWe conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information—separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP.ResultsWe surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89–6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06–5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08–4.68); and secondary/university education (aOR: 0.15–0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms.ConclusionVaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns. 相似文献
104.
Robert K. Horsley Juliana M. Kling Suneela Vegunta Roxanne Lorans H’hamed Temkit Bhavika K. Patel 《Journal of the American College of Radiology》2019,16(2):164-169
Objectives
Studies have shown that having a baseline mammogram, the first screening mammogram, available for comparison at the time of interpreting a subsequent mammogram significantly decreases the potential of a false-positive examination. Our aim was to evaluate knowledge of and perception about the significance of baseline mammograms in those women undergoing screening mammography.Materials and Methods
A cross-sectional prospective survey study was conducted in women without a history of breast cancer presenting for their screening mammogram. Respondents were surveyed anonymously between March and April 2017. The questionnaire was developed by primary care providers and radiologists and pretested for readability and clarity.Results
In all, 401 women (87% white, 93% educated beyond high school) completed surveys in which 77% of women reported having yearly mammograms, 31% reported having a history of an abnormal mammogram, and 45% had not heard the term baseline mammogram. Of those who had heard the term, the most commonly reported source was their primary care provider (31%). Although 74% chose the correct definition of a baseline mammogram, 67% did not think that a baseline mammogram was important for decreasing associated cost, time, and discomfort due to the number of mammograms incorrectly read as abnormal.Conclusion
In a group of educated women who routinely get mammograms, almost one-half had not heard the term baseline mammogram. Furthermore, most women did not think baseline mammography was important for decreasing associated cost, time, and discomfort due to mammograms incorrectly read as abnormal. This study suggests that efforts to improve women’s understanding of baseline mammograms and their importance are warranted, with greatest opportunity for health care providers and radiologists. 相似文献105.
Jennifer L. Brown Lisa B. Haddad Nicole K. Gause Sarah Cordes Cecilia Bess Caroline C. King 《Women & health》2019,59(3):305-317
This study qualitatively examined factors that influenced contraceptive choices in a sample of young, HIV-infected women. Individual qualitative interviews were conducted among 30 vertically and horizontally HIV-infected women (n = 26 African American) from the ages of 14 to 24 years (Mean age = 20.9 years). We recruited sample groups with the following characteristics: (a) current contraceptive/condom use with ≥1 child (n = 11); (b) current contraceptive/condom use with no children (n = 12); and (c) no current contraceptive/condom use with no children (n = 7). A semi-structured interview guide was used to ask participants about factors influencing past and current contraceptive choices. Individual interviews were digitally recorded and transcribed verbatim; analyses to identify core themes were informed by the Grounded Theoretical approach. Young, HIV-infected women did not identify their HIV serostatus or disease-related concerns as influential in their contraceptive decisions. However, they reported that recommendations from health-care providers and input from family and friends influenced their contraceptive choices. They also considered a particular method’s advantages (e.g., menstrual cycle improvements) and disadvantages (e.g., increased pill burden) when selecting a method. Findings suggested that HIV-infected young women’s contraceptive decisions were influenced by factors other than those related to their infection. 相似文献
106.
目的 筛查广东省惠州地区女性体检人群人乳头瘤病毒 (HPV) 感染情况,分析其型别特征、年龄分布特点及宫颈病
变程度。方法 收集 2016 年 8 月-2017 年 6 月共 702 例广东省惠州地区女性体检人群的宫颈脱落细胞标本,采用 Luminex 200
的流式荧光技术检测 27 种人乳头瘤病毒 (HPV) 的基因型,包括高危型别 (17 种 ):16、18、31、33、35、39、45、51、52、56 、
58、59、66、68、26、53 和 82,低危亚型 (10 种 ):6、11、40、42、43、44、55、61、81 和 83。同时对 HPV 分型阳性的标本行
液基细胞学检测 (TCT)。分析 HPV 流行率、感染型别、年龄分布及宫颈病变程度。结果 702 例女性体检人群中 HPV 感染者人
数为 101 例,感染率为 14.4%。HPV 单一感染型占 82.2%(83 例 /101 例 ),以高危亚型为主 (83.1%,69 例 /83 例 ),前 3 位感染亚
型分别是 52 型 (24.1%,20 例 /83 例 )、16 型 (10.8%,9 例 /83 例 )、58 型 (10.8%,9 例 /83 例 )。多重亚型感染占 17.8%(18 例 /101 例 )。
≤30岁、31~40岁、41~50岁、>50岁年龄组感染率分别为18.7%、14.4%、14.0%和11.7%,各年龄层感染率无统计学差异(P>0.05)。
其中 92 例 HPV 分型阳性患者同时进行了 TCT 检测,25% 人群宫颈有炎症细胞或出血,10.9% 人群出现了非典型鳞状细胞不能
排除高级别上皮内病变 (ASC-H) 和低度鳞状上皮内病变 (LSIL)。结论 广东省惠州地区女性体检人群中 HPV 感染主要以 52 型、
16 型、58 型为主,且为单一感染,其中部分 HPV 感染体检人群宫颈已经出现了病变。流式荧光技术可以精确分出 27 种最见的
HPV 亚型,对 HPV 的筛查具有良好的应用前景。 相似文献
107.
Kaifeng Deng Shanying Mo Xuexiang Liu Jifei Chen Qiaoyun Zhang Xiaoli Chen Jianming Chen Shengming Dai 《Clinical breast cancer》2019,19(2):e337-e342
Background
Based on estrogen active substances, many women consume soy foods in the belief that it could prevent breast cancer (BC). Women with different molecular subtypes would be likely to have diverse reactions to soy foods, especially those with the estrogen-receptor-positive (ER+) subtype. The aim of the current study is to identify the differentially expressed genes (DEGs) on soy foods in premenopausal patients with Lumina A subtype of BC (LABC) after soy food treatment, and to further investigate the critical molecule change.Materials and Methods
GSE58792 retrieved from Gene Expression Omnibus was analyzed to obtain DEGs using GEO2R. Gene Ontology and pathway enrichment analysis were performed using FunRich and GeneMINIA. Overall survival of critical genes was performed by the Kaplan-Meier plotter online tool.Results
A total of 108 DEGs were obtained from the dataset, among which 35 were up-regulated and 73 down-regulated. Soy foods significantly reduced the expression of TFF3, TFF1, GATA3, and ESR1, which were related to the activity of the ER-related pathway and the sensitivity of tamoxifen. Furthermore, the lower expressions of TOX3, FSIP1, ESR1, and CLGN were related to prolonged survival time of patients with BC. The most significant signaling pathways were epithelial-to-mesenchymal transition in up-regulated DEGs, mesenchymal-to-epithelial transition, and mammary gland alveolus development in down-regulated DEGs, which were all related to the development and prognosis of BC.Conclusions
Soy foods could dramatically alter the ER-related gene profile in LABC. Particularly, down-regulated DEGs of TFF3, TFF1, GATA3, and ESR1 might weaken the sensitivity of tamoxifen and increase the efficacy of neoadjuvant chemotherapy in premenopausal patients with LABC. 相似文献108.
郭水惠 《中国继续医学教育》2020,(14):130-132
目的对肝内胆汁淤积症孕妇的胎儿不良结局进行分析研究。方法随机选择在本院接受治疗的肝内胆汁淤积症孕妇作为观察组,与同期在本院正常分娩的对照组孕妇相比胎儿的不良结局。结果观察组的分娩结果 :12例早产、5例流产、5例死胎、4例新生儿窒息、40例正常分娩。对照组的分娩结果 :1例早产、1例新生儿窒息,64例正常分娩。观察组中胎儿不良结局发生率显著高于对照组,P <0.05;观察组中重度患者的胎儿不良结局发生率高于轻度患者,P <0.05。结论肝内胆汁淤积症导致胎儿不良结局发生率升高,应对加强对肝内胆汁淤积症的预防从而改善胎儿结局。 相似文献
109.
目的 通过前瞻性队列研究,评价孕20周内母体甲状腺功能相关激素指标水平与新生儿出生体格和婴幼儿期神经精神发育水平之间的剂量反应关系。方法 在安徽省马鞍山市建立945名孕妇队列,留取队列孕妇血清标本,使用电化学发光免疫法检测孕妇血清甲状腺功能相关激素水平;收集孕妇的一般社会人口统计学资料,测量新生儿出生体格和婴幼儿神经精神的发育情况等。结果 孕期母体血清促甲状腺激素(TSH)水平处于不同百分段的孕妇所分娩的活产儿出生时身长和头围差异均有统计学意义(P<0.05)。孕期母体TSH水平<P5和≥ P95的新生儿出生身长和头围比母体TSH水平位于P25~P75的新生儿偏低,差异均有统计学意义(P<0.05)。新生儿出生头围与母体TSH-Z分呈倒"U"形分布模式(Y=33.940+0.003X-0.109X2,F=4.685,P=0.009)。孕期母体TSH水平处于不同百分段的孕妇所分娩后代在出生后18~30个月时的精神发展指数(MDI)差异有统计学意义(P<0.05),孕期母体TSH水平≥ P90的婴儿MDI评价水平比母体TSH水平P25~P75的婴儿低6.39分(95% CI:2.29~10.49;P=0.002)。婴幼儿18~30个月时MDI与母体TSH-Z分亦呈倒"U"形分布模式(Y=103.249-1.524X-0.939X2,F=6.616,P=0.001)。结论 孕妇血清TSH水平与新生儿出生时身长、头围,以及婴幼儿18~30个月时MDI关系密切;孕期母体TSH-Z分与新生儿头围和婴幼儿18~30个月时MDI均呈现倒"U"形的分布模式。 相似文献
110.
Jack Cuzick Rachael Adcock Francesca Carozzi Anna Gillio-Tos Laura De Marco Annarosa Del Mistro Helena Frayle Salvatore Girlando Cristina Sani Massimo Confortini Manuel Zorzi Paolo Giorgi-Rossi Raffaella Rizzolo Guglielmo Ronco the New Technologies for Cervical Cancer Screening Working Group 《International journal of cancer. Journal international du cancer》2020,147(7):1864-1873
Human papillomavirus (HPV) testing is very sensitive for primary cervical screening but has low specificity. Triage tests that improve specificity but maintain high sensitivity are needed. Women enrolled in the experimental arm of Phase 2 of the New Technologies for Cervical Cancer randomized controlled cervical screening trial were tested for high-risk HPV (hrHPV) and referred to colposcopy if positive. hrHPV-positive women also had HPV genotyping (by polymerase chain reaction with GP5+/GP6+ primers and reverse line blotting), immunostaining for p16 overexpression and cytology. We computed sensitivity, specificity and positive predictive value (PPV) for different combinations of tests and determined potential hierarchical ordering of triage tests. A number of 1,091 HPV-positive women had valid tests for cytology, p16 and genotyping. Ninety-two of them had cervical intraepithelial neoplasia grade 2+ (CIN2+) histology and 40 of them had CIN grade 3+ (CIN3+) histology. The PPV for CIN2+ was >10% in hrHPV-positive women with positive high-grade squamous intraepithelial lesion (61.3%), positive low-grade squamous intraepithelial lesion (LSIL+) (18.3%) and positive atypical squamous cells of undetermined significance (14.8%) cytology, p16 positive (16.7%) and, hierarchically, for infections by HPV33, 16, 35, 59, 31 and 52 (in decreasing order). Referral of women positive for either p16 or LSIL+ cytology had 97.8% sensitivity for CIN2+ and women negative for both of these had a 3-year CIN3+ risk of 0.2%. Similar results were seen for women being either p16 or HPV16/33 positive. hrHPV-positive women who were negative for p16 and cytology (LSIL threshold) had a very low CIN3+ rate in the following 3 years. Recalling them after that interval and referring those positive for either test to immediate colposcopy seem to be an efficient triage strategy. The same applies to p16 and HPV16. 相似文献