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Eliza Hartley Briony Hill Cate Bailey Matthew Fuller-Tyszkiewicz Helen Skouteris 《Women's health issues》2018,28(6):530-538
Background
Postpartum depression and anxiety are prevalent in the first year after giving birth and can have problematic health outcomes for the mother and infant, although further research is required about the factors that contribute to their development. This study explored the trajectory of depressive and anxiety symptoms across the first postpartum year and their associations with body attitudes, body mass index, and weight retention.Methods
Participants were 467 women recruited during pregnancy via online forums, in parenting magazines, and at baby and children's markets, or from a large tertiary Australian hospital. Participants reported retrospectively on the prepregnancy period and provided data in early pregnancy (Baseline; M = 17.1 weeks pregnant), at 3 months postpartum (T1; M = 13.1 weeks after birth), 6 months postpartum (T2; M = 26.6 weeks after birth), and 12 months postpartum (T3; M = 52.8 weeks after birth).Results
Latent growth curve modelling revealed that, from T1 to T3, depressive symptoms significantly decreased, whereas anxiety symptoms did not change significantly. Demographic factors, weight retention, body mass index, and body attitudes at T1 did not significantly predict the course of depression and anxiety over time; however, greater postpartum weight retention and negative body attitudes at T1 predicted a more severe experience of both depression and anxiety at T3.Conclusions
These findings emphasize the need to assess and monitor the risk factors that can have an adverse impact on postpartum women's psychological health. This finding is particularly important for women deemed to be at risk of problematic body image or weight issues so that health professionals can intervene, and better ensure the health of new mothers in the longer term. 相似文献4.
Lisa S. Callegari Jodie G. Katon Kristen E. Gray Kemi Doll Sara Pauk Kristine E. Lynch Uchenna S. Uchendu Laurie Zephyrin Carolyn Gardella 《Women's health issues》2019,29(1):48-55
Background
In the general population, Black and Latina women are less likely to undergo minimally invasive hysterectomy than White women, which may be related to racial/ethnic variation in fibroid prevalence and characteristics. Whether similar differences exist in the Department of Veterans Affairs Healthcare System (VA) is unknown.Methods
Using VA clinical and administrative data, we identified all women veterans undergoing hysterectomy for benign indications in fiscal years 2012–2014. We identified hysterectomy route (laparoscopic with/without robot-assist, vaginal, abdominal) by International Classification of Diseases, 9th edition, codes. We used multinomial logistic regression to estimate associations of race/ethnicity with hysterectomy route and tested whether associations varied by fibroid diagnosis using an interaction term. Models adjusted for age, income, body mass index, gynecologic diagnoses, medical comorbidities, whether procedure was performed or paid for by VA, geographic region, and fiscal year.Results
Among 2,744 identified hysterectomies, 53% were abdominal, 29% laparoscopic, and 18% vaginal. In multinomial models, racial/ethnic differences were present among veterans with but not without fibroid diagnoses (p value for interaction < .001). Among veterans with fibroids, Black veterans were less likely than White veterans to have minimally invasive hysterectomy (laparoscopic vs. abdominal relative risk ratio [RRR], 0.52; 95% CI, 0.38–0.72; vaginal vs. abdominal RRR, 0.58; 95% CI, 0.43–0.73). Latina veterans were as likely as White veterans to have laparoscopic as abdominal hysterectomy (RRR, 1.34; 95% CI, 0.87–2.07) and less likely to have vaginal than abdominal hysterectomy (RRR, 0.32; 95% CI, 0.15–0.69).Conclusions
Receipt of minimally invasive hysterectomy among women veterans with fibroids varied by race/ethnicity. Further investigation of the underlying mechanisms and potential interventions to increase minimally invasive hysterectomy among minority women veterans is needed. 相似文献5.
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Rebekah H. Nagler Erika Franklin Fowler Nora M. Marino Kari McClure Mentzer Sarah E. Gollust 《Women's health issues》2019,29(1):87-95
Background
There is longstanding expert disagreement about the age at and frequency with which women should be screened for breast cancer. These debates are reflected in the conflicting recommendations about mammography issued by major professional organizations, such as the U.S. Preventive Services Task Force and the American Cancer Society. Previous research has shown that these recommendations garner substantial media attention—and therefore might affect women's screening perceptions and behaviors—but to date analyses of such media coverage have focused on single publicized announcements.Methods
To assess whether media coverage of mammography screening recommendations has evolved, we conducted a content analysis of televised news from four discrete media events from 2009 to 2016, all of which focused on publicized screening recommendations from the U.S. Preventive Services Task Force and American Cancer Society (N = 364 stories).Results
Media coverage of mammography screening recommendations has featured persistent messages of conflict and/or controversy over time. The evolution of controversy was also reflected in shifts in the relative attention given to mammography screening's risks and benefits, with consistent and, in some cases, heightened attention to screening's risks during more recent media events. Overall, the accuracy of media coverage improved over time.Conclusions
Results underscore the continued prevalence of conflicting and/or controversial information about mammography screening in the public information environment. Cumulative exposure to such messages could influence women's decision making around screening and trust in cancer prevention recommendations. Strategies are needed to better equip all women (and particularly underserved women) to negotiate mammography controversy and weigh the benefits and risks of screening. 相似文献7.
Objectives
Childrearing responsibilities create additional demands on women's time and effort, especially in low-income families. We explore whether childrearing demands and differences in time use increase the risk of overweight and obesity for women in different income brackets.Methods
We use data for women ages 18–55 years from the 2006–2008 and 2014–2015 American Time Use Surveys (N = 17,914). We predict whether women engage in particular activities using logistic regression and, among those who do particular activities, we predict the minutes spent in various activities using ordinary least squares models. We also predict women's risk of overweight or obesity using logistic regression. All models examine conditional relationships between income level and motherhood status.Results
Replicating prior research, we find a greater risk of overweight and obesity for mothers with low (odds ratio, 1.66; p < .001) and subpoverty (odds ratio, 1.93; p < .001) incomes compared with mothers with moderate/upper incomes and all child-free women. Motherhood and income status jointly predict women's time use, but including these time use behaviors in models of overweight and obesity does not attenuate the significantly higher risks for mothers with low and subpoverty incomes.Conclusions
Mothers experiencing economic hardship are at greater risk of overweight and obesity relative to other women. Additional research is warranted, however, because differences in time use do not explain this important health disparity. 相似文献8.
Wambui Gathirua-Mwangi Andrea Cohee Will L. Tarver Andrew Marley Erika Biederman Timothy Stump Patrick Monahan Susan Rawl Celette Sugg Skinner Victoria L. Champion 《Women's health issues》2018,28(5):462-469
Background
Breast cancer is the second leading cause of cancer mortality, yet mammography screening rates remain less than optimal and differ by income levels. The purpose of this study was to compare factors predicting mammography adherence across income groups.Methods
Women 41 to 75 years of age (N = 1,681) with health insurance and with no mammogram in the last 15 months were enrolled to participate in an interventional study. Binary logistic regression was used to estimate multivariable-adjusted odds ratios (ORs) for demographic and health belief factors predicting mammography adherence for each income group: 1) low, less than $30,000, 2) middle, $30,000 to 75,000, and 3) high, greater than $75,000 per year.Results
Being in the contemplation stage (vs. precontemplation) of obtaining a mammogram predicted mammography adherence across all income groups and was the only predictor in the middle-income group (OR, 3.9; 95% CI, 2.61–5.89). Increase in age was associated with 5% increase (per year increase in age) in mammography adherence for low-income (OR, 1.05; 95% CI, 1.01–1.09) and high-income (OR, 1.05; 95% CI, 1.02–1.08) women. Having a doctor recommendation predicted mammography adherence only in low-income women (OR, 10.6; 95% CI, 2.33–48.26), whereas an increase in perceived barriers predicted mammography adherence only among high-income women (OR, 0.96; 95% CI, 0.94–0.99). In a post hoc analysis, high-income women reported difficulty in remembering appointments (53%) and lack of time to get a mammogram (24%) as key barriers.Conclusions
For all income groups, being in contemplation of obtaining a mammogram predicted mammography adherence; however, age predicted mammography adherence for low- and high-income groups, whereas doctor recommendation and perceived barriers were unique predictors for low- and high-income women, respectively. Health care providers should be aware of differences in factors and emphasize strategies that increase mammography adherence for each income group. 相似文献9.
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A.Fadeke Aderounmu L.A. Salako O. Walker 《Transactions of the Royal Society of Tropical Medicine and Hygiene》1981,75(5):637-640
Plasmodium falciparum malaria was treated in 82 children with 25 mg/kg chloroquine orally over three days. They were observed for 28 days during which blood films were examined periodically for malaria parasites. Asexual forms of P. falciparum, present in the blood films of all the patients before commencing treatment, disappeared rapidly and by the third day no parasites were seen in blood films from any of them. Among the patients observed for more than three days, blood films remained negative throughout the observation period. In vitro tests of sensitivity of blood samples from 10 patients showed chloroquine concentrations of 0·5 to 0·8 nmol/ml to inhibit completely maturation from ring forms to schizonts.This suggests that P. falciparum in the Ibadan area is probably still fully sensitive to chloroquine. 相似文献
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Aims
Researchers at the U.S. Centers for Disease Control and Prevention (CDC) recently estimated the number of women at risk for alcohol-exposed pregnancies (AEPs) as 3.3 million per month. The number of women at risk was widely interpreted as the actual number of AEPs. The actual number of AEPs may be easier to interpret and may be more a more relevant public health metric for evaluating efforts to reduce AEPs. We estimated the expected actual number of AEPs among U.S. women 15–44 years of age and the expected actual number of alcohol-exposed births (AEBs).Methods
Like the CDC researchers, we used data about women aged 15–44 years who were neither pregnant nor sterile from the 2011–2013 National Survey of Family Growth. We identified women who had had sex without contraception in the last 4 weeks and reported binge drinking or drinking on more than 7 of the last 30 days. We then estimated the expected actual number of AEPs and AEBs, accounting for the chances of becoming pregnant and for pregnancy outcomes (birth, miscarriage, and abortion). We also conducted sensitivity analyses with varying assumptions.Results
Estimated prevalences of AEPs and AEBs were 1.2% (95% confidence interval, 0.9–1.7) and 0.8% (95% confidence interval, 0.5–1.2), respectively. During a 1-month period, we estimate 731,000 U.S. women had AEPs and 481,000 resulted in AEBs. Sensitivity analyses indicate expected actual AEP estimates ranging from 104,000 to 1,242,000 and AEBs from 79,000 to 816,000.Conclusions
Under our assumptions, the estimated expected actual number of AEPs is 2.5 million less than the CDC estimate of the number at risk of an AEP. By using evidence-informed assumptions for the chances of becoming pregnant and common pregnancy outcomes, our estimate of the expected actual number of AEPs is only 22% as large as the CDC's estimate of number at risk, and our estimate of expected actual number of AEBs only 15% as large. The evidence-informed assumptions used here should inform future efforts to estimate expected actual numbers of AEPs and AEBs. 相似文献14.
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Katie Woodruff 《Women's health issues》2019,29(1):80-86
Background and Objectives
News coverage can shape public understanding of policy issues in important ways. In the last decade, many new state-level abortion restrictions have been passed, often based on claims about the safety of abortion care, yet little is known about recent news coverage of abortion. This study analyzes a sample of news on abortion in the United States and explores the implications for reproductive health policymakers, practitioners, and advocates.Methods
We analyzed a sample of news and opinion articles containing the term “abortion” published in three major U.S. newspaper sources in 2013 and 2016. The total sample was 783 unique pieces. We coded for story topics, references to fetal personhood, women's stories, and basic abortion facts. Three trained coders conducted the coding, with intercoder reliability rates ranging from 0.777 to 1.0.Findings
Most of the time abortion appears in the news, it is merely mentioned, rather than discussed substantively. Abortion is covered as a political issue more than a health issue. The personal experiences of people who get abortions are present in only 4% of the sample, and language personifying the fetus appears more often than women's abortion stories. State abortion restrictions are newsworthy, yet basic facts on the commonality and safety of abortion are virtually absent.Conclusions
This study suggests that the news does not support public understanding of abortion as a common, safe part of reproductive health care. Such framing may undermine public support for policies that protect access to this common health care service. 相似文献16.
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Andrea Swartzendruber Anna Newton-Levinson Ashley E. Feuchs Ashley L. Phillips Jennifer Hickey Riley J. Steiner 《Women's health issues》2018,28(1):14-20
Background
Pregnancy resource centers (PRCs) are nonprofit organizations with a primary mission of promoting childbirth among pregnant women. Given a new state grant program to publicly fund PRCs, we analyzed Georgia PRC websites to describe advertised services and related health information.Methods
We systematically identified all accessible Georgia PRC websites available from April to June 2016. Entire websites were obtained and coded using defined protocols.Results
Of 64 reviewed websites, pregnancy tests and testing (98%) and options counseling (84%) were most frequently advertised. However, 58% of sites did not provide notice that PRCs do not provide or refer for abortion, and 53% included false or misleading statements regarding the need to make a decision about abortion or links between abortion and mental health problems or breast cancer. Advertised contraceptive services were limited to counseling about natural family planning (3%) and emergency contraception (14%). Most sites (89%) did not provide notice that PRCs do not provide or refer for contraceptives. Two sites (3%) advertised unproven “abortion reversal” services. Approximately 63% advertised ultrasound examinations, 22% sexually transmitted infection testing, and 5% sexually transmitted infection treatment. None promoted consistent and correct condom use; 78% with content about condoms included statements that seemed to be designed to undermine confidence in condom effectiveness. Approximately 84% advertised educational programs, and 61% material resources.Conclusions
Georgia PRC websites contain high levels of false and misleading health information; the advertised services do not seem to align with prevailing medical guidelines. Public funding for PRCs, an increasing national trend, should be rigorously examined. Increased regulation may be warranted to ensure quality health information and services. 相似文献18.
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Kelly M. Bower Ruth J. Geller Nancy A. Perrin Jeanne Alhusen 《Women's health issues》2018,28(6):495-501