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Elizabeth L. Adams Michele E. Marini Krista S. Leonard Danielle Symons Downs Ian M. Paul Jennifer L. Kraschnewski Kristen H. Kjerulff Jennifer S. Savage 《Women's health issues》2019,29(2):194-200
Introduction
Factors that occur between consecutive pregnancies may influence repeated excessive gestational weight gain (GWG) and infants born large-for-gestational age (LGA). We examined interpregnancy interval, weight retention, and GWG in women's first pregnancy as predictors of excessive GWG and LGA in women's second pregnancy.Methods
We used data from women's first two live births during the First Baby Study, a 3-year prospective observational cohort of first-time mothers (N = 549). GWG was calculated as weight at delivery minus prepregnancy weight for first and second pregnancies and categorized using the Institute of Medicine guidelines. Weight retention at 6 and 12 months and interpregnancy interval (time from first live birth to conception of second infant) were quantified. Infants were considered LGA if birthweight was in the 90th percentile or greater for gestational age.Results
Many women (51.7%) exceeded GWG recommendations in both pregnancies. Women who exceeded guidelines in their first pregnancy had a 5.08 greater odds (p < .01) for exceeding guidelines in their second pregnancy, compared with women who did not exceed guidelines in their first pregnancy. Interpregnancy interval and weight retention had no association with exceeding guidelines in women's second pregnancy. Exceeding guidelines in women's first pregnancy resulted in a 4.48 greater odds (p < .01) of first-born infants being LGA, and exceeding guidelines in women's second pregnancy resulted in a 1.82 greater odds of second-born infants being large-for-gestational age (p = .02), compared with women who met guidelines in their first or second pregnancy, respectively.Conclusions
Exceeding GWG guidelines in women's first pregnancy predicted exceeding guidelines in their second pregnancy, independent of interpregnancy interval and weight retention. 相似文献3.
Donna L. Washington Marjorie Danz LaShawnta Jackson Kristina M. Cordasco 《Women's health issues》2019,29(2):135-143
Background
Abnormal uterine bleeding (AUB) is a common women's health complaint. However, the quality of primary care (PC) management of AUB is unknown. Our objective was to develop quality indicators for Veterans Health Administration (VA) PC assessment and management of AUB.Methods
We drafted candidate indicators based on comprehensive review of the scientific literature, including published consensus guidelines. Then, we convened a national panel of nine experts including PC providers, obstetrician-gynecologists, VA policy stakeholders, and quality measurement experts, and used a modified Delphi panel process. First, panelists individually rated 19 candidate indicators, using 9-point scales, on three metrics: consistency with established guidelines, importance to women's health, and reliability of measurement from VA electronic health records. Panelists then discussed the indicators. Finally, panelists re-rated revised indicators using the same metrics. Indicators were selected if final median ratings were ≥7 on each 9-point scale, without dispersion in ratings.Results
Eighteen indicators were selected. Three focused on assessing need for emergency care (e.g., profuse bleeding or pregnancy). Three addressed ascertaining key aspects of the medical history (e.g., endometrial cancer risk). Two addressed performing a physical examination (e.g., pelvic examination). Six addressed indications for diagnostic studies and specialty care referrals, (e.g., transvaginal ultrasound examination). Four addressed initiation of treatment and counseling (e.g., hormone therapy).Conclusions
We developed quality indicators for PC assessment and management of AUB that span reproductive and postmenopausal life phases. Applying these indicators in VA and other health systems with integrated electronic health records can assess need for, and effects of, AUB quality improvement programs. 相似文献4.
Caroline Heller Krista M. Perreira Adele Shartzer Emily M. Johnston Brigette Courtot 《Women's health issues》2019,29(2):161-169
Objectives
Given persistent racial/ethnic disparities in unintended pregnancies, this study aims to understand factors associated with emergency contraception (EC) use among non-Hispanic White, non-Hispanic Black, and Hispanic women.Methods
This study used a nationally representative sample of 1,990 women of reproductive age in the United States who participated in the 2016 Survey of Family Planning and Women's Lives. Logistic regressions were estimated to assess the association of sexual/pregnancy history, attitudes toward pregnancy, attitudes toward contraception, awareness and beliefs about EC, and source of information regarding contraception with ever using EC.Results
After adjusting for demographic characteristics, we found no significant differences in ever using EC by race/ethnicity. Among non-Hispanic White women, those who used barrier methods of contraception, reported a previous unplanned pregnancy, reported having heard some or a lot about EC, and believed that EC is somewhat to very effective had higher odds of EC use. Among non-Hispanic Black women, those who reported a previous unplanned pregnancy and believed that EC was somewhat to very effective had higher odds of EC use. Among Hispanic women, those who reported using long-acting reversible contraceptives, having recent male sexual partners, and believing that EC is both somewhat to very safe and effective had higher odds of EC use.Conclusions
Awareness and beliefs about safety and effectiveness are modifiable factors that may influence EC use. Population-level interventions can focus on improving awareness and understanding of the safety and effectiveness of EC. 相似文献5.
Kristina M. Cordasco Anita H. Yuan Marjorie J. Danz Melissa M. Farmer LaShawnta Jackson Ellen F. Yee Donna L. Washington 《Women's health issues》2019,29(2):144-152
Background
Abnormal uterine bleeding (AUB) is common among primary care patients. We assessed the extent to which Veterans Health Administration (VA) primary care patients with AUB are receiving guideline-adherent primary care.Methods
We identified women with AUB presenting to primary care providers across four VA health care systems from June 2013 to September 2015. We performed a structured abstraction of electronic medical record data for 15 indicators of guideline-adherent AUB care. We determined whether documented care was guideline-adherent and compared adherence of care by primary care providers by VA Designated Women's Health Provider status and by volume of clinical encounters with women veterans.Results
Across 305 episodes of AUB, 53% of the care was guideline adherent. There was high adherence with documenting menopausal status (98%), ordering diagnostic studies and referrals for postmenopausal women (92%), and documenting bleeding patterns (87%). There was lower adherence with documenting whether there was active bleeding (55%), performing thyroid testing (47%), performing a pelvic examination (42%), ordering diagnostic studies and referrals in younger women with increased endometrial cancer risk (40%), assessing for pregnancy (32%), assessing for cervical motion, uterine, or adnexal tenderness in patients with intrauterine devices (30%), and assessing for elevated endometrial cancer risk (6%). There were no significant differences in overall guideline adherence between primary care providers who were, versus were not, VA Designated Women's Health Providers, or by provider volume of encounters with women veterans.Conclusions
VA primary care has high guideline adherence when caring for postmenopausal women with AUB. Quality improvement and educational initiatives are needed to improve primary care for AUB in younger women veterans. 相似文献6.
Kathryn M. Nowotny Anastasiia Kuptsevych-Timmer Carrie Oser 《Women's health issues》2019,29(2):125-134
Background
It is well-established in the United States that incarceration negatively influences women's health, and researchers have called for examinations of the health effects of criminal justice contact more broadly. This study uses the behavioral model for vulnerable populations to document the prevalence of illness and health risks for recently arrested women, and examines potential ways that illness and health risks are associated with health service use across health care settings.Methods
We conducted a mediation analysis using pooled data from the National Survey on Drug Use and Health (2010–2014).Results
These findings reveal that recent arrest is associated with different types of health care use among women. Specifically, women recently arrested are hospitalized and seek care at the emergency department at higher rates than non–recently arrested women and this may be associated with their vulnerable mental and behavioral health status.Conclusions
The findings suggest an increasing overlap between criminal justice and public health sectors. Increased access to appropriate health services is a necessary strategy to reduce resource intensive hospitalizations and emergency department use among women experiencing a recent arrest. 相似文献7.
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Financial Strain and Contraceptive Use Among Women in the United States: Differential Effects by Age
Sophie Lyons Jennet Arcara Julianna Deardorff Anu Manchikanti Gomez 《Women's health issues》2019,29(2):153-160
Introduction
Low-income and young women experience disproportionately high rates of unintended pregnancy. Traditional measures of socioeconomic status may not be appropriate indicators of financial status, particularly during emerging adulthood. This study investigates the relationship between financial strain and contraceptive use, focusing on the differential effects by age group.Methods
Multinomial logistic regression analyses assessed the relationship between financial strain and contraceptive use in a national sample of U.S. women ages 18–39 years (N = 932). Models were adjusted for income, employment status, and other sociodemographic characteristics and tested the interaction of financial strain and age group.Results
Women with high financial strain were less likely to use short-acting methods (compared with using no method) in the adjusted model; when the age and financial strain interaction was included, associations held only for women ages 18–24 and 25–29 years of age. Relative to contraceptive nonuse, women ages 18–24 years with high financial strain were less likely to use long-acting reversible (relative risk ratio [RRR], 0.10; 95% confidence interval [CI], 0.01–0.99) and short-acting hormonal (RRR, 0.03; 95% CI, 0.00–0.18) methods. Women ages 25–29 with high financial strain were less likely to use short-acting hormonal (RRR, 0.20; 95% CI, 0.05–0.87) and coital-specific (RRR, 0.11; 95% CI, 0.02–0.51) methods.Implications for Practice and/or Policy
Young women may be vulnerable to the effect of high financial strain on contraceptive nonuse. Providers working with this group should consider incorporating financial strain into screening tools to identify patients who may need extra attention in contraceptive decision-making conversations. Antipoverty programs could also have a positive effect on effective contraceptive use. 相似文献9.
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10.
Bethany M. Coston 《Disability and health journal》2019,12(2):164-170
Background
Research on disabled non-heterosexual women's post-intimate partner violence mental health outcomes—such as anxiety, depression, suicidal ideation, and alcohol use—is lacking.Objective
To examine the impact of the intersection of disability and sexual orientation on women's post-intimate partner violence mental health outcomes: including difficulty sleeping, missing school or work, or reporting some post-traumatic stress disorder symptomology and a self-reported subjective measure of overall wellbeing.Methods
Data come from the National Intimate Partner and Sexual Violence Survey (2010). A series of chi-square analyses were conducted (applying standardized sample weights and adjusting standard errors for both clustering and stratification for survey data).Results
Bisexual women are significantly more likely than straight women to report being disabled prior to victimization, but all disabled women—regardless of sexual orientation—are equivalently likely to rate their mental health as poor and/or actively experience difficulty sleeping, difficulty going to work or school, and/or PTSD.Conclusions
Aligned with previous work, this study finds that bisexual women are significantly more likely than straight women to be disabled prior to experiencing all forms of intimate partner violence; and that disabled women, generally, are significantly more likely than not-disabled women to experience the negative mental health consequences of that violence. However, contrary to previous work, there are no sexual orientation disparities in said mental health outcomes among disabled women. Clinically, it is important for health care providers to be aware of the significant impact of intimate partner violence on the disabled women they regularly provide care to. 相似文献11.
Teresa A. Marshall Alexandra M. Curtis Joseph E. Cavanaugh John J. Warren Steven M. Levy 《Journal of the Academy of Nutrition and Dietetics》2019,119(3):425-434
Background
Sugar-sweetened beverages (SSB) are considered a risk factor for obesity.Objective
The objective of the current study was to investigate associations between the predictors of beverage and energy intakes and mean adequacy ratios (MARs), and the outcome of body mass index (BMI) z scores, in a birth cohort using longitudinal models.Design
This was a longitudinal analysis of secondary data.Participants/setting
Participants in the Iowa Fluoride and Iowa Bone Development Studies with two beverage intake questionnaires completed between ages 2 and 4.7 years or 5 and 8.5 years or one questionnaire between ages 9 and 10.5, 11 and 12.5, 13 and 14.5, or 15 and 17 years (n=720); two food and beverage diaries completed between ages 2 and 4.7 years or 5 and 8.5 years or completion of the Block’s Kids’ Food Frequency Questionnaires at age 11, 13, 15, or 17 years (n=623); and anthropometric measures at the corresponding age 5-, 9-, 11-, 13-, 15-, or 17-year examination(s).Predictors
Mean daily 100% juice, milk, SSB, water/sugar-free beverage, and energy intakes and MARs averaged over ages 2 to 4.7, 5 to 8.5, 9 to 10.5, 11 to 12.5, 13 to 14.5, or 15 to 17 years were predictors.Outcome
BMI z score was the outcome.Statistical analyses
Linear mixed models were fit for each beverage, energy, and MAR variable, with the beverage, energy, or MAR variable as the predictor and BMI z score as the outcome. Beverage models were adjusted for energy and MAR and baseline socioeconomic status.Results
SSB intake adjusted for energy intake, MAR, and baseline socioeconomic status was associated with BMI z score; each additional 8 oz SSB consumed/day throughout childhood and adolescence increased the BMI z score an average 0.050 units (95% CI 0.022 to 0.079; P=0.001). Adjusted water/sugar-free beverage intake (0.026 units; 95% CI 0.006 to 0.046; P=0.013) was modestly associated with BMI z score, while 100% juice (–0.001 units; 95% CI –0.059 to 0.057; P=0.97) and milk (0.022 units; 95% CI –0.007 to 0.052; P=0.13) intakes were not associated with BMI z scores.Conclusions
Higher SSB intakes were associated with increased BMI z scores throughout childhood and adolescence in Iowa Fluoride Study participants. Public health initiatives targeting SSB consumption during childhood and adolescence remain relevant. 相似文献12.
Introduction
In July 2015, the antiabortion Center for Medical Progress released a covertly filmed video of a Planned Parenthood official discussing the dispensation of postabortion remains for research, a practice the general public was not familiar with. Research shows that people use preexisting frameworks (such as support for or opposition to abortion rights) to make sense of new information. We examine the presence and use of abortion-related movement heuristics, language, and framing in the lay public's engagement with this video and their response to it.Methods
Using modified grounded theory, we analyzed user comments on five online news articles about the video, drawn from sources representing different segments of the spectrum of support for abortion rights, to serve as a proxy for the public conversation.Results
Commenters used language and framing consistent with the abortion rights and antiabortion social movements to debate basic information about this practice (i.e., the language of “fetal tissue” vs “baby parts” and whether the abortion provider profited from the exchange). Discussion of the abortion provider's casual demeanor, however, did not always use movement language and association consistently, with some commenters demonstrating inconsistency between their support for abortion and response to the video.Conclusions
Online commenters largely used language consistent with the contemporary abortion movements’ ideological frames in their engagement about the video. The presence of this language suggests that people may draw on existing frameworks about abortion when they engage with abortion-related information, which could have implications for efforts to address abortion misinformation. 相似文献13.
Paolo Dionigi Rossi Sarah Damanti Carolina Nani Mauro Pluderi Giulio Bertani Daniela Mari Matteo Cesari Dario Consonni Diego Spagnoli 《Journal of the American Medical Directors Association》2019,20(3):373-376.e3
Objectives
To evaluate the effects of repeated cerebrospinal fluid (CSF) tap procedures in idiopathic normal pressure hydrocephalus (iNPH) patients ineligible for surgical treatment.Design
Prospective, monocentric, pilot study.Setting
University hospital.Participants
Thirty-nine patients aged 75 years and older, ineligible for shunting surgical intervention.Intervention
Repeated CSF taps.Measurements
All patients underwent a comprehensive geriatric assessment before and after each CSF tap. Adverse events were recorded.Results
No major side effect was reported. Eleven patients showed no response to the first CSF tap test and were excluded. In the remaining 28 patients, all physical and cognitive functions improved after the drainage procedures, except for continence (which seemed poorly influenced). According to clinical judgment, the mean time frame of benefit between CSF taps was 7 months. Patients withdrawing from the protocol during the clinical follow-up showed a worsening of functional and cognitive performances after the interruption.Conclusions/Implications
Periodic CSF therapeutic taps are safe, allow a better control of iNPH symptoms, and prevent functional decline in geriatric patients. 相似文献14.
Willi Horner-Johnson Esther L. Moe Ryan C. Stoner Krystal A. Klein Alison B. Edelman Karen B. Eden Elena M. Andresen Aaron B. Caughey Jeanne-Marie Guise 《Disability and health journal》2019,12(2):139-154
Background
Women spend most of their reproductive years avoiding pregnancy. However, we know little about contraceptive knowledge and use among women with disabilities, or about strategies to improve contraceptive knowledge and decision-making in this population.Objective
To systematically review published literature on women with disabilities and: 1) contraceptive knowledge; 2) attitudes and preferences regarding contraception; 3) contraceptive use; 4) barriers and facilitators to informed contraceptive use; and 5) effectiveness of interventions to improve informed contraceptive decision-making and use.Methods
We searched MEDLINE, PsychINFO, the Cochrane Library, CINAHL, and ERIC databases from inception through December 2017. Two reviewers independently reviewed studies for eligibility, abstracted study data, and assessed risk of bias following PRISMA guidance.Results
We reviewed 11,659 citations to identify 62 publications of 54 unique studies (total n of women with disabilities?=?21,246). No standard definition of disability existed across studies. The majority of studies focused on women with intellectual disabilities (ID). Women with ID and those who were deaf or hard-of-hearing had lower knowledge of contraceptive methods than women without disabilities. Estimates of contraceptive use varied widely, with some evidence that women with disabilities may use a narrower range of methods. Five of six studies evaluating educational interventions to increase contraceptive knowledge or use reported post-intervention improvements.Conclusions
Women with disabilities may use a more narrow mix of contraceptive methods and are often less knowledgeable about contraceptives than women without disabilities. Interventions to improve knowledge show some promise. A lack of data exists on contraceptive preferences among women with disabilities. 相似文献15.
Anne C. Wheeler Amanda Wylie Adrienne Villagomez Ellen Bishop Melissa Raspa 《Disability and health journal》2019,12(2):269-277
Background
Previous research suggests that individuals with intellectual or developmental disabilities (IDD) may experience challenges accessing quality health care.Objective/Hypothesis
This study explored parent perceptions of access and quality of health care services for children with fragile X syndrome (FXS), the leading hereditary cause of intellectual/developmental disabilities.Methods
Nearly 600 primary caregivers of at least one child with FXS completed an online survey on access, barriers, and quality of health care for their family member with FXS (N?=?731).Results
In a convenience sample of well-educated and affluent caregivers, the majority did not report experiencing difficulties with access to services. Caregivers of younger children and those with lower family incomes reported greater challenges with health care access. Nearly 40% of caregivers indicated that their child's PCP was not as knowledgeable about FXS-related needs as they would prefer, indicating a possible knowledge gap on the part of providers.Conclusions
These factors represent potential barriers to quality health care for individuals with FXS, with potential lifelong effects ranging from delayed age of diagnosis to difficulty accessing a PCP in adulthood. 相似文献16.
The relation of abuse to physical and psychological health in adults with developmental disabilities
Rosemary B. Hughes Susan Robinson-Whelen Dora Raymaker Emily M. Lund Mary Oschwald Marsha Katz Albert Starr Elesia Ashkenazy Laurie E. Powers Christina Nicolaidis 《Disability and health journal》2019,12(2):227-234
Background
People with developmental disabilities are at disproportionately high risk of abuse. Although considerable evidence exists on the health-related consequences of abuse in the general population, little is known about those consequences in people with developmental disabilities.Objective
To examine the relation of abuse with psychological and physical health outcomes in adults with developmental disabilities.Methods
We used an accessible audio computer-assisted self-interview to collect anonymous data on demographic and disability characteristics, childhood and adult abuse experiences, and physical and psychological health from 350 women and men with developmental disabilities. Abuse experience was reflected by five factor scores consisting of three child abuse factors (childhood sexual abuse, childhood physical abuse, childhood disability-related abuse) and two adult abuse factors (adult sexual abuse, adult mixed abuse). We examined each of four health outcomes (depression, post trraumatic stress disorder, physical health symptoms, secondary health conditions) separately to determine the extent to which childhood and adult abuse experiences uniquely predicted psychological and physical health outcomes above and beyond demographic and disability-related characteristics.Results
All five abuse factor scores were significantly related to all four health outcomes. When examined simultaneously, childhood disability-related abuse and adult mixed abuse accounted for unique variance in outcomes. Exploratory analyses revealed no difference in the impact of abuse by gender.Conclusions
In this study, childhood disability-related abuse and adult mixed abuse significantly predicted lower levels of psychological and physical health in a sample of adults with developmental disabilities. Our findings highlight the importance of addressing abuse and its sequalae in the developmental disabilities community. 相似文献17.
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Susan M.H. Gills Garry Auld Ann Hess Susan S. Baker 《Journal of the Academy of Nutrition and Dietetics》2019,119(3):500-506
Background
The Expanded Food and Nutrition Education Program (EFNEP) is a federally funded, community nutrition education program that assists the low-income population in acquiring knowledge and skills related to nutrition, food safety, food resource management, food security, and physical activity. Evaluation of EFNEP includes a 24-hour dietary recall (24HDR) administered by paraprofessional educators, yet protocols for most large-scale nutrition research studies employ registered dietitian nutritionists (RDNs) or individuals with educational backgrounds in nutrition or related fields to collect dietary recalls.Objective
To compare 24HDRs collected by trained paraprofessional educators with recalls collected by an RDN.Design
Exploratory cross-over study comparing same-day 24HDR in a one-on-one setting collected by paraprofessional educators and an RDN. Paired recalls were separated by at least 1 hour.Participants and setting
The participants (n=41) were volunteer women who were eligible for participation in EFNEP in two states.Main outcome measures
The 24HDRs were compared for energy, macronutrients, micronutrients, and food groups.Statistical analysis performed
Mixed-model analysis to account for repeated measures. Intraclass correlation and Spearman correlation coefficients to determine interrater agreement.Results
No difference in 24HDR was seen when compared by interviewer (paraprofessional vs RDN) or by site (Colorado vs North Carolina). There were significant differences in four components (energy, total fat, saturated fat, and solid fats-added sugar) based on recall order, with a higher intake in the second recall compared with the first.Conclusion
The results of this preliminary study suggest that a well-trained paraprofessional educator using a valid methodology can collect a 24HDR that is similar to a recall collected by an RDN. The paraprofessional educator can be employed for dietary data collection, allowing the RDN to focus on more advanced aspects of scope of practice, such as data evaluation and program development. 相似文献19.
Background
This research deals with the way people create discourses around disability, which shape the community's concept of disability.Objective
The purpose of this article is to find out how the community configures "disability", in particular by understanding the ideas, needs and strategies that the community uses towards people with disabilities. Specifically, different roles have been involved, such as professionals, volunteers, family members and citizens. The final aim is intervening on the discourses that can contrast the full personal fulfilment of people with disabilities and social inclusion.Methods
This paper relates to discursive psychology's theoretical references and makes use of the Methodology of Textual Analysis. The tools we used include investigation protocols specially designed to detect text both through manual "pencil and paper" and computerized denominations.Results
The results show that those who are in direct contact with people with disabilities (volunteers and family members) are more exposed to treating them as disabled, making the deficit coincide with the person and also have a more judgemental approach.Conclusions
From the results obtained we can see which practices can be activated to facilitate the network between the various roles in order to implement inclusive interventions and help those more exposed to prejudices. 相似文献20.
Nicole Fran Kahn Chirayath M. Suchindran Carolyn Tucker Halpern 《Disability and health journal》2019,12(2):155-163