Reviewing the evidence on vasomotor symptoms: the role of traditional and non-traditional factors.

This narrative review aims to synthesize evidence on factors that may influence the severity, occurrence, and incidence of vasomotor symptoms (VMS) that encompass hot flashes and/or night sweats. A comprehensive literature search was conducted electronically using Web of Science, Ovid MEDLINE, PubMed, and Google Scholar to retrieve all English language studies on predictors of VMS from 2000 to 2018. Studies evaluating treatment options for VMS, studies of women with comorbidities such as breast cancer or osteoporosis, studies on VMS outcomes, and studies on quality of life among women with VMS were excluded. After screening, 88 articles were reviewed. Findings showed that different factors such as biological, demographic, behavioral, social, and non-traditional were associated with VMS. The most consistent risk factors of VMS were: being in later menopausal stages, smoking, lower socioeconomic status, higher follicle stimulating hormone levels, ethnicity, and higher body mass index. Most studies were either cross-sectional or observational in design, and were conducted in western countries. A more nuanced understanding of the factors contributing to VMS can assist clinicians in screening women for optimal VMS counseling and treatment. This review found that further large-scale studies set in developing countries that examine VMS factors are warranted.

Factors associated with complementary and alternative medicine use among women at midlife.

Hormone replacement therapy (HRT) has been established as the first-line treatment for women experiencing menopausal symptoms. The use of complementary and alternative medicine (CAM), however, is becoming increasingly popular among women at midlife for management of such symptoms. Despite the equivocal evidence of CAM's efficacy in the reduction and alleviation of menopausal symptoms in placebo-controlled, randomized trials, 50% of women at midlife use CAM. To date, several large, population-based studies have focused upon CAM use amongst menopausal women and the factors associated with the adoption of such therapies. By identifying women in the menopausal transition who tend to use CAM, this narrative review highlights evidence that aids women at this stage of life make better and individualized treatment choices to relieve these symptoms. The available evidence suggests that the prevalence of CAM use among menopausal women is high world-wide, but there is a paucity of high-quality studies that adequately assess the factors associated with its use. Further studies are needed to confirm the characteristics of women who employ CAM to manage their night sweats and hot flushes. Results of this study might enable the development of policies catering to the needs of those women and provide a resource to support their decision-making regarding treatment options.

Prevalence and characteristics of water-pipe smoking in Canada: results from the Canadian Tobacco Use Monitoring Survey.

OBJECTIVES: To investigate the prevalence and characteristics of water-pipe smoking (WPS) nationally in Canada. STUDY DESIGN: This study was a cross-sectional study. METHODS: Data from the Canadian Tobacco Use Monitoring Survey 2011 and 2012 was used. Outcomes investigated were ever and current WPS. Demographic, socio-economic and smoking-related variables were included in a multivariable logistic regression model to determine associations with the outcomes. RESULTS: Prevalence of WPS was 8.9% for ever and 0.8% for current WPS (1.8% among <18 years old and 4.0% among 18-24 years old). The highest prevalence of ever WPS was in Quebec (11.3%) and of current WPS in Alberta (1.2%). Age was the strongest predictor for WPS with an odds ratio = 47.86, 95% confidence interval: 37.97-60.33 for current WPS for those aged <18 years compared to 35 + years. Male gender, urban residence, being single, speaking another language at home (not English/French), higher education, cigarette smoking and marijuana use were also significantly associated with increased WPS. CONCLUSIONS: Multiple factors impact WPS, with the younger population having the highest prevalence. This necessitates further research into the attitudes of this age group to better focus health promotion efforts.

Inadequate prenatal care use among Canadian mothers: findings from the Maternity Experiences Survey.

OBJECTIVE: This study aims to investigate predictors of inadequate prenatal care (PNC) use among pregnant women in Canada. STUDY DESIGN: Data for this secondary analysis was drawn from the Maternity Experiences Survey, a cross sectional, nationally representative survey that assessed peri- and post-natal experiences of mothers aged 15 and above in the Canadian provinces and territories. PNC use was measured by the Adequacy of Prenatal Care Utilization Index. Multivariate logistic regression analysis was conducted to determine socio-economic, demographic, maternal, delivery related and health service characteristics associated with inadequate PNC use. RESULTS: Prevalence of inadequate PNC was at 18.9%. Regression analysis revealed that mothers who were immigrants (odds ratio (OR)=1.40; 95% (confidence interval) CI: 1.13-1.74), primiparous (OR=1.22; 95% CI: 1.04-1.44), smoked (OR=1.33; 95% CI: 1.04-1.69) or consumed alcohol (OR=1.32; 95% CI: 1.03-1.68) during their pregnancy were more likely to receive inadequate PNC. Mothers with a family doctor as PNC provider versus those with an obstetrician (OR=1.26; 95% CI: 1.08-1.48) were more likely to have inadequate PNC. CONCLUSIONS: This is the first nationwide study in Canada to examine the factors associated with inadequate PNC use. Results of this study may help design interventions that target women with profiles of socio-demographic and behavioral risk to optimize their PNC use.