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1.
Soins ; 66(855): 14-18, 2021 May.
Artículo en Francés | MEDLINE | ID: mdl-34103126

RESUMEN

The condition of women has vastly improved over recent decades: respect of equality, better salary conditions and health status. Although women, like men, are living longer, certain differences in care are emerging. This survey studies the characteristics of women's cardiovascular health, especially in terms of treatment and follow-up.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/terapia , Femenino , Estudios de Seguimiento , Estado de Salud , Humanos , Masculino , Salud de la Mujer
2.
Online braz. j. nurs. (Online) ; 20: e20216483, 05 maio 2021.
Artículo en Inglés, Español, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1223160

RESUMEN

OBJETIVO: Compreender as expectativas e vivências de mulheres primíparas no parto. MÉTODO: Trata-se de um estudo descritivo, qualitativo tendo como referencial teórico o Interacionismo Simbólico. A coleta de dados ocorreu por meio de oficinas, entrevista semiestruturada no pré e pós-parto. Os dados foram analisados por meio de análise de conteúdo. RESULTADOS: Participaram do estudo 11 mulheres no pré-parto e oficina e 05 no pós-parto. Foram identificadas duas categorias: Parto: experiência marcante; e Entre expectativas e vivências. DISCUSSÃO: Nas expectativas e na realidade, no momento do parto, estiveram presentes significados construídos e modificados pelas interações com profissionais e rede social. CONCLUSÃO: A vivência do parto pode ressignificar paradigmas culturais e sociais. A valorização das técnicas relacionais qualifica a assistência na direção da construção de significados e experiências.


OBJECTIVE: To understand expectations and experiences related to childbirth in primiparous women. METHODS: Descriptive and qualitative study that applied symbolic interactionism as a theoretical framework. Data were collected during workshops with the pregnant participants, and by semi-structured interviews carried out before and after childbirth. Content analysis was used to analyze the gathered information. RESULTS: Eleven pregnant women and five postpartum women participated in the study. Two categories were identified: Childbirth: a remarkable experience; and Among expectations and experiences. DISCUSSION: Meanings developed and modified by interactions with professionals and social networks were present during childbirth, in both expectations and reality. CONCLUSION: Experiencing childbirth can resignify cultural and social paradigms. Recognizing relational techniques can improve quality of care by the inclusion of the development of meanings and experiences.


OBJETIVO: Comprender las expectativas y vivencias del parto en mujeres primerizas. MÉTODO: Se trata de un estudio descriptivo, cualitativo, cuyo referencial teórico fue el Interaccionismo Simbólico. Los datos fueron recolectados mediante talleres y entrevistas semiestructuradas aplicadas antes y después del parto. Datos analizados utilizando análisis de contenido. RESULTADOS: Participaron del estudio 11 mujeres en el preparto y el taller, y 5 en el posparto. Fueron identificadas dos categorías: Parto: experiencia trascendente; y Expectativas y vivencias. DISCUSIÓN: En las expectativas en la realidad, al momento del parto estuvieron presentes significados construidos y modificados por las interacciones con los profesionales y con la red social. CONCLUSIÓN: La vivencia del parto puede resignificar paradigmas culturales y sociales. La valoración de las técnicas relacionales califica la atención en el camino a la construcción de significados y experiencias.


Asunto(s)
Humanos , Femenino , Embarazo , Trabajo de Parto/psicología , Parto/psicología , Mujeres Embarazadas/psicología , Emociones , Interaccionismo Simbólico , Salud de la Mujer , Investigación Cualitativa , Periodo Posparto
3.
Online braz. j. nurs. (Online) ; 2005 maio 2021. tab
Artículo en Inglés, Español, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1224610

RESUMEN

OBJETIVO: Associar as variáveis sociodemográficas de idosas com câncer cervical e estadiamento de um hospital de referência oncológica. MÉTODO: Estudo observacional, retrospectivo e analítico de 559 idosas. RESULTADOS: As variáveis que apresentaram correlação estatística significativa com o estadiamento do câncer do colo do útero foram: idosas casadas, o tipo histopatológico carcinoma de células escamosas, radioterapia + quimioterapia como primeiro tratamento recebido no hospital, remissão completa da doença ao final do primeiro tratamento, sem óbitos por câncer e nunca haver fumado. CONCLUSÃO: Embora algumas características estarem relacionadas à maior prevalência, não estavam associadas ao estadiamento, como idades mais avançadas. Tratamento precoce também foi um aspecto associado a estádios menos tardios. Desta forma o estudo reafirma a importância em conhecer as características epidemiológicas dessas idosas, pois favorece o planejamento e avaliação de programas efetivos no controle do câncer do colo do útero. 


OBJECTIVE: To associate the sociodemographic variables of elderly women with cervical cancer and staging of an oncology reference hospital. METHOD: An observational, retrospective analytical study of 559 elderly women. RESULTS: The variables that presented a statistically significant correlation with cervical cancer staging were: married elderly women, histopathological squamous cell carcinoma, radiotherapy + chemotherapy as the first treatment received in the hospital, complete remission of the disease at the end of the first treatment, without deaths from cancer and never having smoked. CONCLUSION: Although  some characteristics are related to higher prevalence, they were not associated with staging, such as older ages. Early treatment was also an aspect associated with less late staging. Thus, the study reaffirms the importance of knowing the epidemiological characteristics of these women, as it favors the planning and evaluation of effective programs in the control of cervical cancer. 


OBJETIVO: Asociar las variables sociodemográficas de mujeres ancianas con cáncer de cuello uterino y la estadificación de un hospital oncológico de referencia. MÉTODO: Estudio observacional, retrospectivo y analítico de 559 mujeres mayores.  RESULTADOS: Las variables que mostraron correlación estadísticamente significativa con la estadificación del cáncer de cuello uterino fueron: ancianas casadas, tipo histopatológico de carcinoma epidermoide, radioterapia + quimioterapia como primer tratamiento recibido en el hospital, remisión completa de la enfermedad al finalizar el primer tratamiento , sin muertes por cáncer y sin haber fumado nunca. CONCLUSIÓN: Aunque algunas características están relacionadas con una mayor prevalencia, no se asociaron con la estadificación, como la edad avanzada. El tratamiento temprano también fue un aspecto asociado con etapas menos tardías. Así, el estudio reafirma la importancia de conocer las características epidemiológicas de estas ancianas, ya que favorece la planificación y evaluación de programas efectivos en el control del cáncer cervicouterino.


Asunto(s)
Humanos , Femenino , Anciano , Anciano de 80 o más Años , Neoplasias del Cuello Uterino , Demografía , Salud del Anciano , Salud de la Mujer , Estadificación de Neoplasias , Instituciones Oncológicas , Estudios Retrospectivos
5.
Reprod Health ; 18(1): 99, 2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34020660

RESUMEN

OBJECTIVES: Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth. METHODS: This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women's and Children's Health Research. Bivariate comparisons and multivariable logistic regression were used to answer our study question, and the data was analyzed with STATA software v.15.1. RESULTS: Of 26,465 Guatemalan women enrolled in the registry, 2794 (10.6%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI, all p-values > p = 0.05. Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR ranged from 0.009 to 0.10), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2), but again IPI was not associated with the outcome. CONCLUSION: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.


Asunto(s)
Intervalo entre Nacimientos/estadística & datos numéricos , Cesárea/estadística & datos numéricos , Resultado del Embarazo/epidemiología , Parto Vaginal Después de Cesárea/estadística & datos numéricos , Adulto , Cesárea/efectos adversos , Niño , Salud del Niño , Estudios de Cohortes , Femenino , Guatemala/epidemiología , Humanos , Recién Nacido , Trabajo de Parto , Embarazo , Estudios Retrospectivos , Factores de Tiempo , Salud de la Mujer
6.
Reprod Health ; 18(1): 100, 2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34020669

RESUMEN

BACKGROUND: Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for desired outcomes. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to assess the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. METHODS: A community-based cross-sectional study was conducted from February 1 to 30, 2020. A total of 600 mothers who have given birth in the last 12 months have been randomly selected. A two-stage sampling technique was employed. For data collection, a pre-tested, semi-structured questionnaire was used. The data was encoded and entered into Epi-Data version 3.1 and exported for analysis to SPSS version 23. Household wealth status was determined through the application of principal component analysis(PCA). The practice PCC was considered as a count variable and measured as a minimum score of 0 and a maximum of 10. A bivariable statistical analysis was performed through analysis of variance (ANOVA) and independent t-tests and variables with a p-value of < 0.05 were eligible for the generalized linear regression model. To see the weight of each explanatory variable on PCC utilization, generalized linear regression with a Poisson link was done. RESULTS: Of the sampled 600 participants, 591 took part in the study, which yielded a response rate of 98.8%.The mean (± SD) score of the practice of PCC was 3.94 (± 1.98) with minimum and maximum scores of 0 and 10 respectively. Only 6.4% (95%CI: 4.6, 8.6) of mothers received all selected items of PCC services. Thecommonest item received by 67.2% of mothers was Folic acid supplementation, while 16.1% of mothers received the least item of optimizing psychological health. Education status of mother[AOR 0.74, 95%CI 0.63, 0.97], time spent to access nearby health facilities [AOR 0.69, 95%CI 0.58, 0.83], availability of PCC unit [AOR 1.46; 95%CI 1.17, 1.67], mother's knowledge on PCC [AOR 1.34, 95%CI 1.13, 1.65], being a model household [AOR 1.31, 95%CI 1.18, 1.52] and women's autonomy in decision making [AOR 0.75, 95%CI 0.64, 0.96] were identified as significant predictors of practice of PCC. CONCLUSION: The uptake of WHO-recommended PCC service elements in the current study area was found to be unsatisfactory. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice. Plain language summary Preconception care (PCC) is a series of biomedical, mental, and psycho-social health services provided to women and a couple before pregnancy and throughout subsequent pregnancies for better endings. The main goal of the PCC is to improve maternal and child health outcomes, by-promoting wellness and providing preventive care. It can also be seen as an earlier chance for teenage girls, mothers, and children to live a better and longer-term healthy life. Pieces of PCC service packages suggested by the World Health Organization(WHO) are, micronutrient supplementation (Folate supplementation), infectious disease (STI/HIV) screening and testing, chronic disease screening and management, healthy diet therapy, vaccination, prevention of substance use (cessation of cigarette smoking and too much alcohol consumption), optimizing psychological health, counseling on the importance of exercise and reproductive health planning and implementation. Millions of women and new-borns have died in low-income countries due to impediments that arise before and exaggerate during pregnancies that are not deal with as part of pre-conception care. To the best of our knowledge, however, there is a lack of information about preconception care practice and its determinants in southern Ethiopia, including the study area. This study was therefore planned to evaluate the practice of preconception care and its determinants among mothers who recently gave birth in Wolkite town, southern Ethiopia, in 2020. Mothers who have given birth in the last 12 months have been randomly selected Household wealth status was determined through the application of principal component analysis(PCA). To see the weight of each explanatory variable on PCC, generalized linear regression with a Poisson type was done. Accordingly, the Education status of the mother, time spent to access nearby health facilities, availability of PCC unit, mother's knowledge on PCC, being a model household, and women's autonomy in decision making were identified as significant predictors of practice of PCC. Stakeholders must therefore increase their efforts to align PCC units with existing MNCH service delivery points, improve women's decision-making autonomy, and focus on behavioral change communication to strengthen PCC practice.


Asunto(s)
Atención a la Salud/organización & administración , Instituciones de Salud/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Aceptación de la Atención de Salud/psicología , Atención Preconceptiva/métodos , Atención Preconceptiva/estadística & datos numéricos , Salud Reproductiva , Adolescente , Adulto , Niño , Estudios Transversales , Etiopía , Femenino , Humanos , Masculino , Embarazo , Salud de la Mujer
7.
Reprod Health ; 18(1): 106, 2021 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-34039342

RESUMEN

BACKGROUND: Male involvement in maternal healthcare has been widely recognized as essential for positive health outcomes for expectant mothers and their unborn babies. However, few studies have explored men's experiences of maternal health services. The purpose of this paper is to explore men's involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of space, place, and gender. METHODS: A qualitative exploratory study using semistructured interviews, focus group discussion, and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed, and observation was conducted at a selected public hospital in Accra. RESULTS: The findings suggest that the few men who attend antenatal care with their expecting partners become involved to a limited extent in the clinic's activities. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds and rarely participate in consultations with their partner and midwife. Men still view their presence as necessary to acquire knowledge and as sources of emotional, financial, and physical support for their partners. On the health workers' side, the study found no clear agenda for engaging men at the clinic, and nurses/midwives felt there was a lack of staff who could engage more directly with the men. CONCLUSION: The study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care/maternity wards. Health workers do not feel they have the necessary resources to involve men fruitfully. Thus, men do not engage in the activity as hoped but rather remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space in which both expecting mothers and fathers can actively participate and be engaged to the benefit of all.


Asunto(s)
Padre/psicología , Servicios de Salud Materna , Hombres/psicología , Atención Prenatal , Adulto , Salud del Niño , Femenino , Grupos Focales , Ghana , Humanos , Entrevistas como Asunto , Masculino , Embarazo , Investigación Cualitativa , Rol , Salud de la Mujer
8.
Reprod Health ; 18(1): 109, 2021 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-34049572

RESUMEN

BACKGROUND: Pelvic inflammatory disease (PID) is the inflammation of the adnexa of the uterus, that mainly manifests in a subclinical/chronic context and goes largely underreported. However, it poses a major threat to women's health, as it is responsible for infertility and ectopic pregnancies, as well as chronic pelvic pain. Previous studies in Jordan have not reported PID, attributed mainly to the social structure of the country which largely represents a sexually conservative population. Our study aims to report the clinical symptoms that point towards PID and investigate the major risk determinants for the Jordanian population, in a cross-sectional study, using our scoring system based only on clinical data and examination. METHODS: One hundred sixty-eight consecutive adult women that came in the Outpatient Clinics of Gynaecological Department of the Jordan University Hospital were interviewed and their medical history and symptoms were registered and analysed. A Score for PID symptoms, we developed, was given to each woman. Results and correlations were then statistically tested. RESULTS: Our study population consisted of relatively young women (37.7 ± 11) that had their first child at an average age of 24.1 (± 4.8) and a mean parity of 3.1 (± 2.2). Fifty-eight women (34.5%) reported having undergone at least one CS, while the mean PID Symptom Score was 3.3 (± 2.3). The women in our study exhibited 8 symptoms of PID, namely dysmenorrhea and vaginal discharge; being the commonest (45.2% and 44.6% respectively), in addition to chronic pelvic pain, pelvic heaviness, menorrhagia, dyspareunia, urinary symptoms, and smelly urine. They also reported history of 3 conditions that can be attributed to PID, that is infertility, preterm labour, and miscarriages. CONCLUSIONS: Our PID Scoring System seems to identify the risk factors of PID and predict well the PID likelihood. This score predicts that women with higher parity, who used contraceptives and underwent any invasive medical procedure are expected to score higher in the PID Symptom Score. Our data also suggest that PID should not be ruled out in the Jordanian population when symptoms are compatible to this diagnosis.


Asunto(s)
Anticonceptivos/efectos adversos , Infertilidad Femenina/microbiología , Enfermedad Inflamatoria Pélvica/epidemiología , Dolor Pélvico/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Recién Nacido , Infertilidad Femenina/epidemiología , Jordania/epidemiología , Enfermedad Inflamatoria Pélvica/complicaciones , Dolor Pélvico/etiología , Embarazo , Prevalencia , Factores de Riesgo , Conducta Sexual , Salud de la Mujer , Adulto Joven
9.
AIDS Educ Prev ; 33(3): 169-186, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34014113

RESUMEN

The objective of this study was to evaluate the efficacy of two psychosocial interventions (Didactic and ACCENT) on socio-cognitive risk factors, in vulnerable Mozambican women at risk for HIV/AIDS infection. The study design was a randomized controlled trial on Mozambican women at HIV/AIDS risk (n = 150). The participants were randomized into three groups: Didactic Intervention (experimental group), ACCENT intervention (experimental group), and control group. We used an adapted version of the Women's Health Questionnaire, which includes a series of scales and questionnaires assessing psychosocial relevant dimensions to female protection towards HIV/AIDS: HIV/AIDS knowledge, condom use negotiation self-efficacy, and perceived barriers against safer sex. Both interventions were equally effective in increasing HIV/AIDS knowledge. The ACCENT intervention was especially effective in promoting condom use negotiation self-efficacy and in decreasing perceived barriers against safer sex, essential variables for sexual protection. These results support the adaptation of Western interventions to the African context.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Negociación , Intervención Psicosocial , Autoeficacia , Adolescente , Adulto , Cognición , Femenino , Promoción de la Salud , Humanos , Factores de Riesgo , Sexo Seguro , Conducta Sexual/psicología , Salud Sexual , Encuestas y Cuestionarios , Salud de la Mujer
10.
Menopause ; 28(6): 610-618, 2021 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-33950030

RESUMEN

OBJECTIVE: To assess the utility of cardiovascular disease (CVD) risk scores compared to age or years since menopause for prediction of CVD events in the WHI clinical trials. METHODS: Briefly, in the randomized clinical trial 27,347 postmenopausal women age 50 to 79 years entered from 1993 to 1998. Women with a uterus (16,608) were randomized to receive daily oral conjugated equine estrogen (CEE) (0.625 mg) plus medroxyprogesterone acetate (2.5 mg) (5.7 years or placebo), while women with a hysterectomy (10,739) were randomized to receive daily oral CEE (0.625 mg) alone or placebo (7.2 y). CVD risk scores were assessed at baseline and CVD events were adjudicated throughout the follow-up period to the end of the main study phase and to the end of cumulative follow-up. The median follow-up time after the start of the randomized clinical trial to the end of the main study phase was 8.2 years. The median follow-up time to the end of cumulative follow-up was 17.6 years. We compared The American Heart Association/American College of Cardiology (AHA/ACC) and Framingham Heart Study risk scores to age or years since menopause all obtained at baseline to predict subsequent CVD events. The absolute event rates, hazard ratios, and C-statistics (Uno Concordance from Cox proportional models) were compared. RESULTS: Overall, the hazard ratios for CVD events were highest with calculated CVD scores calculated at trial onset both at the end of the main study (ranging from 2.02 to 10.8 for Q2-Q5, compared to Q1) and at cumulative follow-up (ranging from 1.76 to 8.86 for Q2-Q5, compared to Q1). While older age and years since menopause at baseline were also associated with higher CVD event rates, better risk prediction was accomplished by using CVD risk scores. The Framingham Heart Study BMI score had the highest C-statistic at the end of the main study (0.711) and after 17.6 years through the end of follow-up (0.689). CONCLUSIONS: CVD risk scores can help identify postmenopausal women at higher risk for CVD beyond age or time since menopause. Risk scoring that better estimates vascular aging may facilitate CVD risk prevention. When performed prior to initiation of menopausal hormone therapy, scores can better inform HT risk/benefit discussions.


Asunto(s)
Enfermedades Cardiovasculares , Anciano , Enfermedades Cardiovasculares/epidemiología , Terapia de Reemplazo de Estrógeno , Estrógenos Conjugados (USP) , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Posmenopausia , Factores de Riesgo , Salud de la Mujer
12.
BMC Public Health ; 21(1): 909, 2021 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-33980197

RESUMEN

BACKGROUND: Gender is a crucial consideration of human rights that impacts many priority maternal health outcomes. However, gender is often only reported in relation to sex-disaggregated data in health coverage surveys. Few coverage surveys to date have integrated a more expansive set of gender-related questions and indicators, especially in low- to middle-income countries that have high levels of reported gender inequality. Using various gender-sensitive indicators, we investigated the role of gender power relations within households on women's health outcomes in Simiyu region, Tanzania. METHODS: We assessed 34 questions around gender dynamics reported by men and women against 18 women's health outcomes. We created directed acyclic graphs (DAGs) to theorize the relationship between indicators, outcomes, and sociodemographic covariates. We grouped gender variables into four categories using an established gender framework: (1) women's decision-making, (2) household labor-sharing, (3) women's resource access, and (4) norms/beliefs. Gender indicators that were most proximate to the health outcomes in the DAG were tested using multivariate logistic regression, adjusting for sociodemographic factors. RESULTS: The overall percent agreement of gender-related indicators within couples was 68.6%. The lowest couple concordance was a woman's autonomy to decide to see family/friends without permission from her husband/partner (40.1%). A number of relationships between gender-related indicators and health outcomes emerged: questions from the decision-making domain were found to play a large role in women's health outcomes, and condoms and contraceptive outcomes had the most robust relationship with gender indicators. Women who reported being able to make their own health decisions were 1.57 times (95% CI: 1.12, 2.20) more likely to use condoms. Women who reported that they decide how many children they had also reported high contraception use (OR: 1.79, 95% CI: 1.34, 2.39). Seeking care at the health facility was also associated with women's autonomy for making major household purchases (OR: 1.35, 95% CI: 1.13, 1.62). CONCLUSIONS: The association between decision-making and other gender domains with women's health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. Future studies should integrate and analyze gender-sensitive questions within coverage surveys.


Asunto(s)
Salud Materna , Salud de la Mujer , Niño , Toma de Decisiones , Composición Familiar , Femenino , Humanos , Renta , Masculino , Tanzanía
13.
Curr Neurol Neurosci Rep ; 21(7): 34, 2021 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-33970361

RESUMEN

PURPOSE OF REVIEW: The menstrual cycle involves recurrent fluctuations in hormone levels and temperature via neuroendocrine feedback loops. This paper reviews the impact of the menstrual cycle on several common neurological conditions, including migraine, seizures, multiple sclerosis, stroke, and Parkinson's disease. RECENT FINDINGS: The ovarian steroid hormones, estrogen and progesterone, have protean effects on central nervous system functioning that can impact the likelihood, severity, and presentation of many neurological diseases. Hormonal therapies have been explored as a potential treatment for many neurological diseases with varying degrees of evidence and success. Neurological conditions also impact women's reproductive health, and the cessation of ovarian function with menopause may also alter the course of neurological diseases. Medication selection must consider hormonal effects on metabolism and the potential for adverse drug reactions related to menstruation, fertility, and pregnancy outcomes. Novel medications with selective affinity for hormonal receptors are desirable. Neurologists and gynecologists must collaborate to provide optimal care for women with neurological disorders.


Asunto(s)
Ciclo Menstrual , Trastornos Migrañosos , Estrógenos , Femenino , Humanos , Menopausia , Embarazo , Salud de la Mujer
14.
BMC Womens Health ; 21(1): 217, 2021 05 22.
Artículo en Inglés | MEDLINE | ID: mdl-34022858

RESUMEN

BACKGROUND: Sexual assault is a prevalent crime against women globally with known negative effects on health. Recent media reports in Canada indicate that many sexual assault reports are not believed by police. Negative reporting experiences of sexual assault have been associated with secondary victimization and trauma among survivors. However, little is known about the impact that being sexually assaulted and not believed by police has on a survivor's health and well-being. The purpose of this study was to explore women's experiences of not being believed by police after sexual assault and their perceived impact on health. METHODS: We conducted open-ended and semi-structured interviews with 23 sexual assault survivors who were sexually assaulted and not believed by police. The interviews explored the self-reported health impacts of not being believed by police and were conducted from April to July, 2019. All interviews were audio-recorded, transcribed, and entered into NVIVO for analysis. Data were analyzed using Colaizzi's analytic method. RESULTS: Analysis revealed three salient themes regarding the health and social impact of not being believed by police on survivors of sexual assault: (1) Broken Expectations which resulted in loss of trust and secondary victimization, (2) Loss of Self, and (3) Cumulative Health and Social Effects. The findings showed that not being believed by police resulted in additional mental and social burdens beyond that of the sexual assault. Many survivors felt further victimized by police at a time when they needed support, leading to the use taking of alcohol and/or drugs as a coping strategy. CONCLUSION: Reporting a sexual assault and not being believed by police has negative health outcomes for survivors. Improving the disclosure experience is needed to mitigate the negative health and social impacts and promote healing. This is important for police, health, and social service providers who receive sexual assault disclosures and may be able to positively influence the reporting experience and overall health effects.


Asunto(s)
Víctimas de Crimen , Delitos Sexuales , Canadá , Femenino , Humanos , Policia , Sobrevivientes , Salud de la Mujer
15.
Washington, D.C.; OPS; 2021-05-11.
en Español | PAHO-IRIS | ID: phr-53920

RESUMEN

[Introducción]. En el informe Situación de la enfermería en el mundo 2020: invertir en educación, empleo y liderazgo, publicado el mismo año por la Organización Mundial de la Salud (OMS), se estima que hay en el mundo cerca de 28 millones de profesionales de la enfermería, un número que representa más de la mitad de los profesionales de la salud. También se destaca que sigue existiendo un défi cit mundial de 5,9 millones de profesionales de la enfermería, la mayoría en países de África, Asia Sudoriental y la Región del Mediterráneo Oriental de la OMS, así como en algunos países de América Latina. Las acciones necesarias para disminuir el défi cit de estos profesionales son aumentar la inversión nacional para evitar una situación de escasez mundial, incrementar el número de graduados en enfermería, mejorar las opciones de empleo y retener a los profesionales en el sistema de salud. El informe también concluye que invertir en profesionales de enfermería y de partería permitirá lograr mejoras en el campo de la salud, pero también contribuirá a mejorar la calidad de la educación, promoverá la igualdad de género y garantizará el trabajo decente y el crecimiento económico, logros todos ellos en línea con los Objetivos de Desarrollo Sostenible. La OMS declaró el 2020 Año Internacional de los Profesionales de Enfermería y de Partería. Sin embargo, los planes de celebración resultaron afectados por el intenso trabajo de los profesionales durante la pandemia de COVID-19, declarada el 11 de marzo del 2020 por la OMS. En consecuencia, la OMS declaró el 2021 Año Internacional de los Trabajadores y Cuidadores de la Salud. La pandemia de COVID-19 ha evidenciado las desigualdades y las inequidades que existen en los sistemas de salud y en los países de la Región de las Américas. Los países han implementado medidas de salud pública no farmacológicas durante la respuesta a la pandemia, entre ellas el confi namiento domiciliario y el cierre de escuelas y negocios, que han tenido distintos efectos sobre las condiciones sociales, económicas y culturales de los diferentes grupos de población. En los países donde el acceso a la salud ha resultado aún más afectado por la pandemia, los profesionales y cuidadores de la salud han personifi cado una de las mejores respuestas para poder combatirla...


Asunto(s)
Servicios de Enfermería , Salud de la Mujer , Partería , Enfermería en Salud Pública , Atención a la Salud , Enfermería de Atención Primaria , Poblaciones Vulnerables , Enfermería en Salud Comunitaria , Zonas Remotas , Américas , COVID-19
16.
Nursing (Säo Paulo) ; 24(275): 5484-5495, abr.-2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1223669

RESUMEN

Objetivo: avaliar a assistência às gestantes na atenção primária à saúde e a adequação das consultas de pré-natal. Método: trata-se de uma revisão integrativa de literatura, descritiva de abordagem qualitativa, realizada no ano de 2019. Utilizou-se artigos da Biblioteca Virtual em Saúde (BVS), através dos seguintes descritores padronizados no DeCS: qualidade da assistência à saúde, cuidado pré-natal e saúde da mulher, resultando em 107 artigos. Após filtragem com os critérios de inclusão/exclusão, seguida de uma leitura criteriosa em resposta ao problema de pesquisa, totalizou numa amostra de 14 artigos. Resultados: destes, onze artigos tiveram em suas conclusões a necessidade de mudanças no acompanhamento pré-natal. Conclusão: a pesquisa possibilitou a visualização das dificuldades relacionadas à gestão, a união da equipe multiprofissional, da capacitação e aperfeiçoamento dos profissionais de saúde, da melhoria das consultas de pré-natal e também da diferença na qualidade da assistência prestada às mulheres negras e indígenas.(AU)


Objective: to evaluate the assistance to pregnant women in primary health care and the adequacy of prenatal consultations. Method: this is an integrative literature review, descriptive of a qualitative approach, carried out in 2019. Articles from the Virtual Health Library (VHL) were used, using the following standardized descriptors in DeCS: quality of health care, prenatal care and women's health, resulting in 107 articles. After filtering with the inclusion / exclusion criteria, followed by a careful reading in response to the research problem, it totaled a sample of 14 articles. Results: of these, eleven articles had in their conclusions the need for changes in prenatal care. Conclusion: the research made it possible to visualize the difficulties related to management, the unification of the multidisciplinary team, the training and improvement of health professionals, the improvement of prenatal consultations and also the difference in the quality of care provided to black and indigenous women.(AU)


Objetivo: evaluar la atención a la gestante en la atención primaria de salud y la adecuación de las consultas prenatales. Método: se trata de una revisión de literatura integradora, descriptiva de abordaje cualitativo, realizada en 2019. Se utilizaron artículos de la Biblioteca Virtual en Salud (BVS), utilizando los siguientes descriptores estandarizados en DeCS: calidad de la atención en salud, atención prenatal y salud de la mujer, resultando en 107 artículos. Luego de filtrar con los criterios de inclusión / exclusión, seguido de una lectura atenta en respuesta al problema de investigación, totalizó una muestra de 14 artículos. Resultados: de estos, once artículos tenían en sus conclusiones la necesidad de cambios en la atención prenatal. Conclusión: la investigación permitió visualizar las dificultades relacionadas con la gestión, la unificación del equipo multidisciplinario, la formación y perfeccionamiento de los profesionales de la salud, el mejoramiento de las consultas prenatales y también la diferencia en la calidad de la atención brindada a mujeres negras e indígenas.(AU)


Asunto(s)
Humanos , Femenino , Embarazo , Atención Prenatal , Atención Primaria de Salud , Calidad de la Atención de Salud , Salud de la Mujer , Salud Materno-Infantil , Mujeres Embarazadas
17.
Cell Host Microbe ; 29(4): 543-545, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33857416

RESUMEN

In many parts of the world, women are co-infected with intestinal helminths and sexually transmitted pathogens. In this issue of Cell Host & Microbe, Chetty et al. demonstrate that intestinal helminth infection increases epithelial damage and pathology associated with herpes virus infection.


Asunto(s)
Coinfección , Helmintiasis , Helmintos , Virosis , Animales , Eosinófilos , Femenino , Helmintiasis/complicaciones , Herpesvirus Humano 2 , Humanos , Salud de la Mujer
18.
PLoS One ; 16(4): e0249780, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33882096

RESUMEN

Pregnant and postpartum women face unique challenges during the COVID-19 pandemic that may put them at elevated risk of mental health problems. However, few large-scale and no cross-national studies have been conducted to date that investigate modifiable pandemic-related behavioral or cognitive factors that may influence mental health in this vulnerable group. This international study sought to identify and measure the associations between pandemic-related information seeking, worries, and prevention behaviors on perinatal mental health during the COVID-19 pandemic. An anonymous, online, cross-sectional survey of pregnant and postpartum women was conducted in 64 countries between May 26, 2020 and June 13, 2020. The survey, available in twelve languages, was hosted on the Pregistry platform for COVID-19 studies (https://corona.pregistry.com) and advertised in social media channels and online parenting forums. Participants completed measures on demographics, COVID-19 exposure and worries, information seeking, COVID-19 prevention behaviors, and mental health symptoms including posttraumatic stress via the IES-6, anxiety/depression via the PHQ-4, and loneliness via the UCLA-3. Of the 6,894 participants, substantial proportions of women scored at or above the cut-offs for elevated posttraumatic stress (2,979 [43%]), anxiety/depression (2,138 [31%], and loneliness (3,691 [53%]). Information seeking from any source (e.g., social media, news, talking to others) five or more times per day was associated with more than twice the odds of elevated posttraumatic stress and anxiety/depression, in adjusted models. A majority of women (86%) reported being somewhat or very worried about COVID-19. The most commonly reported worries were related to pregnancy and delivery, including family being unable to visit after delivery (59%), the baby contracting COVID-19 (59%), lack of a support person during delivery (55%), and COVID-19 causing changes to the delivery plan (41%). Greater worries related to children (i.e., inadequate childcare, their infection risk) and missing medical appointments were associated with significantly higher odds of posttraumatic stress, anxiety/depression and loneliness. Engaging in hygiene-related COVID-19 prevention behaviors (face mask-wearing, washing hands, disinfecting surfaces) were not related to mental health symptoms or loneliness. Elevated posttraumatic stress, anxiety/depression, and loneliness are highly prevalent in pregnant and postpartum women across 64 countries during the COVID-19 pandemic. Excessive information seeking and worries related to children and medical care are associated with elevated symptoms, whereas engaging in hygiene-related preventive measures were not. In addition to screening and monitoring mental health symptoms, addressing excessive information seeking and women's worries about access to medical care and their children's well-being, and developing strategies to target loneliness (e.g., online support groups) should be part of intervention efforts for perinatal women. Public health campaigns and medical care systems need to explicitly address the impact of COVID-19 related stressors on mental health in perinatal women, as prevention of viral exposure itself does not mitigate the pandemic's mental health impact.


Asunto(s)
/epidemiología , Trastornos Mentales/epidemiología , Salud Mental , Embarazo/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Soledad/psicología , Persona de Mediana Edad , Pandemias , Parto/psicología , Atención Perinatal , Periodo Posparto/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Salud de la Mujer
19.
BMC Pregnancy Childbirth ; 21(1): 318, 2021 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-33882886

RESUMEN

BACKGROUND: The new Chinese fertility policy has recently received widespread public attention. However, there are few studies available on the comprehensive epidemiology of maternal and infant health with respect to the characteristic changes of childbearing women. In the study, we compared the maternal characteristics and pregnancy outcomes at different time points according to policy adjustments, accessed the possible relationship among these factors, and evaluated the impacts of these policies for medical and policy assistance. METHODS: This was a retrospective study. Data were collected from three representative hospitals in Zhejiang Province using stratified random sampling. The annual number of births, and maternal and child healthcare levels were the determining factors of sampling. Women who gave birth in November of 2012, 2014, and 2016 were recruited in accordance with the time of the change in the fertility policy, and we explored the differences in maternal socio-demographic characteristics, delivery mode and pregnancy outcomes. RESULTS: A total of 11,718 women were recruited, including 3480, 4044, and 4194 in November of 2012, 2014, and 2016, respectively. The proportions of multiparous women, women who aged ≥35 years, who received higher education, who had previous cesarean sections (CS), and who delivered in a high level hospital increased over time. In 2016, multipara accounted for 49.12, 14.47% were aged ≥35 years, nearly half of women had previous CS and delivered in a provincial hospital, 41.73% gave birth by CS, and 31.62% suffered pregnancy complications. The results of multiple logistic regression mode showed CS risk decreased significantly in 2014 (ORadj = 0.62; 95% CI, 0.55-0.67) relative to 2012, and risks of pregnancy complications (ORadj = 2.30; 95% CI, 1.86-2.83) and multiple births (ORadj = 3.25; 95% CI, 2.19-4.83) only increased in 2016 compared to 2012. CONCLUSIONS: Some pregnancy outcomes increased as several key characteristics of childbearing women changed after China ended its "one-child" policy. This suggests that policy providers and medical staff need to strengthen healthcare in a consistent fashion regarding changes in birth policy.


Asunto(s)
Política de Planificación Familiar/legislación & jurisprudencia , Complicaciones del Embarazo , Resultado del Embarazo/epidemiología , Mujeres Embarazadas/psicología , Adulto , Cesárea/estadística & datos numéricos , China/epidemiología , Parto Obstétrico/métodos , Parto Obstétrico/estadística & datos numéricos , Demografía , Femenino , Humanos , Edad Materna , Parto/psicología , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/psicología , Factores Socioeconómicos , Salud de la Mujer
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