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Int J Equity Health ; 18(1): 158, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619244


BACKGROUND: There has been an increasing number of refugee women globally; yet, there is little recent data describing the health profile of refugee women by region of origin in the United States. It is important to monitor the health status of women by region of origin to provide needed targeted interventions. METHODS: We analyzed the Refugee Health Electronic Information System (RHEIS), a population-based dataset that included 14,060 female refugees who entered California between October 3, 2013 and February 15, 2017. We assessed differences in health status by region of origin. RESULTS: Almost one out of three women experienced a traumatic event. Women from Africa and Latin America and the Caribbean experienced higher levels of trauma compared to other regions, including sexual assault, physical, and weapon assault. More than half of women and girls (56.6%) reported experiences of persecution, with Southeast Asians reporting the highest levels. Among women of reproductive age, 7.0% of women were currently pregnant at the time of arrival to the US, 19.0% ever had a spontaneous abortion, and 8.6% reported ever having an abortion. One in three women from Africa reported female genital cutting. Moreover, 80.0% of women reported needing language assistance at the time of their health assessment. CONCLUSIONS: Refugee women and girls experience high levels of trauma and persecution, suggesting the need for trauma-informed care. Those working with refugee women, such as resettlement agencies and health providers, should be equipped with information about antenatal care, nutrition, and pregnancy to newly arrived women. Lastly, differences in health status by region of origin indicate a need for tailored interventions and linguistically appropriate health information.

Nível de Saúde , Refugiados/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adolescente , Adulto , África/etnologia , California , Região do Caribe/etnologia , Conjuntos de Dados como Assunto , Feminino , Humanos , América Latina/etnologia , Gravidez , Adulto Jovem
BMC Womens Health ; 19(1): 113, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481033


BACKGROUND: Accurately measuring stigmatized experiences is a challenge across reproductive health research. In this study, we tested a novel method - the list experiment - that aims to reduce underreporting of sensitive events by asking participants to report how many of a list of experiences they have had, not which ones. We applied the list experiment to measure "self-managed abortion" - any attempt by a person to end a pregnancy on one's own, outside of a clinical setting - a phenomenon that may be underreported in surveys due to a desire to avoid judgement. METHODS: We administered a double list experiment on self-managed abortion to a Texas-wide representative sample of 790 women of reproductive age in 2015. Participants were asked how many of a list of health experiences they had experienced; self-managed abortion was randomly added as an item to half of the lists. A difference in the average number of items reported by participants between lists with and without self-managed abortion provided a population level estimate of self-managed abortion. In 2017, we conducted cognitive interviews with women of reproductive age in four states to understand how women (1) interpreted the list experiment question format, and (2) interpreted the list item on prior experiences attempting to self-manage an abortion. RESULTS: Results from this list experiment estimated that 8% of women of reproductive age in Texas have ever self-managed an abortion. This number was higher than expected, thus, the researchers conducted cognitive interviews to better understand how people interpreted the list experiment on self-managed abortion. Some women interpreted "on your own" to mean "without the knowledge of friends or family", as opposed to "without medical assistance", as intended. CONCLUSION: The list experiment may have reduced under-reporting of self-managed abortion; however, the specific phrasing of the list item may also have unintentionally increased reporting of abortion experiences not considered "self-managed." High participation in and comprehension of the list experiment, however, suggests that this method is worthy of further exploration as tool for measuring stigmatized experiences.

Aborto Induzido/psicologia , Anamnese/métodos , Saúde da Mulher/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Saúde Reprodutiva/estatística & dados numéricos , História Reprodutiva , Projetos de Pesquisa/normas , Estereotipagem , Texas
BMC Cancer ; 19(1): 807, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412822


BACKGROUND: The association between oral contraceptive (OC) use and long-term mortality remains uncertain and previous studies have reported conflicting findings. We aim to assess the long-term impact of OC use on all-cause and cancer-specific mortality. METHODS: Out of 49,259 participants, we analysed data on 2120 (4.3%) women diagnosed with first primary breast cancer between 1993 and 2012, in the Swedish Women's Lifestyle and Health Study. Kaplan-Meier plots were used to graph the hazard of mortality in association with oral contraceptives use, stage of disease and hormone receptors status at diagnosis. Cox proportional hazard model were used to estimate hazard ratios (HR) between OC use and all-cause mortality. The same association was studied for breast cancer-specific mortality by modelling the log cumulative mortality risk, adjusting for clinical stage at diagnosis, hormone receptor status, body mass index and smoking. RESULTS: Among 2120 women with breast cancer, 1268 (84%) reported ever use of OC and 254 died within 10 years of diagnosis. The risk of death for OC ever-users relative to never-users was: HR = 1.13 (95% CI: 0.66-1.94) for all-cause mortality and HR = 1.29 (95% CI: 0.53-3.18) for breast cancer-specific mortality. A high percentage of women (42.9%) were diagnosed at early stage disease (stage I). CONCLUSIONS: Among women with primary breast cancer, OC ever-users compared to never- users did not have a higher all-cause or breast cancer specific-mortality, after the adjustment of risk factors.

Neoplasias da Mama/mortalidade , Anticoncepcionais Orais , Saúde da Mulher/estatística & dados numéricos , Adolescente , Adulto , Idoso , Neoplasias da Mama/patologia , Causas de Morte , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
BMC Public Health ; 19(1): 1184, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31462316


BACKGROUND: Social capital is a multilevel construct impacting health. Community level social capital, beyond the neighborhood, has received relatively less attention. Moreover, the measurement of community level social capital has tended to make use of aggregated individual data, rather than observable community characteristics. METHODS: Herein, metropolitan religious adherence, as an observable community-level measure of social capital, is used. We match it to city of residence for 2826 women in the Fragile Families Childhood Wellbeing Study (a cohort study) who have lived continuously in that city during a nine-year period. Using ordered logistic regression with clustered standard errors to account for area effects, we look at the relationship between metropolitan religious adherence and self-rated health, while controlling for lagged individual, neighborhood, and socioeconomic factors, as well as individual level religious attendance. RESULTS: Religious adherence at the community level is positive and statistically significant; every 1% increase in area religiosity corresponds to a 1.2% increase in the odds of good health. CONCLUSIONS: These findings shed light on a possible pathway by which social capital may improve health, perhaps acting as a stress buffer or through spillover effects of reciprocity generated by exposure to religion.

Religião , Características de Residência/estatística & dados numéricos , Capital Social , Saúde da Mulher/estatística & dados numéricos , Adulto , Cidades , Feminino , Humanos , Estudos Retrospectivos , Estados Unidos
Obstet Gynecol Clin North Am ; 46(3): 399-408, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378284


An investment in assuring the health of women, before pregnancy, can reap improved health for women, children, and their families. A paradigm shift of health must occur if perinatal outcomes are to improve, moving beyond reactive care to preventive or preconception care. Preconception health is centered on an assumption a woman is planning on becoming pregnant. But for many women, pregnancy is unplanned and medical conditions may have a negative impact on the trajectory of pregnancy and health. A new paradigm focusing on prevention and wellness can prepare women for lifelong health and healthy perinatal outcomes.

Cuidado Pré-Concepcional , Saúde da Mulher , Adolescente , Grupos Étnicos , Feminino , Ácido Fólico , Humanos , Lactente , Saúde Mental , Cuidado Pré-Concepcional/estatística & dados numéricos , Gravidez , Complicações na Gravidez , Resultado da Gravidez , Fatores Socioeconômicos , Estados Unidos , Saúde da Mulher/estatística & dados numéricos , Adulto Jovem
Artigo em Inglês | MEDLINE | ID: mdl-31357386


Introduction: This study aims to investigate the association between gender discrimination in the workplace and pregnancy planning/childbirth experiences among working women in South Korea. Methods: We analyzed data from the Korean Longitudinal Survey of Women and Families (KLoWF) for the years 2007 to 2016. The study population consisted of 7996 working women, between the ages of 19 and 45. Gender discrimination was measured through the 6-item Workplace Gender Discrimination Scale, evaluating discrimination in terms of recruitment, promotions, pay, deployment, training and lay-offs. Multiple logistic regression analysis was employed to measure the association between gender discrimination and the pregnancy planning/childbirth experience. Results: Compared to individuals experiencing no discrimination in the workplace, those experiencing low [odds ratio (OR): 0.78, 95% confidence interval (95% CI) 0.61-0.99] or medium (OR: 0.69, 95% CI: 0.54-0.89) levels of discrimination had decreased odds of pregnancy planning. Likewise, individuals scoring low (OR: 0.70, 95% CI 0.54-0.92), medium (OR: 0.68, 95% CI: 0.51-0.92), or high (OR: 0.47, 95% CI: 0.27-0.80) levels of discrimination also had decreased odds of childbirth experience when compared to the no-experience group. When stratified by income, compared to individuals experiencing no discrimination in the workplace, those experiencing gender discrimination had decreased odds of pregnancy planning for low income (low OR: 0.64, 95% CI: 0.45-0.92; medium OR: 0.55, 95% CI: 0.52-0.97; high OR: 0.45, 95% CI: 0.24-0.87), medium income (medium OR: 0.53, 95% CI: 0.37-0.77; high OR: 0.29, 95% CI: 0.14-0.63), and high income groups (low OR: 0.64, 95% CI: 0.49-0.84; medium OR: 0.69, 95% CI: 0.52-0.92). Conclusions: The present study finds that gender discrimination in the workplace is associated with decreased odds of pregnancy planning/childbirth experience among working South Korean women. Furthermore, low and medium income groups were especially more likely to be affected by the level of gender discrimination in the workplace when planning pregnancy.

Parto/psicologia , Gravidez/psicologia , Saúde Reprodutiva/estatística & dados numéricos , Sexismo/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Mulheres Trabalhadoras/psicologia , Local de Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Emprego , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Estudos Longitudinais , Pessoa de Meia-Idade , Razão de Chances , Gravidez/estatística & dados numéricos , República da Coreia , Mulheres Trabalhadoras/estatística & dados numéricos , Adulto Jovem
MSMR ; 26(6): 20-27, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31237765


This report presents the incidence and prevalence of diagnosed female infertility among active component service women. During 2013-2018, 8,744 active component women of childbearing potential were diagnosed with infertility for the first time, resulting in an overall incidence of 79.3 cases per 10,000 person-years (p-yrs). Compared to their respective counterparts, women in their 30s, non-Hispanic blacks, those in healthcare and pilot/air crew occupations, Army personnel, and those who were married had the highest incidence rates. The incidence of diagnosed female infertility decreased from 85.1 per 10,000 p-yrs in 2013 to 63.6 per 10,000 p-yrs in 2018 despite a concurrent increase in the rate of fertility testing. During the surveillance period, the average annual prevalence of diagnosed female infertility was 1.6%. Of the service women who were diagnosed with infertility for the first time during the surveillance period, 1,808 (20.7%) delivered a live birth within 2 years after the incident infertility diagnosis. Current findings indicate that the prevalence of diagnosed female infertility among active component service women is lower than estimates of self-reported infertility from surveys of U.S. civilians and service women.

Infertilidade Feminina , Saúde Reprodutiva/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adulto , Feminino , Humanos , Incidência , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/epidemiologia , Militares/estatística & dados numéricos , Vigilância da População , Estados Unidos/epidemiologia
Gac. sanit. (Barc., Ed. impr.) ; 33(3): 222-228, mayo-jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183740


Objetivo: Describir los desafíos, recursos y estrategias del equipo de planificación familiar del Centro de Salud Polígono Sur de Sevilla en su atención a mujeres gitanas. Método: Estudio cualitativo descriptivo en el que se realizaron entrevistas en profundidad y grupos de discusión con todas las profesionales del programa, así como una revisión documental de este. La información fue analizada a partir del Roma Health Integration Policy Index, una herramienta que evalúa la titularidad, accesibilidad, sensibilidad y capacidad de cambio de los programas de salud para población gitana. Resultados: Las profesionales encuentran numerosos desafíos para implementar el programa de planificación familiar con mujeres gitanas debido a las características de las usuarias, así como a la baja sensibilidad del programa hacia ellas. La ausencia de actuaciones específicas para mujeres gitanas dentro del programa de planificación familiar establecido por el distrito sanitario obliga a las profesionales a desarrollar adaptaciones y estrategias que aseguren servicios de salud sexual y reproductiva de calidad para sus usuarias. Conclusión: Es necesario adaptar los programas de salud sexual y reproductiva dirigidos a mujeres gitanas a partir de: a) la detección, evaluación, sistematización y difusión de buenas prácticas; b) el desarrollo de actuaciones que contemplen las múltiples vulnerabilidades de esta población; c) el reconocimiento de profesionales que aboguen por la salud de estas mujeres dentro de sus organizaciones; y d) la promoción de la justicia reproductiva como fin último de estos programas

Objective: To describe the challenges, resources and strategies of the staff of the family planning programme of the Polígono Sur Healthcare Centre in Seville (Spain) in their care of Roma women. Method: This is a descriptive study in which in-depth interviews and discussion groups were held with all programme professionals, including a documentary review of the programme. The information was analyzed based on the Roma Health Integration Policy Index, a tool that evaluates the entitlement, accessibility, sensitivity and capacity for change of health programmes for the Roma population. Results: The professionals encountered multiple challenges to implement the family planning programme with Roma women due to the characteristics of the users and the low sensitivity of the programme towards them. The absence of specific actions for Roma women within the family planning programme, agreed to by the healthcare district, obliges professionals to develop adaptations and strategies to ensure quality sexual and reproductive health services for their users. Conclusions: It is necessary to adapt sexual and reproductive health programmes targeted at Roma women by (a) detecting, evaluating, systematizing and disseminating good practices, (b) developing actions that address the multiple vulnerabilities of Roma women, (c) acknowledging professionals who advocate for the health of these women within their organizations, and (d) promoting reproductive justice as the goal of these programmes

Humanos , Feminino , Saúde Sexual e Reprodutiva , Saúde das Minorias Étnicas , Saúde da Mulher/estatística & dados numéricos , Planejamento Familiar , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Roma (Grupo Étnico)/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , História Reprodutiva , Estratégias Locais , Gravidez não Planejada , Epidemiologia Descritiva
J. Health NPEPS ; 4(1): 242-257, jan.-jun. 2019. tab
Artigo em Português | LILACS | ID: biblio-999693


Objetivo: descrever o perfil de saúde de mulheres atendidas em estratégias saúde da família em Mato Grosso. Método: estudo transversal, descritivo e com abordagem quantitativa, realizada com 261 mulheres. A coleta de dados ocorreu no período de setembro a dezembro de 2017, por meio da aplicação de questionário estruturado, que abrangeu características sóciodemográficas, estilo de vida, nutrição e fatores de riscos específicos. Para análise de dados, utilizou-se estatística descritiva, Teste de Mann Whitney e ANOVA, considerando nível de significância de 5%, que foi realizado através do programa Epi Info. Resultados: houve predomínio na faixa etária entre 25 a 44 anos (34,1%). A realização de atividade física foi referida por 36,4%, prática do tabagismo por 10,3% e a ingestão de bebidas alcoólicas por 20,3% das mulheres. A medida da circunferência abdominal encontrava-se inadequada em 47,9% das mulheres. Conclusão: as condições de saúde das participantes, relacionadas principalmente aos hábitos de vida, caracterizaram um perfil de risco para desenvolvimento de doenças crônicas não transmissíveis. Conhecer o perfil das mulheres atendidas na ESF contribui para o planejamento de estratégias educativas a esta população.(AU)

Objective: to describe the health profile of women assisted in family health strategies (FHS) in Mato Grosso. Method: a cross-sectional, descriptive study with a quantitative approach was performed with 261 women. Data collection took place in the period from September to December 2017, through the application of a structured questionnaire, which covered sociodemographic characteristics, lifestyle, nutrition and specific risk factors. For data analysis, descriptive statistics, Mann Whitney test and ANOVA were carried out considering a level of significance of 5%, which was performed through the Epi Info program. Results: there was predominance in the age group between 25 and 44 years (34.1%). Physical activity was reported by 36.4%, smoking practice by 10.3% and alcoholic beverages by 20.3% of women. Measurement of abdominal circumference was inadequate in 47.9% of women. Conclusion: the health conditions of the participants, related mainly to the habits of life, characterized a risk profile for the development of chronic noncommunicable diseases. Knowing the profile of the women attended at the FHS contributes to the planning of educational strategies for this population.(AU)

Objetivo: describir el perfil de salud de mujeres atendidas en estrategias salud de la familia en Mato Grosso. Método: estudio transversal, descriptivo y con abordaje cuantitativo, realizado con 261 mujeres. La recolección de datos ocurrió en el período de septiembre a diciembre de 2017, a través de la aplicación de cuestionario estructurado, que abarcó características sóciodemográficas, estilo de vida, nutrición y factores de riesgo específicos. Para análisis de datos, se utilizó estadística descriptiva, Prueba de Mann Whitney y Anova, considerando nivel de significancia del 5%, que fue realizado a través del programa Epi Info. Resultados: hubo predominio en el grupo de edad entre 25 a 44 años (34,1%). La realización de actividad física fue referida por el 36,4%, práctica del tabaquismo por el 10,3% y la ingestión de bebidas alcohólicas en el 20,3% de las mujeres. La medida de la circunferencia abdominal se encontraba inadecuada en el 47,9% de las mujeres. Conclusión: las condiciones de salud de las participantes, relacionadas principalmente con los hábitos de vida, caracterizaron un perfil de riesgo para el desarrollo de enfermedades crónicas no transmisibles. Conocer el perfil de las mujeres atendidas en la ESF contribuye a la planificación de estrategias educativas a esta población.(AU)

Humanos , Feminino , Perfil de Saúde , Saúde da Mulher/estatística & dados numéricos , Estratégia Saúde da Família , Epidemiologia Descritiva , Estudos Transversais
Med Clin North Am ; 103(4): 699-711, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078201


Gender-related alcohol and drug abuse problems are related not only to biological differences, but also to social and environmental factors, which can influence the clinical presentation, consequences of use, and treatment approaches. Women are becoming the fastest-growing population of substance abusers in the United States. Given that women experience a more rapid progression of their addiction than men, it is important that we understand and address the differences to help develop prevention and treatment programs that are tailored for women, incorporating trauma assessment and management, identification and intervention for medical and psychiatric comorbidities, financial independence, pregnancy, and child care.

Comportamento Aditivo/epidemiologia , Comportamento Aditivo/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Saúde da Mulher/estatística & dados numéricos , Adulto , Feminino , Nível de Saúde , Humanos , Masculino , Caracteres Sexuais , Distribuição por Sexo , Fatores Sexuais , Problemas Sociais , Estados Unidos
Med Clin North Am ; 103(4): 751-766, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078205


Reproductive rights are essential to the recognition/treatment of women as full-fledged human beings/citizens. Barriers to reproductive rights pose a grave danger to women's well-being. This article explores the origins of these barriers, their nature, and their impact on mental health. The most controversial relationship is between induced abortion and mental health. Barriers, misinformation, and coercion affecting contraceptive, abortion, and pregnancy care are an ongoing danger to women's mental health and the well-being of their families. Mental health professionals are best qualified, and have an obligation, to know the facts, apply them, and provide accurate information to protect women's health.

Direitos Sexuais e Reprodutivos/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Direitos da Mulher/estatística & dados numéricos , Aborto Induzido/psicologia , Feminino , Humanos , Saúde Mental , Defesa do Paciente/estatística & dados numéricos , Direitos Sexuais e Reprodutivos/psicologia
Artigo em Inglês | MEDLINE | ID: mdl-30991645


Lifestyle behaviours have an important role in preventing cancer, reducing treatment side effects, and improving survival and quality of life for cancer survivors. This study investigated adherence to multiple lifestyle behaviours among women with and without a cancer history. From the Australian Longitudinal Study on Women's Health (ALSWH) surveys, 2407 cancer survivors and 3896 controls (cancer free population) were identified. Based on the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations, adherence to six health behaviours (smoking, physical activity, fruit and vegetable intake, alcohol consumption, sugary drink intake, and Body Mass Index [BMI]) were assessed. Overall adherence was low, and there were no differences between survivors and controls on adherence to any of the six individual health behaviours. However, both recent and long-term cancer survivors were more likely than controls to adhere to multiple health behaviours (p < 0.05). When participants with melanoma or non-melanoma skin cancer were excluded, adherence was less likely (but not significant) in the cancer group than controls. Higher education (p < 0.01), being married (p < 0.01), and lower comorbidity of chronic illnesses (p < 0.01) were significantly associated with adherence to multiple lifestyle behaviours. Overall, the findings suggest that a cancer diagnosis may result in increased compliance with multiple health behaviour guidelines.

Sobreviventes de Câncer/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Cooperação do Paciente/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Idoso , Austrália , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade
BMC Pregnancy Childbirth ; 19(1): 111, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940107


BACKGROUND: Vitamin D deficiency is a growing public health problem, with pregnant women being particularly vulnerable due to its influences on maternal and neonatal outcomes. However, there are limited data published about mediators of vitamin D status in Louisiana women. We aimed to assess the vitamin D status and its determinants among low-income pregnant and non-pregnant reproductive-aged women from southeast Louisiana. METHODS: This study was conducted using data from the Gulf Resilience on Women's Health (GROWH) research consortium cohort of pregnant and non-pregnant women which contained sociodemographic and dietary variables as well as blood and salivary element concentrations. Serum 25-hydroxy vitamin D was measured using an enzyme-linked immunosorbent assay in 86 pregnant and 98 non-pregnant women with an even distribution of race in both groups. RESULTS: The prevalence of deficient vitamin D levels in the total cohort (184 women) was 67% and the mean 25(OH) vitamin D3 was 24.1 ng/mL (SD 10.7). Self-identifying as White, being pregnant, autumn season, young age and high exposure to tobacco smoke measured by cotinine were significantly associated with higher serum levels of vitamin D. Visiting Women and Infant clinics (WIC) was an important determinant in improving 25(OH) vitamin D3 levels for Black women but not for White women and concentrations varied more among Black women across seasons compared to White women. CONCLUSIONS: Serum vitamin D levels are inadequate among a high proportion of Black and White low-income pregnant and reproductive-aged women living in Southeast Louisiana who were enrolled in the GROWH study. Black women who are over 35 years old and non-WIC participants constitute the subpopulation most at risk for vitamin D deficiency, especially during the winter. As an overall higher level of deficiency exists in Black women, if even small behavioral and dietary modifications are produced by WIC, this can lead to a comparatively greater improvement in vitamin D status in women from Southeast Louisiana who self-identify as Black.

Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Louisiana/epidemiologia , Estado Nutricional , Pobreza/etnologia , Gravidez , Complicações na Gravidez/etnologia , Prevalência , Estações do Ano , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/etnologia , Saúde da Mulher/etnologia , Saúde da Mulher/estatística & dados numéricos , Adulto Jovem
BMC Womens Health ; 19(1): 51, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30943953


BACKGROUND: Between 1957 and 1961 the substance Thalidomide was sold in West Germany and taken by many women as a sedative during pregnancy. This lead to miscarriages and infants been born with several severe malformations. The aim of this study was to describe the current situation of women impaired by Thalidomide induced embryopahty in North Rhine-Westphalia (Nordrhein-Westfalen), Germany, in comparison with the results found in a study done in 2002 by Nippert et al. METHODS: Questionnaires as well as examinations were performed. Data were compared using descriptive and inductive statistical methods. RESULTS: Both studies show that women impaired by Thalidomide embryopathy face a poorer health status than women their age in the general population and live in fear of further deteriorating health. The majority can only work reduced hours or are already retired due to poor health. Most of those who need assistance are being assisted by their social environment, while professional care is still utilized in only few cases. CONCLUSIONS: An obvious need for a shift in the provision of assistance and/or care provided was found as the social environment supporting the impaired women is also aging and therefore in high danger of breaking apart. TRIAL REGISTRATION: The study has been registered at German Clinical Trials Register, DRKS00010593 , on 07.06.2016 retrospectively.

Anormalidades Induzidas por Medicamentos/epidemiologia , Imunossupressores/efeitos adversos , Talidomida/efeitos adversos , Saúde da Mulher/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Doenças Fetais/epidemiologia , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários
Complement Ther Med ; 43: 66-72, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935557


OBJECTIVE: Examine the generational differences in complementary medicine (CM) utilisation between young women from the X and Millennial generations. DESIGN: Secondary analysis of two cross-sectional surveys from the Australian Longitudinal Study on Women's Health (ALSWH). SETTING: Australia. MAIN OUTCOME MEASURES: Differences between young Generation X women (surveyed 1996; aged 18-23 years), and Millennial women (surveyed 2014; aged 19-24 years) regarding consultations with CM practitioners, sociodemographic characteristics, and health. Predictors for CM consultations were analysed via logistic regression analyses. RESULTS: Of the 14,247 Generation X women, 19.4% reported consulting CM, compared to 26.8% of the 11,344 Millennial women. CM consultations was predicted in both cohorts by higher age, education beyond primary school, non-urban (vs. urban) residence, and frequent back pain or headaches. Obesity and regular smoking predicted non-use in both. Significant cohort differences were found in physical activity levels (moderate/high levels associated with increased CM consultations in Millennial, but not Generation X women), and health status (Generation X women reporting fair-poor health were more likely to consult CM practitioners, while Millennial women reporting good health were less likely to do so, compared to women with very good/excellent health). CONCLUSIONS: The increase in CM utilization among young Australian women from Generation X compared to the Millennial generation could indicate different health consumer patterns for future middle-aged and older adult Australian women. Further increases in CM usage may be observed as current young women age into characteristics traditionally linked with higher CM use such as worsening health status and increased disposable income.

Terapias Complementares/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adulto , Austrália , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Estudos Longitudinais , Encaminhamento e Consulta/estatística & dados numéricos , Adulto Jovem
Healthc Q ; 21(4): 6-9, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30946647


Reproductive healthcare needs of women with intellectual and developmental disabilities (IDD) have received little attention. Using health and social services administrative data in Ontario, Canada, we comprehensively documented the reproductive health of women with IDD, including their fertility rates, pregnancy outcomes and reproductive health after pregnancy. Our findings showed high rates of adverse health outcomes for these women and their babies, supporting the development of reproductive healthcare programs tailored to their unique needs.

Deficiências do Desenvolvimento , Deficiência Intelectual , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Adulto , Feminino , Fertilidade , Humanos , Pessoa de Meia-Idade , Ontário/epidemiologia , Período Pós-Parto , Gravidez , Resultado da Gravidez , Saúde da Mulher/estatística & dados numéricos
PLoS One ; 14(4): e0213975, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30947260


The genital tract of African women has been shown to differ from what is currently accepted as 'normal', defined by a pH≤4.5 and lactobacilli-dominated microbiota. Adolescent girls and young women (AGYW) from sub-Saharan Africa are at high risk for HIV, and we hypothesized that specific biological factors are likely to be influential. This study aimed to compare characteristics of vaginal health in HIV-negative AGYW (16-22-years-old), from two South African communities, to international norms. We measured plasma hormones, vaginal pH, presence of BV (Nugent scoring), sexually transmitted infections (multiplex PCR for Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, Mycoplasma genitalium) and candidiasis (Gram stain) in AGYW (n = 298) from Cape Town and Soweto. Cervicovaginal microbiota was determined by 16S pyrosequencing; 44 genital cytokines were measured by Luminex; and cervical T-cell activation/proliferation (CCR5, HLA-DR, CD38, Ki67) was measured by multiparametric flow cytometry. 90/298 (30.2%) AGYW were negative for BV, candidiasis and bacterial STIs. L. crispatus and L. iners were the dominant bacteria in cervicovaginal swabs, and the median vaginal pH was 4.7. AGYW with L. crispatus-dominant microbiota (42.4%) generally had the lowest cytokine concentrations compared to women with more diverse microbiota (34/44 significantly upregulated cytokines). Frequencies of CCR5+CD4+ T-cells co-expressing CD38 and HLA-DR correlated positively with interleukin (IL)-6, TNF-α, GRO-α, macrophage inflammatory protein (MIP)-1α, and IL-9. While endogenous oestrogen had an immune-dampening effect on IL-6, TNF-related apoptosis-inducing ligand (TRAIL) and IL-16, injectable hormone contraceptives (DMPA and Net-EN) were associated with significantly lower endogenous hormone concentrations (p<0.0001 for oestrogen and progesterone) and upregulation of 34/44 cytokines. Since genital inflammation and the presence of activated CD4+ T cells in the genital tract have been implicated in increased HIV risk in South African women, the observed high levels of genital cellular activation and cytokines from AGYW may point towards biological factors increasing HIV risk in this region.

Infecções por HIV/imunologia , Microbiota/imunologia , Vagina/microbiologia , Vaginose Bacteriana/epidemiologia , Saúde da Mulher/estatística & dados numéricos , Adolescente , Linfócitos T CD4-Positivos/imunologia , Colo do Útero/citologia , Colo do Útero/imunologia , Colo do Útero/microbiologia , Estudos de Coortes , Citocinas/imunologia , Citocinas/metabolismo , Estrogênios/sangue , Estrogênios/imunologia , Feminino , Infecções por HIV/prevenção & controle , Humanos , Concentração de Íons de Hidrogênio , Lactobacillus crispatus/imunologia , Lactobacillus crispatus/isolamento & purificação , Progesterona/sangue , Progesterona/imunologia , Fatores de Risco , África do Sul/epidemiologia , Vagina/citologia , Vagina/imunologia , Vaginose Bacteriana/sangue , Vaginose Bacteriana/imunologia , Adulto Jovem
Prog. obstet. ginecol. (Ed. impr.) ; 62(2): 112-118, mar.-abr. 2019. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-184904


Objective: To establish the features of menstrual bleeding and their interindividual variations in a population of healthy women in Southern Andalusia, Spain. Material and methods: Observational, cross-sectional study of the Pictorial Blood Loss Assessment Charts (PABC) filled in by women aged between 12 and 50 years with spontaneous menstruation who were not taking estrogen-progestin contraceptives. The women were recruited at 2 educational institutions and a workplace in the city of Granada (Spain). Results: A total of 327 women participated, with a mean (SD) age of 30.36 (9.08) years. The results showed that the duration of bleeding was 5.09 (1.41) days and that this was age-related (p=0.002). The mean consumption of menstrual hygiene products was 20.39 (11.68) per menstruation, with a PBAC score of 192.33 (155.75). This was higher in older women (p=0.019) and in those with more days of bleeding (p=0.000); the PBAC score was higher than 100 in 231 cases (71%). Conclusions: Applying the PBAC in a sample of healthy women enabled us to conclude that in our region, a high percentage of women could be suffering from heavy menstrual bleeding, depending on their age and the duration of menstruation

Objetivo: Establecer las características del sangrado menstrual y sus variaciones interindividuales en una población de mujeres sanas del sur de Andalucía. Material y métodos: Estudio observacional, transversal de un PBAC (Pictorial Blood Loss Assessment Chart), cumplimentado por mujeres con menstruaciones espontáneas (edades entre 12 y 50 años), sin estar bajo los efectos de fármacos estro-progestagénicos, y captadas en dos centros educativos y en un centro de trabajo de Granada. Resultados: Participaron un total de 327 mujeres, con una media edad de 30 (DE 9,08) años. Se encontró que la duración de su sangrado era de 5,09 (DE 1,41) días y que ésta guardaba relación con la edad (p = 0,002). El consumo medio de Productos de Higiene Menstrual fue de 20,39 (DE 11,68) por menstruación, el PBAC score era de 192,33 (DE 155,75), siendo más elevado en las mujeres de más edad (p = 0,019) o en las que tenían más días de sangrado (p = 0,000); en 231 casos (71%) el PBAC score fue superior a 100. Conclusiones: Aplicando el PBAC, en una población de mujeres sanas, hemos podido constatar que en nuestro medio, un elevado porcentaje de las mismas podrían estar padeciendo sangrado menstrual abundante, en función de su edad y de la duración de la menstruación

Humanos , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Distúrbios Menstruais/epidemiologia , Menorragia/epidemiologia , Menstruação/fisiologia , Espanha/epidemiologia , Voluntários Saudáveis/estatística & dados numéricos , Produtos de Higiene Menstrual/estatística & dados numéricos , Estudos Transversais , Saúde da Mulher/estatística & dados numéricos
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 816-822, abr.-maio 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987303


Objective: The study's goal has been to both know and analyze the aspects that the studies from national and international literatures can reveal about the profile of maternal mortality. Methods: It is an integrative literature review. The search was conducted in August 2017, through the Virtual Health Library (VHL), searching in the databases named Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) [Latin-American and Caribbean Literature in Health Sciences], Medical Literature Analysis and Retrieval System Online (MEDLINE), Nursing Database (ND); establishing inclusion and exclusion criteria, and then selecting nine studies. Results: The epidemiological profile of maternal deaths is influenced by social factors, which reflect the inequalities present in the world, the disparities in accessing health services, education and other factors that affect a vulnerable group at alarming rates. Conclusions: The studies suggest the need for greater efforts regarding the engagement of society, public agencies and health professionals, aiming to bigger commitment and co-responsibility in the struggle to reduce maternal mortality

Objetivo: Conhecer e analisar os aspectos que os estudos da literatura nacional e internacional revelam sobre o perfil da mortalidade materna. Métodos: Revisão da literatura, a busca foi realizada em agosto de 2017, por meio da Biblioteca Virtual em Saúde, nas bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e, Base de dados da Enfermagem, estabelecendo-se critérios de inclusão e exclusão, sendo selecionados nove estudos. Resultados: O perfil epidemiológico dos óbitos maternos é influenciado por fatores sociais, os quais refletem as desigualdades que assolam o mundo, a disparidade nas formas de acesso aos serviços de saúde, a educação e demais fatores que repercutem num grupo vulnerável para índices alarmantes. Conclusões: Os estudos refletem a necessidade de maiores esforços com engajamento da sociedade, órgãos públicos, profissionais de saúde, com vista a maior comprometimento e co-resposabilização na luta pela redução da mortalidade materna

Objetivo: Investigar y analizarlos aspectos que elestudio de la literatura nacional e internacional revelan sobre el perfil de lamortalidad materna. Metodos: La revisión se realizóen agosto de 2017, a través de la Biblioteca Virtual enSalud, enlas bases de datos de la Literatura Latinoamericana y del Caribe enCiencias de laSalud, Medical LiteratureAnalysis and Retrieval System Online y, Base de datos de la literatura Enfermería, estableciéndosecriterios de inclusión y exclusión, siendo selecionado snueve estudios. Resultados: El perfil epidemiológico de lasmuertes maternas se ve influenciada por factores sociales, que reflejanlas desigualdades que aquejan al mundo, la disparidadenlas formas de acceso a losservicios de salud, educación y otrosfactores que afectan a un grupo vulnerable a niveles alarmantes. Conclusiones: Los estúdios reflejan la necesidad de mayores esfuerzos para involucrar a lasociedad, agencias gubernamentales, profesionales de lasalud, con miras a um mayor compromiso y co-resposabilizaçãoenla lucha por reducir la mortalidad materna

Humanos , Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Mortalidade Materna/tendências , Saúde da Mulher/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Políticas Públicas de Saúde