Considerations For Women Research Articles

Do cancer risk and benefit-harm ratios influence women's consideration of risk-reducing mastectomy? A scenario-based experiment in five European countries.

BackgroundPersonal cancer risk assessments enable stratified care, for example, offering preventive surgical measures such as risk-reducing mastectomy (RRM) to women at high risk for breast cancer. In scenario-based experiments, we investigated whether different benefit–harm ratios of RRM influence women’s consideration of this, whether this consideration is influenced by women’s perception of and desire to know their personal cancer risk, or by their intention to take a novel cancer risk-predictive test, and whether consideration varies across different countries.MethodIn January 2017, 1,675 women 40 to 75 years of age from five European countries—Czech Republic, Germany, UK, Italy, and Sweden—took part in an online scenario-based experiment. Six different scenarios of hypothetical benefit–harm ratios of RRM were presented in accessible fact box formats: Baseline risk/risk reduction pairings were 20/16, 20/4, 10/8, 10/2, 5/4, and 5/1 out of 1,000 women dying from breast cancer.ResultsVarying the baseline risk of dying from breast cancer and the extent of risk reduction influenced the decision to consider RRM for 23% of women. Decisions varied by country, risk perception, and the intention to take a cancer risk-predictive test. Women who expressed a stronger intention to take such a test were more likely to consider having RRM. The desire to know one’s risk of developing any female cancer in general moderated women’s decisions, whereas the specific desire to know the risk of breast cancer did not.ConclusionsIn this hypothetical scenario-based study, only for a minority of women did the change in benefit–harm ratio inform their consideration of RRM. Because this consideration is influenced by risk perception and the intention to learn one’s cancer risks via a cancer risk-predictive test, careful disclosure of different potential preventive measures and their benefit–harm ratios is necessary before testing for individual risk. Furthermore, information on risk testing should acknowledge country-specific sensitivities for benefit–harm ratios.

Dry Eye Disease: Consideration for Women's Health.

Dry eye disease (DED) is a multifactorial disorder of the ocular surface and tear homeostasis that can result in discomfort, pain, and visual disturbance. Untreated, DED can become chronic, progressive, and significantly affect an individual's quality of life. Women are disproportionately affected by DED, are diagnosed at a younger age, and experience more severe symptoms compared with men. DED is associated with a wide range of comorbid conditions; there is a strong association between DED and autoimmune disorders, especially those that affect women at many times the rate of men. Treatment response questionnaires indicate women respond better to a wellness model of treatment for DED than men. Furthermore, women's health care-seeking behaviors provide opportunities for general practitioners, specialists, and women's health centers to help identify women with DED or at risk for DED for referral to an eye care specialist. This review of the prevalence of DED in women, and gender and sex-specific aspects of DED, highlight a significant opportunity for action. Earlier diagnosis and treatment of this common but burdensome condition could significantly improve a woman's quality of life.

Antiplatelet Therapy Considerations in Women

Coronary artery disease (CAD) is the leading cause of death worldwide, but because of several factors, one of which is antiplatelet therapy, the mortality rates have steadily declined. However, women continue to experience higher CAD mortality rates than men. This may be explained by differences in comorbidities, increased time to presentation, higher bleeding rates, and differences in management. There are numerous landmark trials in the field of antiplatelet therapy; however, women are consistently underrepresented in these trials. The results of these trials reveal that women experience the same benefit as men from antiplatelet therapy but experience higher bleeding rates; therefore bleeding-reduction strategies are imperative in this patient population. This review provides an overview of the available evidence on CAD in women and its implications for antiplatelet medications.

A Study of Women’s Life World in Japanese Mountainous Areas: Through Consideration of Women’s Career Choices by Familism and Women’s Life Consciousness

A Study of Women’s Life World in Japanese Mountainous Areas: Through Consideration of Women’s Career Choices by Familism and Women’s Life Consciousness

Aesthetic Consideration in Women's Health, Introduction.

Aesthetic Consideration in Women's Health, Introduction.

Sex-Specific Considerations in Women with Aortic Stenosis and Outcomes After Transcatheter Aortic Valve Replacement.

Aortic stenosis (AS) is the most common valvular disease in the elderly and is associated with poor outcomes. Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) in high-risk patients. Herein, we describe the gender-related differences in baseline characteristics and pathophysiologic response to severe AS, imaging considerations unique to females, and short- and long-term outcomes after TAVR. Women undergoing TAVR are older and frailer, have less cardiovascular comorbidities, smaller femoral artery size, better left ventricular systolic function, hypertrophied and small left ventricles leading to a higher incidence of paradoxical low-flow low-gradient AS, and a greater prevalence of porcelain aorta, smaller aortic annulus size, and lower coronary ostia heights. Imaging and histopathological data also suggests a sex-related myocardial response to pressure overload from AS. Women experience more vascular complications and blood transfusion requirements, serious procedural complications, and a greater incidence of stroke, but have better long-term outcomes than men. Patient-prosthesis mismatch, which is a concern in patients with a small aortic annulus size undergoing SAVR, has not been problematic with TAVR. The aforementioned findings suggest that TAVR may be preferable for women with severe AS. Further studies are warranted to directly compare TAVR with SAVR in women.

Attention-Deficit Hyperactivity Disorder: Clinical Considerations for Women.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by hyperactivity, impulsivity, and/or inattention. Women with ADHD represent a particularly vulnerable group, given their increased risk for psychosocial and parenting difficulties. Women's health care clinicians should expect to encounter women with diagnosed and undiagnosed ADHD that may or may not be treated. Pharmacologic intervention, namely, prescription stimulants, is an important consideration for pregnant and breastfeeding women with ADHD, especially because the US Food and Drug Administration has determined that there is not enough information to confirm either harm or lack of harm to the developing fetus following exposure to these drugs. Due to the increase in use of prescription stimulants without a prescription, clinicians are also likely to encounter women misusing stimulants for a variety of reasons. This article provides an overview of ADHD diagnosis, outlines effective treatment options, and offers insight into the importance for clinicians to consider prescription stimulant misuse. Guidance concerning treatment of ADHD during pregnancy and lactation is reviewed.

Supplemental Material for Further Examination of the Factor Structure of the Male Role Norms Inventory-Short Form (MRNI-SF): Measurement Considerations for Women, Men of Color, and Gay Men

Supplemental Material for Further Examination of the Factor Structure of the Male Role Norms Inventory-Short Form (MRNI-SF): Measurement Considerations for Women, Men of Color, and Gay Men

Contraceptive Considerations for Women with Gastrointestinal Disorders.

Gastroenterologists are in a unique position to assist women with chronic gastrointestinal disorders in order to optimize their health prior to pregnancy. Women, whether with chronic conditions or not, and their infants are more likely to be healthy when pregnancies are planned. Achieving a planned pregnancy at the ideal time or preventing pregnancy altogether requires the use of appropriate contraceptives. There is a broad range of contraceptives available to women in the USA, and the majority of women with digestive diseases will be candidates for all effective methods. Guidance from the Centers for Disease Control and Prevention aids clinicians in prescribing appropriate contraceptives to women with medical disorders. This review will focus on contraception for women with inflammatory bowel disease and chronic liver disease, including liver transplant.

Perinatal Considerations in Women With Previous Diagnosis of Cancer.

As the average age that women have their first child increases and cancer therapies improve survival, obstetricians are more likely to care for pregnant women who have survived cancer. Managing these pregnancies can be challenging, as they may be associated with higher risks of maternal and neonatal morbidity and mortality. Different types of cancer require different types of intervention, including surgery, chemotherapy, radiation, or combinations of these. Prior cancer treatments therefore present different potential complications during pregnancy. Although for most women who survive cancer carrying a pregnancy does not seem to increase mortality rates, there are some associated neonatal morbidities. The most common perinatal complication associated with pregnancy after cancer is prematurity. Women who desire pregnancy after cancer survival should not be discouraged, but appropriate counseling and follow-up should be provided.

Beyond Sociocultural Influence: Self-monitoring and Self-awareness as Predictors of Women's Interest in Breast Cosmetic Surgery.

The aim of the present research was to analyze the role of self-awareness, self-monitoring, perceived media pressures, and peer attributions on the consideration of breast cosmetic surgery among women. The internalization of thin ideals was taken into account as a key moderating variable. Participants were 132 Italian women (mean age = 33.62), who completed a questionnaire aimed at measuring the variables of interest. Path analysis was used to test our hypotheses. The results indicated that perceived media pressure, self-monitoring, and peer attributions influenced participants' interest in breast modification procedures through the internalization of thin ideals. Self-awareness (both private and public) had a direct effect on women's consideration of breast cosmetic surgery. This research is one of few analyzing how specific aspects of the self could influence women's interest in cosmetic surgery. These findings contribute to the understanding of the reasons that trigger women's interest in cosmetic surgery. Not only sociocultural influences contribute to the development of favorable attitudes toward cosmetic surgery, but also specific aspects of the self have a relevant role. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online Instructions to Authors www.springer.com/00266 .

Women's considerations in disaster risk reduction trainings

Women's considerations in disaster risk reduction trainings

Epilepsy: Special Consideration in Women

ABSTRACT Epilepsy is one of the most common chronic neurological disorder complicating pregnancy. The article reviews various management issues in women in preconceptional, antenatal and postnatal period. An online search was carried out for articles on epilepsy in women and different aspects relating to contraception, conception, antenatal, intranatal and postnatal management. The available guidelines on the subject were also reviewed. How to cite this article Ahmad A, Rabbani TK, Kumar S. Epilepsy: Special Consideration in Women. Int J Infertil Fetal Med 2015; 6(1):11-14.

Eco-Criticism and Nature Writing .the Trails of the American Approaches

Ecocritical attention has primarily focused on nineteenth– and twentieth-century British and American texts, predominantly non-fiction nature writing, and also nature-conscious fiction and poetry. The paper attempts to shed light to a series of puzzling but response-inciting questions regarding the American gendered approaches to nature, and the niche that Ecocriticism occupies in mainstream American Literature. The study is conceived as a merging of theoretical arguments and textual study. The theoretical part attempts to shed light on such issues as: Ecocritical traits and approaches; European vs. American approaches to nature; and Nature and Women's writing .The focus of the textual study are 10 American Nature Writing non-fiction classics and illustrated considerations of the main topics handled in these works. The study seeks to show that though ecocriticism is attempting to break new trails by going through the untrammeled nature-centered works, humans are failing to go within the unchartered depths of their spirit and consciousness. In terms of distinguishing in between the male gendered nature narrative and the female gendered nature narrative, the paper comes to the conclusion that there is a close connection between the systematic undervaluing of women's writing and the exploitation and abuse of the earth. While male nature writers mostly develop themes such as: the austerity of nature and the wish to explore and alter landscapes to suit the "human design"; the idea of hunting for a "trophy"; grandfather wisdom; wilderness and governmental institutions; earth as a religion, female-centered approaches to nature are marked by the occurrence of such themes as: moral –considerability of non-human beings; disapproval of economism; the bond to the land; anthropogenic destructive tendencies; nature/self consciousness. Nevertheless, although male writers fall into the snares of economism and exploring as a way of controlling, they still implicitly share women's consideration of the unbreakable bond to the earth and their awareness of the impactive immediacy to humankind.

Deciding treatment for miscarriage--experiences of women and healthcare professionals.

Women experiencing miscarriage are offered a choice of different treatments to terminate their wanted pregnancy at a time when they are often shocked and distressed. Women's and healthcare professionals' experiences of the decision-making process are not well described. We aimed to gain insight into this process and the circumstances that may affect it. A qualitative study using a grounded theory approach. Data were obtained through semi-structured interviews with six women who had chosen and completed either surgical, medical or expectant treatment for miscarriage and five healthcare professionals involved in the decision-making at an emergency gynaecological department in Denmark. An inductive explorative method was chosen due to limited knowledge about the decision-making process, and a theoretical perspective was not applied until the final analysis. Despite information and pretreatment counselling, choice of treatment was often determined by unspoken emotional considerations, including fear of seeing the foetus or fear of anaesthesia. These considerations were not discussed during the decision-making process, which was a time when the women were under time pressure and experienced emotional distress. Healthcare professionals did not explore women's considerations for choosing a particular treatment and prioritised information differently. We found theory about coping and decision-making in stressful situations useful in increasing our understanding of the women's reactions. In relation to theory about informed consent, our findings suggest that women need more understanding of the treatments before making a decision. This study is limited due to a small sample size, but it generates important findings that need to be examined in a larger sample. Frequently, women did not use information provided about treatment pros and cons in their decision-making process. Because of unspoken thoughts, and women's needs being unexplored by healthcare professionals, information did not target women's needs and their reasoning remained unapparent.

Urethritis in Women—Considerations Beyond Urinary Tract Infection

Urethritis is a common condition affecting women in the USA. The symptoms, however, are not specific to a unique cause and are shared among a wide variety of urogenital diseases. This article evaluates the current literature and provides tools to the practicing clinician. Infections, particularly urinary tract infection and vaginitis, are common causes. The sexually transmitted infection Chlamydia trachomatis continues to be one of the most common etiologies for urethritis. Newer research provides evidence for the importance of Ureaplasma and Mycoplasma genitalium. Mechanical trauma, vaginal atrophy, chemical and mechanical exposure, and Skene’s gland and other anatomical pathology will also be reviewed. The diagnosis and treatment of urethritis often require the practitioner to treat associated diseases such as chronic pelvic pain syndrome and dyspareunia. Urethritis is intensely symptomatic leading to a pressured office interaction, and it is our intent to provide the tools for a comprehensive approach to female urethritis.

Systemic Treatment Considerations for Women with BRCA1/2-Associated Breast Cancer

Both BRCA1 and BRCA2 proteins play a role in DNA damage response, and their deficiency leads to chromosomal instability and carcinogenesis. Hereditary mutations in either of these genes increase strikingly the lifetime risk of breast and ovarian cancer and to a lesser extent the risk of males’ breast and prostate cancer and of pancreatic cancer. It is generally accepted that when treated by standard therapy, the prognosis of BRCA- mutated breast cancer patients is equivalent to that of patients with sporadic disease. Increased sensitivity of BRCA-associated breast cancer to DNA damaging chemotherapy, especially platinum compounds, was demonstrated in preclinical models and in clinical trials. However, definitive evidence that would justify their advancement to clinical practice is lacking. Inhibitors of poly (ADP-ribose) polymerase target BRCA-deficient cells specifically. Multiple clinical trials with these compounds are ongoing, although none made its way to clinical practice yet. Hopefully, ongoing clinical research would eventually result in better treatment and improved prognosis.

Epilepsy: Clinical Considerations in Women of Childbearing Age

Epilepsy is the commonest chronic neurological disorder to complicate pregnancy, having an incidence of 0.15% to 10%. Sudden unexpected death in epilepsy is the principal cause of death, and seizure control is the key to minimizing this risk. The aim of antenatal care is to optimize seizure control. The lowest dose of antiepileptic medication that protects against seizures should be chosen. Non-adherence to treatment may present a greater risk to the developing fetus than antiepileptic drug exposure. Adequate rest and sleep is mandatory for epileptic women. The normal anti epileptic drug regimen should be continued during labor. An elective cesarean section should be considered if there have been frequent tonic clonic or prolonged complex partial seizures towards the end of pregnancy. Breast feeding is not contraindicated. Appropriate contraceptive advice should be given. The importance of pre conceptual care in a subsequent pregnancy should be reiterated. DOI: http://dx.doi.org/10.3329/bjms.v12i4.12818 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 364-369

Considerations in Women with Hypertension

Considerations in Women with Hypertension

Considerations in Women with Hypertension

Cardiovascular disease is the most common cause of death in women in the United States, and hypertension is a major contributor to cardiovascular mortality. The incidence of hypertension in women is steadily increasing, paralleling the epidemics of obesity and diabetes. Blood pressure control rates among women are suboptimal, even when secondary causes are identified and treated. There are few high-quality data describing specific hypertension-related outcomes in women. Some data comparing hypertensive women to age-matched men suggest advantages to sex-specific strategies, but further study is needed to determine optimal regimens for women throughout their lives. Pregnancy and menopause present unique, complex challenges in hypertension management.