Distribution Of Women Research Articles

The epidemiology of female pelvic floor dysfunction

Pelvic floor dysfunction, specifically urinary and fecal incontinence, is thought to be widespread. Prevalence figures for these disorders vary greatly. This review highlights the accepted prevalence and incidence figures for pelvic floor dysfunction and their relative age distribution in women. Remission and natural history is examined with an emphasis on gaps in our knowledge. The limited data on racial differences in the epidemiology of this disorder are also reviewed.

Comparison of waist measurements: A methodologic issue in longitudinal studies

One of the strengths of a longitudinal study is that changes over time in anthropometric variables such as the ratio of waist to hip measurements can be observed. Although waist and hip circumference measurements may not be as reliable as other anthropometric measurements such as height (1,2), assessment of body fat distribution is particularly important in studies of changes in cardiovascular risk factor as women age and experience menopause. Researchers have demonstrated an association between a preponderance of upper body fat, as evidenced by a waist to hip ratio greater than 0.90, and risk of cardiovascular disease and death (3,4). Fat distribution in women may be influenced by menopause (5).

High density lipoprotein cholesterol subfractions in older people.

High density lipoprotein (HDL) may be an important risk factor for cardiovascular disease in older people. HDL is heterogeneous with several subfractions. This article describes the distribution and correlates of HDL2 cholesterol (C) and HDL3-C in older people. HDL subfraction cholesterols were measured in 1,127 females and 825 males > or = 65 years old who participated in the Cardiovascular Health Study. Distributions of HDL subfraction cholesterols and bivariate and multivariate relationships were determined in cross-sectional analyses. Mean (+/- SD) concentrations of HDL subfractions were: HDL3-C (M .98 +/- .25, F 1.2 +/- .29 mmol/l), HDL2-C (M .09 +/- .08, F .13 +/- .09 mmol/l). HDL2-C, but not HDL3-C, was slightly higher with age. Using multivariate analysis, both HDL2-C and HDL3-C (in females) were inversely correlated with triglyceride, body weight, and fasting insulin; HDL3-C was inversely correlated with central fat distribution in women. Both HDL2-C and HDL3-C were lower in participants with prevalent cardiovascular disease. However, only HDL3-C was significantly inversely related to carotid stenosis, as measured by ultrasound. The slight increase in HDL-C with age appears to be due to an increase in the HDL2-C subfraction. HDL-C subfractions are independently related to triglyceride levels, body weight, and insulin concentrations in older people, all potentially modifiable risk factors. Both HDL2-C and HDL3-C are lower in older people with prevalent cardiovascular disease, although only HDL3-C was correlated with carotid atherosclerosis. These findings are consistent with the hypothesis that HDL subfractions are important risk factors for atherosclerotic cardiovascular disease in the elderly.

Stress‐Induced Cortisol Response and Fat Distribution in Women

Recent studies have shown an association between uncontrollable stress and abdominal fat distribution. It has been suggested that changes in cortisol secretion might represent one possible mechanism for this relationship. This study investigated whether body fat distribution, determined by waist-to-hip ratio (WHR), is related to salivary cortisol levels in response to laboratory stressors. Subjects were 41 overweight women with a Low or a High WHR. Multiple measures of cortisol and mood were obtained during a session of stressful tasks (eg., timed arithmetic) and during a time-matched, control rest session. Also, background life stress and psychological trait variables were assessed. Compared to Low WHR subjects, High WHR subjects secreted significantly more cortisol during the stressful session after 60 minutes of stress, and considering the total area under the curve of secretion. This difference was not seen on the rest day. In terms of background and psychological measures, High WHR subjects were characterized by poorer coping skills and differences in mood reactivity. Specifically, although all subjects became more angry in response to the stressful session, High WHR subjects showed smaller increases in anger. This could indicate that they are more likely to evidence a helpless reaction to uncontrollable stress. These findings support the hypothesis that cortisol secretion might represent a mechanism for the observed association between stress and abdominal fat distribution. Furthermore, differences in coping and appraisal may suggest that a particular psychological pattern might influence the reactivity of the adrenal-cortical system to stress, and subsequent fat distribution.

MOVING FROM `THE STATUS OF WOMEN' TO `GENDER INEQUALITY': CONCEPTUALISATION, SOCIAL INDICATORS AND AN EMPIRICAL APPLICATION

This paper extends the conceptualisation and refines the operationalisation of gender inequality. The aim is to bridge theory - on gender relations - and measurement - of the reality of gender for women and men - by means of a set of social indicators of gender inequality. We first elaborate the concept of gender inequality and differentiate it from `women's status'. Gender inequality is defined as the departure from parity in the representation of women and men in key dimensions of social life. Next, we operationalise the concept through a set of social indicators developed from statistics provided in the United Nations Women's Statistics and Indicators (WISTAT) database. The 21 indicators measure disparities in the distribution of women and men in socially valued positions in five dimensions - physical well-being, public power, family formation, education and economic activity - within two spheres: human rights and social relations. Finally, we apply the social indicators of gender inequality in a cross-national analysis of the disparities between women and men at different levels of national development. The findings reveal the dismal state of women's human rights across all levels of national income and the disadvantage women experience in the interconnection between social relations of production and reproduction in countries rich or poor. This more complex measure of gender inequality has the potential to inform policy and practices aimed at achieving gender equality.

Fat and Female Fecundity

OBJECTIVES--To study the effect of body fat distribution in women of reproductive age on fecundity. DESIGN--Prospective cohort study of all women who had entered a donor insemination programme. SETTING--One fertility clinic serving a large part of the midwest of the Netherlands. SUBJECTS--Of 542 women attending the clinic for artificial insemination for the first time, 500 women were eligible for study. MAIN OUTCOME MEASURES--Probability of conception per cycle and number of insemination cycles before pregnancy or stopping treatment. RESULTS--A 0.1 unit increase in waist-hip ratio led to a 30% decrease in probability of conception per cycle (hazard ratio 0.706; 95% confidence interval 0.562 to 0.887) after adjustment for age, fatness, reasons for artificial insemination, cycle length and regularity, smoking, and parity. Increasing age was significantly related to lower fecundity (p < 0.05); very lean and obese women were less likely to conceive (p < 0.10) as were women with subfertile partners (p < 0.10). All other exposure variables were not significantly related to fecundity. CONCLUSIONS--Increasing waist-hip ratio is negatively associated with the probability of conception per cycle, before and after adjustment for confounding factors. Body fat distribution in women of reproductive age seems to have more impact on fertility than age or obesity.

Variation in body fat distribution and breast cancer risk in the families of patients with breast cancer and control families

The pattern of body fat distribution in women has been correlated with the risk of developing breast and endometrial cancer. The authors determined whether body fat distribution varied between first-degree relatives of patients with breast cancer and in cancer-free families by comparing the body fat distribution of first-degree relatives of patients with breast cancer with age and Quetelet Index-matched controls. Fifty-six first-degree relatives of newly diagnosed patients with breast cancer were compared with 56 controls (non-cancer family members) matched for age and Quetelet Index and were studied for variation in body fat distribution. Anthropometric measurements were taken for the abdomen, thigh, suprailiac, subscapular, biceps, and triceps skinfold thickness; waist and hip circumference; weight; and height. The distribution of body measurements and derived ratios in both case and control family members were compared using the Student t test. A significant variation in body fat distribution occurred among first-degree relatives in breast cancer and control families. In families with a history of breast cancer, first-degree family members were found to have significantly greater waist:hip ratio (P < 0.001) compared with controls without family history matched for age and Quetelet Index. Other variables indicating upper body fat localization, such as abdomen and suprailiac skinfold were significantly greater in family members of patients with breast cancer compared with controls. A marked variation occurred in body fat localization among first-degree relatives of patients with breast cancer and in cancer-free families. This finding implies a variation in breast cancer risk in these families. Identifying family members with upper body fat distribution in breast cancer families would allow targeting of these individuals for energetic screening and risk factor reduction interventions.

Fat and female fecundity: prospective study of effect of body fat distribution on conception rates.

To study the effect of body fat distribution in women of reproductive age on fecundity. Prospective cohort study of all women who had entered a donor insemination programme. One fertility clinic serving a large part of the midwest of the Netherlands. Of 542 women attending the clinic for artificial insemination for the first time, 500 women were eligible for study. Probability of conception per cycle and number of insemination cycles before pregnancy or stopping treatment. A 0.1 unit increase in waist-hip ratio led to a 30% decrease in probability of conception per cycle (hazard ratio 0.706; 95% confidence interval 0.562 to 0.887) after adjustment for age, fatness, reasons for artificial insemination, cycle length and regularity, smoking, and parity. Increasing age was significantly related to lower fecundity (p < 0.05); very lean and obese women were less likely to conceive (p < 0.10) as were women with subfertile partners (p < 0.10). All other exposure variables were not significantly related to fecundity. Increasing waist-hip ratio is negatively associated with the probability of conception per cycle, before and after adjustment for confounding factors. Body fat distribution in women of reproductive age seems to have more impact on fertility than age or obesity.

Insulin and androgen relationships with abdominal body fat distribution in women with and without hyperandrogenism.

This retrospective study was carried out to investigate, in a large group of hyperandrogenized women with polycystic ovary syndrome (PCOS) and nonhyperandrogenized control women, the interrelationships between sex steroids and indices of body fat distribution. Moreover, we investigated the relationships between these parameters and insulin blood levels, since obese women with abdominal pattern of fat distribution (A-BFD), as well as those with PCOS (either obese and nonobese) are characterized by moderate to severe hyperinsulinemia. A sample of 100 women with PCOS and that of 138 women without clinical signs of hyperandrogenism, who served as a control group, were investigated. The waist to hip circumference ratio (WHR) which was used to define different patterns of fat topography was significantly (p < 0.05) higher in PCOS (0.84 +/- 0.10) than in control women (0.81 +/- 0.08). In both groups, women with WHR values lower than or equal to 0.85 were considered as having a peripheral pattern of body fat distribution (P-BFD) whereas those having WHR values higher than 0.85 had A-BFD. Compared to controls, women with PCOS had higher LH, androgen and estrogen concentrations. In both PCOS and controls there were no differences in sex hormone levels between women with different patterns of fat distribution, except androstenedione, which levels were significantly higher in women with A-BFD than with P-BFD. Women with PCOS showed significantly higher insulin levels than controls. Moreover, in both groups fasting and stimulated insulin were significantly higher in women with A-BFD than in those with P-BFD.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum cholesterol and cancer risk: an epidemiologic perspective.

This review has examined the evidence surrounding two questions: (a) Is having low serum cholesterol associated with increased risk of cancer? (b) Does reducing serum cholesterol increase the occurrence of cancer? Some elevated risk of cancer for males with low serum cholesterol levels has been noted: the median of the studies examined is consistent with a 30% increased risk. The answer for females is less clear. The median of the studies examined suggests no more than a 5-10% increased risk associated with having low serum cholesterol. However, the risk seems to depend strongly on whether females have a central or peripheral body fat pattern (54). The cancers most consistently associated with low serum cholesterol levels are those of the colon and lung in males, the cervix and breast (but only for females under 50 years of age) in females, and leukemia in both sexes. In contrast, high cholesterol levels have been linked with an increase in brain cancer. While immunologic, genetic, and dietary explanations have been offered to explain the association, it is difficult to support the idea that low serum cholesterol causes cancer in any direct manner. First, the findings themselves tend to be generally weak and somewhat inconsistent. Second, the strong influence of fat distribution in women suggests that a metabolic/hormonal basis underlies the association. One would not expect the results to differ by body fat pattern if the relationship were a causal one. Finally, if there were a direct causal role, one would expect populations with low serum cholesterol levels to have higher cancer rates. In China, counties with the lowest average plasma cholesterol levels have the lowest cancer rates (78). While this observation is open to a number of interpretations, it does not support the idea that low serum cholesterol is a tumor initiator. In aggregate, the trials of lipid-lowering interventions reviewed here show an increase in cancer occurrence (primarily mortality) of approximately 24% in the cholesterol-lowered groups. However, the post-trial experience has shown a comparative deficit of cancer occurrence in the experimental groups. Recent evidence indicates that products in the cholesterol biosynthetic pathway affect DNA replication and cell proliferation. These findings suggests a mechanism by which cholesterol lowering might accelerate the development of tumors already initiated. The data that have been reviewed in no way suggest that treatment of hypercholesterolemia should not be pursued. They do suggest the presence of a relatively small subpopulation in whom reduction of plasma cholesterol may lead to increased occurrence of cancer.(ABSTRACT TRUNCATED AT 400 WORDS)

Occupational Segregation: Comparing the Civilian and Military Work Force

This article compares the differential location of women and men across occupations in the civilian labor force to the distribution of women and men in military occupations. Findings indicate that, although the U.S. military as a whole is extremely male-intensive, the distribution of women and men in the military, across occupational categories, is more representative than the representation of women and men across civilian occupational categories. This holds true across all services and for both the enlisted force and the officer corps. Results further suggest the need for continuing to support affirmative action programs and increasing efforts to recruit women and promote them into high-level officer and noncommissioned officer grades.

The Relative Effects of Unionism on the Earnings Distributions of Women and Men

This study examines the differential effects of union density on the degree of earnings inequality among women and among men. Our results suggest an equalizing impact of union density for all men and for both men and women who work year‐round and full time. Union density does not appear to equalize and may even contribute to a disequalization of the earnings distribution for all women.

Residuales und rekonvertiertes hämatopoetisches Knochenmark im distalen Femur

The distal femur contains usually only fatty marrow in the adult. We investigated the incidence of areas of residual and reconverted hematopoietic marrow in the distal femur in a series of 50 adult patients using conventional spin-echo and opposed-phase gradient-echo MR images. Zones with intermediate to low signal intensity in both sequences representing hematopoietic marrow within high signal intensity fatty marrow were observed in 17 of the 50 patients. Opposed-phase gradient-echo sequences demonstrated significantly greater red-yellow marrow contrast than conventional spin-echo sequences. Residual red marrow may represent a biologic variation of the normal adult pattern of red-yellow marrow distribution in women of menstruating age. Reconverted red marrow appears to be related to increased erythrocyte demand. It should not be mistaken for bone marrow malignancy. Absence of epiphyseal involvement, cortical destruction and soft-tissue mass in residual and reconverted hematopoietic marrow are helpful differential criteria.

Eliminating a sparse data problem in nonparametric bivariate survival analysis with an application to women's age at first marriage and age at first birth

A new solution is proposed for a sparse data problem arising in nonparametric estimation of a bivariate survival function. Prior information, if available, can be used to obtain initial values for the EM algorithm. Initial values will completely determine estimates of portions of the distribution which are not identifiable from the data, while having a minimal effect on estimates of portions of the distribution for which the data provide sufficient information. Methods are applied to the distribution of women's age at first marriage and age at birth of first child, using data from the Current Population Surveys of 1975 and 1986.

Convergence on the two-child family norm in Australia.

Data on ever-married women 15-17 and all women 18-44 from the 1986 Australian Family Formation Survey were examined for childbearing patterns. Transition from high to low fertility began between 1961-66 and 1971-76 from a peak in 1961 of 3.55 children/woman to 1.85 in 1976. Since 1985 there has been stabilization. During these periods there was socioeconomic change which necessitated small families. Marriage age rose childbearing was delayed and childlessness within marriage increased. The fertility age range narrowed. Parity distribution among younger cohorts was lower and the % distribution of women with 2 children was higher. Birth order specific parity progression ratios (PPRs) and birth intervals are calculated using the life table technique. Exposure is within marriage and not since marriage. Those women with dissolved marriages had lower PPRs. The following patterns emerge from the graphic display of the cumulative proportions of women who had a subsequent child by duration since marriage or the previous birth by parity cohort: 1) there were a higher proportion having a 1st birth within 5 years of marriage and with shorter birth intervals pre-1971. Post-1971 the cumulative proportion of women having a 1st birth within 5 years of marriage remained around 76% vs. 90% for marriage cohorts of 1956-70. Exnuptial births were also higher after 1970 from 4% to 11%. Delayed childbearing and childlessness is evident. 2) Progression from 1st to 2nd birth remained almost the same in both periods suggesting the preference for a 2-child family norm. 3) The progression to a 3rd birth was lower post-1970 from 20% to 16%. The progression to a 4th birth declined considerably from 45% in 1966-70 to 27% in 1971-75 and 1976-80. Interparity cohort differences reveal further the decline in PPR to the 1st birth over time. The proportion having a 1st birth after 5 years of marriage was 89% in 1966 86% in 1966-70 and 72% in 1971-75. Also post-1970 the higher the marriage age the lower the PPR to the 1st birth and the longer the interval between marriage and 1st birth. The highest PPR and shortest interval to 1st birth was for married women <19 years. Those women marrying after 23 years had higher PPRs to 1st birth and shorter birth intervals than those 19-23 years; this is attributed to a catching up effect. There has been a convergence on a 2-child family norm which is also reflected in the preference of 87.8% of ever-married women 15-44 years.

The Struggle Against Ignorance: John Blacking Remembered

This paper examines the relationship between fertility and mode of mate selection in Urban Nigeria. Data for the study were derived from a 1987/88 survey of nine cities in the North, South-east and Southwest of Nigeria. Ever married women, aged 15 to 49 years, in selected households were interviewed. In addition to information on socio-economic characteristics, respondents also provided information on modes of mate selection, on perceptions of roles within marriage, on desired and achieved family sizes, and on childrearing practices. Distributions of women. by mode of mate selection (family or selt) and socioeconomic variables show that women in family arranged unions marry much earlier (and hence have longer duration of exposure to childbearing oriented sexual relations), have lower levels of education before marriage, marry much older men and are less disposed to the use of contraception. With respect to fertility, our results show that the fertility of women in family arranged unions is generally higher than that of women in self arranged unions. In order to understand more adequately how mode of mate selection relates to fertility, regression models, in which three sets of test variables were controlled, were estimated. Separate estimates were obtained for women aged 15 to 24 years, 25 to 34 years and 35 years and above, respectively. The results show that the difference in fertility between the two groups of women is statistically significant and that the difference is attributable mainly to differences in prenuptial levels of education and in duration of marriage. The findings reinforce - the call for improved education of women and programs of public education that encourage higher ages at marriage.

Factors influencing waist/hip ratio in randomly selected pre- and post-menopausal women in the DOM-project (preliminary results) : Int. J. Obesity 1989 13/6 (817–824)

In 452 pre- and post-menopausal women aged 41-75, participating in a breast cancer screening programme, we studied the associations between several factors and waist/hip ratio. Differences in waist/hip ratio between pre- and post-menopausal women could be accounted for by age and degree of obesity. In post-menopausal women, waist/hip ratio was positively related to age, independently of the degree of obesity. Post-menopausal women who reported to use oestrogens for menopausal complaints were found to have lower waist/hip values compared to non-users (0.74 vs 0.78 P less than 0.05). Waist/hip ratio was not related to age at menopause, age at menarche or parity. We confirmed that the Quetelet's index is positively related to waist/hip ratio and that, at least before menopause, smokers have higher waist/hip values compared to non-smokers although the mechanisms for such an association remain obscure. Hypertension was associated with abdominal fat distribution in premenopausal but not in post-menopausal women. Diabetes mellitus was associated with abdominal fat distribution in post-menopausal women. These observations in this cross-sectional study suggest that environmental factors (smoking and oestrogen use after menopause) relate to the distribution of fat over the body. The other observations illustrate the importance of stratifying for menopausal status in studies on fat distribution in women.

Segregation curves, Lorenz curves, and inequality in the distribution of people across occupations

This paper takes the analytic framework developed to measure inequality in the distribution of income and extends it to the problem of measuring inequality in the distribution of people across population groups (e.g. inequality in the distribution of women across occupations). The paper discusses ‘segregation curves’ and shows that, like Lorenz curves, they are related to value judgments about the nature of inequality. It also derives several new numerical measures of inequality in people across groups. The paper closes with an application: an analysis of U.S. occupational segregation by race and gender between 1958 and 1978.

Interrelationships between body weight, body fat distribution and insulin in obese women before and after hypocaloric feeding and weight loss.

The effects were investigated of weight loss on the relationship between hyperinsulinemia, body weight and body fat distribution in two groups of women with central-type obesity (CTO) (waist-to-hip ratio WHR greater than 0.85) or peripheral-type obesity (PTO) (WHR less than 0.85). An oral glucose tolerance test was carried out before and after a hypocaloric nutritional treatment lasting 4 months. Both groups were matched for age, body mass index and amount of body fat. At the basal condition, group CTO had fasting and glucose-stimulated insulin levels significantly higher than group PTO; fasting (but not stimulated) C peptide levels were also higher in CTO compared with PTO. Weight and fat loss were significantly higher in CTO than in PTO women. Moreover, unlike PTO, CTO subjects significantly reduced their WHR values. In both groups weight loss led to a significant drop in fasting and glucose-stimulated insulin and C peptide levels. However, PTO women reduced their C peptide levels significantly less than CTO. In conclusion, weight loss only modified body fat distribution in women with CTO, who appeared to be prone to a greater weight loss than the PTO women. Compared to PTO, CTO women were characterized by higher insulin levels and peripheral insulin resistance, which improved during hypocaloric feeding probably due to the combined effect of weight loss and the change in body fat distribution.

A Cross-section of Women Engineers in Italy

SUMMARY In Italy as in other European countries, the percentage of women who graduated with a degree in engineering is still very low. However, in past years, matriculation of women in engineering has been increasing, although the trend is still lower than in other departments, where an overall average of 50% increase is projected. Using statistical data from the oldest and one of the most important universities in the world, the University of Bologna, we have analysed the historical and social reasons why particular careers for women,i.e. teaching and medicines, were chosen over other careers. Other data were used to study why women had difficulties being accepted at the University; who were the famous female teachers at the University of Bologna (18th century); who were the first female graduates in engineering in Italy (Turin, 1908) and in particular, in Bologna (1915). In addition, we studied the distribution of women in the various fields of engineering. A survey was sent to a sample of woment gradua...