Health Status Of Women Research Articles

The effects of ageing on female genital and sexual health.

This article will explore the impact of ageing on sexual function in older women and will reflect on the social influences on women's sexual ageing, identify the effects of ageing on sexual activity, particularly on genital skin, and consider the concerns from the perspective of older women. The article will then focus on vulval skin conditions and the functional aspects of living with these conditions. Finally, the article provides a starting point for nurses to consider their own knowledge, skills and attitudes through a series of reflective questions and recommendations for those working with older women to aid the identification of issues relating to older women's sexual health and vulval skin conditions, leading to further discussions to promote genital health.

Pelvic floor muscle spasm, comorbid pain and mental health conditions in women with endometriosis-associated chronic pelvic pain

Pelvic floor muscle spasm, comorbid pain and mental health conditions in women with endometriosis-associated chronic pelvic pain

Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study

Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.

Hidden Figures: Are Ultra-Orthodox Jewish Women Really so Different When it Comes to Health Care?

Incorporating the needs of at-risk populations into national health care initiatives is essential. Israel has identified ultra-Orthodox Jewish, or Haredi, women, as at risk of increased morbidity and mortality, yet actual data on this insular community are lacking. We reviewed published research on Israeli Haredi women's health status, behaviors and health care access and examined methodologies. Of 273 articles identified, 14 publications and four government reports were included. More research is needed on this community, essential not only to Israeli health care policy, but to that of the USA and the UK, who share the largest percentages of Haredi Jews.

Working and health conditions of female taxi drivers in Mexico City: A comparative analysis between women and men

This paper describes working and health conditions of women who drive a taxi in Mexico City as their main economic activity, and the disparities in comparison to male taxi drivers. Based on a questionnaire given to 285 taxi drivers, 201 men and 84 women, it was found that although women have more years of education (p < .001) and work more hours per day (p < .031), their income is less than that of men (p < .196). Most (73.8%) of the women are single or lack financial support for their household—they are single mothers, widows, or divorcees—and 85.48% have children that they take to school and their educational activities, which means a loss of working hours precisely at rush hour, when demand and income rate are at their highest. Furthermore, women have a higher proportion of illness (p < .001) and musculoskeletal ailments than men drivers (p < .001); and they are more likely to get sick, mainly stemming from psychosocial demands such as feeling their work is unpleasant (OR = 2.11), income dissatisfaction (OR = 3.09), and getting traffic tickets (OR = 3.25). Therefore, there are important differences in working and health conditions between men and women, which need to be combatted with labor, safety, and gender equality policies to improve psychosocial factors for female workers.

Socio-Economic Determinants and Status of Women's Health

Socio-Economic Determinants and Status of Women's Health

The Well-Woman Project: Listening to Women's Voices.

Purpose: The U.S. Affordable Care Act (ACA) of 2010 included the Well-Woman Visit (WWV) as one of the preventive services, which must be covered without cost sharing. Despite concerted efforts to increase access to the WWV, data from the early years of the ACA demonstrated ongoing barriers, including insufficient consumer and provider awareness of the ACA's no cost-sharing provision for preventive services. As such, 2 years after full implementation of the ACA, the Well-Woman Project (WWP) used qualitative methods to learn about women's perceptions of the WWV and barriers that affect their ability to be healthy and seek well-woman care.Methods: Women's voices were captured by Listening Sessions in eight cities and through stories from women across the United States posted to a WWP Website, or reported over a WWP toll-free phone line. Thematic analysis of Listening Sessions and stories was conducted using Dedoose software.Results: In 2016, Listening Sessions (17) were held with 156 women; in addition, stories were collected from 102 women across the United States. Women are aware of the importance of preventive care, but report multiple barriers to seeking such care. However, they are able to articulate a variety of system and policy strategies that mitigate the complexity of navigating the health care system; help women prioritize their health and accessing health care; promote positive relationships with providers; empower women to advocate for themselves and others; promote positive mental health as well as access to safe environments, healthy food, and social support systems; decrease barriers related to lack of transportation and childcare; and support the provision of trauma informed care in the health care delivery system.Conclusion: To improve women's health status and reduce inequities, making the preventive well-care visit available without cost-sharing is necessary, but not a sufficient strategy.

Impact of instructional intervention program upon women's psychological health status who undergo chemotherapy after mastectomy

Objective(s): To determine the impact of instructional intervention program upon psychological health status forwomen who undergo chemotherapy after mastectomyMethodology: The sample consisted of (100) women, (50) considered as study group, and another (50) the controlgroup. A pre test was done for both groups (study and control), and then the study samples were exposed to aninstructional intervention and three-dimensional post tests and the length of time between each test 21 days inthe Institute and Hospital of Radiation and Nuclear Medicine. The questionnaire composed of three parts, first,demographic information; include (age, educational level, type of family, occupation, marital status, and adequacyof monthly income). Second, information about breast cancer include (the period in which the disease wasdiagnosed, the type of breast cancer, method of chemotherapy administration, the period of the chemotherapy,the order of the current session of chemotherapy treatment, the number of chemotherapy sessions, the source ofinformation of chemotherapy side effects. Information on previous medical history and consists of (the previousproblem of the breast, the type of injury, the site of disease, type of surgery, stage of the cancer when it wasdiscovered, family members who suffer from breast cancer). Third, the psychological effects. Pre and post test wasused to determine the reliability of the questionnaire with a time interval for a period of more than 3 weeksbetween each test, the results (r = 0.9013) for the psychological effects. Analysis of data was performed throughthe application of descriptive and inferential statistical data analysis approach.Results: Revealed that there is lack of information in women treated with chemotherapy after mastectomy beforethe implementation of the program regarding the side effects of chemotherapy treatment, and the symptomswhich appear on patients increase their anxiety and negative psychological symptoms but after theimplementation of the program the information of women become well and their psychological status improved.Recommendations: the study recommended that the Institute and Hospital of Radiation and Nuclear Medicinemust include an instructional intervention program concerning the psychological health of women who are treatedwith chemotherapy after mastectomy

Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome.

We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian-led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will enable practice benchmarking and feedback to further inform evidence-based practice. We propose that this methodology could be used in developing and implementing guidelines for other women's health conditions and beyond. Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non-fertility indications; and assessment and treatment of infertility. Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as "at risk" and receive follow-up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple pregnancies compared with clomiphene citrate.

Social Exclusion, Caste and Health Status of Women and Children in Jammu &amp;amp; Kashmir, India

The purpose of the present paper was to investigate the linkages between certain selected socially excluded groups (SCs, STs & OBCs) and their health status in Jammu & Kashmir. In the context of India as well as Jammu & Kashmir, the existence of caste system and gender bias is one of the major reasons of social exclusion. Due to exclusion from mainstream groups, the health status of these socially excluded groups is badly affected in one or the other way. We have selected certain health indicators such as health status of women during pregnancy, nutritional status of women and children and other general indicators of child health which directly or indirectly reflect the health status of women and children. Analysis has been done to understand the association between socially excluded groups and their health status in Jammu & Kashmir. The results indicated that huge health disparities in the health status of the women and children belonging to SCs, STs and OBCs do exist when compared to others. It was further observed that the health status of women and children in Jammu & Kashmir is better than all India level.

Effect of Gender Exploitation and Violence on Health Status of Women and Girls in Chitwan District

This study aimed to findout forms and causes of gender exploitation and violence as well as reveal the effect of gender exploitation and violence on the health status of women and girls. The researcher collected secondary data from District Police Office and Women Cell of the same office of Chitwan. Primary data was collected from purposive sampling method. The study reveals that majority of the victims of exploitation and violence suffers from grave physical health problem, psychological and mental health problem and reproductive health problems. Similarly, the study also reveals that the causes of gender exploitation and violence are economical, political, educational and social backwardness. From the research, it is concluded that women and girls are dominated due to lack of education, patriarchal society, polygamy society, sexual dissatisfaction and dowry. Moreover, women are discriminated from birth. This study also shows that literate women are equally victimized as well as the illiterate women and girls. The Sapta Gandaki JournalVol. IX, 2018 Feb. Page: 26-33

Acupuncture and acupressure for premenstrual syndrome.

Acupuncture and acupressure for premenstrual syndrome.

Models for Predicting Recurrence, Complications, and Health Status in Women After Pelvic Organ Prolapse Surgery.

To develop statistical models predicting recurrent pelvic organ prolapse, surgical complications, and change in health status 12 months after apical prolapse surgery. Logistic regression models were developed using a combined cohort from three randomized trials and two prospective cohort studies from 1,301 participants enrolled in surgical studies conducted by the Pelvic Floor Disorders Network. Composite recurrent prolapse was defined as prolapse beyond the hymen; the presence of bothersome bulge symptoms; or prolapse reoperation or retreatment within 12 months after surgery. Complications were defined as any serious adverse event or Dindo grade III complication within 12 months of surgery. Significant change in health status was defined as a minimum important change of SF-6D utility score (±0.035 points) from baseline. Thirty-two candidate risk factors were considered for each model and model accuracy was measured using concordance indices. All indices were internally validated using 1,000 bootstrap resamples to correct for bias. The models accurately predicted composite recurrent prolapse (concordance index=0.72, 95% CI 0.69-0.76), bothersome vaginal bulge (concordance index=0.73, 95% CI 0.68-0.77), prolapse beyond the hymen (concordance index=0.74, 95% CI 0.70-0.77), serious adverse event (concordance index=0.60, 95% CI 0.56-0.64), Dindo grade III or greater complication (concordance index=0.62, 95% CI 0.58-0.66), and health status improvement (concordance index=0.64, 95% CI 0.62-0.67) or worsening (concordance index=0.63, 95% CI 0.60-0.67). Calibration curves demonstrated all models were accurate through clinically useful predicted probabilities. These prediction models are able to provide accurate and discriminating estimates of prolapse recurrence, complications, and health status 12 months after prolapse surgery.

Anemia and associated factors in women at reproductive age in a Brazilian Northeastern municipality.

To identify the prevalence of iron-deficiency anemia and associated factors in women at reproductive age in the city of Vitoria de Santo Antão, Pernambuco. Cross-sectional study with a representative sample of 322 women aged between 15 and 49 years. Anemia was diagnosed by measuring hemoglobin below 12 g/dL. The independent variables were: demographic and socioeconomic conditions (age, race/color, education, literacy, presence of children aged < 5 years in the household, regime of residence occupation, ownership of assets, and per capita income), housing conditions (number of people in the household, number of bedrooms, and basic sanitation), food and nutrition security and women's health conditions (menarche, number of pregnancies, history of miscarriages, body mass index, and ferritin). Poisson regression was used to analyze the factors associated with anemia. The mean age of women surveyed was 31.1 ± 6.61 years old (standard deviation - SD) and the prevalence of anemia was 18.6% (95%CI 14.7 - 23.3). After multivariate analysis, anemia was significantly associated with age ≤ 19 years and low ferritin. The prevalence of anemia is characterized as a mild public health problem and follows the world trend in developing countries.

A Lactobacillus-Deficient Vaginal Microbiota Dominates Postpartum Women in Rural Malawi.

ABSTRACTThe bacterial community found in the vagina is an important determinant of a woman's health and disease status. A healthy vaginal microbiota is associated with low species richness and a high proportion of one of a number of different Lactobacillus spp. When disrupted, the resulting abnormal vaginal microbiota is associated with a number of disease states and poor pregnancy outcomes. Studies up until now have concentrated on relatively small numbers of American and European populations that may not capture the full complexity of the community or adequately predict what constitutes a healthy microbiota in all populations. In this study, we sampled and characterized the vaginal microbiota found on vaginal swabs taken postpartum from a cohort of 1,107 women in rural Malawi. We found a population dominated by Gardnerella vaginalis and devoid of the most common vaginal Lactobacillus species, even if the vagina was sampled over a year postpartum. This Lactobacillus-deficient anaerobic community, commonly labeled community state type (CST) 4, could be subdivided into four further communities. A Lactobacillus iners-dominated vaginal microbiota became more common the longer after delivery the vagina was sampled, but G. vaginalis remained the dominant organism. These results outline the difficulty in all-encompassing definitions of what a healthy or abnormal postpartum vaginal microbiota is. Previous identification of community state types and associations among bacterial species, bacterial vaginosis, and adverse birth outcomes may not represent the complex heterogeneity of the microbiota present. (This study has been registered at ClinicalTrials.gov as NCT01239693.)IMPORTANCE A bacterial community in the vaginal tract is dominated by a small number of Lactobacillus species, and when not present there is an increased incidence of inflammatory conditions and adverse birth outcomes. A switch to a vaginal bacterial community lacking in Lactobacillus species is common after pregnancy. In this study, we characterized the postpartum vaginal bacterial community of a large group of women from a resource-poor, undersampled population in rural Malawi. The majority of women were found to have a Lactobacillus-deficient community, and even when sampled a year after delivery the majority of women still did not have Lactobacillus present in their vaginal microbiota. The effect of becoming pregnant again for those who do not revert to a Lactobacillus-dominant community is unknown, and this could suggest that not all Lactobacillus-deficient community structures are adverse. A better understanding of this complex community state type is needed.

Palestinian women's oral health status, knowledge, practices, and access to dental care during pregnancy: a cross-sectional study

BackgroundNo data exist about the oral health status, beliefs, and practices of women living in the occupied Palestinian territory generally and in pregnant women in particular. The aim of this study was to investigate pregnant women's oral health status, beliefs, and practices and the barriers to access to dental care. MethodsPregnant women visiting prenatal programmes at Ministry of Health centres in Jerusalem governorates were screened using the Decayed, Missed and Filled Teeth (DMFT) index to quantify their dental caries experience. A structured interview was also done to assess oral health beliefs and practices, demographic characteristics, and mothers' stress level and social support. Ethical approval was obtained from Al-Quds University Ethics Committee. Findings119 pregnant women agreed to participate in this study. 103 (87%) women were housewives with mean age 26 years (SD 5). 30 (25%) women had a household monthly income less than US$380, and 54 (45%) women did not finish their high school education. The sample had a mean DMFT index score of 14 (SD 5). 42 (35%) women had not visited a dentist in the past 3 years, and 61 (51%) women were advised by family and friends not to visit the dentist while pregnant. 96 (81%) women had no dental insurance, and 33 (28%) women considered cost to be a barrier to accessing dental care. 42 (35%) women brushed their teeth sometimes, and 106 (89%) women never flossed their teeth. 29 (24%) women perceived their oral health to be poor, and 65 (55%) women believed that a woman can lose a tooth just because she is pregnant. 60 (50%) women did not know the connection between poor oral health and adverse birth outcomes, and 25 (21%) women believed that cavities in baby teeth do not matter. InterpretationWomen in this study had a high prevalence of dental caries and reported substantial barriers to obtaining dental care. Findings from this study suggest the need for preventive and educational interventions to be incorporated in prenatal health-care programmes to improve maternal and child oral health in Palestine. FundingPartially funded by a L'Oréal/UNESCO “For Women in Science” 2014 Fellowship.

Preconception Health Indicators for Public Health Surveillance.

In response to an expressed need for more focused measurement of preconception health (PCH), we identify a condensed set of PCH indicators for state and national surveillance. We used a systematic process to evaluate, prioritize, and select 10 PCH indicators that maternal and child health programs can use for surveillance. For each indicator, we assessed prevalence, whether it was addressed by professional recommendations, Healthy People 2020 objectives, or Centers for Disease Control and Prevention winnable battles, measurement simplicity, data completeness, and stakeholders' input. Fifty PCH indicators were evaluated and prioritized. The condensed set includes indicators that rely on data from the Pregnancy Risk Assessment Monitoring System (n = 4) and the Behavioral Risk Factor Surveillance System (n = 6). The content encompasses heavy alcohol consumption, depression, diabetes, folic acid intake, hypertension, normal weight, recommended physical activity, current smoking, unwanted pregnancy, and use of contraception. Having a condensed set of PCH indicators can facilitate surveillance of reproductive-aged women's health status that supports monitoring, comparisons, and benchmarking at the state and national levels.

The effect of pelvic pain and urinary incontinence on women's self-rated health in northern Mexico.

This study was designed to assess the effect of gynecological morbidities on Mexican women's self-rated health status and emotional health. A cross-sectional population-based study was conducted among Mexican women aged 25-54. We analyzed information on 1,303 participants living in Hermosillo, Mexico. Multiple logistic regression was used to assess the effect of having any one of three kinds of pelvic pain, urinary incontinence or both of these conditions on women's self-rated health. Additionally, we conducted analysis of variance and multiple linear regression to test the effect of these gynecological morbidities on women's self-reported emotional health. Nearly one-third (31.2%) of participants rated their health as fair to very poor. Women reporting of at least one gynecological morbidity were more likely to rate their health as fair to very poor. In adjusted analyses, in addition to older age, low educational attainment, marital status other than single, lack of access to medical care, recurrent kidney infection, asthma, diabetes, and, reporting one or concurrent gynecological morbidities were associated with increased odds (adjusted odds ratios = 1.53-3.91) of reporting fair to very poor self-rated health. Women who did not report any gynecological morbidity had significantly lower mean scores for anxiety/fear 0.30 (±0.30) than women with two to four conditions (anxiety/fear 0.45± 0.31). Pelvic pain, urinary incontinence, and the co-occurrence of these conditions have a negative impact on women's perception of their health status and their emotional health.

Recent Changes in Health Status of Women in Bihar through National Family Health Survey Window

Recent Changes in Health Status of Women in Bihar through National Family Health Survey Window

Association of Low Back and Pelvic Pain with Mental Health Condition during Pregnancy and Postpartum

Background: Low back and pelvic pain (LBPP) as a physical symptom may cause psychological symptoms during pregnancy and the postpartum period. We examined the association of LBPP with mental health condition in women from pregnancy to puerperium in a prospective study. Methods: This study was conducted from March 2015 to December 2016 in a birth center in Kagawa Prefecture in Japan. We recruited 89 pregnant women who responded to questionnaires in all four stages (first, second and third trimesters and one week postpartum). We designed a self-administered questionnaire including a visual analog scale (VAS) of LBPP and Edinburgh postnatal depression scale (EPDS). Results: There were significant differences in EPDS scores and VAS scores among the 4 stages. The EPDS score at the first trimester showed significant positive correlations with VAS scores at the second and third trimesters, and the EPDS score at the second trimester showed a significant positive correlation with VAS score at the third trimester. The VAS scores at the second trimester showed significant positive correlations with EPDS scores at the third trimester and at one week postpartum. Conclusion: It was shown that the mental health condition at early pregnancy was related to an increase in LBPP at mid-pregnancy and that LBPP at mid-pregnancy was associated with the mental health condition thereafter.