Community-based Sample Of Women Research Articles

Testing the Spillover Effect of Intimate Partner Violence Victimization on Emotionally Abusive and Harsh Parenting Practices: The Application of Propensity Score Matching.

Prior research reported a significant association between intimate partner violence (IPV) victimization and negative parenting, but there was an overreliance on U.S. samples and families from low socioeconomic status backgrounds. Therefore, this quasi-experimental study examined the association between recent IPV victimization and abusive parenting practices in a sample of community-based women from Poland. Participants were mothers of children aged 2 to 5 years (N = 610) attending an outpatient clinic located in a city in south-eastern Poland. Mothers were asked about their IPV experiences in the past 12 months and were classed as either IPV positive or IPV negative. Outcome measures assessed emotionally abusive and harsh parenting practices. All data were collected online. To reduce bias in background characteristics (i.e., age, education, employment status, financial distress, self-esteem, childhood violence history, alcohol problems, current mental distress, social support, exposure to COVID-19-pandemic-related stressors, and child sex), we applied the propensity score matching (PSM) technique. Group differences before and after matching were examined using independent samples t-tests. Prematching analyses revealed that IPV-positive mothers used significantly more emotionally abusive and harsh parenting practices than IPV-negative mothers. However, the two samples differed substantially on six background characteristics which are known risk factors for IPV and child maltreatment (financial distress, self-esteem, childhood violence history, current mental distress, social support, and exposure to COVID-19-pandemic-related stressors). PSM was successful in reducing those imbalances. Postmatching group comparisons were statistically nonsignificant for emotionally abusive and harsh parenting, disproving the spillover hypothesis. We conclude that IPV victimization is not related to emotionally abusive and harsh parenting practices when controlling for confounding variables.

Thalassemia and hemoglobinopathy prevalence in a community-based sample in Sylhet, Bangladesh

BackgroundInherited blood disorders affect 7% of the population worldwide, with higher prevalences in countries in the “thalassemia belt,” which includes Bangladesh. Clinical management options for severely affected individuals are expensive; thus, targeted government policies are needed to support prevention and treatment programs. In Bangladesh, there is a lack of data, in particular community-based estimates, to determine population prevalence. This study aims to estimate the prevalence of a wide range of hemoglobinopathies and their associations with anemia in a community-based sample of women and young children in rural Sylhet, Bangladesh.MethodsCapillary blood samples from 900 reproductive-aged women and 395 children (aged 6–37 months) participating in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial in two sub-districts of Habiganj, Sylhet Division, Bangladesh were analyzed for alpha thalassemia, beta thalassemia, and other hemoglobinopathies. We examined the association of each inherited blood disorder with hemoglobin concentration and anemia using linear and logistic regression.ResultsWe identified at least one inherited blood disorder in 11% of women and 10% of children. Alpha thalassemia was most prevalent, identified in 7% of women and 5% of children, followed by beta thalassemia and hemoglobin E in 2–3%. We also identified cases of hemoglobin S and hemoglobin D in this population. Having any of the identified inherited blood disorders was associated with lower hemoglobin values among non-pregnant women, largely driven by alpha and beta thalassemia. Pregnant women with beta thalassemia were also more likely to have lower hemoglobin concentrations. Among children, we found weak evidence for a relationship between hemoglobinopathy and lower hemoglobin concentrations.ConclusionsWe found a high prevalence of alpha thalassemia among both women and children in rural Sylhet, Bangladesh–higher than all other identified hemoglobinopathies combined. Community-based estimates of alpha thalassemia prevalence in Bangladesh are scarce, yet our findings suggest that alpha thalassemia may comprise the majority of inherited blood disorders in some regions of the country. We recommend that future research on inherited blood disorders in Bangladesh include estimates of alpha thalassemia in their reporting for public health awareness and to facilitate couples counseling.

Psychometric properties of the ORTO-R in a community-based sample of women and men from Poland

PurposeOver the past two decades, orthorexia nervosa (ON) has been increasingly investigated. Recently, a new revision version of the ORTO-15, namely ORTO-R, was used. The main objective of the present study was to confirm the factor structure of Polish version of the ORTO-R for evaluating ON thoughts and behaviors.MethodIn three studies, a total of 3081 participants was selected by random sampling through several universities and companies. In Study 1, we used original items of ORTO-15, in Study 2 we used both, the ORTO-15 items and the revised items from ORTO-R, and in Study 3 we used only the items from the ORTO-R. Confirmatory factor analysis was used for determining the factorial structure of the Polish version of the ORTO-R. We also assessed internal consistency and convergent and criterion validity of the ORTO-R.ResultsThe model composed of the revised items (ORTO-R) was characterized of good convergent and criterion validity. Furthermore, ORTO-R appeared to be more internally consistent as compared to ORTO-15.ConclusionThe 6-item ORTO-R is valid and reliable method to assess orthorexic thoughts and behaviors among Polish-speaking population and could be applied in future research. Using revised version of the items is strongly preferred to using the items in their original ORTO-15 form.

Predicting breast cancer risk in a racially diverse, community-based sample of potentially high-risk women.

Identifying women with high risk of breast cancer is necessary to study high-risk experiences and deliver risk-management care. Risk prediction models estimate individuals' lifetime risk but have rarely been applied in community-based settings among women not yet receiving specialized care. Therefore, we aimed: (1) to apply three breast cancer risk prediction models (i.e., Gail, Claus, and IBIS) to a racially diverse, community-based sample of women, and (2) to assess risk prediction estimates using survey data. An online survey was administered to women who were determined by a screening instrument to have potentially high risk for breast cancer. Risk prediction models were applied using their self-reported family and medical history information. Inclusion in the high-risk subsample required ≥20% lifetime risk per ≥1 model. Descriptive statistics were used to compare the proportions of women identified as high risk by each model. N=1053 women were initially eligible and completed the survey. All women, except one, self-reported the information necessary to run at least one model; 90% had sufficient information for >1 model. The high-risk subsample included 717 women, of which 75% were identified by one model only; 96% were identified by IBIS, 3% by Claus, <1% by Gail. In the high-risk subsample, 20% were identified by two models and 3% by all three models. Assessing breast cancer risk using self-reported data in a community-based sample was feasible. Different models identify substantially different groups of women who may be at high risk for breast cancer; use of multiple models may be beneficial for research and clinical care.

Using Photovoice to Understand Survivors' Healthcare Experiences and Strategies

The unique, individual nature of traumatic experiences and trauma symptoms and the limited healthcare resources typically allocated for individual patients pose barriers to implementing trauma-informed care. Developing knowledge on how survivors of violence engage in healthcare and self-advocate can lead to more empowering and efficient implementation of trauma-informed care. However, survivor perspectives on trauma-informed care are underrepresented in current literature and survivors' strategies for navigating healthcare are understudied. The aims of this participatory Photovoice study were to describe the healthcare experiences of female survivors of violence and their strategies for dealing with difficult healthcare experiences, healthcare providers, and the healthcare system. A sample of community-based women participated in an iterative series of five Photovoice meetings. Participants discussed multifaceted vulnerability in healthcare settings with regard to past traumatic violence, triggering or retraumatizing health care experiences, medical knowledge, and provider-patient relationships. They agreed that providers believing their symptoms, health concerns, and trauma disclosures was essential for positive provider-patient relationships and healthcare experiences. Findings on the importance of perceived belief with regard to trauma disclosure and health concerns and survivors' healthcare strategies are unique contributions to the literature. Providers should be accountable for integrating survivors’ self-knowledge in collaborative healthcare decision-making, for making medical records and information easily accessible, and for expressing belief in trauma disclosures and health concerns. Future research should continue using participatory methods to assess evolving trauma-informed practices and patient engagement among survivors and to hasten progress toward trauma-informed care that effectively meets the needs of survivors.

Eating disorders in a community-based sample of women with alcohol use disorder and nicotine dependence

BackgroundStudies consistently report a higher prevalence of substance use disorders (SUDs) among women with eating disorders than control women. However, limited research exists on the prevalence of eating disorder symptoms and diagnoses in women with SUDs, especially in community-based populations. We examined the prevalence of eating disorder symptoms and diagnosis by the presence or absence of lifetime alcohol use disorder (AUD) and/or nicotine dependence (ND) in a community-based sample of women. Methods3756 women (median age = 22 years) from the Missouri Adolescent Female Twin Study completed a modified semi-structured interview assessing lifetime DSM-IV psychiatric disorders and SUDs. Logistic regression models adjusted for demographic characteristics and other psychopathology, and robust standard errors accounted for the non-independence of twin data. ResultsIn general, women with comorbid AUD and ND had a higher prevalence of eating disorder symptoms and diagnoses than women with AUD or ND Only, who in turn had a higher prevalence than those without either SUD. After adjustment for covariates, women with AUD and ND had significantly greater risk of broad anorexia nervosa (RRR = 3.17; 99 % CI = 1.35, 7.44), purging disorder (2.59; 1.24, 5.43), and numerous eating disorder symptoms than women with neither disorder. Significant differences emerged between individuals with both AUD and ND versus women with AUD Only or ND Only for some eating disorder symptoms. ConclusionsWomen with lifetime AUD or ND diagnoses are at high risk for eating disorder symptoms and diagnoses, underscoring the importance of assessing eating disorder symptoms among women with these disorders.

Weight-related stigma mediates the relationship between weight status and bodily pain: A conceptual model and call for further research

Women are disproportionately impacted by pain compared to men, highlighting the need to better understand factors that contribute to this gender disparity. Previous findings suggest weight-related stigma may be associated with pain among women attempting to lose weight. The goal of this study is to determine if experienced and/or internalized weight bias mediate the relationship between body mass index (BMI) and pain-related impairment in a large, community-based sample of women across the weight spectrum (N = 309; MAge = 56.5, SD = 14.5; MBMI = 28.5, SD = 7.1), and to evaluate whether this relationship differs for women with a pain condition. Analyses were performed using the Conditional-PROCESS Macro to examine the relationships between BMI, pain-related impairment, internalized and experienced weight-stigma, and the potentially moderating effect of pain-related conditions on these relationships. After adjusting for covariates, both experienced stigma and internalized weight stigma statistically mediated the BMI and pain-related impairment relationship; however, in the tests of moderated mediation, the indirect effect of internalized weight bias only held true for those without pain conditions. These findings offer a preliminary conceptual model and highlight the importance of pain research to include weight-related stigma.

The long-term effects of childhood financial hardship mediated by physical abuse, shame, and stigma on depression in women

Le difficolta finanziare hanno varie consequenze sui bambini nel lungo-termine. Questo studio esplora se queste aumentino il rischio di depressione e altre difficolta finanziare nel corso della vita e i meccanismi attraverso i quali cio avvenga, inclusi l’associazione con abuso e conseguenze quali stigma e vergogna. La path analysis e stata utilizzata per valutare se le difficolta finanziare infantili predicano difficolta finanziare una volta adulti e depres-sione, se queste associazioni sono mediate da sentimenti di vergogna durante l’infanzia, abuso fisico e stigma e se lo stigma e l’abuso fisico medino la relazione tra difficolta finan-ziare e sentimenti di vergogna e risultati nella vita adulta retrospettivamente in un campione generale di donne. Questo studio ha trovato che le difficolta finanziare infantili/adulte predi-cono la depressione adulta e i loro effetti sono mediati da abuso fisico, stigma e vergogna. L’abuso fisico e la vergogna mediano anche la relazione tra le difficolta finanziare infanti-li/adolescenziali e quelle adulte. Focalizzarsi sui sentimenti di vergogna potrebbe quindi es-sere un obiettivo chiave degli interventi di supporto per famiglie con vissuti di difficolta economiche e abuso fisico nei bambini a essi associati.

Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years.

This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age. This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms. The prevalence of moderate to severe VMS was as follows: 2.8% in premenopausal women, 17.1% in perimenopausal women, 28.5% in postmenopausal women younger than 55 years, 15.1% in postmenopausal women aged 55 to 59 years, and 6.5% in postmenopausal women aged 60 to 65 years. Prescription therapy for menopausal symptoms was used by 135 women: 120 (5.9%) women using hormone therapy and 15 (0.7%) women using nonhormonal medication. The factors positively associated with moderate to severe VMS were smoking (odds ratio, 1.6; 95% CI, 1.1-2.3; P < 0.05) and a body mass index of 25 to 29.9 kg/m (odds ratio, 1.7; 95% CI, 1.1-2.5; P < 0.05); education beyond high school was inversely associated (odds ratio, 0.7; 95% CI, 0.5-0.9; P < 0.05). In this large, representative, community-based sample of women, there is a high prevalence of untreated moderate to severe VMS even in women aged 60 to 65 years. The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low, suggesting that menopause remains an undertreated condition.

017 Interpersonal Violence, Posttraumatic Stress Disorder, and Aging-Related Genitourinary Dysfunction in an Ethnically-Diverse, Community-Based Sample of Women

Posttraumatic stress disorder (PTSD) and exposure to interpersonal violence are associated with genitourinary complaints among younger women, but little is known about the prevalence or impact of trauma experiences among midlife and older women. We examined the strength and direction of relationships between PTSD and interpersonal violence with aging-related genitourinary symptoms in midlife and older women. Data were drawn from a multiethnic cohort of women aged 40 to 80 years enrolled in Kaiser Permanente Northern California, a large integrated health care system. PTSD symptoms and lifetime history of interpersonal violence exposures (physical and emotional intimate partner violence, sexual assault) were assessed using standardized, structured-item questionnaire measures, including the Posttraumatic Stress Disorder Checklist-Civilian Version. Aging-related genitourinary symptoms (urinary incontinence, nocturia, vaginal pain with sexual intercourse, vaginal irritation, and vaginal soreness) were assessed using structured-item questionnaire measures. Multivariable logistic regression models examined associations between PTSD or interpersonal violence exposures with aging-related genitourinary dysfunction, adjusting for age, race/ethnicity, body mass index, menopausal status, and hormone therapy.

Polydrug use patterns, risk behavior and unmet healthcare need in a community-based sample of women who use cocaine, heroin or methamphetamine

BackgroundThe use of multiple illicit drugs (polydrug use) is associated with health-related harms and elevated risk of drug overdose. Polydrug use in common among women who use ‘hard’ drugs, such as cocaine, heroin or methamphetamine. MethodsQuantitative data collection was conducted with a community-recruited sample of 624 women who used heroin, methamphetamine or cocaine in Oakland, CA during 2014–2015. We conducted latent class analysis to classify polydrug use patterns. We assessed associations between classes of polydrug use and infectious disease risk behaviors, health care utilization and unmet health care need. ResultsWe identified four distinct classes of drug use: (1) predominantly crack (52% of women); (2) powder cocaine & non-heroin opioids (8%); (3) moderate polydrug use (25%); (4) heavy polydrug use (15%). Odds of sexual risk, injection drug use and unmet healthcare need were twice as high in the heavy polydrug use class as the predominantly crack class (p > 0.01 for each outcome). The rate of binge drinking (as days per month) was also significantly higher in the heavy polydrug class (p = 0.01). The moderate polydrug use class had higher odds of injection drug use and drug treatment participation, compared to the mainly crack class (p < 0.001 for each outcome). There were no differences between classes in health insurance or health care utilization. DiscussionReduction of polydrug use could be an effective harm reduction strategy to address sexual and injection risk among women. The use of both opioids and stimulants in three of the four classes suggests that multi-modal substance abuse treatment approaches may be most appropriate.

MP79-01 DO ABNORMAL TOILETING BEHAVIORS CONTRIBUTE TO WORSE URINARY SYMPTOMS IN WOMEN?

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II1 Apr 2018MP79-01 DO ABNORMAL TOILETING BEHAVIORS CONTRIBUTE TO WORSE URINARY SYMPTOMS IN WOMEN? Casey G Kowalik, Adam Daily, Sophia Delpe, W. Stuart Reynolds, Melissa R. Kaufman, and Roger R. Dmochowski Casey G KowalikCasey G Kowalik More articles by this author , Adam DailyAdam Daily More articles by this author , Sophia DelpeSophia Delpe More articles by this author , W. Stuart ReynoldsW. Stuart Reynolds More articles by this author , Melissa R. KaufmanMelissa R. Kaufman More articles by this author , and Roger R. DmochowskiRoger R. Dmochowski More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2669AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lower urinary tract symptoms are common in women and presumably relate to four recognized domains of toileting behaviors, including 1) place, 2) timing, 3) position, and 4) style. However, little is still known about the associations between abnormal or dysfunctional toileting behaviors and urinary symptoms. Our aim was to investigate whether increased lower urinary tract symptoms, specifically overactive bladder (OAB), are correlated with increased self-report of dysfunctional toileting behaviors in a community-based sample of women. METHODS In this cross-sectional study, we recruited 2,215 community women to complete online, validated questionnaires, including the Toileting Behavior Scale (TBS) and International Consultation on Incontinence Questionnaire-Overactive bladder (ICIQ-OAB). Dysfunctional behavior questions were grouped by premature voiding (voiding without the need to urinate), delayed voiding, and straining to void. Pearson correlation was used to examine the strength of associations between ICIQ-OAB and dysfunctional toileting behavior scores. RESULTS The average age was 47.3 (range: 18-89). All except 3 women (99.9%) reported a place preference for voiding, with 10.5% (n=233) always avoiding public restrooms. Overall, 79.9% (n=1,770) reported premature voiding, 64.5% (n=1,429) straining to void, and 97.8% (n=2,166) delayed voiding. Reasons for delaying urination at least sometimes were ″busy″ (84.5%, n= 1,873) or ″at work″ (37.6%, n= 832). There were significant positive correlations between ICIQ-OAB scores and all dysfunctional toileting behaviors, with the strongest correlation being premature voiding (r=0.364, p<0.001). CONCLUSIONS Nearly all women in our sample endorsed dysfunctional toileting behaviors with voiding. There was correlation of toileting behaviors and lower urinary tract symptoms. Women with worse OAB symptoms were most likely to void pre-emptively, in the absence of desire, although many also reported straining to void and delaying voiding. Further study is needed to explore the effects of dysfunctional toileting behaviors on the development or worsening of lower urinary tract symptoms in adult women. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1080 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Casey G Kowalik More articles by this author Adam Daily More articles by this author Sophia Delpe More articles by this author W. Stuart Reynolds More articles by this author Melissa R. Kaufman More articles by this author Roger R. Dmochowski More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

MP27-06 RISK FACTORS ASSOCIATED WITH FECAL INCONTINENCE IN PATIENTS WITH OVERACTIVE BLADDER

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2018MP27-06 RISK FACTORS ASSOCIATED WITH FECAL INCONTINENCE IN PATIENTS WITH OVERACTIVE BLADDER Caitlin Lim, Joshua Cohn, Casey Kowalik, Melissa Kaufman, Roger Dmochowski, and W. Stuart Reynolds Caitlin LimCaitlin Lim More articles by this author , Joshua CohnJoshua Cohn More articles by this author , Casey KowalikCasey Kowalik More articles by this author , Melissa KaufmanMelissa Kaufman More articles by this author , Roger DmochowskiRoger Dmochowski More articles by this author , and W. Stuart ReynoldsW. Stuart Reynolds More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.885AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Overactive bladder (OAB) and bowel conditions often occur together, and both can have profound effects on a woman′s quality of life. Treatment of OAB can impact bowel function as well, either negatively (e.g. constipation and antimuscarinics), or positively (e.g. reduced fecal incontinence, FI, with sacral neuromodulation). We sought to identify factors associated with FI in a community-based sample of women with OAB. METHODS Adult women with symptoms of OAB were identified via clinical practice and email-based advertisements. In all subjects, OAB was confirmed by a score of 4 on the OABv3 screening questionnaire. Standardized questionnaires assessed clinical characteristics, OAB severity (OAB-q8), quality of life (OAB-q SF HRQoL), and FI (Fecal Incontinence Severity Index, FISI). These data were compared between subjects with and without FI, defined as any leakage of mucus, liquid or solid stool at least monthly, and the association between OAB and FI severity assessed. RESULTS 101 (53%) participants reported having FI and 91 (47%) did not. Mean FISI scores were 27.9 ± 8.6 in those reporting FI and 5.5 ± 5.2 in those reporting no FI (p<0.001). Women reporting FI had more severe OAB (mean OABq8 SS: 47.5 ± 25.6 vs. 39.3 ± 21.2, p=0.017) and worse OAB-HRQL (59.6 ± 29.5 vs 69.3 ± 23.0, p=0.012). OAB severity (OABq8) (β 0.29, 95% 0.04-0.55) and OAB-related quality of life (OABq-SF HRQL) (β -0.33, 95% CI -0.61, -0.05) were significantly correlated with FISI scores. In addition to suffering from more severe OAB, women reporting any FI were older (mean age 46.8 ± 15.2 vs. 41.6 ± 14.0 years, p=0.015) and more likely to report suffering from neuropathy (p=0.013), spine or degenerative disc disease (p=0.003), irritable bowel syndrome (p=0.013), fibromyalgia (p=0.035), and chronic fatigue syndrome (p=0.044). CONCLUSIONS Over half of women with OAB reported at least monthly FI, which was associated with increased age and the presence of neuropathy, degenerative spinal disease, irritable bowel syndrome, and chronic pain syndromes. Furthermore, FI was associated with increased OAB symptom severity and decreased OAB condition-specific quality of life. In many patients, FI and OAB may be unique symptoms resulting from common pathophysiology, either due to pelvic organ or more global dysfunction. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e348 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Caitlin Lim More articles by this author Joshua Cohn More articles by this author Casey Kowalik More articles by this author Melissa Kaufman More articles by this author Roger Dmochowski More articles by this author W. Stuart Reynolds More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Exploring Lifetime Accumulation of Criminal Justice Involvement and Associated Health and Social Outcomes in a Community-Based Sample of Women who Use Drugs.

Among people who use illegal drugs, engagement with the criminal justice (CJ) system often involves an ongoing, intermittent series of arrests, incarcerations, and periods of community supervision. The potential associations between the lifetime accumulation of CJ involvement and social and health outcomes is largely unexplored. In a cross-sectional sample of women who use crack, heroin, and/ or methamphetamine recruited from communities in Oakland, CA (N=624), we developed an approach to characterize CJ accumulation. We used latent class analysis (LCA), a multivariate person-centered method that assumes an unobserved categorical variable that divides a population into a small number of mutually exclusive and exhaustive classes. Using observed measures of incarceration and community supervision as indicator variables, we developed a model of CJ accumulation that elucidates patterns of involvement as lived by the women in the sample. Based on model fit statistics, we selected a three-class model and labeled the classes "low," "medium," and "high." We then explored associations between the classes of CJ accumulation and health and health-related outcomes using logistic regression. The odds of homelessness (p for trend=0.004), transience (p for trend=0.017), and recent victimization (p for trend=0.023) were higher among women in higher accumulation classes. Higher class of CJ accumulation was associated with higher odds of reporting unmet need for physical health care (p for trend <0.001) and mental health care (p for trend=0.002). The odds of physical health conditions, such as hepatitis C infection (p for trend<0.001) and mental health conditions, such as depression (p for trend=0.003), also increased with higher class of accumulation. While the findings described here are limited by the cross-sectional nature of the study, they suggest that CJ accumulation is a potentially meaningful concept for assessing associations between the CJ system and health-related issues.

Body esteem and self-esteem in middle-aged women

ABSTRACTThe aims of the study were (a) to identify predictors of body esteem and (b) to expand on previous research by examining the link between global self-esteem and body esteem in a community-based sample of women in midlife. We found that body esteem in midlife women was predicted by body mass index (BMI), optimism, self-esteem, and menopausal symptoms. Although BMI was the main predictor of body esteem in middle-aged women, global self-esteem was more strongly related to feelings about appearance and physical condition than feelings about body size.

Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT.

This pilot randomized controlled trial evaluated a novel trauma-informed model of mindfulness-based stress reduction (TI-MBSR) as a phase I trauma intervention for female survivors of interpersonal violence (IPV). A community-based sample of women (mean age = 41.5, standard deviation = 14.6) with a history of IPV was randomly assigned to an 8-week TI-MBSR intervention (n = 23) or a waitlist control group (n = 22). Symptoms of posttraumatic stress disorder (PTSD) and depression as well as anxious and avoidant attachment were assessed pre- and postintervention. Relative to the control group, participation in TI-MBSR was associated with statistically and clinically significant decreases in PTSD and depressive symptoms and significant reductions in anxious attachment. Retention in the intervention was high, with most participants completing at least 5 of the 8 sessions for the intervention. Minutes of mindfulness practice per week significantly predicted reductions in PTSD symptoms. TI-MBSR appears to be a promising and feasible phase I intervention for female survivors of interpersonal trauma.

Abortion experiences among Zanzibari women: a chain-referral sampling study.

BackgroundIn Zanzibar, a semi-autonomous region of Tanzania, induced abortion is illegal but common, and fewer than 12 % of married reproductive-aged women use modern contraception. As part of a multi-method study about contraception and consequences of unwanted pregnancies, the objective of this study was to understand the experiences of Zanzibari women who terminated pregnancies.MethodsThe cross-sectional study was set in Zanzibar, Tanzania. Participants were a community-based sample of women who had terminated pregnancies. We carried out semi-structured interviews with 45 women recruited via chain-referral sampling. We report the characteristics of women who have had abortions, the reasons they had abortions, and the methods used to terminate their pregnancies.ResultsWomen in Zanzibar terminate pregnancies that are unwanted for a range of reasons, at various points in their reproductive lives, and using multiple methods. While clinical methods were most effective, nearly half of our participants successfully terminated a pregnancy using non-clinical methods and very few had complications requiring post abortion care (PAC).ConclusionsEven in settings where abortion is illegal, some women experience illegal abortions without adverse health consequences, what we might call ‘safer’ unsafe abortions; these kinds of abortion experiences can be missed in studies about abortion conducted among women seeking PAC in hospitals.

Intimate Partner Violence Associated with Postpartum Depression, Regardless of Socioeconomic Status.

Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)]. Socioeconomic status was defined by insurance (Medicaid-paid-delivery or not). This analysis controlled for the following covariates, collected through interview and medical-record review: demographics, obstetric history, prenatal health and additional psychosocial risk factors. After adjusting for significant covariates, multiple linear regression was conducted to test whether socioeconomic status confounded or moderated IPV's relationship with EPDS-score. Results Ten percent of participants screened positive for postpartum depression, 21.3% screened positive for current or previous adult emotional or physical abuse by a partner, and 32.2% met poverty criteria. IPV and poverty were positively associated with each other (χ(2) (1)=11.76, p<.001) and with EPDS score (IPV: beta 3.2 (CI 2.0, 4.5) p<.001, poverty: beta 1.3 (CI 0.2, 2.4) p=.017). In the multiple linear regression, IPV remained significantly associated, but poverty did not (IPV: adjusted beta 3.1 (CI 1.8, 4.3) p<.001, poverty: adjusted beta 0.8 (CI -0.3, 1.9) p=.141), and no statistically significant interaction between IPV and poverty was found. Conclusions Study findings illustrated that IPV was strongly associated with postpartum depression, outweighing the influence of socioeconomic status upon depression for postpartum women.

Correlates of Risky Heterosexual Behaviors Among Women Who Use Methamphetamine

Women who use methamphetamine are at heightened risk of engaging in sexual behaviors that increase their odds of contracting HIV or sexually transmitted infections (STIs). However, little is known regarding correlates of such behaviors within this population. In a community-based sample of women who use methamphetamine ( N = 322), we examined participant characteristics (i.e., demographics, drug- and sex-related behaviors, and mental health characteristics) associated with three operationalizations of risky heterosexual behaviors in the past 6 months (i.e., number of male partners, condomless sex with male partners, and both multiple male partners and condomless sex). Analyses revealed important distinctions in the correlates of risky heterosexual behaviors as a function of outcome. Results suggest that HIV and STI prevention strategies should consider characteristics associated with differing risky heterosexual behaviors. In addition, differences in correlates of these behaviors suggest a need for standardization in measurement and evaluation of sexual risk in research and practice with women who use methamphetamine.

Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years.

This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age. This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms. The prevalence of moderate to severe VMS was as follows: 2.8% in premenopausal women, 17.1% in perimenopausal women, 28.5% in postmenopausal women younger than 55 years, 15.1% in postmenopausal women aged 55 to 59 years, and 6.5% in postmenopausal women aged 60 to 65 years. Prescription therapy for menopausal symptoms was used by 135 women: 120 (5.9%) women using hormone therapy and 15 (0.7%) women using nonhormonal medication. The factors positively associated with moderate to severe VMS were smoking (odds ratio, 1.6; 95% CI, 1.1-2.3; P < 0.05) and a body mass index of 25 to 29.9 kg/m(2) (odds ratio, 1.7; 95% CI, 1.1-2.5; P < 0.05); education beyond high school was inversely associated (odds ratio, 0.7; 95% CI, 0.5-0.9; P < 0.05). In this large, representative, community-based sample of women, there is a high prevalence of untreated moderate to severe VMS even in women aged 60 to 65 years. The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low, suggesting that menopause remains an undertreated condition.