Health Problem For Women Research Articles

The impact of childhood abuse history and domestic violence on the mental health of women in Japan

Objective To understand the independent and interactive effects of childhood abuse history (CAH) and domestic violence (DV) on the mental health status of women in Japan. Methods A self-administered questionnaire survey was conducted among a sample of 340 women staying in 83 Mother-Child Homes in Japan to assess the women's CAH and DV experiences, along with their current mental health problems, including dissociated, depressed, and traumatic symptoms. Results Independent from DV, CAH, especially psychological abuse, had a significant impact on all of the women's mental health symptoms. DV was found to have an independent effect on traumatic symptoms. Weak interactive effects of CAH and DV were found on dissociated and traumatic symptoms. Among those women without CAH, DV was significantly associated with dissociated and traumatic symptoms; however, DV had no impact on dissociated and traumatic symptoms if CAH was present. Conclusions The findings suggest the significant impact of CAH on women's mental health problems, independent from DV. CAH and DV weakly interact on women's mental health. Practice implications In psychological therapy for battered women with mental health problems, if the cases were abused during childhood, it is recommended that therapy be focused on childhood abuse, especially if the client was psychologically abused. In addition, mental health care and welfare providers should be aware that the mental health problems of mothers without CAH might be exacerbated by DV; thus, appropriate resource allocation should be considered.

History of Sexual and Physical Abuse in Women with Dyspareunia: Association with Pain, Psychosocial Adjustment, and Sexual Functioning

Dyspareunia is a women's sexual health problem that still often goes undiagnosed despite its high prevalence and its detrimental impact on sexual, relationship, and psychological adjustment. Although sexual and physical abuse may constitute risk factors for the development of dyspareunia, the effects of past abuse on current pain and associated sexual and psychosocial impairments have never been examined. Thus, the aim of this study is to determine the relation between a history of sexual and physical abuse and a series of pain, psychological, dyadic, and sexual functioning variables in a sample of women with dyspareunia. A hundred and fifty-one women took part in the study via health professional referrals and advertisements in local newspapers. Each participant underwent a standardized gynecological examination and a structured interview in order to confirm the diagnosis of dyspareunia. They also completed self-report questionnaires investigating past sexual and physical abuse, in addition to current pain, psychosocial adjustment, and sexual functioning. Dependent measures included: (i) The Brief Symptom Inventory; (ii) the Sexual History Form; and (iii) the Locke-Wallace Marital Adjustment Scale. Pain was assessed via the McGill Pain Questionnaire and a visual analogue scale. Results revealed that a history of sexual abuse involving penetration was associated with poorer psychological adjustment and sexual functioning. Additionally, findings showed that women who perceived a link between their dyspareunia and their past sexual abuse reported worse sexual functioning than those who did not. Finally, the experience of sexual abuse was not associated with pain intensity and physical abuse was not associated with any of the outcome measures. Findings suggest that the presence of a sexual abuse history in women with dyspareunia is associated with increased psychological distress and sexual impairment, although there is no relation between a history of physical abuse and these outcomes.

Targeted Therapies in Epithelial Ovarian Cancer

Epithelial ovarian cancer remains a major women's health problem due to its high lethality. Despite great efforts to develop effective prevention and early detection strategies, most patients are still diagnosed at advanced stages of disease. This pattern of late presentation has resulted in significant challenges in terms of designing effective therapies to achieve long-term cure. One potential promising strategy is the application of targeted therapeutics that exploit a myriad of critical pathways involved in tumorigenesis and metastasis. This review examines three of the most provocative targeted therapies with current or future applicability in epithelial ovarian cancer.

Engaging parliamentarians as advocates for women's health: Findings from Kenya and Namibia

Members of parliament (MPs) are well placed to promote national health policies that improve women's access to quality health care, including HIV services. To catalyse political will and leadership, the International Centre for Research on Women, Centre for the Study of AIDS at the University of Pretoria, International Community of Women Living with HIV/AIDS and Realising Rights: The Ethical Globalisation Initiative, conducted the Parliamentarians for Women's Health project in select African countries. This paper focusses on participatory community assessments – a methodology used by the project to improve MPs’ understanding of women's health issues, particularly HIV/AIDS, and to increase their engagement with civil society in order to better represent women's health needs and concerns. In-depth interviews with eight MPs from Kenya and Namibia highlight the value of the assessments in identifying women's health problems and service gaps. The MPs reported that they undertook various activities after the assessments, including gathering more information about women's health from local communities, pushing for new parliamentary committees to be a platform for health issues, using the information from the assessments to inform policy, more carefully reviewing budget allocations and establishing relationships with civil society. Participatory methods can be used to meet political leaders’ needs for information and communities’ needs to influence policymaking that affects their lives.

Your faith or mine: a pregnancy spacing intervention in an ultra-orthodox Jewish community in Israel

Ultra-orthodox (haredi) Jews in Israel have an exceptionally high fertility rate of 7.7. As most fathers spend their days studying the Bible, the women struggle to support their large families under severe economic pressures. Some women experience maternal exhaustion coping with this life situation. Contraception for pregnancy spacing raises myriad dilemmas in the haredi community, however, many of which apply to promoting family planning in religious settings more generally. In a health promotion course for 23 haredi registered nurses at the University of Haifa in 2006–2007, pregnancy spacing was selected as the subject of the class project, the main aim of which was to convey an influential health message in a culturally acceptable manner. As the issue was debated, it was agreed the project should also address a range of women's health problems as well as pregnancy spacing. Thus, maternal nutrition, pelvic floor tone, dental health, maternal exhaustion and competition over number of children were added. A brochure was prepared and widely distributed in the haredi community, where it was well received. This paper describes the classroom dynamics during the planning and application of the project. It illustrates the importance of cultural awareness when addressing sensitive issues and communities with particular cultural dispositions.

It’s Not All About Birth: Biomechanics Applied to Pelvic Organ Prolapse Prevention

Pelvic organ prolapse is a common and costly women's health problem. Prevention of prolapse continues to play a role in the debate about the risks and benefits of elective cesarean section, making this an important topic for midwives to understand. While some women appear to be at higher risk for prolapse because of intrinsic anatomic and physiologic factors, others have modifiable risk factors that can be addressed by health care providers. This article discusses the current knowledge related to the etiology of prolapse and related components of pelvic anatomy. Biomechanical principles are then applied to enhance the understanding of prolapse development and prevention. Clinical recommendations are based on current evidence regarding topics such as physical activity during pregnancy, treatment of vaginal atrophy, and optimal pelvic floor muscle exercises.

INDIAN SYSTEM OF MEDICINE AND WOMEN’S HEALTH: A CLIENTS’ PERSPECTIVE

India has a strong base of ancient indigenous systems of medicine and its national health policies and programmes have consistently promoted the integration of Indian Systems of Medicine (ISM) into the country's official health system. Realizing the safety and efficacy of ISM drugs, the Department of Indian Systems of Medicine and Homoeopathy (ISM&H) has suggested their use for certain women's health problems and during pregnancy. Although the Government of India has attempted to integrate ISM through the country's contemporary health programme of Reproductive and Child Health (RCH), utilization dynamics from the clients' perspective is little understood. This study shows that, at least in urban areas, for the majority of women's health problems biomedicine is regarded as the first choice, failure of which leads clients to seek treatment from ISM as a final resort. Nevertheless, women showed a preference for ISM treatment for certain specific health problems, strongly backed by a belief in their efficacy. Of the predictors that positively influenced women's choice of ISM treatment, 'strong evidenced-based results' was found to be the most important. Women's preference for ISM is dependent on the availability of competent providers.

Exposure to Child Abuse and Risk for Mental Health Problems in Women

Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

Functional Imaging of Estrogen Receptors with Radiolabeled-GAP-EDL in Rabbit Endometriosis Model

Endometriosis is a common women's health problem. Animal models provide an invaluable tool to study the natural history of endometriosis. We previously have reported that (99m)Tc-labeled glutamate peptide-estradiol ((99m)Tc-GAP-EDL) is a useful agent for imaging functional estrogen receptor (ER) via an ER-mediated process. This study was to evaluate the feasibility of using radiolabeled GAP-EDL to image ER-positive (ER +) endometriosis in nonprimate animal models. 3-Aminoethyl estradiol (EDL) was conjugated to glutamate peptide (GAP) to yield GAP-EDL. In vitro cellular uptake studies of (99m)Tc and (68)Ga-GAP-EDL inhibition with cold estrone were conducted in 13,762 rat mammary tumor cells. To create a rabbit model with endometriosis, part of uterine tissue was dissected and grafted in the peritoneal wall. Eight weeks after surgery, scintigraphic images were obtained after intravenous injection of (99m)Tc-GAP-EDL (1 mCi/rabbit, intravenous) at 0.5-2.0 hours, and (68)Ga-GAP-EDL at 45 minutes. We also performed (68)Ga-GAP-EDL blocking study in rabbit model by using tamoxifen. The rabbits were sacrificed and the grafts were excised for histologic examination. In vitro uptake study of (99m)Tc- and (68)Ga-GAP-EDL in 13,762 rat breast cancer cells showed gradually increasing uptake of both tracers. Accumulation of (68)Ga-GAP-EDL in 13,762 cells was inhibited with cold estrone in a dose-dependent manner. In the endometriosis model, the grafted uterine tissue could be visualized by (99m)Tc-GAP-EDL. Necropsy was performed at 2.5 hours after injection time. Four follicular endometrial lesions in eight implanted endometrial tissues were detected, and all lesions could be detected by (99m)Tc-GAP-EDL. Planar scintigraphy of uterus, ovary and implants of necropsy specimen revealed an increased uptake of (99m)Tc-GAP-EDL in comparison with surrounding abdominal wall tissue. Microscopic examinations support that (99m)Tc-GAP-EDL was accumulated in the microinvasive endometrial tissue. After blocking with tamoxifen, (68)Ga-GAP-EDL accumulation in the endometrial grafts could not be visualized, and endometrial tissue-to-normal tissue count ratios were statistically higher in a nonblocked image than that in the blocked image. Endometriosis uptake of radiolabeled GAP-EDL was via an estrogen receptor-mediated process. Radiolabeled-GAP-EDLs are useful agents for imaging endometriosis.

Associations between Smoking, Screening, and Death Caused by Cervical Cancer in Korean Women

PurposeCervical cancer is a major women's health problem in the world today. The purpose of this study was to estimate the incidence and mortality rates and to investigate risk factors for cervical cancer in Korean women.Materials and MethodsReproductive factors, cigarette smoking, as well as the risk of incidence and death from cervical cancer were examined in a 12-year prospective cohort study of 475,398 Korean women aged 30 to 95 years who received health insurance from the National Health Insurance Corporation and who had a medical evaluation in 1992. Relative risks (RR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model after adjusting for age, body mass index, cigarette smoking, alcohol use, menarche, parity, and Papanicolaou test status.ResultsThis study showed that the RR of death due to cervical cancer among current smokers was two times higher compared with non-smokers (RR = 2.00; 95% CI, 1.23-2.91). In addition, the RR of death due to cervical cancer among all women who smoked ≥ 10 cigarettes/day was 2.4 times higher than the RR among women that had never smoked. More interestingly, those who had never been screened by Papanicolaou smears had twice the risk of death due to cervical cancer (RR = 2.00; 95% CI, 1.37-1.81).ConclusionOur prospective study concluded that current smokers had an increased risk of death due to cervical cancer. We suggest that the target age group for cervical cancer screening tests be reconsidered and should begin as early as possible.

Low socio-economic status, smoking, mental stress and obesity predict obstructive symptoms in women, but only smoking also predicts subsequent experience of poor health

This study was conducted among female subjects to assess the possible association between selected risk factors and lung function as well as airway symptoms in a 32-year perspective. The Prospective Population Study of Women was initiated in 1968-1969 in Göteborg, Sweden (population about 450,000) with follow-ups in 1974-1975, 1980-1981, 1992-1993 and 2000-2001. Women born in 1930, representative of women of the same age in the general population in 1968, were selected. Initially, 372 participants were included in the cohort. In 2000-2001, 231 of these women (73%), now 70 years old, underwent lung function tests. The main outcome measures were lung function values, airway symptoms and health outcome in 2000-2001 in relation to self-reported exposures in 1968-1969 including smoking status. Smoking in 1968-1969 was associated with self-reported chronic bronchitis, obstructive symptoms and poor health 32 years later as well as lower lung function values, compared to non-smokers. Obesity, low socio-economic status and self-reported mental stress in 1968-1969 were associated with obstructive symptoms 32 years later. There are only a few longitudinal studies concerning women's health problems in this field and epidemiological studies of lung function impairment in women and risk factors in a long-term perspective are scarce. The results of the study suggest that life-style factors such as mental stress, obesity and smoking among women are related to airway symptoms and also quality of life many years later.

The process of change for victims of intimate partner violence: Support for a Psychosocial Readiness Model

Intimate partner violence (IPV) victimization is a women's health problem that imposes a significant health and health care cost burden. Although IPV victims cannot change the perpetrator's behavior, they can take actions to reduce exposure to the partner's abuse. The process of change for IPV victims has been described using the transtheoretical model (TTM), among others. We report results of a qualitative study with current and past IPV victims to 1) explicate the process of safety-seeking behavior change for female victims of IPV and 2) explore the fit of the TTM for explaining this process. Based on the results, we propose the psychosocial readiness model to describe the process of change for female victims of IPV. This model considers readiness as a continuum that ranges from robustly defending the status quo on 1 end to being ready to take action toward change on the other. Movement toward and away from change along the continuum results from a dynamic interplay of both internal factors and external interpersonal and situational factors.

A comprehensive women's health care center: Are gynecologists offering primary care?

The purpose of this study was to compare patient characteristics and diagnoses in a comprehensive Women's Health Care Clinic between gynecologists and internal medicine physicians. This retrospective cohort study evaluated International Classification of Diseases, 9th Revision, codes that were recorded between January 1, 2001, and January 4, 2004, at the Women's Health Care Clinic. We compared demographics and prevalence of diagnosis codes for patients who were seen by obstetricians/gynecologists and internal medicine physicians and compared these data with national survey statistics. A sampling of charts was reviewed for coding verification. We analyzed 13,462 visits at the Women's Health Care Clinic. Patients who were seen by internists were older, had greater racial diversity, and had more gender-nonspecific medical disorders (hypertension, depression). Gynecologists saw more specific women's health problems (P < .05). The diagnoses of menstrual disorders, menopause, pelvic pain, and abnormal cytologic findings within the Women's Health Care Clinic follow closely with the national ambulatory survey data. Within this multispecialty Women's Health Care Clinic, internal medicine physicians are practicing primary care and obstetricians/gynecologists are providing specialty care.

Pelvic Organ Prolapse Current State of Knowledge About This Common Condition

<h2>ABSTRACT</h2> More than 300,000 women undergo surgery for pelvic floor prolapse each year in the United States. Yet little is known about the prevalence or risk factors for this common women's health problem. What is normal, and what needs treatment? This article reviews the types and prevalence of pelvic floor prolapse, the current knowledge about the prevalence and risk factors, and treatment options for symptomatic women.

Premenstrual dysphoric disorder: Prevalence, diagnostic considerations, and controversies

Premenstrual dysphoric disorder (PMDD) has been included as a formal diagnosis of a mood disorder in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition in 1994. The ensuing, critical attention has resulted in increased research productivity and clinical recognition of this neglected women's health problem. A decade later, this paper will review the current literature on PMDD focusing on prevalence, biopsychosocial etiological correlates, history of the development of a formal DSM diagnosis, and the controversies surrounding the current classification of PMDD. The authors conclude that PMDD presents a distinct diagnostic entity and that recognition through formal diagnostic criteria serves the important minority of women who suffer from this cyclical mood disorder distinct from premenstrual symptoms and major depression.

An international comparison of women's occupational health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore: the CIDA-SEAGEP Study

An international comparison study of women's occupational health issues was carried out in 2000 for the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore. The study was funded by the Canadian International Development Agency's Southeast Asia Gender Equity Program. The objective was to compare the issues, risk factors, social determinants, and challenges in women's occupational health, according to the status of economic development as defined by the World Bank. Data were collected through 27 key informant interviews of high-ranking government officials and senior researchers, self-administered questionnaires on country or regional statistics and 16 courtesy calls. Results indicated that women's occupational health problems common in these countries or regions included women's long hours of work (double workday), shift work and a caring role for family and friends. Problems reported in developing countries but not developed countries included poor access to training and protective equipment, and insufficient legislation to protect women's rights. Problems reported in developed countries but not in developing countries included obesity, smoking and not including women in health research. This paper provides insights into the changing environment in the workplace, such as increasing participation of women in the paid workforce and changes in gender differences due to the changing country economy, for improving women's occupational health.

Practices for early detection of breast camcer among Muslim women in Southern California

Breast cancer (BC) is a serious women's health problem. Its early detection necessitates women to practice breast self-examination (BSE), have clinical breast examination (CBE) and mammogram. Our study aims at exploring BC detection practices of Muslim women in Southern California. We collected data from a convenience sample of 226 Muslim women ≥30 years old using a questionnaire in the primary language of the subjects. Among the 226 women, 82% were ≥40 years old, 78% were married, and 20% had family history of BC. The racial/ethnic distribution was 30% Asian, 27% South Asian, 17% Arab, 9% Iranian, 9% African American, and 7% White. One third of the women never practiced BSE and one third had not undergone CBE during the past two years. Among women ≥40 years old, 46% did not have mammogram in the past two years. The data showed that practices for early detection of BC varied by race/ethnicity. Iranians (47%) and Arabs (54%) had the lowest percentage of BSE relative to other groups (p < 0.05). CBE was lower among Iranians (47%) and South Asians (58%) relative to other groups (p < 0.05). Among women ≥40 years old, Iranian (47%), African American (50%) and Arab (54%) reported the lowest prevalence of mammography relative to other groups (p < 0.05). A significant number of Muslim women in California did not engage in early BC detection practices. Utilization of mammography among women ≥40 years old in our study (54%) was lower than both the national level (70%) and the level for California (75.5%). This difference could be due to differences in culture and/or religion. Further studies are needed to investigate the factors associated with the low utilization of practices for early detection of breast cancer among Muslim women population in California.

A Survey of Attendees at Native American Health Care Conferences: Knowledge, Attitudes, and Practices about Cigarette Smoking

Cigarette smoking rates and related health consequences among Native Americans are the highest of any US ethnic group. A sample of the attendees at American Indian and Alaska Native health care conferences participated in a survey about cigarette smoking. Of 162 respondents, 11.1% were current smokers, 7.5% of physicians were current smokers, and 80% were lifelong nonsmokers. The majority would ask a smoker to put out cigarettes and would not display ashtrays at home. Nearly all Native American physicians asked their patients about smoking and advised smokers to quit. Respondents were more likely to agree that smoking causes lung cancer (98.7%) as compared to knowing of the associations of smoking with cervical cancer (70.2%), depression (54.5%), and that it is more serious in women (55.2%; P < .01). Current smoking rates were low, and the physicians advised smokers to quit. However, there was less awareness about women's health problems that relate to cigarette smoking as compared to other health consequences of smoking.

Predictors of women's physical health problems after childbirth

The objectives of this study were to document the extent and the correlates of common physical health symptoms in women two months after childbirth. Of special interest was determining whether violence and depression histories increase the risk for experiencing these symptoms. Participants were recruited in six Toronto-area hospitals and were interviewed by telephone 8–10 weeks later. Two hundred of the 332 (60.2%) women who were approached completed the study. Most women (96%) reported at least one physical health symptom 2 months postnatally (Mean = 3.4, SD = 2.0). Stepwise logistic regression was conducted for each outcome. Antenatal depression was a significant predictor of excessive fatigue and bad headaches. Sick leave during pregnancy predicted postpartum backaches. Adult emotional abuse and household income were associated with bowel problems. Episiotomy, maternal complications, and planned pregnancy predicted perineal pain. Finally, being Canadian born and having an assisted vaginal delivery increased the risk for hemorrhoids while cesarean section decreased the risk. A high prevalence of physical symptoms was found in women after childbirth. History of depression and violence were implicated in the occurrence of some of these symptoms. Other important predictors included demographic, maternal, and delivery-related factors.

Should Dyspareunia Be Retained as a Sexual Dysfunction in DSM-V? A Painful Classification Decision

The DSM-IV-TR (American Psychiatric Association, 2000) classifies dyspareunia as a sexual dysfunction and describes it as a "sexual pain" disorder. This classification has been widely accepted with little controversy despite the absence of a theoretical rationale or supporting empirical data. An examination of the validity of this classification suggests that there is little current justification for the use of the term "sexual pain" or for considering dyspareunia a sexual dysfunction. Dyspareunia fits the current DSM-IV-TR classification criteria for pain disorder better than it fits those for sexual dysfunction. Empirical data from diagnostic, experimental, and therapy outcome studies support this conclusion. The reconceptualization of dyspareunia as a pain disorder rather than as a sexual dysfunction has important implications for the understanding and treatment of this prevalent but neglected women's health problem.