Women's Health Care Research Articles

The Effects of Psychological Interventions on Menstrual Health in Exercising Women: A Comprehensive Experimental Study

Purpose. This comprehensive experimental study explores the effects of psychological interventions on menstrual health in physically active women. The research aims to investigate the influence of stress reduction techniques, body image enhancement programs, and counseling on menstrual irregularities, stress levels, body image perceptions, and psychological well-being. It also examines the interplay between psychological factors and menstrual health, contributing to women's reproductive well-being. Material & Methods. The study employs a rigorous randomized controlled trial design with 40 physically active women aged 18-23. Participants are divided into an intervention group receiving psychological interventions and a control group without interventions. The interventions include mindfulness meditation, deep breathing exercises, mirror affirmations, media literacy workshops, and gratitude journaling. Data is collected over six months through menstrual calendars, the Perceived Stress Scale, the Body Image Assessment Scale, and the Psychological Well-being Scale. Statistical analyses involve repeated measures ANOVA and regression analyses. Results. The intervention group experiences significant improvements in menstrual regularity, stress reduction, body image perception, and psychological well-being. Menstrual regularity significantly improves (p<0.001), stress levels decrease (p<0.001), body image perception improves (p<0.001), and psychological well-being enhances (p<0.001). Correlations indicate positive relationships between psychological well-being and menstrual regularity (r=0.31, p=0.021) and negative relationships with stress levels (r=–0.42, p<0.001) and body image perception (r=0.28, p=0.031). Conclusion. This study demonstrates the positive impact of psychological interventions on menstrual health, stress reduction, body image perception, and psychological well-being in physically active women. The findings underscore the potential of integrating psychological strategies into women's healthcare, offering holistic approaches to address both menstrual irregularities and related psychological concerns.

Speculum self-insertion: an alternative method for gynaecological examination?

Speculum examination is an intrusive practice in the clinical care of women. It requires privacy and patients may experience discomfort or anxiety related to the procedure, which can result in delays or avoidance of necessary healthcare. Speculum self-insertion originated in the United States in the 1970s as part of the self-help movement. However, this clinical practice is largely unknown among healthcare providers and has rarely been assessed. This study investigates the women's views and healthcare providers' experiences of the self-insertion method. A qualitative study was conducted between December 2021 and October 2022, including fieldwork combining semi-structured interviews (10 women) and focus groups associated with individual interviews of 13 healthcare providers. The data collected were independently coded by 2 authors and analysed using an inductive approach and grounded theory method. Speculum self-insertion was described as a way to decrease discomfort and facilitate speculum insertion. Self-insertion was proposed as a means of allowing women to participate in the examination, reducing their vulnerability against power imbalances in the doctor-patient relationship. Both patients and healthcare providers have reported that speculum self-insertion is a method that can contribute to improving trust and communication during the examination. The practice of speculum self-insertion during the consultation is an alternative to traditional practitioner insertion and may be offered to all women by any practitioner who wishes to use this technique.

Career Reflections: The Winding Path From County Mayo, Ireland to New York City.

Dr. Mary D'Alton's career journey intertwines her upbringing in County Mayo, Ireland, with impactful contributions to Obstetrics and Gynecology in New York City. From childhood lessons in community care to transformative experiences in Canada and prestigious mentorships, her leadership at Columbia University and NewYork-Presbyterian has fostered innovative initiatives addressing maternal health. Philanthropy plays a pivotal role in realizing her vision, including mental health integration within women's health care. International reach, exemplified by a successful fellowship program with Ireland, underscores her commitment to collaboration Dr. D'Alton's reflections illuminate the transformative power of teamwork, mentorship, and innovation in advancing women's health worldwide.

A Contemporary View of Menopausal Hormone Therapy.

Enthusiasm for the use of hormones to ameliorate symptoms of perimenopause and menopause has waxed and waned over the years. Both treatment for symptoms and training of women's health care practitioners in the management of menopause have sharply declined since publication of the Women's Health Initiative initial results in 2002. Findings from that trial, which treated a population of older, asymptomatic patients, have been extrapolated over the past 21 years to all estrogen products, all menopausal women, and all delivery mechanisms. Our patients deserve a more nuanced, individualized approach. Conjugated equine estrogens and medroxyprogesterone acetate are no longer the predominant medications or medications of choice available for management of menopausal symptoms. All hormones are not equivalent any more than all antiseizure medications or all antihypertensives are equivalent; they have different pharmacodynamics, duration of action, and affinity for receptors, among other things, all of which translate to different risks and benefits. Consideration of treatment with the right formulation, at the right dose and time, and for the right patient will allow us to recommend safe, effective, and appropriate treatment for people with menopausal symptoms.

Who's Haywood? Path to Leadership: I Am NO Jackie Robinson.

Having been afforded many opportunities throughout my academic career, I took on the challenges that chronicled my path to leadership. In many instances, I was the first person of color to enter that educational and leadership environment. I am grateful to many mentors who have guided and supported me over the 4 decades since the time of my residency through fellowships and the various institutions to which I have been affiliated. It continues to be a great journey, making a contribution to the Ob Gyn academic community and advocating for quality and equitable women's health care.

HPV Vaccine Uptake, Willingness to Receive, and Causes of Vaccine Hesitancy: A National Study Conducted in Saudi Arabia Among Female Healthcare Professionals.

Epidemiological evidence has shown that human papillomavirus (HPV) is the most frequent cause of sexually transmitted infection, and vaccination is an essential measure to prevent associated diseases and complications. This study aimed to assess the HPV vaccine uptake and its associated factors as well as HPV vaccine hesitancy by female healthcare workers (HCWs) in Saudi Arabia. This online, questionnaire-based, cross-sectional study involved female HCWs in Saudi Arabia between July and October 2022. The study tool included questions about sociodemographic, occupational, and reproductive characteristics, uptake of HPV vaccination, and reasons of hesitancy. Chi-squared and t-tests were used for bivariate analyses, and multivariable logistic regression was used to adjust for confounders. The total number of participants was 1857. Around 20% of HCWs received at least one dose of the HPV vaccine, and around 45% were willing to take it this year. Lower odds of vaccine uptake were reported among older participants and those with a higher level of education. However, nurses, HCWs with a previous HPV infection, those with a family history of cervical cancer, or those with a previous cervical cancer screening test had higher odds of receiving the vaccine. On the other hand, older participants and diploma degree holders were less willing to take the HPV vaccine. Higher odds of willingness were reported in married HCWs, those with a previous HPV infection, those who received a previous HPV vaccine dose, or those who were screened for cervical cancer. Lack of knowledge and some misconceptions were the most reported reasons for hesitancy. Certain factors that affect HCWs personal decisions to take the vaccine were identified. By targeting these issues, epidemiologists, public health officialsand women's health care providers can work to increase HPV vaccine uptake and reduce the burden of HPV-related diseases in this population.

Barriers to Leadership for Women in Health Care.

Research shows gender stereotypes help men advance more quickly.

Overcoming barriers to COVID‐19 herd immunity in Afghanistan

AbstractAfghanistan faces numerous obstacles in its endeavor to achieve herd immunity against COVID‐19. Inadequate resources, vaccine hesitancy, and the new government's lack of international recognition have impeded the country and harmed vaccine procurement and distribution. Although the recent power shift has led to a more secure situation, the country's vaccination coverage remains at 44.05% as of November 26, 2023. The main hurdles to herd immunity include limited vaccine accessibility, extensive vaccine hesitancy, an inefficient cold chain system causing high vaccine wastage rates, substandard service delivery, recent restrictions on women's healthcare access, low health literacy, and a weakened economy owing to decades of conflict and international sanctions. This article assesses vaccination progress, and herd immunity barriers, and provides solutions to overcome them in Afghanistan. A comprehensive approach is required, which involves enhancing public awareness of the benefits of vaccination, debunking vaccine‐related misconceptions through the media, expanding vaccine accessibility especially in remote areas, increasing vaccination personnel, promoting the cold chain and delivery system, reversing the ban on women's education and employment, boosting the economy, and increasing the inflow of humanitarian aid by lifting international sanctions. Successfully implementing these measures can help Afghanistan overcome obstacles to herd immunity, leading the country toward a safer and healthier future.

History and advances in women's health care: a narrative review

The role of women in society is dynamic, and its history demonstrates various achievements, along with persistent challenges. Comprehensive care and effective public policies are fundamental to ensuring a more equitable and healthy environment for all women. From the period when women were predominantly associated with motherhood to the present day, significant achievements in the political, social, and professional spheres are evident. This work is a narrative review, using Scielo and PubMed databases in the second semester of 2023, with the main objective of highlighting what the literature reveals about advances in women's health care. The evolution of women's roles in society is a complex narrative with persistent challenges, such as gender-based violence. Therefore, professional training is important to monitor women in their different life cycles, adapting to the evolution of their history. Women's empowerment seeks equality of opportunities, although additional challenges have emerged during the pandemic, highlighting gender disparities. Public policies are of great importance for ensuring equitable monitoring.

Paternal Postpartum Depression and Associated Factors Among Partners of Women Who Gave Birth in Seka Town, Southwest Ethiopia.

Despite epidemiologic studies demonstrating the increased incidence of paternal postpartum depression, their emotional health is overlooked throughout their partner's pregnancy and postpartum period as postpartum depression has been traditionally construed as a disease of women. Traditional masculinity norms also result in a lack of recognition and barriers to the treatment of depression in men. This study is aimed to determine the prevalence and factors of paternal postpartum depression among fathers whose wives gave birth. A community-based cross-sectional study was conducted from July 7 to 17, 2023. The 288 sample size was estimated using a single population proportion formula and selected by random sampling technique. The data were exported from Kobo Toolbox and analyzed using SPSS version 26. Candidate variables were identified in bivariate at p < .25 for the multivariate analysis. A p < .05 and adjusted odds ratio (AOR) were used to determine the significance. A total of 280 partners participated making a 97.22% response rate. Paternal postpartum depression was 19.6%(95% confidence interval [CI] = [15.4%, 24.3%]). It was significantly associated with history of depression (AOR = 4.4, 95% CI = [1.7, 10.9]), unplanned pregnancy (AOR = 4.7, 95% CI = [1.9, 11.3]), alcohol consumption (AOR: 3.0, 95% CI = [1.3, 7.4]), infant sleeping problem (AOR: 3.0, 95% CI = [1.1, 8.9]), and mode of delivery (AOR: 3.0, 95% CI = [1.3, 7.6]). This study concluded that paternal postpartum depression was high. The researchers recommended the inclusion of men's mental health services like screening into women's postnatal health care.

Prison Health Care Issues in Kansas and Ohio: The Perspective of Incarcerated Women

Abstract: This article about women's prison-based health care reports quantitative findings from surveying 206 female prisoners and qualitative findings from 45 female prisoners interviewed in one prison in Kansas and three prisons in Ohio. Respondents expressed concerns about the availability of quality prison health care and the timeliness of attention to requests for assistance. Additionally, respondents identified administrative barriers to receiving quality health care within each state. The detrimental consequences of receiving inadequate care are poignantly described by some women. Suggestions are offered for improving the overall quality of prison health care for women and modifying procedures for obtaining such care.

Evaluating an Enterprise-Wide Initiative to enhance healthcare coordination for rural women Veterans using the RE-AIM framework.

The Veterans Health Administration (VA) Office of Rural Health (ORH) and Office of Women's Health Services (OWH) in FY21 launched a three-year Enterprise-Wide Initiative (EWI) to expand access to preventive care for rural, women Veterans. Through this program, women's health care coordinators (WHCC) were funded to coordinate mammography, cervical cancer screening and maternity care for women Veterans at selected VA facilities. We conducted a mixed-methods evaluation using the RE-AIM framework to assess the program implementation. We collected quantitative data from the 14 program facilities on reach (i.e., Veterans served by the program), effectiveness (e.g., cancer screening compliance, communication), adoption, and maintenance of women's health care coordinators (WHCC) in FY2022. Implementation of the program was examined through semi-structured interviews with the facility WHCC funding initiator (e.g., the point of contact at facility who initiated the request for WHCC funding), WHCCs, and providers. Reach. The number of women Veterans and rural women Veterans served by the WHCC program grew (by 50% and 117% respectively). The program demonstrated effectiveness as screening rates increased for cervical and breast cancer screening (+0.9% and +.01%, respectively). Also, maternity care coordination phone encounters with Veterans grew 36%. Adoption: All facilities implemented care coordinators by quarter two of FY22. Implementation. Qualitative findings revealed facilitators and barriers to successful program implementation and care coordination. Maintenance: The EWI facilitated the recruitment and retention of WHCCs at respective VA facilities over time. In rural areas, WHCCs can play a critical role in increasing Reach and effectiveness. The EWI demonstrated to be a successful care coordination model that can be feasibly Adopted, Implemented, and Maintained at rural VA facilities.

Empowering Women in Healthcare: Breaking Barriers, Building Leaders

In Pakistan, women comprise over 70% of the health workforce yet confront multifaceted challenges limiting their advancement and well-being.1 Pakistan ranks the second lowest in the world for women’s labor force participation, and deep-rooted gender biases permeate the workplace.2 Concrete action is imperative to transform the status quo and empower women across health system levels.

Improving prediction of cervical cancer using KNN imputer and multi-model ensemble learning.

Cervical cancer is a leading cause of women's mortality, emphasizing the need for early diagnosis and effective treatment. In line with the imperative of early intervention, the automated identification of cervical cancer has emerged as a promising avenue, leveraging machine learning techniques to enhance both the speed and accuracy of diagnosis. However, an inherent challenge in the development of these automated systems is the presence of missing values in the datasets commonly used for cervical cancer detection. Missing data can significantly impact the performance of machine learning models, potentially leading to inaccurate or unreliable results. This study addresses a critical challenge in automated cervical cancer identification-handling missing data in datasets. The study present a novel approach that combines three machine learning models into a stacked ensemble voting classifier, complemented by the use of a KNN Imputer to manage missing values. The proposed model achieves remarkable results with an accuracy of 0.9941, precision of 0.98, recall of 0.96, and an F1 score of 0.97. This study examines three distinct scenarios: one involving the deletion of missing values, another utilizing KNN imputation, and a third employing PCA for imputing missing values. This research has significant implications for the medical field, offering medical experts a powerful tool for more accurate cervical cancer therapy and enhancing the overall effectiveness of testing procedures. By addressing missing data challenges and achieving high accuracy, this work represents a valuable contribution to cervical cancer detection, ultimately aiming to reduce the impact of this disease on women's health and healthcare systems.

Healthcare Access Worsened for Women in Precarious Housing During the COVID-19 Pandemic: A Qualitative Study.

This research aims to gain an in-depth understanding of precariously housed women's experiences related to health and access to health care during the COVID-19 pandemic using a grounded theory approach. Qualitative data were obtained through interviews with 17 precariously housed women from Izmir, Turkey. Poor health among most participants was primarily attributed to unfavorable living conditions and weakened community networks. The COVID-19 pandemic exacerbated existing health issues due to barriers in accessing basic needs. Food insecurity was widespread during the pandemic and the critical role of aid and the inadequacy of social assistance in securing food were emphasized. Women's health perceptions were significantly shaped by gender, and gendered caregiving duties have restricted women's healthcare access. Access to healthcare was also limited by financial challenges, with health insurance being a crucial determinant. Longer waiting times, often exacerbated by the appointment system, and language were significant barriers to healthcare access. The findings propose that the participants were precarized by the blindness of COVID-19 measures to vulnerabilities, which resulted in deeper inequalities in housing, food, employment, and healthcare access. This research addresses the political, commercial, and social determinants of precariously housed women's health. Improving precariously housed women's health and wellbeing requires implementation of public policies targeting to improve housing quality, provide targeted assistance to food insecurity, promote gender inclusiveness, and foster gender empowerment.

Gaps in health coverage for racialized im/migrant sex workers in metro Vancouver: Findings of a community-based cohort study (2014–2021)

BackgroundSex workers face substantial health inequities related to sexual health and gender-based violence, many of which are amplified for the large proportion of workers who are racialized im/migrants. While criminalization and stigma are known barriers to health care for this population, we know little about health insurance coverage, and in particular how this relates to im/migration experience and racialization. We examined associations between im/migration status, duration, and racialization on gaps in health insurance coverage in a cohort of women sex workers. MethodsAnalyses used data from a prospective, community-based cohort of women sex workers in Vancouver, BC (Sept 2014-August 2021). Interviewer-administered questionnaires were by experiential (current/former sex workers) and community-based staff. We developed multivariable logistic regression confounder models with generalized estimating equations (GEE) to examine associations between migration and racialization exposures of interest and health insurance coverage. ResultsOf 644 sex workers, 411 (63.8%) reported lacking health insurance coverage for services needed during the 7-year study. In multivariable GEE analysis, precarious im/migration status (adjusted odds ratio (AOR) 2.37, 95% confidence interval (CI) 1.56 – 3.60), recent (AOR 4.22, 95% CI 2.42 – 7.35) and long-term (AOR 2.13, 95% CI 1.54 – 2.96) migration, and being a racialized Asian im/migrant (AOR 3.06, 95% CI 2.14 – 4.39) were associated with recent lack of health insurance coverage. ConclusionPolicy and program reforms are needed to decouple health insurance access from immigration status, remove mandatory waiting periods for health insurance coverage, and ensure that provincial insurance provides sufficient coverage for marginalized women's healthcare needs.

Evaluating the performance of an AI-powered VBAC prediction system within a decision-aid birth choice platform for shared decision-making.

Vaginal birth after cesarean (VBAC) is generally regarded as a safe and viable birthing option for most women with prior cesarean delivery. Nonetheless, concerns about heightened risks of adverse maternal and perinatal outcomes have often dissuaded women from considering VBAC. This study aimed to assess the performance of an artificial intelligence (AI)-powered VBAC prediction system integrated into a decision-aid birth choice platform for shared decision-making (SDM). Employing a retrospective design, we collected medical records from a regional hospital in northern Taiwan from January 2019 to May 2023. To explore a suitable model for tabular data, we compared two prevailing modeling approaches: tree-based models and logistic regression models. We subjected the tree-based algorithm, CatBoost, to binary classification. Forty pregnant women with 347 records were included. The CatBoost model demonstrated a robust performance, boasting an accuracy rate of 0.91 (95% confidence interval (CI): 0.86-0.94) and an area under the curve of 0.89 (95% CI: 0.86-0.93), surpassing both regression models and other boosting techniques. CatBoost captured the data characteristics on the significant impact of gravidity and the positive influence of previous vaginal birth, reinforcing established clinical guidelines, as substantiated by the SHapley Additive exPlanations analysis. Using AI techniques offers a more accurate assessment of VBAC risks, boosting women's confidence in selecting VBAC as a viable birthing option. The seamless integration of AI prediction systems with SDM platforms holds a promising potential for enhancing the effectiveness of clinical applications in the domain of women's healthcare.

Menstrual Hygiene Management: An Overview of Global Awareness

In developing nations, menstrual hygiene management (MHM) is a problem that is frequently disregarded. Women and girls who are menstruating are compelled to live in seclusion, are subject to mobility limitations and dietary restrictions, and may be barred from engaging in daily activities. Due to its relationship with social and cultural components of a natural process that is sometimes shrouded in ingrained shame and taboos, menstrual hygiene waste management has not gotten enough attention and, as a result, has not been adequately researched. As a result, information on the amounts and whole lifespan of the created trash is either lacking or fraught with uncertainty. However, this work raises important and pertinent issues that may impact on the environment as well as the health, equality, and dignity of women. The present review also identifies the knowledge gaps that still need to be filled and offers potential solutions for the near future. Menstrual hygiene requires immediate consideration in the context of a pandemic, as does understanding the potential role that waste produced, for instance, in refugee camps, may have in spreading SARS-CoV-2. The current analysis suggests potential intervention tactics intended to remedy this ignorance. In order to achieve Sustainable Development Goals (SDG) 3.7 and 6.2, which address women's healthcare and hygiene requirements, there looked to be room for interventions through a coordinated national effort to promote awareness of MHM among women utilizing a variety of media outlets.

Gender Disparity in Hemorrhoid Cases: Cultural and Socio-Economic Barriers to Women's Healthcare Access [Letter

Gender Disparity in Hemorrhoid Cases: Cultural and Socio-Economic Barriers to Women's Healthcare Access [Letter

Retrato das mães doadoras e variáveis associadas à doação de leite materno em um Banco de Leite Humano

ABSTRACT Objective To describe and analyze the donor mothers’ profile and variables associated with breast milk donation at Human Milk Bank in the municipality of Guarapuava, Paraná, Brazil. Methods This was a cross-sectional study obtained from information contained in the donor registration form between the period July 2013 (implementation of the service) to December 2019. The collected data were tabulated and descriptive analysis of variables and Chi-square and Fischer’s exact association tests were performed. Results Of 1,491 records analyzed, this research identified that 70.73% of donors were between 20 to 34 years old; 67.69% had prenatal care at public health network and 61.37% have had cesarean delivery. Most mothers (61.44%) remained as donor for 29 days and 53.83% of them donated up to 500 ml of milk. In addition, statistically significant association was observed between milk volume donated and donation time for the following variables: prenatal place care, gestational age, child's birth weight, child age, and smoking. Maternal age was associated with a higher volume of donated milk. Conclusion The study's findings reinforce the approaching importance the possibility of human milk donation during prenatal care, with emphasis on private health service, and throughout the women's and children's health care network, as well as on the community.