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Articles 181 - 210 of 348
Full-Text Articles in Women's Health
The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman
The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman
Rowan-Virtua Research Day
Background
- Symptoms of depression lasting longer than 2 weeks following birth
- 10-15% of new mothers affected yet 50% of cases go undiagnosed
- Long-lasting consequences for the mother, baby, and father
- Multi-factorial condition
Conclusion
- Primary care providers are the first-line defense against PPD
- Many providers are resistant to PPD screenings
- Interventions from primary care providers are effective
Zero Balancing In The Chiropractic Practice, Michele Doucette Dc
Zero Balancing In The Chiropractic Practice, Michele Doucette Dc
Journal of Transformative Touch
Discovering the profound gifts of the leading-edge structural and energetic manual therapy Zero Balancing (ZB), and adding it to my chiropractic and nutrition practice, has unified my personal growth with the sustainability of my professional practice. Much of humanity is starving for wholeness, authenticity, and meaningful connection with ourselves, others, and something greater. Chiropractors are well positioned to be leaders in a true evolution of healthcare, especially if, as we continue to explore the various branches of our therapeutic repertoires, we stay connected to our vitalistic roots that are now more supported than ever by new findings in the fields …
Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji
Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji
Journal of Patient-Centered Research and Reviews
Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …
A Patient-Centered Study Examining Self-Identification Of Mental Health Challenges Among Female Military Officers, Rosellen Roche, Joel Manzi, Katelyn Bard
A Patient-Centered Study Examining Self-Identification Of Mental Health Challenges Among Female Military Officers, Rosellen Roche, Joel Manzi, Katelyn Bard
Journal of Patient-Centered Research and Reviews
Due to the expansion of leadership roles in the military for women, female military personnel now face stressors equal to, and yet unique from, their male counterparts. This pilot study surveyed 73 female U.S. Army officers regarding their experiences of leadership and mental wellness within the military. A mixed-methods survey was distributed via 2 private Facebook groups for female Army officers following an anonymized convenience sampling. This anonymous, patient-centered protocol was used to protect against known stigma surrounding disclosing mental health concerns in the military. Respondents were asked a series of questions including perceived mental health status and access to …
The Covid Ceiling: Super-Moms Are Struggling, Verónica C. Gonzales
The Covid Ceiling: Super-Moms Are Struggling, Verónica C. Gonzales
Faculty Scholarship
COVID Ceiling is the unique combination of identity, discipline, and academic work requirements with care crisis and public health crisis that is contributing to the current and soon larger wave of mental health crises.
James's Choice: Treating An Infant With Craniosacral Therapy (Cst), Veronica Quarry
James's Choice: Treating An Infant With Craniosacral Therapy (Cst), Veronica Quarry
Journal of Transformative Touch
No abstract provided.
Deconstructing Patriarchy In The Healing Arts, Rebekah Harbour
Deconstructing Patriarchy In The Healing Arts, Rebekah Harbour
Journal of Transformative Touch
Sometimes we perpetuate the very systems we want to change because it's the only way we know. Making a change in the outer world can require a shift in our inner perspective.
Assisted Reproductive Technologies And Health-Related Issues Among Women And Children: A Research Review, Laura Maria Corradi
Assisted Reproductive Technologies And Health-Related Issues Among Women And Children: A Research Review, Laura Maria Corradi
Dignity: A Journal of Analysis of Exploitation and Violence
From their first use in the late 1970s until the mid-1990s, Assisted Reproductive Technologies (ART) gave rise to serious concerns by feminists internationally. Their questions ranged from asking about health risks to ethical and political problems inherent in these technologies. However, over the last 25 years, interest in women’s health which used to be central to feminist theory and politics, progressively decreased and with it concerns about ART. Today, while the medical literature about health risks in ART is increasing, the topic of women’s health in relation to reproductive technologies remains marginal in feminist discourse, social sciences, and the mainstream …
Oxytocin, Cortisol, And Cognitive Control During Acute And Naturalistic Stress, Shari Young Kuchenbecker, Sarah D. Pressman, Jared Celniker, Karen M. Grewen, Ken D. Sumida, Naveen Jonathan, Brendan Everett, George M. Slavich
Oxytocin, Cortisol, And Cognitive Control During Acute And Naturalistic Stress, Shari Young Kuchenbecker, Sarah D. Pressman, Jared Celniker, Karen M. Grewen, Ken D. Sumida, Naveen Jonathan, Brendan Everett, George M. Slavich
Health Sciences and Kinesiology Faculty Articles
Although stress is a strong risk factor for poor health, especially for women, it remains unclear how stress affects the key neurohormones cortisol and oxytocin, which influence stress-related risk and resilience. Whereas cortisol mediates energy mobilization during stress, oxytocin has anti-inflammatory, anxiolytic, and analgesic effects that support social connection and survival across the lifespan. However, how these neurohormones interrelate and are associated with cognitive control of emotional information during stress remains unclear. To address these issues, we recruited 37 college-aged women (Mage = 19.19, SD = 1.58) and randomly assigned each to a one-hour experimental session consisting of …
Hello Darkness My Old Friend: An Experience Of A Transformative Session With Zero Balancing, James Mccormick
Hello Darkness My Old Friend: An Experience Of A Transformative Session With Zero Balancing, James Mccormick
Journal of Transformative Touch
An Experience of a Transformative Session with Zero Balancing showing the effects of client experiencing an expanded state of consciousness furring a Zero Balancing session.
Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison
Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison
Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)
Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …
Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman
Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman
Pitzer Senior Theses
This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …
Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell
Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell
Theses and Dissertations--Family Sciences
The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …
Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili
Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili
Theses and Dissertations
This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:
- Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
- Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …
The Effect Of Quality Of Life On Cardiometabolic Risk Factors In Postmenopausal Women, Chavela Lynn Riotutar
The Effect Of Quality Of Life On Cardiometabolic Risk Factors In Postmenopausal Women, Chavela Lynn Riotutar
Cal Poly Humboldt theses and projects
Background: The emergence of cardiometabolic (CMD) indicators for Metabolic Syndrome (MetS) coincides with the decline in estrogen production during menopause and substantially increases development of cardiovascular disease (CVD) in women. Quality of life (QOL) encompasses physical, material, and social well-being. Research reveals a correlation between low QOL scores and CMD disease. Menopause significantly increases CMD risk, and may also lower QOL scores. Objective: To investigate the relationship between QOL and CMD risk in postmenopausal women. Method: Cisgender, postmenopausal women (age > 45 years) were recruited through emails to complete the online survey. Data collection included demographics, physical characteristics and activity level, …
Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason
Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason
The Journal of Sociology & Social Welfare
This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …
User And Provider Perspectives On Improving Mental Healthcare For Syrian Refugee Women In Winnipeg, Manitoba, Canada, Sanjida Newaz, Natalie Riediger
User And Provider Perspectives On Improving Mental Healthcare For Syrian Refugee Women In Winnipeg, Manitoba, Canada, Sanjida Newaz, Natalie Riediger
Journal of Refugee & Global Health
Introduction: Refugees have higher risk of developing mental illness like anxiety, depression and Post-Traumatic Stress Disorder as they flee from violence. Women refugees may have unique mental healthcare needs due to their vulnerability to gender-based violence and abuse during flight from war. The research question of this study was what the health system can do better to address the mental healthcare needs of refugee women in Winnipeg.
Methods: Semi-structured interviews were conducted with 9 Syrian refugee women and 6 service providers/decision makers. The interviews were analyzed using qualitative inductive analysis and coded for themes based on recurring issues.
Results: Limited …
Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams
Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams
Master's Projects and Capstones
Introduction
Perinatal substance use continues to be a major public health issue in women’s health. The purpose of this study was to determine the frequency of substance use screenings in care and assess how well the existing services in Marin County are serving the needs of pregnant and parenting women and identifying the gaps and/or weaknesses in current practice.
Methods
Data for this study was collected via semi-structured interviews with five professionals that worked at the local community clinic, hospital and a non-profit agency. Some questions were slightly modified to be configured toward the participant’s specific profession.
Results
Results from …
Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala
Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala
Journal of Patient-Centered Research and Reviews
Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …
Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek
Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek
DNP Qualifying Manuscripts
Abstract
The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.
Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …
Non-Obstetric Vulvar/Paravaginal Hematoma In An Adolescent Female With Scleroderma: An Opportunity For Intimate Partner Violence Intervention, Amanda Burnham, Jo Cooke-Barber, Stephen Thacker, Donna Evans, David Carney, William Boswell
Non-Obstetric Vulvar/Paravaginal Hematoma In An Adolescent Female With Scleroderma: An Opportunity For Intimate Partner Violence Intervention, Amanda Burnham, Jo Cooke-Barber, Stephen Thacker, Donna Evans, David Carney, William Boswell
HCA Healthcare Journal of Medicine
A 15-year-old female presented to the emergency department with swelling and pain in her left labial region as well as urinary retention after intercourse. This was the patient’s first time having sexual intercourse and the patient stated that her boyfriend “kneed” her in the labia. A CT scan of the pelvis revealed a large vulvar/external hematoma measuring 6 x 10 x 7 cm which extended into the vaginal vault. This case is the first of a vulvar hematoma reported in a pediatric patient with scleroderma. This case was complicated by the fact that our patient claimed her boyfriend intentionally “kneed” …
A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso
A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso
Electronic Theses and Dissertations
Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …
Examining The Factors That Mediate The Relationship From Legal Advocacy Satisfaction To Resilience, Desta T. Gebregiorgis
Examining The Factors That Mediate The Relationship From Legal Advocacy Satisfaction To Resilience, Desta T. Gebregiorgis
Clinical Psychology Dissertations
Sexual assault is a public health issue that can impact one’s resilience. Using a multisystemic approach to resilience, there may be person-level and environment-level factors that can affect one’s resilience, such as one’s coping self-efficacy, satisfaction with the court process, and negative effects associated with court process. Legal advocacy programs, such as those offered by the King County Sexual Assault Resource Center (KCSARC), support clients during the court proceedings. In order to better serve KCSARC’s clientele, it is helpful to understand how the legal advocacy program impacts post-trauma resilience. This dissertation had three phases: (a) evaluating the structural validity of …
Womanism & Wellbeing: A Manuscript Dissertation Exploring The Effects Of Shame, Loss And Gender Issues, Christy Angelle-Vidrine Bauman
Womanism & Wellbeing: A Manuscript Dissertation Exploring The Effects Of Shame, Loss And Gender Issues, Christy Angelle-Vidrine Bauman
Education Dissertations
The purpose of this study is to contribute to the research on gender issues and psychological well-being across the adult lifespan utilizing qualitative research examining factors (e.g., societal influences, sexual objectification, shame, loss, meaning-making, and internal identity) in developing resilience and mitigating mental health issues. This paper discusses the importance of addressing well-being through expression of loss, meaning-making, and social impact. This manuscript style dissertation will review publications in such areas as sexuality, spirituality, grief, shame, intimacy, social, and interpersonal relationships. The exploration of biopsychosocial impacts as it relates to meaning-making, resilience, and communal involvement. The three publications will be …
An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes, Joy Morgan Myers
An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes, Joy Morgan Myers
Honors Theses
This thesis investigated the connection between socioeconomic status, healthcare coverage, and birth outcomes. The research question that was posed specifically looked at twenty perinatal services that states covered under Medicaid to varying degrees to see their association, if any, with premature birth rates and low birthweight rates. State-level and Mississippi county-level data were compiled regarding preterm birth rates, low birthweight rates, presumptive eligibility adoption, and coverage of twenty different perinatal services. Using these data, the correlation between state Medicaid expansion status and birth outcomes was first calculated in order to determine if variation in birth outcomes was associated with expanded …
An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton
An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton
Graduate Theses and Dissertations
This study was done to examine what psychosocial factors influence treatment seeking behavior among female survivors of eating disorders. This study uses a mixed methods survey consisting of open-ended item questions regarding treatment experience and social environment, and close-ended items to measure constructs from the Health Belief Model. Fourteen participants were recruited for this study to retrospectively detail their experiences of treatment during their eating disorder. All fourteen participants identified as Caucasian, thirteen identified as female, one identified with other gender, each with a history of medically diagnosed anorexia nervosa. The mean of age of current participants was 29.46, and …
Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd
Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd
Medical Student Research Symposium
Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).
Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …
Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman
Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman
Michigan Journal of Public Health
Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.
Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …
Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones
Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones
Health, Behavior & Society Faculty Publications
BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.
METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …
Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.
Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.
Journal of Health Disparities Research and Practice
Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …