Women's Health Commons^™

Making Women's Health Connections: Between Researchers And To Resources, Martha E. Meacham, Len L. Levin, Lisa A. Palmer, Elaine Martin

Lisa A. Palmer

The Lamar Soutter Library at the University of Massachusetts Medical School has recently completed the second year of a National Library of Medicine grant funded project; the Women’s Health Resources Dissemination Outreach Project. The goals include assisting women’s health researchers by providing them with access to information and making them more aware of opportunities and available resources. This, ultimately, enables both an improvement in women’s health and the advancement of women in academic medicine. Moreover, by supporting women’s health research and women researchers through the objectives of this project, women researchers build connections, knowledge, and skills. This facilitates meaningful contributions …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Peter Lindenauer MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Attitudes Of Women In Their Forties Toward The 2009 Uspstf Mammogram Guidelines: A Randomized Trial On The Effects Of Media Exposure, Autumn Davidson, Xun Liao, B. Magee

B. Dale Magee

OBJECTIVE: The objective of the study was to assess women's attitudes toward 2009 US Preventive Services Task Force mammography screening guideline changes and evaluate the role of media in shaping opinions. STUDY DESIGN: Two hundred forty-nine women, aged 39-49 years, presenting for annual examinations randomized to read 1 of 2 articles, and survey completion comprised the design of the study. RESULTS: Eighty-eight percent overestimated the lifetime breast cancer (BrCa) risk. Eighty-nine percent want yearly mammograms in their 40s. Eighty-six percent felt the changes were unsafe, and even if the changes were doctor recommended, 84% would not delay screening until age …

Role Of Multiple Births In Very Low Birth Weight And Infant Mortality, B. Magee

B. Dale Magee

OBJECTIVE: To determine the percentage of very-low-birth-weight (VLBW) infants (g) and infant deaths attributable to multiple births in the general population and in women aged 35+. STUDY DESIGN: The year 2000 Massachusetts birth certificate database with linked births-deaths was examined. Etiologic fractions (EF) for VLBW and infant mortality attributable to multiples were calculated for the general population and the 35+ age group. The percentages of multiples occurring in the 35+ age group were calculated. Infant deaths due to congenital anomalies and "perinatal conditions" were calculated. RESULTS: There were 81,582 resident births in Massachusetts in 2000. Of them 4.3% were multiples. …

Missed Opportunities In Hpv Vaccination, B. Dale Magee, Autumn S. Davidson, Leslie Regh

B. Dale Magee

Objective: To use the 3 dose Human Papillomavirus (HPV) vaccine administration (given at 0, 1-2 and 6 months) to quantify opportunities to improve efficacy in the delivery of preventive health services. Methods: This was a retrospective, claims-based analysis using data provided by a single managed care plan. Female patients aged 9-26 who were continuously enrolled between 2009 through 2011 and received ≥ dose of the HPV vaccine during 2010 were analyzed. The proportion of initiators who did and did not completed the vaccine series, the timing and location of doses, and the number of outpatient visits during which the vaccine …

Doing The Best With What We Have: We Need Better: Informing Obstetric Policy With Administrative Data, Tiffany Moore Simas, B. Magee, Ellen Delpapa

B. Dale Magee

In this issue of Medical Care, Backes Kozhimannil and colleagues present data from the National Inpatient Sample on differences between rural and urban obstetric care. We applaud their efforts in examining this issue and agree that all women should be afforded safe deliveries, and ideally each woman’s experience would not be different. That being said, there are some practical considerations that must be applied to their analyses and recommendations. We would like to take this opportunity to capitalize on their efforts and speak to 2 other highly related implications for policy and practice.

Role Of Smoking In Low Birth Weight, B. Magee, Dale Hattis, Nancy Kivel

B. Dale Magee

OBJECTIVE: To assess the role of smoking on low birth weight (LBW). STUDY DESIGN: From Massachusetts for 1998, 79,904 birth certificates were reviewed. Birth weight, gestational age, plurality and maternal race were analyzed in relation to the mother's smoking status during the pregnancy. The etiologic fraction (EF) was calculated for smoking and LBW for the group as a whole as well as for various subgroups. RESULTS: A total of 11.7% of women acknowledged smoking during pregnancy. The overall LBW rate was 6.83%. The relative risk (RR) of LBW among smokers was 1.58. For all births the EF for smoking was …

Associations Of Adipose Tissue Architecture, Adipokines And Inflammatory Markers With Body Mass Index And Gestational Weight Gain In Non-Diabetic Pregnancies, Tiffany A. Moore Simas, Crina Boeras, Ningning Zhang, Olga Gaelikman, Katherine G. Leung, Nicole M. Wedick, Laura Robidoux, Jodi Adams Puleo, Mary M. Lee, Silvia Corvera, Milagros C. Rosal

Mary M. Lee

Background: Some pregnancy weight gain is stored as adipose tissue (AT). Human AT depots vary in their capacity for expansion. Data suggests that subcutaneous (SQ) is adapted for healthy lipid storage. Conversely visceral (V) accumulation is associated with inflammation, obesity-related co-morbidities and Type 2 diabetes (T2DM) risk. We investigated SQ and VAT histologic architecture along with insulin, adipokines and inflammatory markers in relationship to prepregnancy BMI and gestational weight gain (GWG). Methods: Subset of non-diabetic singleton gravidas from the Pregnancy & Postpartum Observational Dietary Study (PPODS), undergoing Cesareans and consenting to SQ & VAT biopsies were included. Average adipocyte size …

Meaning Of The Family-Cap Policy For Poor Women: Contraceptive And Fertility Decision-Making, Diana Romero, Hannah Fortune-Greely, Jorge Verea, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

In 1996 the US Congress enacted welfare reform legislation. In addition to new lifetime time limits and work requirements for those receiving cash and other forms of social assistance, the states could impose policies pertaining to reproductive-related behaviors of poor women. One such policy is the so-called “family-cap,” which denies additional income support to poor women who have a baby while receiving cash assistance; 24 states have implemented such policies. The ostensible goal of the policy is to limit fertility among current cash assistance recipients. This pilot study sought to explore whether poor women in a family-cap state (NJ) base …

Sourcebook: Women Veterans In The Veterans Health Administration. Volume 2: Sociodemographics And Use Of Vha And Non-Va Care (Fee), Susan M. Frayne, Kristin M. Mattocks

Kristin M. Mattocks

Describes sociodemographic characteristics and health care utilization patterns of women Veteran patients in the VHA. Its primary purpose is to present data to inform policy and program planning as VHA implements and evaluates new ways of providing care to women Veterans. Provides data about women residing in rural versus urban areas and by examining use of health care through VHA’s “Non-VA Care (Fee)” system, which is comprised of services provided to Veterans by non-VHA providers but reimbursed through VHA. Produced by the Women’s Health Evaluation Initiative, Women’s Health Services, Veterans Health Administration, Department of Veterans Affairs, Washington DC.

Pregnancy And Mental Health Care Among Women Veterans Returning From Iraq And Afghanistan, Kristin M. Mattocks, Melissa Skanderson, Joseph Goulet, Sally Haskell, Elizabeth M. Yano, Erin Krebs, Amy Justice, Cynthia Brandt

Kristin M. Mattocks

Presentation looking at pregnancy and mental health care in the VA system. Documents a study examining the prevalence of pregnancy care and comparing the mental health diagnoses among pregnant and non-pregnant women in VA care. Then examining the degree to which pregnant veterans receive VA mental health care during their pregnancy. Concludes that pregnant women veterans using VA care have a substantial mental health burden.

The Future Of Teratology Research Is In Vitro, Jarrod Bailey, Andrew Knight, Jonathan Balcombe

Jonathan Balcombe, Ph.D.

Birth defects induced by maternal exposure to exogenous agents during pregnancy are preventable, if the agents themselves can be identified and avoided. Billions of dollars and manhours have been dedicated to animal-based discovery and characterisation methods over decades. We show here, via a comprehensive systematic review and analysis of this data, that these methods constitute questionable science and pose a hazard to humans. Mean positive and negative predictivities barely exceed 50%; discordance among the species used is substantial; reliable extrapolation from animal data to humans is impossible, and virtually all known human teratogens have so far been identified in spite …

The Future Of Teratology Research Is In Vitro, Jarrod Bailey, Andrew Knight, Jonathan Balcombe

Jonathan Balcombe, PhD

Birth defects induced by maternal exposure to exogenous agents during pregnancy are preventable, if the agents themselves can be identified and avoided. Billions of dollars and manhours have been dedicated to animal-based discovery and characterisation methods over decades. We show here, via a comprehensive systematic review and analysis of this data, that these methods constitute questionable science and pose a hazard to humans. Mean positive and negative predictivities barely exceed 50%; discordance among the species used is substantial; reliable extrapolation from animal data to humans is impossible, and virtually all known human teratogens have so far been identified in spite …

The Role Of Multiple Sclerosis As A Risk Factor For The Development Of Osteoporosis, Christopher Perrone, Christine M. Foley, Linda C. Churchill, Sybil L. Crawford, Judith K. Ockene, Carolina Ionete

Sybil L. Crawford

Background: Osteoporosis is the most common bone disease in the United States, and it is particularly common among women with multiple sclerosis (MS). However, despite this association, the temporal relationship between these two conditions has not been previously studied. Data from the Women’s Health Initiative provides a unique opportunity to examine the risk of developing osteoporosis over time in individuals diagnosed with MS. Objective: The purpose of this study is to refine the relationship between MS and osteoporosis, clarifying the impact of environmental and pharmacologic factors on each condition, as well as addressing treatment and preventative efforts for a patient …

Lived Experiences Of Breast Cancer Survivors After Diagnosis, Treatment And Beyond: Qualitative Study, Faustine Williams, Stephen C. Jeanetta

Faustine Williams

Urinary Isoflavone Concentrations Are Inversely Associated With Cardiometabolic Risk Markers In Pregnant U.S. Women, Ling Shi, Heather Ryan, Emily Jones, Tiffany Moore Simas, Alice Lichtenstein, Qi Sun, Laura Hayman

Laura L. Hayman

Some evidence suggests that phytoestrogens, such as soy-derived isoflavones, may have beneficial effects on cardiovascular health and glycemic control. These data are mainly limited to postmenopausal women or individuals at elevated cardiometabolic risk. There is a lack of data for pregnant women who have elevated estrogen levels and physiologically altered glucose and lipid metabolism. We analyzed data from 299 pregnant women who participated in the NHANES 2001-2008 surveys. Multivariable linear regression analyses were used to examine the association between urinary concentrations of isoflavonoids and cardiometabolic risk markers, adjusted for body mass index, pregnancy trimester, total energy intake, dietary intake of …

Annual Women's Health Through The Lifespan, Marna Greenberg

Marna R Greenberg DO, MPH, FACEP

No abstract provided.

Prenatal Oral Health Education In U.S. Dental Schools And Obstetrics And Gynecology Residencies, Megan Curtis, Hugh Silk, Judith A. Savageau

Judith A. Savageau

Prenatal oral health (POH) is an important health issue, but dental and obstetrical clinicians are not meeting the oral health needs of pregnant patients. This study evaluates how training contributes to this paradox with a national survey of sixty dental school deans and 240 obstetrics and gynecology residency program directors. Response rates were 53 percent and 40 percent for deans and program directors, respectively. According to the respondents, 94 percent of responding dental schools provided POH education, only 39 percent of responding residencies taught POH, and 65 percent of responding deans and 45 percent of responding program directors were aware …

The Consequences Of Abortion Restrictions For Women's Healthcare, Maya Manian

Maya Manian

This Essay challenges the false assumption that abortion care can be segregated from women’s medical care and targeted for special restrictions without any effects on women’s health more broadly. As a matter of medical reality, abortion cannot be isolated from the continuum of women’s healthcare. Yet policymakers and the public have failed to understand the interconnectedness of abortion with other aspects of women’s medical care. In fact, existing abortion restrictions harm women’s health even for women not actively seeking abortion care, but these impacts remain obscured. For example, antiabortion laws and policies have spillover effects on miscarriage management, prenatal care, …

Evaluation Of Physical Fitness And Weight Status Among Fisherwomen In Relation To Their Occupational Workload, Pallav Sengupta

Pallav Sengupta, PhD

Fisherwomen contribute significantly to the coastal economy of Eastern India; however, data about their physical fitness and weight status are scant.

OBJECTIVES:

The present cross-sectional study was designed to investigate cardiorespiratory fitness and weight status of fisherwomen, which may be influenced by their occupational workload, using morphometric and anthropometric measures.

METHODS:

The study was conducted among young fisherwomen (mean age 23.7 years) randomly selected from Araku, Visakhapatnam, Andhra Pradesh, and among young women who are not engaged in the fishing industry but are residents of Araku, who served as controls (mean age 21.3 years). Measurements of body composition included several …

Ud Wellness Program: A Success Story, Maureen E. Schlangen

Maureen E. Schlangen